200(平成年)月日実施 ??Web viewd.Rathke cyst(ラトケ嚢胞)

Download 200(平成年)月日実施 ??Web viewd.Rathke cyst(ラトケ嚢胞)

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2002032510284 101T3,T4a.TSHb.c.d.LDLe.a,eTSHbdLDLLDLA100972a.TSHb.freeT3c.freeT4d.e.a,ca.TSHb.T3c.T4d.e.A100973a.b.c.d.e.b,cb.c.A100974a. b. c. TSH(TRAb)d. e. 99mTca,c()a.()(AST,ALT)b.c.TRAbd.e.A100155TSHabcdeT4d4TSHTSHvol.3A100176a.b.Tcc.d.e.TSHfreeT4a,ca.2030b.P173c.d..e.TSHfreeT4TSHT4A100977a. TRHb. c. d. e. c,e1 (WBC) 2000 or (Neu) 5002 ASTALT3 4 5 MPO-ANCAc.e.A1002782a. b. c. 8090%d. T4e. (FNA)a,ea.16b. c. d. T3,T4TSHTSHe.9Afree T4,free T3,TSHAT41a,TSHb,free T4c,d,e,2dCEAP226P226-227A10033Christiano Ronaldo102abc22dea,ba b c d e a 8~9b c MEN2d e vol.311762: 7.8g/dl3.4g/dl 31.8mg/dl 1.41mg/dlCa 12.2mg/dlPi 4.6mg/dl 92mg/dl:Ca 16.2mg/dl 30.3mg/dla)Ca11.6mg/dlb)c)d)e)c,eCaPiDa) Ca=Ca+(4-)=12.2+(4-3.4)=12.8b) CaPiDCaPiPTHrPDc) d) Cae) Ca09A100411229112/64mmHg7.2g/dL3.8g/dL13.6mg/dL0.63mg/dLCa 7.2mg/dLPi 4.9mg/dLintact PTH 10.8pg/mL10-602a. Ellsworth-HowardcAMPb. TRPc. d. 1,25De. Trousseaub,e4.0g/dLCaCaCa47.243.87.4mg/dLCa8.510mg/dLCaPi2.54.5mg/dLintact PTHCaChvosteka. Ellsworth-HowardPTHcAMPPcAMPb. PTHTRPc. D1,25Dd. PTH1,25De. CaTrousseauvol.3A1013a b c d e c,da 1,25-(OH)DCab c d PHPPTHPTHCaPe 3A10052141a.b.c.Cad.1e.CacPTHCaPc.Cavol.3p.23115a:30b:50c:MLOCCd:3e:a,ea: 4050 203050 25040 0.3e: ()16a.b.c.d.10e.ca. b. 80c. d. e. d.e.c.c.99175a b c d e d,eXL-dopaGHRP1530http://allabout.co.jp/gm/gc/392016/2/A101872a. b. c. d. e. GnRHc,d(b.)e.GnRHGnRH()a.MRIc.d.A1007219CT155.848.5kg144/76mmHgCaMRIT2Na 143mEq/LK 4.3mEq/LCl 106mEq/LBUN 12.6mg/dL0.47mg/dLACTH 14.6pg/mL7.2-63.39.4mg/dL5.3-11.018.4pg/mL1001620pg/mL100-4509pg/mL2018.4mg/day3.4-26.9320.6 mg/day48.6-168.41.12mg/day0.04-0.191.04mg/day0.09-0.33a.b.c.d.CTCT10HUe.a. b. c. 2d. CT10HU25HUe. A1020()a. RETb. c. RETd. 35e. SDHBBa,bA:P.65B:3C:P.65D:P.74E:P.73A100822121.8CT()MRI()a.pituitary adenomab.germinomac.craniopharyngiomad.Rathke cyste.meningiomaa09()a.pituitary adenoma()b.germinoma(())c.craniopharyngioma()d.Rathke cyst()T1:high,T2:lowe.meningioma() ( )A1022a. T1W1b. Gd-DTPAc. d. e. MRIc,e09a.T1W1; T1W1: T1W1; T1W1: b.c.d.e. ( )A1022232a HOMA-IRb Cc d e a,d() HOMA-IR()p.171 IRI 10U/ml2 HOMA-IR 1.0 1.73()3 4 SSPG(Stedy state plasma glucose)5 IVGTT/6 ITT(Insulin tolerance test)(1)b,d (2)a,d (3)a,e(1)b,d (2)a,c (3)a,c (1)c (2)b,d (3)a,e(1)a,b (2)c,d (3)(c 4/ e 2/) (4)b,eA1023242a.GADb.c.insulinogenic index d.HLA-DR4e.b,c2(insulinogenic index)GADHLA-DR41vol.3A10097-A10100252abMODY3cIRIdIRIe1GADa,da P9b MODY3HNF-1MODY2MODYMaturity onset diabetes of the youngP9c P10IRIimmunoreactive insulindP10e1GADP6262a. 10g/b. 128mg/dlc. 75gOGTT1213mg/dld. 186mg/dle. HbA1c6.6%(NGSP)b,e20102012126mg/dl75gOGTT2200mg/dl200mg/dlHbA1c6.5%NSGP%A10272A) B) C) D) E) a,cACDEBBABCSheehan08282a SUb c DPP4d e b,ca SU()b PPARPPARNa()c DPP4(GIPGLP-1)DPP4d (2)e ()vol.3A10114292a. b. c. d. e. a,da. b. DKAWBCc. H2ONaNaDKANad. DKAe. 302a. b. ANPBNPc. SIADHANPd. NT-proBNPe. b,ca. b. ANPBNPc. ADHANPd. e. 31357174cm56kg886mg/dLHbA1c 6.2NGSPa. GADb. pH7.45c. d. HLA-DR2e. Na 128mEq/Lc,e11123HbA1c4C-10g/day56Kussmaul+3+Na140Eq/LpH7.3a. b. e. c. 211HbA1cd. 1HLA-DR4DR9HLA-DR2PBL132562SU170cm78kg128/78mmHg156mg/dlHbA1c 8.0(NGSP)%BUN 20.6 mg/dl0.85mg/dl2a. b. 1800kcalc. d. 2e. a,baSUb1.7222281780.24cd1eA10007Ishikawa33a. LHE2b. PRLREMc. ACTHd. GHe. TSHb,c09d(09)a. E2(LHsurge)b. PRL...09c. d. GH()e. TSH()A1001534a. b. c. d. e. d,ea. 7b. c. paracrineautocrined. me. TGF-MAPvol.3 09A10020352a. b. c. d. cAMPe. H2b,da. GHRHPRLP.171b. IGF-GHGHGH(P.172)c. d. LHP.1664e. H2H2H2P.185vol.33936a. b. c. d. e. b,caTRH2PIFPIFPIF1 2 e11A10027372a. QOLb. c. d. 75gGHe. b,ca. b. GHc.d. 75gOGTTGH()GH1ng/ml10ng/mlL-DOPAGHTRHGnRHe. GH0938546516668154/96mmHg76/Ca 9.6mg/dL Pi 5.4mg/dL128mg/dLHbA1c 6.9NGSP242mg/dL (50-149) 218mg/dL (150-219)HDL-C52mg/dL (40-86)GH 56.4g/L (

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