Periodic drop thumb, hypokalemia and adrenal adenoma

To report an unusual involvement of focal distal muscles but not proximal muscles in a patient with hypokalemic periodic paralysis [hypoPP]. A middle-aged woman presented with episodic weakness of the bilateral thumbs lasting for 2 years. Hypokalemia and a left adrenal mass were subsequently found. Her weakness subsided after surgical removal of the adrenal mass, which was pathologically proven to be an adrenal adenoma. The findings for this patient should alert physicians to consider focal distal motor paresis due to hypoPP. A preexisting occult trauma may predispose to paralysis at an atypical location in secondary hypoPP

Prediction of total cholesterol: high-density-lipoprotein-cholesterol ratio in young adults.

Abnormal cholesterol fraction is an essential risk factor for atherosclerosis of large cerebral arteries in young Asians. In order to reduce the medical cost and social resource for cholesterol electrophoresis, especially in undeveloped and developing Asian countries, we evaluated the validity of Nanji's GUT score for predicting TC: HDLC ratio in this population. Results showed that GUT score only predicted 71% of them. We also tested the predictive power of CUT index, and predicting rate was 81%. Therefore, Nanji's GUT score is not an ideal surrogate for cholesterol electrophoresis. We recommend CUT index to screen for high-risk subjects till a new method can satisfy the economic pattern in Asian countries.

The lipoprotein profile of young adults with cerebral atherosclerosis.

In order to elucidate the relationship between the lipoprotein profile and large cerebral artery atherosclerosis in the young adults living in developing Asian countries, the serum lipoprotein profile and the luminal diameter of large cerebral arteries (internal carotid, middle/anterior cerebral and vertebrobasilar arteries) were measured and correlated in 67 young Taiwanese with non-embolic cerebral infarct (CI). Totally 23 (21.9%) patients had atherosclerotic stenosis. A significant elevation of the serum total cholesterol (TC), triglyceride, total lipids, beta-lipoprotein (beta-LP) and pre-beta-LP level was found in atherosclerotic CI patients. But multiple regression analysis showed only the serum beta-LP (p = 0.0041) and TC (p = 0.0324) level to be the independent risk factors for atherosclerosis. Secondary dyslipoproteinemia is the main cause for hyperlipoproteinemia in our atherosclerotic patients. Therefore, an abnormal lipoprotein profile is linked to large cerebral artery atherosclerosis in young Asians regardless of ethnic group. A tailored program is recommended to modify the life style and dietary habit, as well as to gain access to secondary control for large cerebral atherosclerosis prevention in developing countries.