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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Type-1 diabetes, resulting from immune-mediated destruction of beta cells, appears to be rare in cats. Type-2 diabetes, characterised by inadequate insulin secretion and impaired insulin action, is the most common form of diabetes in cats. Other specific forms of diabetes constitute a substantial minority of cases. The most common is pancreatic destruction from pancreatic adenocarcinoma. Less frequent causes are insulin resistance from other endocrinopathies including acromegaly. Diabetes in cats is characterised by variable loss of insulin secretory capacity and insulin resistance. Glucose toxicity, islet amyloid-deposition, and pancreatitis contribute to further loss of beta cells and failure of insulin secretion. A significant number of cats undergo remission of their diabetes, usually 1-3 months after good glycaemic control is instituted. Obesity, old age, and Burmese breed are recognised risk factors for the development of diabetes in cats.
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PMID:Current understanding of feline diabetes: part 1, pathogenesis. 1191 29

Several experimental studies suggest that disturbed methylation can influence cellular differentiation in the pancreas and contribute to toxic injury in ways that enhance the pathogenesis of pancreatitis and carcinogenesis. In vitro development of fetal rat pancreas requires a basal level of methionine, but full differentiation requires a higher methionine level. Involvement of methylation in normal differentiation is supported by reports of development of hepatocyte-like cells in the pancreas of rats fed a choline-deficient diet. The administration of ethionine by feeding to mice in a choline-sufficient diet caused a lower incidence of acute hemorrhagic pancreatitis than in mice given a choline-deficient diet. Feeding or injections of ethionine in choline-sufficient diets induces low grade pancreatitis and pancreatic atrophy in rats. In the N-nitrosobis(2-oxopropyl)amine-induced model of ductal adenocarcinoma in hamsters, the latent period for induction of carcinomas has been dramatically reduced by the intermittent feeding of a choline-deficient diet combined with ethionine treatment. A recent epidemiologic study in smokers indicates that the risk of pancreatic carcinoma is inverse to serum levels of folate. These studies suggest that compromised methyl metabolism might be associated with pancreatic cancer risk in humans. Finally, it has recently been demonstrated that serum homocysteine and erythrocyte S-adenosylhomocysteine levels are elevated, and erythrocyte S-adenosylmethionine content is reduced in patients with diabetes mellitus and renal failure, likely reflecting disturbed methylation pathways. The latter may contribute to the pathogenesis of complicating lesions in diabetes. These studies suggest that disturbed methyl metabolism may contribute to the pathogenesis of several pancreatic diseases.
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PMID:Abnormal methyl metabolism in pancreatic toxicity and diabetes. 1216 95

A carefully taken history and clinical examination are necessary for assessing the relative benefits and risks of estrogen replacement therapy for an individual patient. The patient's weight, blood pressure and urine need to be checked. Benefits of estrogen replacement are seen in relation to vasomotor symptoms, atrophy of the genital tract, bone metabolism, psychological symptoms, libido, skin, and cardiovascular effects. Estrogens are contraindicated with a history of previous deep vein thrombosis, ischemic heart disease or carcinoma of the breast. Care needs to be taken with liver disease, hyperlipidemias, diabetes, gallbladder disease, gross obesity, or in heavy smokers. Progesterones should always be administered if the uterus is present to prevent endometrial hyperplasia and adenocarcinoma. When properly selected and carefully monitored, many women may be relieved of unnecessary suffering due to menopause.
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PMID:Estrogen replacement therapy: its benefits and risks. 1227 83

Pancreatic cancer is the fourth leading cause of cancer death in both men and women with a mortality incidence ratio of 0.99. In an effort to describe the role of clinical features at initial presentation, we conducted a retrospective observational study in patients with a biopsy-proven diagnosis of adenocarcinoma of the pancreas. Between 1986 and 2001, 308 patients (160 males, 148 females) were diagnosed with pancreatic adenocarcinoma. The mean age at diagnosis was 70.1 yr (range: 34-96 yr). The mean survival was 7.6 mo (range: 0-97 mo). Statistical analysis was performed using log-rank tests and analysis of variance. As expected, age at diagnosis was a significant factor affecting survival, with older patients doing relatively poorly (p < 0.05). Patients with a good performance status performed significantly better than those with a poor performance status (p < 0.01). In addition, the presence of the tumor in the head of the pancreas was a predictor for improved survival (p < 0.01). Although smoking increased the chances of detection at an earlier age, neither diabetes mellitus nor a positive smoking history had a statistically significant effect on the survival. Pancreatic adenocarcinoma is a disease of the elderly associated with a poorer outcome. Knowledge of possible clinical predictors of survival may lead to better patient counseling regarding prognosis.
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PMID:Predictive value of clinical features at initial presentation in pancreatic adenocarcinoma: a series of 308 cases. 1251 17

Vascular permeability factor/vascular endothelial growth factor (VPF/VEGF), the critical molecule in tumor angiogenesis, is regulated by different stimuli, such as hypoxia and oncogenes, and also by growth factors. Previously we have shown that in AsPC-1 pancreatic adenocarcinoma cells, insulin-like growth factor receptor (IGF-IR) regulates VPF/VEGF expression. Insulin receptor substrate-1 and -2 (IRS-1 and IRS-2), two major downstream molecules of IGF-1R, are known to be important in the genesis of diabetes. In this study, we have defined a new role of IRS in angiogenesis. Both of the IRS proteins modulate VPF/VEGF expression in pancreatic cancer cells by different mechanistic pathways. The Sp1-dependent VPF/VEGF transcription is regulated mainly by IRS-2. Protein kinase C-zeta (PKC-zeta) plays a central role in VPF/VEGF expression and acts as a switching element. Furthermore, we have also demonstrated that the phosphatidylinositol 3-kinase pathway, but not the Ras pathway, is a downstream event of IRS proteins for VPF/VEGF expression in AsPC-1 cells. Interestingly, like renal cancer cells, in AsPC-1 cells PKC-zeta leads to direct Sp1-dependent VPF/VEGF transcription; in addition, it also promotes a negative feedback loop to IRS-2 that decreases the association of IRS-2/IGF-1R and IRS-2/p85. Taken together, our results show that in AsPC-1 pancreatic carcinoma cells, Sp1-dependent VPF/VEGF transcription is controlled by IGF-1R signaling through IRS-2 proteins and modulated by a negative feedback loop of PKC-zeta to IRS-2. Our data also suggest that IRS proteins, which are known to play crucial roles in IGF-1R signaling, are also important mediators for tumor angiogenesis.
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PMID:Role of insulin receptor substrates and protein kinase C-zeta in vascular permeability factor/vascular endothelial growth factor expression in pancreatic cancer cells. 1460 96

Recent studies have emphasized the importance of patient selection for the surgical resection of pancreatic adenocarcinoma based on reproducible prognostic factors. The aim of the study was to investigate the prognostic factors affecting long-term survival in patients with resectable and nonresectable pancreatic cancer and to evaluate their prognostic value. Forty six patients (25 women, 21 men, aged 44-80) with ductal adenocarcinoma of the pancreas were reviewed. Primary tumor size and regional enlargement of lymph nodes was assessed with enhanced CT scan. 13 patients were treated conservatively, 9 with standard Whipple procedure (pancreatoduodenectomy) and 24 - with palliative surgery. Survival probabilities were computed using univariate Kaplan-Meier analysis. Log-rank test was used to compare survival between groups. Overall median survival was 6 months with a 4 years survival of 2.2%. There was no difference in survival time (ST) between patients aged 65 years or younger and older (p=0.71). MeanST in patients after Whipple procedure was 10.3, after palliative surgery - 9.4 and after conservative treatment - 4.4 months (p<0.05). Thirty-day surgical mortality was 9.4%. ST was significantly longer in patients with tumors 3 cm or less of diameter compared with larger ones (p<0.05). Presenting signs and symptoms, like jaundice, diabetes, alkaline phosphatase, aspartate and alanine aminotransferase elevation and history of cholecystectomy did not have any significant impact on survival. The only significant independent factors improving survival were: operative treatment and tumor size smaller than 3 cm.
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PMID:Prognostic factors in the operative and palliative treatment of pancreatic cancer. 1462 94

Diagnosis of human disease has been undergoing steady improvement over the past few centuries. Many ailments that were once considered a single entity have been classified into finer categories on the basis of response to therapy (e.g. type I and type II diabetes), inheritance (e.g. familial and non-familial polyposis coli), histology (e.g. small cell and adenocarcinoma of lung) and most recently transcriptional profiling (e.g. leukaemia, lymphoma). The next dimension in this finer categorization appears to be the typing of the patient rather than the disease i.e. disease X in person of type Y. The problem of personalized medicine is to devise tests which predict the type of individual, especially where the type is correlated with response to therapy. Immunology has been at the forefront of personalized medicine for quite a while, even though the term is not often used in this connection. Blood grouping and cross-matching (for blood transfusion), and anaphylaxis test (for penicillin) are just two examples. In this paper I will argue that immunological tests have an important place in the future of personalized medicine. I will describe methods we developed for personalizing vaccines based on MHC allele frequencies in human populations and methods for predicting peptide binding to class I MHC molecules. In conclusion, I will argue that immunological tests, and consequently immunoinformatics, will play a big role in making personalized medicine a reality.
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PMID:Immunoinformatics in personalized medicine. 1471 31

IGF-binding protein-related protein-1 (IGFBP-rP1) is a member of the IGF axis. In our previous work, we separated cDNA fragments of IGFBP-rP1 from colonic adenocarcinoma and normal mucosa cDNA subtraction libraries. In this study, we compared the expression of IGFBP-rP1 by semi-quantitative RT-PCR and immunohistochemistry among colorectal cancer, adenoma, normal tissue adjacent to cancer site, and normal tissue. Associations between IGFBP-rP1 and plasma glucose were further explored. We found that the mRNA level of IGFBP-rP1 was highest in cancer, moderate in adenoma and tissue adjacent to the cancer site and lowest in normal tissue (P<0.05). A significant difference was found in the immunoreactivity of IGFBP-rP1 between paired normal and cancer tissue (P<0.05). Tumor samples with upregulated expression of IGFBP-rP1 in invading tumor cells showed an increased frequency of metastasis to the lymph node, an increased depth of infiltration and stronger staining of IGFBP-rP1 compared with other samples (P<0.05). The fasting glucose level was significantly correlated with the staining of IGFBP-rP1 in cancer tissue (Spearman's rho=0.4, P<0.000). Thus, we concluded overexpression of IGFBP-rP1 might play an important role in the initiation and promotion of colorectal cancer. IGFBP-rP1 expression may also be associated with fasting glucose level and the presence of diabetes mellitus.
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PMID:Detection of the differentially expressed gene IGF-binding protein-related protein-1 and analysis of its relationship to fasting glucose in Chinese colorectal cancer patients. 1502 91

Small pancreatic cancers, intractable diseases, offer the possibility of cure. Can this be true? Through the National Pancreatic Cancer Registry, the Japan Pancreas Society (JPS) has collected 822 cases of invasive cancer with tumors <2 cm in diameter (TS1 pancreatic cancer). Papillary adenocarcinoma and the well-differentiated type of tubular adenocarcinoma are more frequent in TS1 pancreatic cancer than the larger tumors, suggesting that further genetic and phenotypic changes occur during their progression. Patients with TS1 pancreatic cancer presented with abdominal pain, jaundice, and exacerbation of diabetes, while 17.3% of them had no symptoms. Further imaging diagnosis should be employed to detect TS1 pancreatic cancer, but conventional US and ERCP play an important role in the diagnostic process. In this study, of 822 patients with TS1 pancreatic cancer, only 216 patients (26.3%) had T1 tumors because of invasion to adjacent tissue. There were 306 patients (37.2%) with lymph node metastasis, of whom 63 (7.7%) had N3 metastasis that is counted as a distant metastasis. As a result, only 136 patients (16.5%) had stage I disease with a median survival time of 78.2 months and a 5-year survival rate of 58.1%. Small pancreatic cancer does not necessarily mean early pancreatic cancer, and surgery alone is not sufficient to cure this disease.
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PMID:Clinicopathological aspects of small pancreatic cancer. 1508 63

Acute pancreatitis occur after autodigestion of pancreatic tissue with pancreatic enzymes followed by necrosis and secondary infection. Two most common causes are biliary stones and alcoholism. Other causes are rare. Computerised tomography and abdominal ultrasonography are of basic diagnostic value. In early phase of pancreatitis ultrasound of biliary three is important. Urgent intervention with stone extraction can prevent severe forms of pancreatitis. Chronic pancreatitis with its etiology is related to alcohol consumption (70-80%). Other causes are common to acute pancreatitis. Long lasting papillar obstruction could cause chronic inflammatory changes on pancreas. Natural course of disease reduce tissue of gland significantly with maldigestion and malabsorption symptoms. Most common tumor of pancreas is ductal adenocarcinoma with increasing incidence of 10/100,000 per year. Risk factors are: smoking, diabetes mellitus, 65% of cancers are in the head of gland. Treatment is surgical but rarely in early phase that allows radical resectability. Endoscopic palliation is placing of biliary stents. Biliodigestive anastomoses are performed surgically.
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PMID:[Diseases of the pancreas]. 1513 43


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