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A 27-Year-Old Woman Diagnosed as Polycystic Ovary Syndrome Associated with Graves' Disease
Jung, Jung Hwa,Hahm, Jong Ryeal,Jung, Tae Sik,Kim, Hee Jin,Kim, Ho Soo,Kim, Sungsu,Kim, Soo Kyoung,Lee, Sang Min,Kim, Deok Ryong,Choi, Won Jun,Seo, Yeong Mi,Chung, Soon Il The Japanese Society of Internal Medicine 2011 Internal medicine Vol.50 No.19
<P>Polycystic ovary syndrome (PCOS) and Graves' disease are the common causes of menstrual irregularity leading to infertility in women of child-bearing age. A 21-year-old female patient visited us with complaints of oligomenorrhea and hand tremor. She was diagnosed as having PCOS and hyperthyroid Graves' disease, simultaneously. She had low body weight (BMI: 16.4 kg/m<SUP>2</SUP>), mild hirsutism, and thyrotoxicosis. The patient was treated with anti-thyroid drug and beta-blocker for about two years, and then recovered to normal thyroid function. Although some studies have suggested a connection between PCOS and autoimmune thyroiditis, no study indicated that PCOS is associated with Graves' disease until now. Here, we describe the first case report of a lean woman with normal insulin sensitivity presenting PCOS and Graves' disease simultaneously.</P>
Presence of Malignant Mesothelial Cells in the Sputum
Choi, Yoon Hee,Park, Kwang Young,Ryoo, Baek-Yeol,Na, Im II,Yang, Sung Hyun,Koh, Jae Soo,Kim, Cheol Hyeon,Lee, Jae Cheol The Japanese Society of Internal Medicine 2008 Internal medicine Vol.47 No.1
<P>Malignant pleural mesothelioma and peripheral adenocarcinoma, of the lung, also known as pseudomesotheliomatous adenocarcinoma, have similar clinical and radiological characteristics and even similar microscopic findings, and this makes it difficult to differentiate them. Malignant pleural mesothelioma rarely invades the bronchial lamina or bronchioloalveolar spaces, and tumor cells are not usually found in the sputum. Therefore, the appearance of tumor cells in sputum more likely supports the diagnosis of peripheral lung cancer. We report a rare case in which malignant pleural mesothelioma cells were found in the sputum. For the differential diagnosis of a mass involving both the pleura and lung, physicians should consider that malignant mesothelial cells can be found in the sputum, although this is very rare.</P>
An, Jae Young,Yoon, Bora,Kim, Joong Seok,Song, In Uk,Lee, Kwang Soo,Kim, Yeong In The Japanese Society of Internal Medicine 2008 Internal medicine Vol.47 No.17
<P>We report a case of Guillain-Barré syndrome (GBS) accompanied by optic neuritis and a central white matter lesion subsequent to Epstein-Barr virus (EBV) infection. A 49-year-old man presented with visual disturbance and hemiparesis one week after developing cold-like symptoms. T2- and diffusion-weighted brain MRI showed a high-signal intensity lesion in the left internal capsule. The patient's visual acuity improved during steroid pulse therapy, but his hemiparesis progressed to quadriparesis. Nerve conduction studies showed demyelination predominant in the distal nerve terminals, consistent with GBS. Serological testing suggested EBV reinfection. Our findings indicate that EBV-related central and peripheral demyelination can occur simultaneously and can be successfully treated with a combination of corticosteroids and immunoglobulin.</P>
Lee, Jaehee,Cha, Seung Ick,Park, Tae In,Park, Jae Yong,Jung, Tae Hoon,Kim, Chang Ho The Japanese Society of Internal Medicine 2011 Internal medicine Vol.50 No.5
<P>Cryptogenic organizing pneumonia (COP) generally responds well to corticosteroids with a favorable outcome. However, it can rapidly worsen and lead to respiratory failure that is refractory to corticosteroids. Adjunctive drugs have been used in refractory cases with various outcomes, but treatment experience is still lacking. We present a case of rapidly progressive COP accompanying air leak syndrome, which showed no prompt response to corticosteroids alone but gradual improvement with the addition of cyclosporine and macrolide. This case report supports the existing literature suggesting that an early therapeutic trial of this drug combination might be considered in COP patients whose condition worsens despite corticosteroid administration.</P>
Leem, Jaechan,Hee Koh, Eun,Jeong, Eunheui,Jang, Jung Eun,Lee, Seung-Whan,Kang, Joon-Won,Lim, Tae-Hwan,Lee, Woo Je,Kim, Min-Seon,Park, Joong-Yeol,Lee, Ki-Up Japanese Society of Internal Medicine 2012 Internal medicine Vol.51 No.21
<P>The aim of this study was to determine whether the absence of coronary artery calcium (CAC) can safely exclude obstructive coronary artery disease (CAD) in asymptomatic patients with type 2 diabetes.</P>
Gastrointestinal stromal tumors of the stomach with extensive calcification: report of two cases.
Kim, Hyun-Soo,Sung, Ji-Youn,Park, Won Seo,Kim, Youn Wha Japanese Society of Internal Medicine 2012 Internal medicine Vol.51 No.18
<P>Gastrointestinal stromal tumors (GISTs) can present with focal calcification. However, the presence of extensive calcification that constitutes the major portion of a GIST is extremely rare and can be associated with diagnostic pitfalls. We herein present the first two cases of rare gastric GIST with predominantly calcified components that mimicked pancreatic solid and pseudopapillary neoplasms with extensive calcification. In patients presenting with hyper-dense, heavily calcified masses in the abdominal cavity, the possibility of GIST should be considered in the differential diagnosis. A careful search for cellular areas and the judicious application of immunostaining will thus make it possible to make a correct diagnosis.</P>
The first Vietnamese patient with fulminant type 1 diabetes mellitus.
Kim, Hee Jin,Kim, Ho-Su,Hahm, Jong Ryeal,Jung, Jung Hwa,Kim, Soo Kyoung,Lee, Sang Min,Kim, Sungsu,Chung, Soon Il,Jung, Tae Sik Japanese Society of Internal Medicine 2012 Internal medicine Vol.51 No.17
<P>A 23-year-old pregnant woman had a stillbirth at 30 weeks gestation due to abrupt diabetic ketoacidosis. The patient had a normal HbA1c, severe hyperglycemia, negative islet cell autoantibodies, and very low insulin secretion capacity. The viral markers associated with fulminant type 1 diabetes were negative. The patient's human leukocyte antigen genotypes were DRB1*04:06 and DQB1*03:01/05:02, not common subtypes for fulminant type 1 diabetes. This is the first Vietnamese patient with fulminant type 1 diabetes mellitus.</P>