Carney Complex Complicated with Primary Pigmented Nodular Adrenocortical Disease without Cushing's Syndrome Recurrence for Five Years after Unilateral Adrenalectomy.

We herein report a case of Carney complex (CNC) complicated with primary pigmented nodular adrenocortical disease (PPNAD) after unilateral adrenalectomy. A 44-year-old woman was admitted to our hospital for PPNAD surgery. She had previously undergone surgery for cardiac myxoma and had a PRKAR1A mutation with no family history of CNC.

Determinants and impact of physical impairment in patient-reported outcomes among older patients with type 2 diabetes mellitus in Japan.

Objective: To investigate the predictive factors associated with physical impairment among older patients with type 2 diabetes mellitus (T2DM) in Japan and to examine the potential impact of physical impairment on patient-reported health outcomes in this population.

Methods: A cross-sectional analysis was conducted using patient-reported data from the 2012-2014 Japan National Health and Wellness Survey. Physical impairment was measured using the Physical Component Summary (PCS) score of the Short-Form 36-Item Health Survey (SF-36) three-component model (using Japanese norms).

Pembrolizumab-induced fulminant type 1 diabetes with C-peptide persistence at first referral.

Summary: A 72-year-old man with no history of diabetes was referred to our department due to hyperglycemia during pembrolizumab treatment for non-small-cell lung carcinoma. His blood glucose level was 209 mg/dL, but he was not in a state of ketosis or ketoacidosis. Serum C-peptide levels persisted at first, but gradually decreased, and 18 days later, he was admitted to our hospital with diabetic ketoacidosis (DKA).

Hungry bone syndrome after thyroidectomy for thyroid storm.

A 39-year-old man was admitted to our hospital with the diagnosis of thyroid storm due to Graves' disease. Near-total thyroidectomy was performed after 1 month's pharmacological treatment, and he presented with tetany next morning. Serum corrected calcium value was 5.

Tuberculous Addison's disease with increased hydrocortisone requirements due to administration of rifampicin.

A 58-year-old man was referred to our hospital for darkened skin, general fatigue and weight loss. His adrenocorticotropic hormone and cortisol levels indicated a primary adrenal insufficiency. Fluorodeoxyglucose positron emission tomography/CT showed bilateral enlargement of the adrenal glands, with fluorodeoxyglucose accumulation.

[A Case of an Elderly Diabetic Patient Developing Wernicke Encephalopathy without Alcohol Abuse or an Unbalanced Diet].

A 70-year-old man with a 28-year history of type 2 diabetes mellitus was admitted due to persistent vomiting and neurological abnormalities in Nov 2012. He had developed gait disturbance and diplopia for six months during antiplatelet therapy, which was initiated following the diagnosis of a cerebellar infarction in June 2012. He had nystagmus, truncal ataxia and an ocular motility disorder, and the MRI study showed increased FLAIR and DWI signals in the peri-third ventricle and periaqueductal region, in addition to the cerebellar vermis.

[A case of an elderly diabetic patient with dementia effectively treated with weekly exenatide].

A 74-year-old man with diabetes mellitus since 64 years of age had been treated with glimepiride, metformin and alogliptin; however, his glycemic control remained poor, i.e., a casual blood glucose level of 318 mg/dl, HbA1c level of 10.

[Bone metabolism and cardiovascular function update. Effects of antiosteoporotic agents on glucose and lipid metabolism].

At present, antiosteoporotic agents that might affect glucose and/or lipid metabolism include bisphosphonates, Selective Estrogen Receptor Modulators ; SERMs and activated vitamin D. Bisphosphonates have little, if any, effect on lipid metabolism, while they are suggested to improve glucose metabolism, via osteocalcin or adiponectin. SERMs are shown to decrease serum triglycerides and LDL cholesterol levels, and increase HDL cholesterol level.

[Acyclovir-induced neurotoxicity and acute kidney injury in an elderly diabetic patient treated with valacyclovir: report of a case].

An 83-year-old Japanese man had a 29-year history of well-controlled diabetes mellitus. His HbA1c level was approximately 6.0%, with no microalbuminuria and a serum creatinine level seven days before admission of 0.

[A case of severe hypokalemia caused by a Chinese herbal remedy (Yokukansan) in an 81-year-old woman with dementia].

An 81-year-old woman had been visiting 2 hospitals for hypertension and dementia, prior to admission to our emergency room for nausea, hypertension, severe hypokalemia (K 1.29 mEq/l) and abnormal electrocardiography findings. She had been taking a Chinese herbal remedy (Yokukansan, 7.

[Thiazide diuretics for hypertensive treatment induced severe hyponatremia with consciousness disturbance in two elderly cases].

The salt intake of the Japanese is among the highest in the world, leading to a high prevalence of salt-sensitive hypertension. To prevent this, salt restriction, suppression of the rennin-angiotensin-aldosterone system, and natriuresis are important. Therefore, the use of a combination of an angiotensin II receptor blocker and thiazide diuretics is used for antihypertensive treatment.

[Effect of glucose and bone metabolism in endocrinal disorder].

It is well known that endocrine disorders; glucocorticoid excess including Cushing syndrome, high dose or long term steroid therapy and hyperthyroidism, induce secondary osteoporosis. These common endocrinal disorders affect not only bone metabolism but also glucose metabolism. Glucose metabolisms also play a important role in the progression of osteoporosis.

Pituitary abscess with panhypopituitarism showing T1 signal hyperintensity of the marginal pituitary area: a non-invasive differential diagnosis of pituitary abscess and pituitary apoplexy.

A 53-year-old man was hospitalized with general fatigue, headache, dizziness and polyuria. The laboratory findings revealed anterior hypopituitarism and central diabetes insipidus. He also showed eye movement disorder and facial sensory impairment.

[A case of lactic acidosis caused by buformin in an oldest elderly diabetic patient].

A 93-year-old male was urgently admitted to our hospital with dyspnea and disturbance of consciousness. The patient had been visiting a general physician regularly for ten years, for treatment of type 2 diabetes. He had been treated with glibenclamide and voglibose, until voglibose was replaced with buformin 3 months before admission.

[Osteoporosis as a lifestyle-related disease].

Although genetic factors determine the limits of peak bone mass, environmental factors can modify the outcome. Relation between lifestyle and osteoporosis is discussed, in terms of nutrition and habits. Significant link between calcium intake and bone mass has been reported.