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

Of 31 domestic cats with diabetes mellitus, 20 (65%) had amyloid deposits in their pancreatic islets (i.e., insular amyloid). The incidence of insular amyloidosis (p = 0.34) was not significantly different between diabetic and age-matched, non-diabetic cats from our previous study. Diabetic cats, however, had a significantly higher mean percentage of islets with amyloid (p = less than .005) and a significantly higher mean percentage of islets with abundant amyloid deposits (p = less than .005) than did non-diabetic cats. These results suggest that insular amyloidosis and diabetes are causally related and are not simply concurrent diseases associated with aging. Although the specific relationship of insular amyloidosis to the pathogenesis of diabetes mellitus was not determined, a functional islet cell abnormality probably precedes the diabetic state and the deposition of insular amyloid.
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PMID:Feline insular amyloid: association with diabetes mellitus. 702 35

Islets were evaluated for the presence of amyloid deposits in 169 pancreases removed at autopsy. Islet amyloid occurred in 17 of 142 (12 per cent) of nondiabetics and in 16 of 27 (59 per cent) of diabetics. When diabetics were divided into categories according to clinical severity of disease, the insulin treated diabetics had the highest prevalence (89 per cent), the most diffuse distribution, and the most severe degree of islet amyloidosis. Amyloid was not found in any pancreases from subjects under 40 years of age. Above the age of 40, there was no correlation between aging and prevalence of islet amyloid. There was a significant association between severity of diabetes and prevalence of islet amyloid. The low prevalence of amyloid seen in nondiabetics and the fact that all adult onset, insulin treated diabetics had islet amyloid indicate that a reaction to endogenous insulin may be the basis for the deposition of islet amyloid.
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PMID:The relation of islet amyloid to the clinical type of diabetes. 702

There are some morphological signs for the clinical diagnosis of diabetes mellitus. The macroscopical findings of the skull (yellow staining, hyperostosis frontalis), of the liver (steatosis), of the pancreas (pancreatitis, atrophy) and the consistency of the brain as well as some histological changes of the pancreas may be important for the diagnosis. Our investigations of specimens form the pancreas of 100 diabetics and 50 nondiabetics allow the conclusion that amyloidosis and increased number of mast cells in the islets of Langerhans and an interstitial fibrosis of the pancreas can be used in the practice as signs for diabetes mellitus.
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PMID:[Histomorphological findings in the pancreas in diabetes mellitus (author's transl)]. 703 85

We determined antibody titers to Endostreptosin (ESS), a recently described protein antigen in the cytoplasm and the plasma membrane of Group A streptococci in 286 normals of different age groups and in 34 children and 19 adults who had or had had at one time a nephrotic syndrome due to idiopathic nephrosis. Antistreptolysin O titers were also determined in 33 of the idiopathic nephrotics. Similarly, antibody titers to Streptozyme were determined in 21 patients with idiopathic nephrosis and 61 normals with a similar age distribution. Severe depression of these antibody titers was found in almost all patients with this disease not only during the presence of a nephrotic syndrome but for long periods up to 20 years following an episode of a nephrotic syndrome when the patients were in complete remission. Patients with a nephrotic syndrome due to chronic glomerulonephritis (5), S.L.E. (4), membranous nephropathy (5), diabetes mellitus (1) or amyloidosis (1) did not show abnormally low values for antibodies to Endostreptosin, Streptolysin O or Streptozyme. High-dose steroid medication as such for prolonged periods of time does not depress Endostreptosin or Streptolysin O antibody titers below the expected mean, as demonstrated in 15 patients with S.L.E.
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PMID:Depression of endostreptosin, streptolysin O and streptozyme antibodies in patients with idiopathic nephrosis with and without a nephrotic syndrome. 724 25

M. mode echocardiography was performed on 16 chronic hemodialysis patients (12 men, 4 women, average use of 21, hematocrit around 24 +/- 5%) with a normal blood pressure and no clinical or roentgenographic signs of heart failure, 18 to 22 hours after the end of a dialysis. Renal diseases due to hypertension, diabetes or amyloidosis were excluded from the study. 8 normal subjects of similar age, heart rate and blood pressure were used as a test group. On these 24 persons, and diastolic time diameter index (DTDI) and end systolic time diameter index (STDI), ejection time (ET), mean velocity of circumferential fiber shortening (VCF) and ejection fraction were calculated. DTDI of hemodialysis patients (31 mm/m(2) +/- 2) is greater than DTDI of the control subjects, and STDI and ET are the same. This explains the increase of VCF (1,69 +/- 0,10 c/s) and EF (0,78 +/- 0,05). After a three minute compression of the fistulas the differences disappear. These results suggest that the previous exam conditions permit a better determination of the true contractile state of the left ventricule of hemodialyzed patients if one disregards the load changes due to the fistula, anemia and the intermittent volume expansion.
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PMID:[Does echocardiography Tm permit to determine the true contractile state of the left ventricle of hemodialysis patients? (author's transl)]. 729 Mar 3

M-mode echocardiography was performed 18 to 22 hours after a haemodialysis session in 16 patients under chronic dialysis. The patients (12 men and 4 women, mean age 21 years, haematocrit 24 +/- 5%) were normotensive and had no clinical or radiological sign of heart failure. Patients with renal hypertension, diabetes or amyloidosis had been excluded from the study. Eight healthy subjects of similar age, heart rate and blood pressure were used as controls. In all 24 individuals the following parameters were calculated: end diastolic time diameter index (DTDI), end systolic time diameter index (STDI), ejection time (ET), mean velocity of circumferential fiber shortening (VCF) and ejection fraction (EF). DTDI was greater in haemodialyzed patients (31 +/- 2 mm/m2) than in controls, but STDI and ET were the same in both groups. This would explain the increase of VCF (1.68 +/- 0.1 c/sec) and EF (0.78 +/- 0.05) observed in dialyzed patients. After compression of the fistula for 3 min the differences disappeared. These results suggest that the echocardiographic measurements listed above give a better idea of the true contractile state of the left ventricle in haemodialyzed patients, disregarding load changes due to the fistula, to anaemia and to intermittent volume expansion.
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PMID:[Echocardiographic measurement of true left ventricular inotropism in patients under haemodialysis (author's transl)]. 731 3

Detailed clinical and biochemical investigations were done in 14 patients with the syndrome of diabetic amyotrophy. Three patients suffered from manifest insulin-dependent diabetes, five had only diminished glucose tolerance. Simultaneously, excretion of creatinine was reduced indicating reduction of healthy muscle mass. In these cases disturbance of glucose tolerance must be considered symptom and not cause of amyotrophy. Further investigations revealed neoplasia (n = 2), generalised amyloidosis (n = 3), polycythaemia vera (n = 1), chronic infectious disease (n = 3), and motor neuron degeneration (n = 3). The attribute "diabetic" must not bea considered representing a single cause in this connection. With treatment aimed at more than one factor, satisfactory results of therapy may be expected in the majority of cases.
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PMID:[Diabetic amyotrophy--a polygenetic syndrome (author's transl)]. 747 82

It has recently been suggested that immunotactoid glomerulopathy be separated from much more common fibrillary glomerulonephritis by ultrastructural features of highly organized immune deposits containing tubules of more than 30 nm in diameter. We report and discuss the results of a light, immunofluorescence and electron microscopic study of a needle renal biopsy from a 75-year-old, non-insulin dependant diabetic female presented with nephrotic syndrome, hypertension and a progressive renal failure. A unique coexistence of nodular glomerulosclerosis, as traditionally ascribed to diabetes with a peculiar type of immunotactoid glomerulopathy was confirmed by the exclusion of amyloidosis, monoclonal gammopathies, systemic autoimmune diseases and cryoglobulinemia. Mesangial, scattered subepithelial and segmentally prominent subendothelial immune deposits were found highly organized in mostly parallel arrays of 40 to 91 nm thick tubules. The average thickness of 67 nm exceeds the average diameter of tubules in all other 11 published cases of immunotactoid glomerulopathy to date. By immunofluorescence, predominantly capillary wall, thick, ribbon-like glomerular deposits contained IgG, IgM, kappa and lambda light chains of equal intensity, C3, C4 and fibrin related antigens. Mild to moderate glomerular cell proliferation associated with nodular sclerosis has been assumed to be causally related to immunotactoid deposits.
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PMID:Immunotactoid glomerulopathy with unusually thick extracellular microtubules and nodular glomerulosclerosis in a diabetic patient. 747 81

The prevalence and immunoreactivity of interstitial amyloid deposits of the pituitary glands of 109 consecutive autopsies of individuals over 84 years of age were studied using Congo red staining and antibodies directed against the major amyloid fibril proteins and pituitary hormones. In addition, the amount of interstitial amyloid formation was evaluated quantitatively and compared with all autopsy-related and clinical diagnoses available. Eighty-seven (80%) of the 109 cases exhibited interstitial amyloid deposits in the anterior lobe. All reacted immunohistochemically with antiamyloid lambda light chain and antiamyloid P-component. Quantitative analysis in 62 cases revealed a mean volume percentage of interstitial amyloid in the anterior lobe of 0.56%. In statistical analysis, only two of the 25 diseases recorded were associated with interstitial amyloid: chronic obstructive pulmonary disease and non-insulin-dependent diabetes mellitus. The prevalence of chronic obstructive pulmonary disease correlated positively with the occurrence (chi 2; P < .02) as well as with the amount of amyloid (Wilcoxon; P < .04) in the pituitary. In addition, non-insulin-dependent diabetes mellitus was accompanied with higher amounts of interstitial amyloid than with all other disorders (Wilcoxon; P < .03). Until now, a correlation was proposed only between non-insulin-dependent diabetes mellitus and islet amyloidosis of the pancreas.
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PMID:Interstitial amyloid deposits in the pituitary gland. Morphometry, immunohistology, and correlation to diseases. 748 7

During triple-drug immunosuppression, consisting of azathioprine, steroids, and cyclosporine, the number of acute rejections was low. Close monitoring of the patient and the graft during the early posttransplant weeks with regular cytological and histological analyses was the cornerstone of early diagnosis and a favorable outcome of acute rejection. Genetic homogeneity of our patient population, third-party transfusion program, and use of well HLA-matched kidney grafts may have been additional factors behind the low rate of acute rejection. Acute rejection within the first three postoperative months did not predispose the renal graft to chronic rejection in the long term. The histologically determined allograft damage index was a reliable predictor of future graft survival. Recipients with systemic diseases such as diabetes and amyloidosis, as well as elderly patients, could be transplanted safely with results only slightly inferior to those achieved with primary kidney disease. Results in diabetic recipients have steadily improved, encouraging the continuation of critical evaluation of the patients' pretransplant status and the preference for cadaveric transplants. Renal transplantation in small children yielded superior patient and graft survival rates. We consider the use of living donors justifiable in these cases. The five million population of Finland offers an ideal size for a transplant center. Continuous education of medical personnel and the general public is crucial for the cadaver transplant program.
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PMID:Thirty years of renal transplantation in Helsinki. 754 43


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