Internal medicine
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Case Reports
Case of type 1 diabetes mellitus following interferon β-1a treatment for multiple sclerosis.
A 57-year-old woman who had been treated with interferon β-1a (IFNβ-1a) for multiple sclerosis was diagnosed with diabetic ketosis. Her fasting serum C-peptide (F-CPR) was 1.9 ng/mL and her daily urinary C-peptide (U-CPR) was 24.1 µg/day. Her anti-glutamic acid decarboxylase (GAD) antibody was 3.5 U/mL. ⋯ Her F-CPR and U-CPR were very low (0.1 ng/mL and 8.35 µg/day, respectively), and anti-GAD antibody became distinctly positive (12.4 U/mL). She had HLA-DRB1*04:05, A24, and B54. For these reasons, IFNβ-1a administration was considered a possible cause of type 1 diabetes mellitus in this case.
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To investigate the influence of glycemic variability on the HbA1c level in elderly male patients with type 2 diabetes (T2DM). ⋯ The glycemic variability had a significant influence on the HbA1c level in elderly male patients with T2DM. The present data suggests that patients with higher glycemic variability might have higher HbA1c levels.
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A 54-year-old man was referred to a local hospital, located about 90 km from our hospital, with cardiogenic shock due to left main coronary artery infarction (LMCA-MI). Percutaneous coronary intervention (PCI) was performed under intra-aortic balloon pumping (IABP) support, but resulted in insufficient reperfusion and his condition worsened. ⋯ A series of intensive therapies saved the patient. The cooperation of medical and emergency service system following revascularization and intensive care saved the patient with LMCA-MI accompanied by cardiogenic shock.
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Although rare, gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. The asynchronous occurrence of other malignancies in patients with GIST during the clinical course is relatively common. ⋯ We experienced a case of coincidental primary lung adenocarcinoma and intestinal GIST. The present case is not only of interest due to the rare coincidence of GIST and lung cancer, but also because there was an epidermal growth factor receptor gene mutation in the lung cancer and a c-kit mutation in the GIST.
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Case Reports
A morbid obese Japanese woman with a body mass index of 83.2 kg/m2: before and after sleeve gastrectomy.
A 34-year-old Japanese woman presented at our institution weighing 182.7 kg, 148.2 cm tall, and with a body mass index of 83.2 kg/m(2). She had been overweight since childhood, but no abnormality was found to explain her obesity. ⋯ We followed the clinical changes before and after the operation. This case provides potentially interesting information regarding operative treatment for morbid obesity in Japanese.