Quingestanol acetate (17-α-ethynyl-19-nortestosterone acetate, 3-cyclopentylenol ether), a synthetic progestational steroid, was well tolerated at a dosage of 300 µg/day per os by 17 diabetic women who, with but one exception, were between 50 and 65 years of age and had ceased menstruating. Body weight, systolic and diastolic blood pressure, and the pulse rate were of the same orders of magnitude prior to and during the 12 months of quingestanol treatment. The diabetes mellitus was not affected but oscillometric readings at certain body points decreased during the year of treatment, probably reflecting the natural course of vascular disease in diabetic individuals.Despite changes in certain laboratory indices, i.e. slight increases of variable but usually short duration in serum sodium, chloride, total globulins and their α₂, β- and γ-fractions, SGOT, SGPT, LDH, FSH, chylomicrons, and blood platelets and the decreases in serum potassium, albumin, α₁-globulin, nonesterified fatty acids, β-lipoproteins, and plasma ll(OH)corticosteroids, most of the values remained within the ranges established for normal persons. One year of quingestanol therapy was associated with decreased first-day responses to metyrapone. This suggests, among other possibilities, that quingestanol inhibits the hypothalamic-pituitary controlled output of ACTH.All of the other items monitored during this course of quingestanol therapy remained unchanged.

Background: The effect of pravastatin on insulin resistance (IR) is controversial and poorly studied in prediabetes. Methods: This study was performed in hyperglycemic patients at Saint Carollo Hospital from January 1, 2013 to December 31, 2015. Among them, we selected 40 patients (24 prediabetes and 16 new onset diabetes [NOD]) who had been treated with pravastatin 20 mg daily for 2 or 4 months and in whom fasting insulin and fasting glucose had been measured before and after administration of pravastatin. IR was defined as a fasting insulin level ≥ 12.94 μU/mL, homeostasis model for IR (HOMA-IR) ≥ 3.04 or quantitative insulin sensitivity check index (QUICKI) ≤ 0.32. Results: Pravastatin treatment decreased total cholesterol and low-density lipoprotein cholesterol levels by 25.2% and 32.3% respectively (P = 0.000 for all), but did not affect fasting insulin level, HOMA-IR, or QUICKI in total, prediabetes, and NOD groups. Prevalence of IR was significantly different between prediabetes and NOD groups both before and after pravastatin treatment (0% versus 37.5%, P = 0.001), but pravastatin treatment did not affect the prevalence of IR in the prediabetes or NOD group. Fasting glucose level was not significantly different before and after pravastatin treatment in prediabetes (106.8 ± 6.4 mg/dL versus 103.8 ± 8.4 mg/dL, P = 0.223) but was significantly different in the NOD group (171.5 ± 혈당이 높은 환자에서 Pravastatin이 인슐린 저항성에 미치는 영향 정용진, 김정민, 장승재, 방준희, 정영곤, 김성택, 강순형, 최종인, 김수성, 강미연

We report a case of spinal, cerebral and cerebellar embolism that occurred following injection sclerotherapy with n-butyl-2-cyanoacrylate for variceal bleeding. The patient had been diagnosed with alcoholic liver cirrhosis and esophageal variceal bleeding. We performed injection sclerotherapy with n-butyl-2-cyanoacrylate. The patient complained of both leg motor weakness and left arm motor weakness after injection and was diagnosed with spinal, cerebral and cerebellar embolism following the n-butyl-2-cyanoacrylate injection. At the follow-up examination, the patient's neurologic symptoms had improved, but left leg motor weakness remained. To our knowledge, this is the first report of a case of multiple embolizations including the spine, cerebrum and cerebellum after n-butyl-2-cyanoacrylate injection for treatment of esophageal variceal bleeding.

No abstract

Aorta-right atrial tunnel is a vascular anomaly that originates from the aortic sinus and terminates in either the superior vena cava or the right atrium. The patency of the tunnel can result in volume overload in both ventricles, bacterial endocarditis, aneurysm formation, and spontaneous rupture. Transesophageal echocardiography was performed in a 42-year-old male patient diagnosed with infectious endocarditis, and vegetation of the mitral and aortic valves, right atrial enlargement, and an extracardiac blood vessel connecting the aorta to the right atrium were discovered. Therefore, we were able to diagnose an aorta-right atrial tunnel leading to infectious endocarditis and proceeded with surgical treatment. Together with a review of the literature, we present a case report of a patient with aorta-right atrial tunnel accompanied by infectious endocarditis.