To determine the incidence of hyperprolactinemia and prolactinoma without symptoms in men, the serum levels of prolactin were measured in 4803 men. Of these, 14 had hyperprolactinemia with prolactin level of over 50 ng/ml, and 3 had prolactin levels of more than 500 ng/ml. Of these 3 subjects, 2 were found to have pituitary prolactinoma by computed tomograph scanning and surgery, the other subject, who was highly suspected to have prolactinoma, refused further examinations. The serum prolactin levels of 51-100 ng/ml in 11 subjects may have been induced by drugs (sulpiride) or unknown factors. The present survey suggests that the incidence of prolactinoma in men in the general population might be estimated to be 1:1600, and that mass screening is useful for early diagnosis of asymptomatic prolactinoma.
There has been no useful treatments for chronic vascular rejection (CVR) after kidney transplantation until now. Recently, however, some reports have suggested that the thromboxane A2 synthetase inhibitor, OKY-046, is useful in reducing proteinuria in nephrotic syndrome and preventing progression of CVR. Five patients with CVR (serum creatinine range: 1.7-2.6 mg/dl) were treated with OKY-046 for over one year and the effect of OKY-046 was evaluated. One patient developed acute rejection and another renal hypertension during this study. Except for the cases of acute rejection and renal hypertension, serum creatinine slightly decreased in 1 case and remained unchanged in 2 cases. Urinary excretion of protein and thromboxane B2 decreased significantly but prostaglandin E2 did not change in the treatment of the deterioration with OKY-046. We concluded that OKY-046 was effective in preventing graft function and decreasing urinary protein excretion in kidney transplant recipients with CVR.
We observed a patient with 48 XXYY Klinefelter syndrome who visited our hospital because of a short penis as chief complaint. The patient was a 21-year-old, tall and obese man. He had gynecomastia. The penis was short and bilateral testes were underdeveloped. Endocrinologically the LH and FSH showed high level and the testosterone was low. A diagnosis of very rare 48 XXYY Klinefelter was made based of the chromosomal analysis.
CDUS is helpful in detecting the perfusion of the testis as well as in getting anatomical information. CDUS is a very useful device which causes a minimal burden to the patient with acute scrotum. In most cases it will rapidly provides us the correct information although it may not be regarded as the definitive adjunct.
The combination of chronic renal failure plus parathyroid adenocarcinoma is very rare. A 53-year-old female had been on hemodialysis for chronic renal failure for 7 years. For 2 years she has had bilateral knee joint pain, hypercalcemia and an increased parathyroid hormone level. Swelling of parathyroid gland was diagnosed and it was excised. Histological examinations of the excised right lower parathyroid gland revealed adenocarcinoma and the left lower gland showed hyperplasia.
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