Increased risk of unfavorable metabolic outcome during short-term follow-up in subjects with nonfunctioning adrenal adenomas

To demonstrate long-term changes in the prevalence of several types of metabolic derangements in subjects with nonfunctioning adrenal adenomas. 273 subjects with adrenal adenomas, including 231 with nonfunctioning adenoma and 42 with subclinical Cushing's syndrome [sCS], were evaluated with respect to anthropometric and laboratory characteristics and prevalence of type 2 diabetes mellitus [T2DM], hypertension, dys-lipidemia, metabolic syndrome [MS], prediabetes and cardiovascular disease [CVD]. Median duration was 24 months. Follow-up data of 114 participants with nonfunctioning adrenal adenomas are also presented while those of 117 were missing. Follow-up data regarding changes in anthropometric and laboratory parameters and prevalence rates of metabolic disturbances were obtained from the medical records. The prevalence rates for both patients with non-functioning adenoma and sCS were: dyslipidemia: 161 [59%], hypertension: 147 [54%], MS: 128 [47%], prediabetes: 62 [23%], T2DM: 49 [18%], and CVD: 21 [8%]. Hypertension and CVD were prevalent in subjects with sCS compared to participants with nonfunctioning adenoma. In follow-up, body mass index [p = 0.005], systolic blood pressure [p < 0.001], waist circumference [p = 0.005], homeostasis model assessment [p = 0.046], high-sensitivity C-reactive protein [p =0.023], total cholesterol [p < 0.001] and low-density lipopro-tein cholesterol [p < 0.001] and prevalence of hypertension [p < 0.001], dyslipidemia [p < 0.001], prediabetes [p < 0.001] and MS [p < 0.01] significantly increased in subjects with nonfunctioning adenoma. The data showed that nonfunctioning adrenal adenomas were associated with the development or deterioration of atherosclerotic risk factors. Therefore, follow-up and management strategies should be developed to decrease atherosclerotic morbidity in those individuals

Accessory muscle in the forearm: a clinical and embryological approach / 대한해부학회지

Muscular variations of the flexor compartment of forearm are usual and can result in multiple clinical conditions limiting the functions of forearm and hand. The variations of the muscles, especially accessory muscles may simulate soft tissue tumors and can result in nerve compressions. During a routine dissection of the anterior region of the forearm and hand, an unusual muscle was observed on the left side of a 65-year-old male cadaver. The anomalous muscle belly arose from the medial epicondyle approxiamately 1 cm posterolateral to origin of normal flexor carpi ulnaris muscle (FCU), and from proximal part of the flexor digitorum superficialis muscle. It inserted to the triquetral, hamate bones and flexor retinaculum. Passive traction on the tendon of accessory muscle resulted in flexion of radiocarpal junction. The FCU which had one head, inserted to the pisiform bone hook of hamate and palmar aponeurosis. Its contiguous muscles displayed normal morphology. Knowledge of the existence of muscle anomalies as well as the location of compression is useful in determining the pathology and appropriate treatment for compressive neuropathies. In this study, a rare accessory muscle has been described.

Unusual presentations of Henoch-Schonlein purpura: case report and review of the literature

Henoch-Schonlein purpura, the most common leukocytoclastic vasculitis of childhood, may present with a wide variation of signs and symptoms. Other systems involvements that are usually rare and underestimated are commonly reported as case reports in the literature. Neuromuscular and hepatic involvement is very rare. We present a ten years old boy who had Henoch-Schonlein purpura with neuromuscular and hepatic involvement and had rapid response to therapy