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Mi Ra Yun, MD Co-Authors: Mi Soon Song, Woo Kun Kim * , Sung-Bae Kim * , Jin-Hee Ahn * College of Nursing, Seoul National University, * Division of Oncology, Department of Medicin, University of Ulsan Collegae of Medicin, Asan Medical Center Abstract Objective: Breast cancer is the most common cancer and the incidence is rapidly increased in Korean women. One of the long term sequale of the breast cancer survivors is the menopausal symptoms. There is a number of study about menopausal symptoms either descriptive and experimental study in US and Western Europe. But little is known about it as yet in Korea. Menopausal symptoms are very various and influenced by race or country, so it cannot be to apply results of other country to Korean women. At first the description of Korean breast cancer survivors' menopausal symptoms is essential to develop the manage strategy of it. The purpose of this study is to describe the prevalence and severity of menopausal symptoms and menstrual changes in breast cancer survivors treated with adjuvant chemotherapy Methods: The subjects is women who had treated adjuvant chemotherapy and premenopausal status at diagnosis. Subjects completed standardized self-report measures of menopausal symptoms and menstrual status. Results: The subjects were 169 women aged 30 to 54 years. 1 ; The common menopausal symptoms in breast cancer survivors were experiencing poor memory, feeling tired, feeling anxious or nervous, aching in muscles and joints, and so on. 2 ; The most bothersome menopausal symptom is hot flashes. With increasing severity of hot flashes, the severity of other menopausal symptoms such as psychosocial domain, physical domain, and sexual domain were increased. 3 ; The variables that influence menopausal symptoms in breast cancer survivors were age, economic status, marital status, menopausal status, alternative therapy, and excercises. 4 ; 20.7% of breast cancer survivors responded that they needed treatment for menopausal symptoms positively Conclusion: It is recommended to develop the management program containing exercises. It is necessary to treatment hot flashes properly.
CLONING AND FUNCTIONAL EXPRESSION OF A GASTRIC PKAAND VOLTAGE-ACTIVATED Cl- CHANNEL THAT IS STABLE AT ACID pH. D. H. Malinowska, E. Y. Kupert and A. M. Sherry Dept. of Mol & Cell Physiol, Univ. of Cinc Coll of Med, Cincinnati, OH 45267.
The conditions shall remain in place until. Respondenth~ ~le~edall conditions ordered. Respondentshall be subject to the condItIons ~tIl Respondent completes three 3 ; Iyears of supervisednursing practice in which she works forty'0 40 ; hours every tv. 2 ; weeks as a nurse. Part time hours of less than forty 40 ; I hours every two 2; weeks shall be credited on a prorated basis. Respondent shall be prohibited from woIrking more than forty 40 ; hours per week. Respondent's licenselitioned is additionally conc asfollows.
In its important report, Crossing the Quality Chasm: a New Health System for the 21st Century Washington, DC: National Academy Press, 2001 ; , the IOM put forward a shorter list of ideal health-system attributes that is well worth considering carefully. The paragraph headings of their list were: 1. Care based on continuous healing relationships. 2. Customization based on patient needs and values. 3. The patient as the source of control. 4. Shared knowledge and the free flow of information. 5. Evidence-based decision making. 6. Safety as a system property. 7. The need for transparency. 8. Anticipation of patient needs. 9. Continuous decrease in waste. 10. Cooperation among clinicians. The ideas are completely compatible with the views expressed above. i Based very roughly on the differences between the most and least expensive premiums charged where employees do have responsible choices among competing plans.
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With open wound 862.39 tuberculous see also Tuberculosis, pleura ; 012.0 primary progressive 010.1 pulmonary - see Effusion, pleura spinal see also Meningitis ; 322.9 thorax, thoracic - see Effusion, pleura Eggshell nails 703.8 congenital 757.5 Ego-dystonic homosexuality 302.0 lesbianism 302.0 Egyptian splenomegaly 120.1 Ehlers-Danlos syndrome 756.83 Ehrlichiosis 082.40 chaffeensis 082.41 specified type NEC 082.49 Eichstedt's disease pityriasis versicolor ; 111.0 Eisenmenger's complex or syndrome ventricular septal defect ; 745.4 Ejaculation, semen painful 608.89 psychogenic 306.59 premature 302.75 retrograde 608.87 Ekbom syndrome restless legs ; 333.99 Ekman's syndrome brittle bones and blue sclera ; 756.51 Elastic skin 756.83 acquired 701.8 Elastofibroma M8820 0 ; - see Neoplasm, connective tissue, benign Elastoidosis cutanea nodularis 701.8 cutis cystica et comedonica 701.8 Elastoma 757.39 juvenile 757.39 Miescher's elastosis perforans serpiginosa ; 701.1 Elastomyofibrosis 425.3 Elastosis 701.8 atrophicans 701.8 perforans serpiginosa 701.1 reactive perforating 701.1 senilis 701.8 solar actinic ; 692.74 Elbow - see condition Electric current, electricity, effects concussion ; fatal ; nonfatal ; shock ; 994.8 burn - see Burn, by site feet foot ; syndrome 266.2 Electrocution 994.8 Electrolyte imbalance 276.9 with abortion - see Abortion, by type, with metabolic disorder ectopic pregnancy see also categories 633.0-633.9 ; 639.4 hyperemesis gravidarum before 22 completed weeks gestation ; 643.1 molar pregnancy see also categories 630-632 ; 639.4 following abortion 639.4.
A 28-yr-old white female, 12 weeks pregnant, noted symptoms of excessive fatigue and heat intolerance. On physical examination her pulse was lOO min, and she had a small goiter, mild tremor, and sweaty palms. Her thyroid function tests revealed a low normal RTaU, an elevated total Ta, a mildly elevated free T * index FTJ ; , and a TSH of 0.9 mU L 0.5-5.0 ; . At 16 weeks gestation her RTJ was even lower, and the' FTiI was normal Table 1 ; rTests 4 yr earlier were normal with Td of 131 nmol L 64-167 ; , RT%Ll of 0.29 0.25-0.36 ; , and FTJ of 3.0 i.2-4.7 ; , and it was felt `that -the patient had a pregnancy-induced binding globulin abnormality. At weeks 24-25, RTzU was low, serum Td, FTJ, FTb, T3, and free Ta FTz ; were elevated, and TSH was detectable. The patient had intermittent symptoms of loose stools, sweating, and tremors. Antithyroglobulin and antimicrosomal antibodies, in addition to TSH receptor antibodies, were negative. Due to repeated elevations of FTd despite measurable TSH, she was thought to be mildly hyperthyroid and was started on propylthiouracil at 37 weeks gestation with the plan to more fully evaluate her postpartum for possible inappropriate TSH secretion. Delivery was uncomplicated and propylthiouracil was stopped 2 weeks postpartum. However, the patient was lost to follow-up for the next 5 months during which time she noted increasing heat intolerance and tremor, while denying any symptoms suggestive of acromegaly. Repeat testing over the next 3 months revealed elevated RTJJ, Td, FTJ, FTh, T3, and FTs with an inappropriate TSH. Radioactive iodine uptake was elevated at 45% normal, 10-30 ; . Magnetic resonance imaging shown in Fig. 1 demonstrated a 1.3-cm intrasellar adenoma. Visual fields were normal. Pituitary testing demonstrated normal adrenal reserve by insulin tolerance test and ACTH stimulation. There was mild blunting of the GH response to insulin-induced hypoglycemia. Somatomedin C was mildly elevated at 320 rig L normal 116-270 nl ; . TRH stimulation test 500 pg iv ; results are given in Table 2. a-Subunit was elevated at 1.7 rig L nl 1.2 ; and the a TSH molar ratio was 7.08. Octreotide was started to obtain a euthyroid preoperative status. After written informed patient consent was obtained and before therapy during a baseline period, serum TSH was sampled hourly over 7 h from 0800-1500. An identical second sampling was then performed the following day after a single 100~pg octreotide dose. Therapy was continued at 50 fig three times daily tid ; and a third sampling was repeated 1 week later. Serum was collected at baseline and after 1 week of octreotide 183 and protopic.
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Park, S. H., S. R. Paulsen, S. R. Gammon, K. J. Mustard, D. G. Hardie, and W. W. Winder. Effects of thyroid state on AMP-activated protein kinase and acetyl-CoA carboxylase expression in muscle. J Appl Physiol 93: 20812088, 2002; protein kinase AMPK ; consists of three subunits: and . Two isoforms exist for the -subunit 1 and 2 ; , two for the -subunit 1 and 2 ; , and three for the -subunit 1, 2, and - and -subunits are 3 ; . Although the specific roles of the not well understood, the -subunit isoforms contain the catalytic site and also the phosphorylation activation site for the upstream kinase. This study was designed to determine the role of thyroid hormones in controlling expression levels of these AMPK subunits and of one downstream target, acetylCoA carboxylase ACC ; , in muscle. AMPK subunit and ACC levels were determined by Western blots in control rats, in rats given 0.01% propylthiouracil PTU ; in drinking water for 3 wk, and in rats given 3 mg of thyroxine and 1 mg of triiodothyronine per kilogram chow for 1 or 3 wk. In gastrocnemius muscle, all isoforms of AMPK subunits were significantly increased in rats given thyroid hormones for 3 wk vs. those treated with PTU. Similar patterns were seen in individual muscle types. Expression of muscle ACC was also significantly increased in response to 3 wk treatment with excess thyroid hormones. Muscle content of malonyl-CoA was elevated in PTU-treated rats and depressed in thyroid hormone-treated rats. These data provide evidence that skeletal muscle AMPK subunit and ACC expression is partially under the control of thyroid hormones. malonyl-CoA; propylthiouracil; thyroxine; triiodothyronine.
DEAR Friends, Faced with the challenge of defeating a chronic disease each and every day, thalassaemia patients, their families, friends and carers need extra sources of strength. And what better source of strength than each other? The recent celebrations to mark International Thalassaemia Day reminded us all how much we rely on each other for guidance, for warmth and for joy. TIF has been happily inundated with photos and stories from the day, each bursting with a well-earned sense of achievement. From Mosul in Iraq, the Nineveh Thalassaemia Society NTS ; sends news of a fantastic day of celebration. From Palestine to Azerbaijan to Pakistan, we hear of thalassaemia associations persuading government and the private sector alike to fund transfusion units, chelation therapy even free education and transport for thalassaemia patients. And all to mark International Thalassaemia Day see Recent Events for more ; . This determination to get what thalassaemia patients need, no matter how challenging the circumstances, is what makes our thalassaemia associations so special. In every corner of the world, there is a group of committed, hard-working people taking the fight against thalassaemia to new levels inspired by the daily fight of their role models, young thalassaemia patients and protriptyline.
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Department of Information Technology, University of Milan via Bramante, 65 - 26013, Crema CR ; , Italy dti mi 2 STMicroelectronics Advanced System Research group Agrate Brianza MI ; , Italy 3 EPFL Ecole Polytechnique Federale de Lausanne Lausanne, Swiss benoit.rat epfl.ch.
TSH were purchased from Sigma Chemical St. Louis, MO ; , carbamylcholine from K and K Plainview, NY ; , ionomycin from Calbiochem-Berhing La Jolla, CA ; , and forskolin FSK ; from Hoechst Pharmaceuticals Bombay, India ; . All other reagents were of the purest grade commercially available. Tissues. Human thyroid tissue was obtained from euthyroid patients undergoing lobectomies for resection of solitary cold nodules. Only the healthy normal-looking nonnodular tissue was used within 1030 min of surgical resection. Sheep, pig, bovine, and horse thyroids were obtained from freshly killed animals at a local slaughterhouse. Dog thyroids were obtained from dogs 10 kg otherwise used for cardiological experiments. Dogs with decreased iodide pool were obtained and treated for 6 wk with propylthiouracil 2 150 mg day ; , strumazol 2 80 mg day ; , and NaClO4 2 1 g day ; . Not to interfere with iodide metabolism during the experiment, treatment with propylthiouracil and strumazol was stopped 48 h before and the treatment with NaClO4 24 h before the experiment. On the day of the experiment, dogs were anesthetized with pentobarbital, and the thyroid lobes were resected. Thyroids were cut into thin slices of 50 mg wet weight wet wt ; with a Stadie-Riggs microtome. H2O2 determinations. Slices were preincubated in KrebsRinger HEPES KRH ; medium supplemented with 8 mM glucose and 0.5 g l of BSA and then transferred to fresh medium containing 0.1 mg ml horseradish peroxidase type II, 440 M homovanillic acid, and the tested agonists. The fluorescence of the medium was measured 90 min later except when stipulated otherwise 315 and 425 nm excitation and emission wavelengths respectively ; 2 ; . cAMP measurements. Slices were preincubated at 37C for 1 h under an atmosphere of 95% O2-5% CO2 vol vol ; in 2 ml Krebs-Ringer bicarbonate KRB ; supplemented with 8 mM glucose and 0.5 g l of BSA. For the test incubation of 1 h, medium was supplemented with 100 M Ro 201724, a cAMP-specific phosphodiesterase inhibitor 22 ; . cAMP was measured according to Brooker et al. 7 ; . Inositol phosphate measurements. Slices were preincubated for 4 h at 37C in a medium similar to cAMP measurements but with 20 Ci ml 3H-labeled inositol specific activity 1020 Ci mmol, Amersham ; . The slices were then transferred to fresh unlabeled medium to which 10 mM lithium was added after 15 min. After an additional 5 min, the tested agents were added. The [3H]inositol phosphates were isolated by stepwise chromatography on a AG1-X8 resin formate form, 100200 m mesh; Biorad, Watford, UK ; Incorporation of [3H]inositol into the total phosphatidylinositide pool was quantitated after chloroform methanol extraction of lipids from the pellet 3 ; . Results are expressed as the percentage of radioactivity incorporated in inositol phosphates IP1 IP2 and provigil.
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Since 1990 the Costantini Collection has been visited by local and international specialists and scholars; it has received numerous requests to loan its artwork to be exhibited in shows of Latin American art in different countries in the Americas and in Europe. In 1996 the collection was publicly presented as a whole for the first time in the Museo Nacional de Bellas Artes in Buenos Aires. It was then shown at the Museo Nacional de Artes Visuales in Montevideo. Between 1998 and 1999, a large set of the collection's most outstanding works was shown at the Museu de Arte Moderna de So Paulo, at the Museu de Arte Moderna de Rio de Janeiro and at the Fundacin "La Caixa" in Madrid. On four occasions between 1997 and 2000 the Foundation awarded the Premio Costantini at the Museo Nacional de Bellas Artes in Buenos Aires. This prize provided a stimulus to Argentinean artistic production at the same time that it served to incorporate works by the latest generation of artists into the collection by way of its acquisition first prize. In late 1998 the Foundation had the possibility of buying a strategically located piece of land on the city's urban and cultural circuit for the construction of a museum. An international open call was then organized by the International Union of Architects, within the framework of the Bienal Internacional de Arquitectura de Buenos Aires. Four hundred and fifty proposals from 45 different countries were presented. The selection was made by an international jury of architects and the first prize was awarded to three young Argentinean architects: Gastn Atelman, Martn Fourcade and Alfredo Tapia. The construction of the new building, the development of the institutional organization, the collection's expansion, the insertion of the museum on the international cultural map and, above all, the public stature of its objectives and mission were all challenges that eventually transformed a private passion into a project with enormous impact on the community. Malba is a dynamic and interactive cultural arena where temporary exhibitions of a very diverse nature for example, joint undertakings with other museums, international collections and similar foundations from around the world ; and exhibitions of contemporary Argentinean and Latin American art are presented. In addition, it has a major film program and an archive that grows on a monthly basis through the acquisitions and the restoration of films essential to film history. The Museum also organizes a variety of literary activities, such as encounters with writers, courses, seminars, literary talks, book presentations, among other events
In our patient, a preoperative platelet count, PT and APTT unfortunately were not obtained and were not measured until seven hours after the operation. By that time the patient had received seven units of whole blood, two units of packed red blood cells, six units of platelets and two units of fresh frozen plasma. After this therapy it is difficult to identify the aetiology of the bleeding during operation. The past medical history, and family history were negative for a congenital bleeding disorder. He had not been on any other medications which might have induced a bleeding tendency.3 Our patient had a low platelet count and a borderline PT until the second postoperative day. Despite the bleeding during operation the patient received propylthiouracil 50 mg q.i.d. until the morning of the second postoperative day. At that time it was discontinued. The low and psyllium.
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Values are means SEM and range ; for each group. 1 ; BMI, body mass index calculated as the body weight kg ; divided by height2 m2 2 ; Energy requirement, estimated EE during the stay in the.
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Study. Transnational Research Group on Oral Contraceptives and the Health of Young Women. BMJ 1996, 312: 83-88. Heinemann LAJ, Dinger J: Safety of a new oral contraceptive containing drospirenone. Drug Safety 2004, 27: 1001-1018. EURAS : [ : euras-drugsurveillance site hrt]. Suissa S, Blais L, Spitzer WO, Cusson J, Lewis M, Heinemann L: Firsttime use of newer oral contraceptives and the risk of venous thromboembolism. Contraception 1997, 56: 141-146. Suissa S, Spitzer WO, Rainville B, Cusson J, Lewis M, Heinemann L: Recurrent use of newer oral contraceptives and the risk of venous thromboembolism. Hum Reprod 2000, 15: 817-821.
Large Metropolitan area Suburban industrial park Rural area distance from major services ; Tidal wave area also tsunami post earthquake ; Severe snow ice blizzard In addition, consider the following risks and add points: If the building is steam heated For every tenant company ; using computers in the building If your offices are above the 20th floor Human Risks Labor dispute or strike Vendor supplier strike Theft burglary robbery Terrorism Kidnapping extortion Bomb threat Water sprinklers in areas with computer servers, etc. High risk tenants in your building i.e. foreign embassy ; Now subtract points if you have any of the following: Diesel or natural gas generators Uninterrupted Power Supply UPS ; systems on critical equipment All key sensitive electronic equipment is secured e.g., location ; Human security presence 7 x 24 Satellite or microwave backup communications Telecommunications route diversity An independent water supply Automatic fire detection and sprinkler system Redundant chillers, pumps, cooling towers, etc. Quarterly disaster drills with staff and patients Bi-annual review of facility disaster plan with staff Quarterly review of employee and patient contact information Security system alarms, card key access, etc. ; Structural retrofit building older building integrity upgraded and pyrimethamine.
PROCEDURAL DETAILS A variety of medication combinations, dosages, and routes were used, customized to the individual patient's needs. Representative sedation regimens included intravenous and propylthiouracil
The normalized variance CV2 ; for a solute in the liver is a function of three terms: one due to vascular dispersion, second due to diffusion in tissue and third due to tissue distribution clearance 30 ; 38 ; . The CV2 values for [3H]palmitate reported in this work normal 2.66 0.25, steatosis 2.53 0.11 ; are much larger than that of [14C]sucrose 0.5 approximately ; which only dispersed in the vascular plus Disse space. Therefore, a larger CV2 value means the hepatic disposition of [3H]palmitate was determined not only by vascular dispersion but also by diffusion and distribution clearance in the tissue and questran.
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Figure 1 shows the changes in body weight of rats fed the high carbohydrate and high fat diet containing propylthiouraTABLE i cil at the appropriate levels. Growth rates Composition of diets ' were depressed in both dietary groups when a toxic level 0.1% ; of propylcarbohydrate was fed. On the other hand, fat diet25.00. thiouracil when the lowest level 0.01% ; of propylthiouracil was fed along with the high fat Caseina-StarchCorn "5.0025.605.000.850.1538.40 diet, growth after day 7 was depressed be oilLardMineral low that obtained by feeding the high fat diet alone P 0.01 ; . However, gains in 2Vitamin mixture body weight of rats fed the high carbo 2'3Choline mixture hydrate diet were unaffected by feeding the chlorideCellulose powder 4High lower levels 0.01 or 0.05% ; of propylthiouracil during the experimental period 1 Diet also contained per 100 g: 600 IU retinyl palmitate, 60 IU ergocalciferol and 10 mg all-rac-a table 2 ; . Food intake changed in propor tocopheryl acetate. 2 Harper, A. E. 1959 J. Nutr. 68: 405. tion to growth in all experimental groups 3 The vitamin mixture contained: % in the mix table 2 ; . Normal rats fed the high fat, ture ; thiamin, 0.059; riboflavin, 0.059; niacin, 0.294; "carbohydrate-free" diet showed the same calcium pantothenate, 0.235; pyridoxine-HCl, 0.029; menaquinone, 0.006; biotin, 0.001; tetrahydropteroyllevel of blood glucose as rats fed the high glutamic acid, 0.002; cyanocobalamin, 0.0002; myoinositol, 1.176; ascorbic acid, 0.588; and lactose, carbohydrate diet, but in hypothyroidism 97.551. * In order to prepare diets isocaloric per gram of the blood glucose concentration decreased.
PATIENT CHARACTERISTICS From March 2002 to March 2003, a total of 18 patients were enrolled. All patients received at least one cycle of the study treatment. The first 7 patients participated in the dose-escalation portion of the protocol. After identification of the MTD, 11 other patients received the recommended dose below the MTD to further evaluate the tolerability and toxicity of the study regimen. The patient characteristics are summarized in Table 1. Two patients had received adjuvant oral fluorouracil-based therapy. TOXICITY No DLT occurred during cycle 1 in the first 3 patients given a dose of 400 mg m2 of 5-FU. Two of the 3 patients initially treated with 500 mg m2 of 5-FU had dose-limiting myelosuppression. One patient had grade 3 thrombocytopenia, and the other had prolonged grade 2 neutropenia, requiring that and quinidine.
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