We report two cases of type V hyperlipoproteinemia and eruptive xanthomas associated with diabetes mellitus in a 44-year-old woman and a 25-year-old woman. They had asymptomatic, diffuse, erythematous yellowish papules on the extremities and buttocks. The laboratory studies showed increased serum blood glucose, total cholesterol, triglyceride, increasing pre-β and chylomicron bands on electrophoresis of lipoprotein. Histopathologic findings of erythematous yellowish papules on the thigh and buttock revealed aggregation of foam cells in the dermis. They have been treated with diet control, hypoglycemic agent (gliclazide) and hypolipidemic drug (gemfibrozil), and are under continued supervision.
Adult ; Blood Glucose ; Buttocks ; Cholesterol ; Dermis ; Diabetes Mellitus* ; Diet ; Electrophoresis ; Extremities ; Female ; Foam Cells ; Humans ; Hyperlipoproteinemia Type V* ; Lipoproteins ; Organization and Administration ; Thigh ; Triglycerides ; Xanthomatosis*

No abstract available.
Physiology*

Cardiovascular disease (CVD) is the major cause of mortality in type 2 diabetes mellitus. CVD is a clinical manifestation of atherosclerosis, a chronic and progressive inflammatory disease characterized by a long asymptomatic phase. Progression of atherosclerosis can lead to the occurrence of acute cardiovascular events. Atherosclerosis can be identified during the subclinical phase by several methods, including using biomarkers, pulse wave velocity, augmentation index, flow-mediated dilation, carotid ultrasound, and calcium score. The appropriate criteria for identifying asymptomatic patients with type 2 diabetes who should undergo CVD screening and therapeutic intervention remain controversial. Non-invasive methods, such as markers of subclinical atherosclerosis, may aid in risk stratification and the design of tailored therapies for patients with type 2 diabetes mellitus.
Atherosclerosis ; Biomarkers ; Calcium ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Humans ; Mass Screening ; Pulse Wave Analysis ; Risk Assessment

Diabetes mellitus is diagnosed and characterized by chronic hyperglycemia. The effects of diabetes mellitus include long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, heart, and blood vessels. Often diabetic symptoms are not severe or may even be absent. Hyperglycemia sufficient to cause pathologic functional changes may quite often be present for a long time before the diagnosis is made. Because diabetes mellitus is a chronic progressive disease, early diagnosis of diabetes is important to prevent chronic diabetic complications, especially in high risk subjects. In most countries, screening methods for the early diagnosis of diabetes have not yet been agreed. The fasting plasma glucose is simple, quick, acceptable to patients, and of low cost, but can miss those with isolated post-challenge hyperglycemia. The oGTT is difficult to perform, impractical for large numbers, and expensive, but is the only way to identify post-load hyperglycemia. Attention is focused on those at high risk of developing diabetes.
Blood Vessels ; Diabetes Complications ; Diabetes Mellitus ; Early Diagnosis ; Eye ; Fasting ; Glucose ; Glucose Tolerance Test ; Heart ; Humans ; Hyperglycemia ; Kidney ; Mass Screening ; Plasma

BACKGROUND: Type 2 diabetes is usually preceded by a long and clinically silent period of increasing insulin resistance. The purpose of this study is to demonstrate that rosiglitazone and metformin fixed-dose combination therapy (RSG/MET) will safely and effectively control glycemia as a first line of oral therapy, better than rosiglitazone (RSG) or metformin (MET) monotherapy in Korean type 2 diabetes patients. METHODS: This study was a 32-week, multicenter, randomized, double-blind study. Twenty-seven type 2 diabetes patients (males 14; females 13) were included and randomly divided into the rosiglitazone, metformin group, or rosiglitazone /metformin combination groups. The primary objective of this study was to determine the change in HbA1c from baseline (week 0) to week 32. The secondary end-points were to determine changes in fasting plasma glucose (FPG) and homeostasis model assessment insulin resistance (HOMA-IR), from baseline to week 32. Other cardiovascular risk markers were also assessed. RESULTS: At week 32, there were significant reductions in HbA1c and FPG, in all three treatment groups. There was no statistical difference in HbA1c among the three groups, but the decrease in FPG in the RSG/MET group was statistically significant compared to the MET group (P < 0.05). RSG/MET significantly reduced HOMA-IR at week 32 compared to baseline, but there was no difference among the three groups. RSG/MET significantly decreased high-sensitive C-reactive protein (hs-CRP) value at week 32, compared to baseline. There were increases in adiponectin from baseline to week 32 in the RSG and RSG/MET groups, and the increase in the RSG/MET group was statistically significant compared to that of the MET group (P < 0.05). At week 32, there was a significant decrease in plasminogen activator inhibitor-1 (PAI-1) in all three treatment groups, but no statistically significant difference among them. The RSG/MET group significantly decreased in terms of urinary albumin-creatinine ratio at week 32, compared to baseline. CONCLUSIONS: In this study, rosiglitazone and metformin combination therapy was effective in glycemic control as an initial therapy, and it improved cardiovascular risk markers in Korean type 2 diabetes patients.
Adiponectin ; C-Reactive Protein ; Diabetes Mellitus, Type 2 ; Double-Blind Method ; Fasting ; Female ; Glucose ; Homeostasis ; Humans ; Insulin Resistance ; Metformin ; Plasma ; Plasminogen Activators ; Thiazolidinediones

BACKGROUND: Obese type 2 diabetic subjects are recently increasing in Korea, indicating the importance of insulin resistance rather than insulin secretory defects in the pathophysioloy of type 2 diabetes. The purpose of this study is to evaluate the safety and efficacy of fixed dose rosiglitazone/metformin combination therapy in poorly controlled subjects with type 2 diabetes mellitus. METHODS: 12 type 2 diabetic subjects who had a HbA1c > 11% or fasting plasma glucose > 15 mmol/L were included. After a 2 week screening period, the subjected took the fixed does rosiglitazone/metformin for 24 weeks. The treatment with rosiglitazone/metformin began at week 0 with an initial dose of 4 mg/1000 mg and, unless tolerability issues arose, subjects would be increased to 6 mg/1500 mg at week 4 and at week 8 to the maximum dose of 8 mg/2000 mg. The primary object of this study was to characterize the magnitude of HbA1c reduction from baseline after 24 weeks of rosiglitazone and metformin treatment in poorly controlled type 2 diabetics. RESULTS: The mean age of the subjects was 48.9 +/- 10.6 years old, body mass index was 25.0 +/- 3.5 kg/m2, HbA1c was 12.0 +/- 1.0%, and fasting plasma glucose was 16.3 +/- 3.1 mmol/L. HbA1c was reduced to 7.54 +/- 1.45% and fasting plasma glucose reduced to 7.96 +/- 2.38 mmol/L at week 24. The proportion of HbA1c responder who showed the reduction from baseline of > or = 0.7% or HbA1c < 7% was 11 among 12 subjects (91.7%). 41% of the subjects (5 among 12 subjects) achieved HbA1c level < 7.0% and 75% (9 among 12 subjects) achieved HbA1c level < 8.0%. CONCLUSIONS: In this study, rosiglitazone and metformin combination therapy was effective in glycemic control in poorly controlled subjects with type 2 diabetes mellitus.
Body Mass Index ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Insulin ; Insulin Resistance ; Korea ; Mass Screening ; Metformin ; Plasma ; Thiazolidinediones

No abstract available.
46, XY Disorders of Sex Development* ; Humans ; Male*

No abstract available.
Humans ; Insulin Resistance* ; Insulin*

Essential thrombocythemia is one type of the related chronic myeloproliferative disorders that also include poly-cythemia vera, chronic myelogenous leukemia, and idiopathic myelofibrosis. It is a rare disorder of unknown origin characterized by thrombocytosis, excessive megakaryocytes, hemorrhage, and thrombotic complication. Several cases of ischemic stroke in essential thrombocythemia have been reported, but cerebral infarction combined with cerebral hemorrhage has been very rare and has not been reported in Korea. We report a case of cerebral infarction and chronic subdural hematoma in a pateint with essential thrombocythemia. A 59-year-old woman with essential thrombocythemia was admitted with mild left hemiparesis that developed 3 days prior. She had a history of minor trauma 15 days prior. A brain MRI showed an infarction in the right temporal lobe and a chronic subdural hematoma in the right frontoparietal area. A cerebral angiography revealed an occlusion of the M2 portion of the right middle cerebral artery.
Brain ; Cerebral Angiography ; Cerebral Hemorrhage ; Cerebral Infarction* ; Female ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Infarction ; Korea ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Magnetic Resonance Imaging ; Megakaryocytes ; Middle Aged ; Middle Cerebral Artery ; Myeloproliferative Disorders ; Paresis ; Primary Myelofibrosis ; Stroke ; Temporal Lobe ; Thrombocythemia, Essential* ; Thrombocytosis

Solitary fibrous tumor(SFT) is a spindle cell neoplasm that usually arises in the pleura. Its involvement of the meninges is rare but increasingly being reported. Our case was a 33-year-old man who presented with clonic seizure around the right mouth angle and sensory disturbance at the right hand. Radiological studies showed a large extra-axial, dural-based mass in the left fronto-parietal region, typically isointense with gray matter and heterogeneous strong enhancement on T1-weighted images. Histologically, the tumor was composed of spindle-shaped cells growing in fascicles within the collagenous matrix. Immunohistochemical staining demonstrated diffuse CD34 positivity. Awareness of this neoplasm is necessary to accurate diagnosis.
Adult ; Collagen ; Diagnosis ; Hand ; Humans ; Meninges* ; Mouth ; Pleura ; Seizures ; Solitary Fibrous Tumors*