Hypothalamic type of hypopituitarism and central diabetes insipidus probably linked to Rathke's cleft cyst.

A 73-year-old woman was admitted due to weight loss and generalized malaise. The basal levels of all the anterior pituitary hormones, except for prolactin, were reduced. However, they were all elevated in response to exogenous hypothalamic hormones.

Circulating betatrophin is elevated in patients with type 1 and type 2 diabetes.

There is evidence that betatrophin, a hormone derived from adipose tissue and liver, affects the proliferation of pancreatic beta cells in mice. The aim of this study was to examine circulating betatrophin concentrations in Japanese healthy controls and patients with type 1 and type 2 diabetes. A total of 76 subjects (12 healthy controls, 34 type 1 diabetes, 30 type 2 diabetes) were enrolled in the study.

Prompt efficacy of tolvaptan in treating hyponatremia of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) closely associated with rupture of a gastric artery aneurysm.

A 78-year-old man with abdominal pain was diagnosed with a rupture of a gastric artery aneurysm. The serum Na level promptly decreased from 135 to 110 mmol/L within several days. Brain magnetic resonance angiography revealed severe vasoconstriction of the cerebral basilar artery and anterior cerebral artery.

Combination therapy of angiotensin II receptor blocker and thiazide produces severe hyponatremia in elderly hypertensive subjects.

Thiazide diuretics are known to produce severe hyponatremia as well as hypokalemia. The present study demonstrated severe hyponatremia in three hypertensive patients who had received combination therapy consisting of an angiotensin II receptor blocker (ARB) and thiazide. The serum sodium (Na) levels in all three cases were markedly reduced to below 116 mmol/L, and the patients exhibited augmented urinary excretion of Na with a reduced circulatory blood volume.

Association of serum osteoprotegerin with vascular calcification in patients with type 2 diabetes.

Background: Osteoprotegerin is a member of the tumor necrosis factor-related family and inhibits RANK stimulation of osteoclast formation as a soluble decoy receptor. The goal of this study was to determine the relationship of serum osteoprotegerin with vascular calcification in patients with type 2 diabetes.

Methods: The subjects were 124 patients with type 2 diabetes mellitus, including 88 males and 36 females with a mean (± SD) age of 65.

Prompt increases in retinol-binding protein 4 and endothelial progenitor cells during acute exercise load in diabetic subjects.

The present study was undertaken to determine whether acute exercise load alters serum retinol-binding protein 4 (RBP4) and numbers of endothelial progenitor cells (EPC) in diabetic subjects. Sixty-two subjects with type 2 diabetes mellitus were enrolled in the present study. They were 50 males and 12 females with the ages of 65.

Hyponatremia is the valuable manifestation for initiating diagnosis of hypopituitarism in elderly.

The present study was undertaken to determine clinical features of hypopituitarism in elderly subjects. Thirty-one elderly patients with hypopituitarism were enrolled. They were 19 males and 12 females, with the ages of 70.

Central diabetes insipidus and hypothalamic type of hypopituitarism associated with atypical location of Rathke's cleft cyst.

A 68-year-old woman was admitted to determine the pathogenesis of weight loss and polyuria. Physical findings on admission showed BMI of 20.9, blood pressure of 147/69 mmHg, and that she had ciliac, axillar and pubic hair loss.

Ectopic ACTH syndrome associated with large cell neuroendocrine carcinoma of the thymus.

A 38-year-old man was admitted for evaluation of Cushing's syndrome. Physical findings showed swelling of the face, and hypertension, but not Cushingoid stigmata. Laboratory data revealed serum cortisol level of 34.

Bilateral aldosteronoma associated with secondary aldosteronism in a chronic hemodialysis subject.

We demonstrated a rare case of bilateral aldosteronoma accompanied by secondary aldosteronism in a 37-year-old man with chronic renal failure on hemodialysis. He initially developed immunoglobulin A nephropathy at 11 years old, and had been treated with hemodialysis since the age of 17 years. His blood pressure was 110/68 mmHg, and no other abnormal findings were detected.

Incomplete deficiency of hypothalamic hormones in hypothalamic hypopituitarism associated with an old traumatic brain injury.

A 62 year-old man was admitted to determine the pathogenesis of his hypoglycemia. He was unconscious and his plasma glucose level was 26 mg/dL. When he was 31 years old, he had a traffic accident and was unconscious for several days.

An increase in serum retinol-binding protein 4 in the type 2 diabetic subjects with nephropathy.

Unlabelled: The present study was undertaken to determine retinol-binding protein 4 (RBP4) levels in subjects with diabetic nephropathy. A total of 149 type 2 diabetic subjects and 19 control subjects were enrolled. Serum levels of RBP4 were measured by a method of ELISA.

Pathogenesis of chronic hypernatremia with dehydrated and non-dehydrated states in hypothalamic space-occupying lesions.

The present study was undertaken to determine pathophysiology of body water control in hypernatremic subjects with hypothalamic space-occupying lesions. Eight subjects with hypothalamic space-occupying lesions were divided into two groups of hypernatremia in the presence or absence of body water deficit. In 5 dehydrated hypernatremic subjects whose ages ranged from 20 to 67 years, serum sodium (Na) levels were 156.

Clinical and laboratory features of hyponatremia-induced myopathy.

Background: The present study was undertaken to determine the clinical and laboratory features of hyponatremia-induced myopathy.

Methods: We collected 14 hyponatremic subjects (six men and eight women) with serum creatine kinase (CK) levels of more than 500 IU/ml during the 5-year period between 2001 and 2005. The mean +/- SD patients' age was 66.

New HLA DRB1 and DQB1 haplotypes in a pedigree of familial Graves' disease in Japan.

The present study demonstrated genetic analysis of human leukocyte antigen (HLA) in a familial Graves' disease linked to autoimmune mechanism. The proband was a 17 year-old female. At 15 years, Graves' disease was diagnosed with serum TSH was <0.

Comparison of once-daily glargine plus sulfonylurea with twice-daily 70/30 aspart premix in insulin-naive Japanese patients with diabetes.

Background: Type 2 diabetes patients insufficiently controlled with sulfonylurea (SU) are commonly treated by switching to twice-daily premix insulin replacing SU. The efficacy of glargine (GL) added on to SU compared with the premix therapy has not been analyzed in Japan.

Methods: The open-label two-arm study was conducted in 30 type 2 diabetes patients poorly controlled [hemoglobin A(1c) (HbA(1c)) >7.

Hypoadiponectinemia in patients with cerebral infarction: comparison with other atherosclerotic disorders.

The present study was undertaken to determine serum adiponectin level in patients with cerebral infarction and to further analyze any difference in serum adiponectin levels among atherosclerotic disorders. One hundred fifty-two subjects with atherosclerotic disorders were enrolled, 110 males and 42 females, with the age of 67.0 +/- 9.

Possibly simultaneous primary aldosteronism and preclinical Cushing's syndrome in a patient with double adenomas of right adrenal gland.

We reported a rare case of simultaneous primary aldosteronism and preclinical Cushing's syndrome due to unilateral double adrenocortical adenomas in a 57 year-old woman who had had hypertension for the last 10 years. Abdominal computed tomography showed double tumors in her right adrenal gland. Physical findings revealed simple obesity and hypertension, but no other abnormal findings were detected.

Elevation of serum adiponectin levels in Basedow disease.

The present study was undertaken to determine whether thyroid hormone affects serum adiponectin levels in the patients with Basedow disease. Sixty-four patients with Basedow disease were examined; 32 patients had hyperthyroid state and 32 patients had euthyroid state who had been treated with antithyroid drugs. In addition, 30 age- and sex-matched subjects served as a control.

Alteration in risk factor accumulations of acute myocardial infarction during the last one decade: analysis of patients admitted in Coronary Care Unit.

The present study was undertaken to determine accumulation of risk factors in acute myocardial infarction during two periods of 2002 and 1990-1991. We collected 173 and 153 patients with acute myocardial infarction in 2002 and 1990-1991, respectively, and analyzed the history of multiple risk factors, including diabetes mellitus, impaired glucose tolerance, hyperlipidemia, hypertension and obesity, and laboratory findings. The numbers and their percentages of all the risk factors increased in 2002 compared with 1990-1991.

Unilateral active adrenal tuberculosis featuring persistent intermittent fever.

The adrenal gland is one of the organs which tuberculosis infects. In most clinical settings bilateral adrenal tuberculosis has been clarified after adrenal insufficiency is overt. On the contrary, active adrenal tuberculosis is rarely detected during the survey of infectious disease.

Contrast-enhanced endoscopic ultrasonography improves the preoperative localization of insulinomas.

We report a case in which endoscopic ultrasonography (EUS), intraductal ultrasonography (IDUS) and contrast-enhanced EUS using Levovist helped to localize insulinoma correctly. A 74-year-old woman complained of symptomatic fasting hypoglycemia with relatively high concentration of serum insulin level. Dynamic contrast-enhanced computed tomography revealed a small tumor of 8 mm diameter in the pancreatic head.