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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A rare case of cardiogenic fibrosarcoma is reported. A 66 y.o. male with dyspnea, cough and fatigue was examined. B-mode echo, MRI, and angiography disclosed a large tumor in the left atrium. A large fibrosarcoma and 2 cm of the left atrial wall around the tumor pedicle were removed. The atrial defect and right lower pulmonary vein were repaired with a patch. Four months later, the tumor recurred in the right lung, mediastinum, and left atrium. The tumor, middle and lower lobes of the right lung, and part of the left atrial wall were excised. One year after the first operation, the patient died of air way obstruction due to another recurrence of the fibrosarcoma in the left lung, esophagus, and mediastinum. Cardiogenic fibrosarcoma invading outward for the mediastinal organs is rare.
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PMID:[A case report of primary fibrosarcoma originated in the heart invading adjacent organs ]. 779 18

A 58-year-old woman was admitted to our hospital for impaired consciousness, hyperglycemia and bitemporal hemianopsia. She was diagnosed as having NIDDM one year ago and was treated with diet and glibenclamide (1.25 mg/day) for 6 months. However, she stopped her medical treatment one month ago and then polydipsia and general fatigue were manifested. She was admitted to a hospital five days ago at which time hyperglycemia (405 mg/dl) and anemia (Hb8.0g/dl) were detected. She was transferred to our hospital for control of blood glucose and further examination of bitemporal hemianopsia. She showed typical acromegalic features including enlargement of the nose, lips and tongue, increased heel pad and acral growth. Conscious disturbance was cured by the infusion of saline and the administration of insulin. Endoscopy revealed an active gastric ulcer (A1). Endocrine data disclosed increased GH levels in plasma and urine, whereas plasma IGF-1 levels were low. Plasma GH paradoxically increased following the administration of TRH. A water deprivation test showed an impaired increase in urinary osmolarity, indicating partial central diabetes insipidus (DI). MRI with Gd-contrast revealed a macroadenoma which progressed toward suprasella. She was diagnosed as having acromegaly, partial DI and probable hyperosmolar hyperglycemic nonketotic diabetic pre-coma. Polyuria (5-101/day) due to partial DI was controlled by the administration of DDAVP (10 micrograms/day). The constant subcutaneous administration of octreotide (240 micrograms/day) resulted in normal plasma GH levels and a marked shrinkage of the pituitary tumor. The pituitary tumor was finally removed by the transsphenoidal approach following treatment with octreotide for 4 months. HE staining of the pituitary tumor showed atrophic and acidophilic cells surrounded by hyaloid connective tissue. After the surgery, plasma GH levels were normalized and complications were cured. In conclusion, this is a very rare case of acromegaly associated with diabetic pre-coma and partial DI, and effectively treated with constant subcutaneous infusion of octreotide.
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PMID:[Effective treatment with constant subcutaneous infusion of octreotide in a patient with acromegaly associated with diabetic pre-coma and diabetes insipidus]. 785 21

After two seizures, a 13 year-old boy experienced headache, fatigue and loss of appetite over a period of 3 weeks. There was a bilateral papilledema with normal visual acuity. CT and MRI disclosed two ischemic foci, that were interpreted as evidence of vasculitis. High serum levels of IgG and IgM antibodies specific to Borrelia burgdorferi, were present. The patient had attended an outdoor scout camp in a area, in south-east Belgium, known to be endemic for tick-born borreliosis. The clinical symptoms, the levels of the specific antibodies and the radiologic abnormalities responded dramatically to treatment. We believe that seizures in this case were related to cerebral vasculitis. This case confirms the extreme diversity of the neurological manifestations of Borreliosis.
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PMID:[Epilepsy disclosing neuroborreliosis]. 800 48

We report a randomized, double-blind, placebo-controlled pilot trial of systemic high-dose recombinant interferon alfa-2a (rIFNA) in 20 patients with relapsing-remitting (RR) multiple sclerosis (MS). Patients received 9 million IU rIFNA (n = 12) or placebo (n = 8) intramuscularly every other day for 6 months. Clinical exacerbations or new or enlarging lesions on serial MRI occurred in two of 12 rIFNA-treated and in seven of eight placebo-treated patients (p < 0.005). There was only one enlarging MRI lesion in the rIFNA group, whereas 27 new or enlarging lesions were present in the placebo group (p < 0.01). Baseline lymphocyte interferon gamma production of 19.10 +/- 7.12 IU/ml significantly decreased to 3.03 +/- 0.66 IU/ml (p < 0.04) in the rIFNA group, whereas production was unchanged in the placebo group. The rIFNA was tolerated without dropouts or serious side effects, but fever, malaise, fatigue (interfering with daily activities in two patients), and leukopenia occurred frequently. Neuropsychological tests excluded neurotoxicity. High-dose systemic rIFNA might reduce clinical and MRI signs of disease activity in RR MS and should be investigated in larger trials.
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PMID:Chronic systemic high-dose recombinant interferon alfa-2a reduces exacerbation rate, MRI signs of disease activity, and lymphocyte interferon gamma production in relapsing-remitting multiple sclerosis. 814 6

A case of systemic lupus erythematosus (SLE) complicated with hypopituitarism after steroid pulse therapy is reported. A 46-years-old-female with a history of SLE starting in 1975 was admitted to our hospital in February 1991 for lupus nephritis. Steroid pulse therapy, 1000 mg methyl-prednisolone for 3 successive days as one therapy unit, was administered. Proteinuria improved remarkably, however, general fatigue and headache appeared 2 weeks after initiation of therapy. Endocrinological examination revealed hypopituitarism including the levels of TSH, FSH, GH and ACTH. The secretion of FSH and LH gradually improved after replacement therapy of dried thyroid. MRI examination of the brain revealed an empty sella. It is known that pituitary tumor, cerebrovascular accident and autoimmune lymphocytic hypophysitis cause hypopituitarism. In this case, it is unlikely that the pulse therapy may be responsible for the infarction of the anterior pituitary artery furthermore, there has been no articles describing such incidence after steroid pulse therapy. This case may be indicative of a very rare case in which the empty sella might have been exacerbated by the pulse therapy in the causation of hypopituitarism.
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PMID:[Hypopituitarism associated with empty sella after steroid pulse therapy in a patient with SLE]. 814 29

Adults rarely present with rhythmic movement disorders in the Sleep Laboratory. We report the case of a 34 year-old woman, in good health, with a complaint of chronic body rolling during sleep and fatigue. Polysomnographic and video recordings showed head and body rhythmic movements, mainly during REM sleep. The contribution of severe psychopathology or neurological disorder was ruled out with personality testing, structured psychiatric interview and neurological examination with EEG, cerebral CT, MRI, and PET scans.
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PMID:[Rhythm of paradoxical sleep in an adult]. 820 63

The authors report two cases of hepatic encephalopathy with chronic hepatic failure. Case 1 was a 78-year-old woman with liver cirrhosis, admitted because of general fatigue and loss of appetite. Her electroencephalogram showed frequent slow waves in the theta range with intermittent triphasic waves T1-weighted MR images showed increased signal intensity in the globus pallidus and the putamen. Case 2 was a 71-year-old woman with chronic hepatitis, admitted because of depression. Her electroencephalogram showed frequent slow wave activities in the theta-delta range with intermittent trisphasic waves. Her serum ammonia level was 84 micrograms/dl (normal 12-54 micrograms/dl). T1-weighted MR images showed increased signal intensity in the globus pallidus, the putamen and the hypothalamus. On the basis of these findings, both patients were diagnosed as having hepatic encephalopathy, although disturbance of consciousness was not obvious. The observed MR image abnormalities might be due to the metabolic and pathological changes of chronic hepatic failure. Such MRI findings may be useful for the diagnosis of hepatic encephalopathy.
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PMID:[Two cases of hepatic encephalopathy associated with a high-intensity area in the basal ganglia on T1-weighted MR images]. 823 Jul 86

Thymoma with thrombocytopenia has rarely been reported. We recently encountered a case of operated invasive thymoma with thrombocytopenia. A 74-year-old woman was admitted to our hospital with the chief complaint of 'shortness of breath' and general fatigue. Chest X-ray, CT and MRI showed a mass 5 x 5 cm in size at the anterior mediastinum. In hematological test, a significant decrease in platelets count (1.6 x 10(4)/mm3) and a increase in PA-IgG (134.5 ng/10 cells) were found. This finding suggests that thrombocytopenia is due to immunological abnormality. Steroid therapy (prednisolone 60 mg) was begun but was not effective and then, extended thymectomy was performed. After operation, prednisolone (30 mg) therapy was continued. Although prednisolone therapy was gradually decreased and stopped, platelets count was gradually increased 10.8 x 10(4)/mm3. Extended thymectomy and steroid therapy were effective.
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PMID:[A case of operated invasive thymoma accompanied with the thrombocytopenia]. 823 Sep 10

A multiplanar approach and a good tissue differentiation characterize magnetic resonance imaging which have a great role in exploring numerous musculo-skeletal lesions; review of main indications and limits. MRI is useful in diagnosing certain undisplaced fractures, fatigue and insufficiency fractures, and consequences. Fibrous cartilage and hyalin cartilage lesions, tears of tendons, ligaments and muscles are well appreciated. MRI is also very good for an early and correct diagnosis of avascular necrosis, spinal degenerative lesions, spinal consequences of rheumatoid arthritis and ankylosing spondylitis, and bone metastases. It is the technique of choice for local staging of bone and soft tissue sarcomas.
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PMID:[Magnetic resonance imaging of the locomotor apparatus]. 876 42

A 50 year-old woman presented in January of 1995 with a prolonged history of symptoms of multiple sclerosis (MS) and was classified at the time with a remitting-progressive course. Her chief symptoms included slurring of speech, impairment of vision with intermittent diplopia, difficulties with gait and balance with spastic-ataxic gait, mental depression, insomnia, fatigue, impaired cognitive functions notably poor short term memory and recurrent urinary tract and sinus infections. An MRI scan showed multiple nodular demyelinating lesions scattered in the subcortical white matter and periventricularly of both cerebral hemispheres. Over the following 18 months, while receiving three treatment sessions per week with picotesla electro-magnetic fields (EMFs) which were applied extracranially, she showed a significant recovery in both physical and mental symptoms and additionally experienced decreased susceptibility to infections. In addition, the course of her disease appeared to have stabilized as opposed to the preceding 5 years during which time she experienced insidious, steady deterioration in her functioning. Despite this remarkable clinical recovery through the application of EMFs, and MRI scan obtained at the same diagnostic center 18 months after initiation of treatment with EMFs showed no changes in the number and size of the demyelinating plaques. These findings demonstrate lack of a correlation between recovery of symptoms and the number and extent of demyelinating plaques on MRI scan. It has been known since the days of Charcot in the latter half of the 19th century that in MS there is a great disparity between the histopathological changes of the disease and neurologic deficits. This report enhances the notion that demyelination may reflect an epiphenomenon of the disease.
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PMID:Lack of a correlation between demyelinating plaques on MRI scan and clinical recovery in multiple sclerosis by treatment with electromagnetic fields. 913 46


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