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

The present study describes various strategies of coping with illness as observed in pancreatectomy patients, a group of patients which has not been investigated before in this field of research. Questionnaire data obtained from a sample of n = 134 were analyzed with regard to sociodemographic (age, sex) and medical characteristics (indication for surgery: chronic pancreatitis vs. pancreatic carcinoma; outcome after surgery: diabetes, hypoglycemia, pain). The relationships between ways of coping and several adaptation criteria were investigated. The question is put up to discussion, if it is possible to clearly separate emotion as a way of coping and emotion as an outcome of coping.
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PMID:Coping and adaptation in pancreatectomized patients: a somatopsychic perspective. 158 94

We experienced 41 cases of Cushing's syndrome (12 males and 29 females, 15 years old - 65 years old) during the last 20 years. These included 20 patients with unilateral adrenal adenoma (Cushing's syndrome), 19 patients with bilateral adrenal hyperplasia (Cushing's disease), one patient with adrenal carcinoma and one patient with primary adrenocortical nodular dysplasia (PAND). Moreover, these cases included some special ones, i.e. 5 cases with destructive thyroiditis after treatment, 2 cases with aggravation of arthritis after treatment, a case of Carney's complex with PAND, one case with paradoxical response to dexamethasone, and one case combined with empty sella syndrome. The most specific clinical signs were moon face (95% occurrence), hypertension (95%) and subcutaneous bruising (80%). Other significant signs were eye edema (66%), buffalo hump (68%), subcutaneous purpura (63%) and osteoporosis (49%). Skin striae was not a common sign in our cases (41%). Renal stone was observed in only 20% of our patients but was a significant sign in this syndrome. There was no difference in the occurrence of each clinical sign between Cushing's syndrome and Cushing's disease. The elevation of white blood cell count (WBC) and serum sodium, a decrease of serum potassium, and a decrease of reabsorption of phosphate (%TRP) were observed. Thyroid-stimulating hormone (TSH) and human growth hormone (HGH) were suppressed in patients with Cushing's syndrome and patients with Cushing's disease. These results were consistent with those of previous reports. However, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin (PRL) were high in those patients with Cushing's syndrome and those with Cushing's disease. Oral glucose tolerance test was carried out in 34 patients before and after treatment. Thirty-one percent of those had diabetes mellitus and 26% had impaired glucose tolerance (IGT). The response of IRI in this test was high in patients with Cushing's syndrome and patients with Cushing's disease, and decreased 4 weeks after treatment in those with Cushing's syndrome but remained high in those with Cushing's disease. Plasma ACTH level and urinary 17-OHCS excretion were significantly higher in Cushing's disease than in Cushing's syndrome. During an 8mg-high-dose dexamethasone suppression test, urinary 17-OHCS excretion in 13 of 14 patients with Cushing's disease (93%) was suppressed by more than 50% of baseline on the second day of testing. However, all of 18 patients with Cushing's syndrome, who had an 8mg-dexamethasone suppression test, failed to suppress urinary 17-OHCS by 50% of baseline.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Forty-one cases of Cushing's syndrome: a comparison between Cushing's syndrome (adrenal adenoma) and Cushing's disease (adrenal hyperplasia)]. 163 31

Pancreas-specific protein (PASP) was compared with serum amylase in 95 episodes of acute pancreatitis with the diagnoses supported by elevated amylase levels. The etiology was typical for Scandinavian countries, with alcohol as the predominant factor, followed by cholelithiasis. PASP values were clearly raised in all patients, except in three cases found to have high salivary-type amylase levels, and one patient with recurrent alcohol pancreatitis. The rise of PASP levels were in general more pronounced than the corresponding amylase elevations, especially in severe pancreatitis. The elevations were generally parallel for the two analytes, but in 41% of the cases PASP levels remained elevated 2-11 days longer than the corresponding amylase levels. PASP was, however, eliminated from the circulation at a rate comparable to that of amylase. The serum range of PASP for 259 healthy subjects was 15-111 micrograms/L with 95% of the values within 16-98 micrograms/L. The upper reference level was set at 100 micrograms/L. PASP levels were also determined for 291 patients with disorders other than acute pancreatitis. Serum levels in patients with renal insufficiency (n = 12), primary biliary cirrhosis (n = 9), and diabetes mellitus (n = 17) were equal to those in healthy subjects. Eight patients of 173 with acute abdominal disorders and no evidence of pancreatitis had elevated PASP levels as well as 4 patients with prostatic carcinoma (n = 28) and 2 patients with benign prostatic hyperplasia (n = 16). PASP values were low in chronic painful pancreatitis (n = 15) and pancreatic cancer (n = 11).
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PMID:A novel assay for pancreatic cellular damage: IV. Serum concentrations of pancreas-specific protein (PASP) in acute pancreatitis and other abdominal diseases. 168 89

A 72-year-old man was found to have a 12 mm solid lesion in the pancreatic tail and an 8 mm cystic lesion in the body of the pancreas by computed tomography carried out during a routine follow-up study of his adult-onset diabetes mellitus. A distal pancreatectomy was performed revealing the pancreas to have an adenocarcinoma in the tail and a conglomeration of intraductal papillary adenoma in the body. A review of the literature disclosed similar coexistences of cystadenoma and carcinoma in four patients, none of which was documented with preoperative imaging features such as we had.
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PMID:Adenocarcinoma and concomitant intraductal papillary adenoma in the pancreas. 180 50

Postmortem examination of 21 patients showed a vacuolar myelopathy resembling that associated with the acquired immunodeficiency syndrome. Underlying diseases included six cases of leukemia or lymphoma, five of carcinoma, three of systemic lupus erythematosus, two of chronic lung disease, and one each of cadaveric renal transplant, cirrhosis, diabetes, hemophagocytic syndrome, and viral encephalitis. Fourteen patients were on long-term steroid therapy and 10 of these also had immunosuppressive chemotherapy. No patient had the acquired immunodeficiency syndrome, although one received blood transfusions in 1978. Signs and symptoms consistent with myelopathy included paraparesis in seven patients, ataxia in one, and bilateral extensor plantar reflexes in one. Microscopic examination showed vacuolation in spinal cord white matter primarily located in posterior and lateral columns. Lipid-laden macrophages and axonal changes were proportional to the severity of the vacuolation, which was severe in five patients, moderate in 10, and mild in six. Eight patients had coexistent viral diseases elsewhere in the central nervous system, but viral-associated antigens or genomic material was not found in regions of vacuolated spinal cord white matter. Although the etiology of these myelopathies is unknown, their association with immune suppression and coexistent viral infection of the central nervous system suggests that an opportunistic viral infection may be important.
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PMID:Idiopathic myelopathies with white matter vacuolation in non-acquired immunodeficiency syndrome patients. 186 65

CA 19-9 is a monoclonal antibody-defined tumor marker expressed by exocrine pancreas. It has been shown that exocrine atrophy was associated with deficiency. Hyperamylasemia has been described during ketoacidosis. Our study aimed at investigating the relationships between CA 19-9 and metabolic control of diabetes. Study was performed on 51 adult consecutive diabetic patients (21 type 1 and 30 type 2), with ketoacidosis or hyperosmolarity (group A, n = 15), poor glycaemic control (group B, n = 19), or good control (group C, n = 17). Serum CA 19-9 and metabolic parameters were evaluated on day 1 and day 30. Analysis of variance showed a very significant global difference between groups for CA 19-9 (p less than 0.0001); group A (66.1 +/- 11.4 u/ml) significantly differed from group B (36.4 +/- 4 u/ml) (p less than 0.01) and group C (22.4 +/- 2.8 u/ml) (p less than 0.001). Simple regression showed a significant correlation between CA 19-9 and fasting blood glucose (r = 0.6, p less than 0.001), plasma creatinine level (r = 0.37, p = 0.01), bicarbonate (r = 0.47, p = 0.001) and HbA 1c (r = 0.33, p = 0.032). The Ca 19-9 decrease on day 30 paralleled the improvement of glycaemic control. We conclude that CA 19-9 in diabetic patients is raised in acute metabolic situations and correlated very well with blood glucose concentration. A careful interpretation of this tumor marker assay is required when screening for pancreatic carcinoma among diabetic patients. CA 19-9 could be a useful and sensitive marker for the severity of exocrine damage and functional cellular disorders following metabolic disturbances in diabetes.
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PMID:Influence of metabolic disturbances of diabetes mellitus on serum CA 19-9 tumor marker. 190 32

Twenty patients with gastrointestinal mucormycosis are reviewed. This often fatal opportunistic fungal infection was diagnosed histologically, and was categorized as colonization (five patients), infiltration (seven patients), or vascular invasion (eight patients). There were no fatalities from colonization. In 10 patients, mucormycosis complicated peptic ulcer disease. Seven of these patients had infiltrative or invasive disease. The presentation and operative findings mimicked malignancy in five of these seven patients, and six had successful surgical intervention. The other patient was cured by medical therapy alone. Ten patients had infection associated with other gastrointestinal diseases: post-traumatic peritonitis (four patients), transmural amoebiasis (two patients), tuberculosis (one patient), gastroenteritis (one patient), gastric carcinoma (one patient) and diabetes (one patient). Eight patients had significant infection and only one survived. In this series, mucormycosis had a less aggressive course when complicating peptic ulcer than when it occurred in association with other gut diseases.
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PMID:Gastrointestinal mucormycosis. 191 15

Necrotizing fasciitis is an often fatal, often initially unrecognized condition. Although it was first described over 60 years ago, occurrence in the vulva was only first recognized in 1972. The condition is most often associated with diabetes, prior injury, surgery, or irradiation. Aggressive surgical excision is required, early in the course of the disease, to salvage the patient. An association with vulvar carcinoma in a nondiabetic patient has not been previously reported. We report such a case, with a poor outcome, because surgical intervention was not possible until late in the course of the disease.
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PMID:Necrotizing fasciitis: a complication of squamous cell carcinoma of the vulva. 191 18

A 41-year-old woman was hospitalized for evaluation of diabetes mellitus and hypertension. The hormonal and radiological examinations revealed that she had pheochromocytoma of bilateral adrenal gland and medullary carcinoma of thyroid gland. Therefore, she was diagnosed as having Sipple's syndrome. She had no definite familial history, but her two sisters, already dead, had been strongly suspected of having had pheochromocytoma. First, bilateral adrenalectomy was performed and secondly, total thyroidectomy, excision of parathyroid and cervical lymph node dissection were performed. Histopathological diagnosis was pheochromocytoma of bilateral adrenal gland, medullary carcinoma of thyroid gland and chief cell hyperplasia of parathyroid gland. We report a case of Sipple's syndrome, which probably is the 88th case in Japan, with the review of the previous Japanese literature.
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PMID:[Sipple's syndrome: a case report]. 198 Nov 25

From July 1985 to January 1989, 133 patients underwent endometrial sampling for evaluation of post menopausal bleeding (PMB). Of these patients, 114 (85.7 percent) showed benign histology with an average age of 58.6 years. Nineteen (14.3 percent) were malignant, all of which showed endometrial carcinoma. The average age was 65. In addition, 26.3 percent of patients with carcinoma had higher grade of tumor at hysterectomy when compared with the preoperative biopsy. The average volume of tissue removed at curettage was significantly greater in those with carcinoma. Hormonal therapy, duration of symptoms, hypertension, obesity or diabetes were not significant risk factors for carcinoma in our series. PMB remains a major symptom that may predict endometrial carcinoma and must be evaluated. In those patients with carcinoma, intraoperative evaluation of the uterus for tumor grade and depth of invasion is important in determining the extent of surgery.
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PMID:Post menopausal bleeding as a risk factor for endometrial carcinoma. 199 92


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