Diabetic ketoacidosis as a presenting symptom of complicated pancreatic cancer

No abstract available.

Mainly Adrenal Gland Involving NK/T-Cell Nasal Type Lymphoma Diagnosed with Delay due to Mimicking Adrenal Hemorrhage

A 29-yr-old man, presented with abdominal pain and fever, had an initial computed tomography (CT) scan revealing low attenuation of both adrenal glands. The initial concern was for tuberculous adrenalitis or autoimmune adrenalitis combined with adrenal hemorrhage. The patient started empirical anti-tuberculous medication, but there was no improvement. Enlargement of cervical lymph nodes were developed after that and excisional biopsy of cervical lymph nodes was performed. Pathological finding of excised lymph nodes was compatible to NK/T-cell lymphoma. The patient died due to the progression of the disease even after undergoing therapeutic trials including chemotherapy. Lymphoma mainly involving adrenal gland in the early stage of the disease is rare and the vast majority of cases that have been reported were of B-cell origin. From this case it is suggested that extra-nodal NK/T-cell lymphoma should be considered as a cause of bilateral adrenal masses although it is rare.

The Education Effect of Glucometer Use on the Glucose Levels and the Glucose Value Comparison among Diverse Glucometers / 임상당뇨병

Self-monitoring of blood glucose (SMBG) and point-of-care testing are widely used in the management of diabetic outpatients. However, SMBG records are sometimes inaccurate, and may differ from glucose values measured in the hospital. Therefore, the aim of our study was to evaluate the effects of patient education regarding glucometer use on blood glucose levels and to compare the glucose values obtained by six different types of glucometers currently used in Korea. Fifty-six diabetic patients participated in the present study. Each patient visited the hospital in a fasting state. Fasting plasma glucose (FPG) levels in capillary blood samples were measured by doctors and by the patients themselves before and after patient education sessions. Then, glucose levels were measured with each of the six glucometers by doctors and by the patients themselves. The differences between FPG and glucose values measured using glucometers were compared, and their relationships with HbA1c were also assessed. There were no significant differences between glucose levels measured by patients regardless of glucometer education. We obtained similar results for differences between glucose levels measured by patients and doctors. Patient HbA1c levels were not correlated with differences in measurements between glucometers and FPG. Measurements of glucose levels by the six different glucometers did not differ significantly. Our study indicates that education about SMBG, including glucometer handling, is important to increase SMBG accuracy, but that errors in SMBG records are trivial for glucometer users and that the different glucometers used in Korea demonstrate similar accuracy.

The Correlation and Accuracy of Glucose Levels between Interstitial Fluid and Venous Plasma by Continuous Glucose Monitoring System / 당뇨병

BACKGROUND: Clinical experience with the continuous glucose monitoring systems (CGMS) is limited in Korea. The objective of this study is to evaluate the accuracy of the CGMS and the correlation between interstitial fluid and venous plasma glucose level in Korean healthy male subjects. METHODS: Thirty-two subjects were served with glucose solution contained same amount of test food's carbohydrate and test foods after separate overnight fasts. CGMS was performed over 3 days during hopitalization for each subjects. Venous plasma glucose measurements were carried out during 4 hours (0, 0.25, 0.5, 0.75, 1, 2, 4 hours) just before and after glucose solution and test food load. The performance of the CGMS was evaluated by comparing its readings to those obtained at the same time by the hexokinase method using the auto biochemistry machine (Hitachi 7600-110). Also, correlations between glucose recorded with CGMS and venous plasma glucose value were examined. RESULTS: CGMS slightly underestimated the glucose value as compared with the venous plasma glucose level (16.3 +/- 22.2 mg/dL). Correlation between CGMS and venous plasma glucose values throughout sensor lifetime is 0.73 (regression analysis: slope = 1.08, intercept = 8.38 mg/dL). Sensor sensitivity can deteriorate over time, with correlations between venous blood glucose and CGMS values dropping from 0.77 during 1st day to 0.65 during 2nd and 3rd day. CONCLUSION: The accuracy of data provided by CGMS may be less than expected. CGMS sensor sensitivity is decreased with the passage of time. But, from this study, CGMS can be used for glucose variability tendency monitoring conveniently to the Korean.

Clear Cell "Sugar" Tumor of the Lung: A Well-Enhanced Mass with an Early Washout Pattern on Dynamic Contrast-Enhanced Computed Tomography

Clear cell tumor of the lung is a rare and very unusual benign pulmonary tumor. As clear cell tumor of the lung contains abundant cytoplasmic glycogen, this tumor is called "sugar tumor". We report a case of sugar tumor in a 64-yr-old man presenting as a round pulmonary nodule. On dynamic computed tomography (CT) scans, the solitary pulmonary nodule showed early wash-in enhancement with an early washout pattern like a lung malignancy. The patient underwent wedge resection for the tumor. Pathologic examination, including immunohistochemical studies, revealed that the nodule was a benign clear cell tumor, so-called "sugar tumor". Because only a small number of cases have been reported previously, clinical aspects, radiological characteristics on dynamic contrast-enhanced CT, and differential diagnosis of the tumor are not well established. Herein we present a clear cell tumor of the lung and discuss the clinical, radiological, and pathological features of the tumor.