Internal medicine
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Objective Muscle atrophy is observed in a subset of patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Its manifestation is associated with a poor functional prognosis and poor response to immunomodulatory therapies. We evaluated muscle atrophy in patients with CIDP using a bioelectrical impedance analysis (BIA). ⋯ A comparison of the outcomes from these two measures showed a good correlation between their muscle atrophy ratings (p<0.05). Conclusion We found that a BIA and muscle CT provided muscle atrophy assessments of equivalent accuracy. Therefore, a BIA can be a simple alternative to muscle CT that is suitable for regular use in daily clinical practice as a reliable tool for assessing muscle atrophy in patients with CIDP.
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Objective Graves' disease (GD) is known to cause glucose intolerance. The present study used continuous glucose monitoring (CGM) in 15 patients newly diagnosed with GD to evaluate changes in glucose trends following improvement in the thyroid function. Methods At the time of the diagnosis of GD, each participant wore a CGM monitor for seven days, and the data recorded on days 3 to 5 were analyzed. ⋯ Other variables also improved after treatment, including the mean amplitude of glycemic excursion (MAGE), daily average glucose level, nocturnal average glucose level (0:00-05:59), maximum and minimum glucose, percent time with glucose at >140 mg/dL, and percent time with glucose at >180 mg/dL; however, the coefficient of variation (CV) and percent time with glucose at <70 mg/dL did not improve. A univariate analysis showed the significant correlation of the SD with TSH receptor antibody (TRAb) and 1,5-Anhydro-D-Glucitol (1,5-AG). Conclusion Our results showed that CGM-based markers of mean glucose and glucose variability improved with the improvement of the thyroid function in newly diagnosed GD patients treated with antithyroid drugs.
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Case Reports
Usefulness of Ultrasonography in the Diagnosis and Follow-up of Extracranial Vertebral Artery Dissection.
Extracranial vertebral artery dissection is a cerebrovascular disease that occurs most commonly in young people. A 32-year-old man experienced sudden cervical pain and was diagnosed with left vertebral artery dissection after arterial changes were identified by ultrasonography. The reduction in the size of an intramural hematoma in the left vertebral artery and in the peak systolic velocity were evaluated over time. Computed tomography, magnetic resonance imaging, and cerebral angiography are generally performed to diagnose and follow-up extracranial vertebral artery dissection; however, carotid ultrasonography has an advantage over these modalities by enabling the simultaneous observation of vascular morphology and hemodynamics.