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

Ninety-five patients with thoracic esophageal cancer who had undergone radical esophagectomies through right thoracotomies from 1986 to 1989 were statistically analyzed semi-quantitatively to identify the risk factors predicting "operative (within 45 days of operation) or hospital death." Age, pulmonary function (%VC or %FEV1.0), cardiac function (EKG or Master test), renal function (Ccr), hepatic function (R15'ICG), diabetes mellitus (75 OGTT), extent of tumor invasion to the adventitia, and the type of operative procedure were each scored according to severity; 0 (no risk), 1, 2, or 3 (high risk). Patients with no severe postoperative complications had an accumulated score of less than 8 and comprised Group I, while those suffering an an "operative death" had a total score of 8 or more, and comprised Group II. Group III included those suffering a "hospital death." There was a significant difference between Group I and Group II (p < 0.005), but not between Group I and Group III. "Operative deaths" could be preoperatively predicted from the risk factors. However, "hospital deaths" could not be predicted, since they resulted mainly from recurrences of the cancer. In cases with scores of 8 or more the operative procedure should be changed to a simpler one for an improved prognosis.
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PMID:Preoperative prediction of mortality following surgery for esophageal cancer. 149 50

During diagnostic procedures for various diseases, five patients underwent intravenous pyelograms which showed gas formations in the collector system, in absence of acute symptoms. Laboratory chemical, bacteriologic and radiologic examinations explained the origin of these gas formations. In one patient with diabetes mellitus and in another with an oesophageal neoplasm, infections were caused by gas forming bacteria. In three cases, bladder fistula formations were present by Crohn's disease, colon diverticulosis and a gynecological malignancy.
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PMID:[Possible causes of gas in the urinary tract]. 388 9

Dr. Grayson (February 21, p. 445) asks about changes in vital statistics of 3rd world populations as they develop. Of African populations, those in Johannesburg and other large South African cities, while still in transition, have now reached a relatively high level of sophistication. Their health pattern is likely to be that of other African countries as they prosper. The (IMR) infant mortality rate of blacks in Soweto, Johannesburg, is about 40/1000 live births, although nearer 30 in the regularly employed elite. This figure is similar to that for blacks in New York in 1965 and for class 5 persons in the United Kingdom. Small-town dwellers have higher IMRs and in rural areas the rates are higher still although they are decreasing everywhere. Family size is decreasing; in urban areas the average family has 3-4 children and the elite have 2-3. In Johannesburg during the 1960s, the birth rate was about 40/1000 and it is now 25. While the rate is higher in rural areas, it is falling. In the very young, gastroenteritis with or without malnutrition is still the leading cause of sickness and death in both urban and rural areas. Rates are however decreasing. Deficiency diseases, especially pellagra, remain a health problem in some areas. Tuberculosis still continues to be a major hazard although it is being dealt with. With the rise in socioeconomic status and associated changes in diet and lifestyle, obesity, especially in urban areas and especially among women, is becoming very prominent. Hypertension is more common and is the leading cause of natural death among urban dwellers. The toll from coronary heart disease and noninfective bowel disease remains inexplicably low, but diabetes is only somewhat less prevalent than it is among whites. Changes in cancar pattern and rates are slight; however, esophageal cancer in men and cervical cancer in women are the main causes of concern in the urban centers and some rural areas. Rising alcohol consumption is a major problem with its ramifications in pancreatic, liver, and heart problems. Cigarette smoking is now as common as among whites. Because of low rates for most degenerative diseases, blacks have, at middle age, a life expectancy exceeding that of whites. As sections of the 3rd world population prosper, the IMR decreases enormously as does family size. However, infections and malnutrition among the very young and tuberculosis in older groups remain important problems. Among adults, rises occur in some degenerative diseases but not in others, and diseases linked with hypertension and alcohol consumption have become formidably common, as they have in other developing and developed countries.
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PMID:Third World policies and realities. 611 Sep 78

A rapid method for determining urinary indole-3-acetic acid (IAA) is introduced as the tumor-marker for the screening and diagnostic purpose of cancer patients by means of high performance liquid chromatography (HPLC). Its clinical significance is discussed along with a review of literatures. The IAA concentration and creatinine level of optionally collected urine samples were measured and used for the calculation of IAA amount per unit creatinine (microgram IAA/mg creatinine) in urine. Thus, an amount of 24-hours urinary IAA could be calculated without collecting a whole day's urine supply. Analysis of urinary IAA was performed within 10 minutes by HPLC. Urinary IAA level is usually high in the patients with the upper G-I tract cancers such as gastric cancer, esophageal cancer and hepato-biliary tract cancer, and also malignant hematopoietic disorders. But it is also high in non-cancer patients such as liver cirrhosis, diabetes mellitus and cholelithiasis occasionally. The patients with high urinary IAA level also showed high urinary levels of 5-hydroxy indoleacetic acid (5-HIAA) and monoamine oxidase activity (MAO). It was characteristic that hepatocellular carcinoma showed slight elevation of urinary IAA with normal levels of 5-HIAA and MAO. It is conclusive that the positive rate of elevated urinary IAA level was high in the patients with gastric cancer with ulcer-forming type in its morphological classification, and its level tends to elevate as the disease progresses. Therefore, the measurement of urinary IAA level in an optionally collected urine sample, as the tumor-marker, can be useful to check the progression and regression of gastric cancer.
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PMID:[A rapid method for determining urinary indoleacetic acid concentration and its clinical significance as the tumor-marker in the diagnosis of malignant diseases]. 620 79

We retrospectively investigated the sputum cultures of patients who underwent esophagectomy (n = 104) from just after operation to 11 postoperative days and evaluated the factors which influenced the cultures. We divided the 0-11 postoperative days into three periods (0-3 postoperative days (p.o.d.), 4-7 p.o.d., 8-11 p.o.d.). The sputum cultures were positive at a rate of 56.7% to 65.4% of patients during the period of observation (0-11 p.o.d.). Gram-negative bacillus was mostly detected. MRSA increased time-dependently. Diabetes mellitus, preoperative irradiation recurrent nerve palsy did not influence the positive rate of the sputum cultures. The positive rate of gram-negative bacillus and gram gram-positive coccus in the sputum of the patients who were given sefem-first generation antibiotics was lower than of patients who were given sefem-second generation antibiotics at 8-11 p.o.d. (p < 0.05). The positive rate of gram-negative bacillus in the sputum of patients who underwent esophagectomy with laryngectomy for cervical esophageal cancer was lower than that of patients who underwent esophagectomy without laryngectomy for thoracic or abdominal esophageal cancer at 4-7 p.o.d. (p < 0.05). The positive rate of gram-negative bacillus in the sputum of patients who underwent intraoperative tracheostomy was lower than that of patients who did not undergo intraoperative tracheostomy at 4-11 p.o.d. No patients had pneumonia during the period of observation except for the secondary lung complications. In conclusion, although we have done a good job of management, we should select the appropriate antibiotics with the patient's background in mind.
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PMID:[Retrospective study of sputum culture after esophagectomy]. 759 48

We described three septicemia cases in which blood cultures yielded gram-positive cocci identified as Leuconostoc spp. and Pediococcus spp. Patients were three male adults aged 63 to 71 years with severe underlying diseases, pancreatic cancer, esophageal cancer and diabetes mellitus with chronic renal failure. They had fever and chills at the onsets of septicemia with acute obstructive suppurative cholangitis, acute pneumonia, and infection complicated with invasion sites of esophageal cancer contagious to bronchus and subcutaneous tissue. Blood cultures yielded catalase and oxidase negative highly vancomycin-resistant (MIC: 1024 micrograms/ml <) gram-positive cocci showing alpha or gamma hemolysis on blood agar plates. Two cases were polymicrobial infections. In one case with esophageal cancer, clinical symptoms persisted after the start of antimicrobial chemotherapy and the patient died 10 days later associated with complications of esophageal cancer. Leuconostoc lactis, Leuconostoc mesenteroides subsp. dextranicum, and Pediococcus acidilactici wee identified by physiological reactions. These strains were also highly resistant to teicoplanin and fosfomycin, and tolerant to all rested beta-lactams such as benzylpenicillin. This is the first report in Japan to our knowledge on the identification of Leuconostoc spp. and Pediococcus spp. isolated from human infectious diseases.
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PMID:[Microbiological and clinical studies of vancomycin resistant Leuconostoc spp. and Pediococcus spp. isolated from septicemia patients]. 796 99

A series of 100 patients with thoracic esophageal cancer who underwent subtotal esophagectomy through a right thoracotomy between 1986 and 1989, were statistically analyzed to assess the risk factors predicting hospital mortality from complications. Hospital mortality was termed as "complication death", and the analyzed factors were age, pulmonary function [% vital capacity (%VC) or % forced expiratory volume1.0 (%FEV1.0)], cardiac function [ECG and Master test], renal function [creatinine clearance (CCR)], hepatic function [15' indocyanine green test (R15.ICG)], diabetes mellitus [75 g oral glucose tolerance test (75OGTT)], depth of tumor invasion [T-factor], and the type of operative procedure [operation]. Each patient was scored according to risk severity on a scale from 0-3, with the higher numbers representing higher risk. Patients not succumbing to complication death had less than 8 points in the total score, while those who suffered a complication death had 8 or more points. Through stepwise logistic regression analysis, we produced a prediction formula. In cases where eight or more points are scored by the semi-quantitative analysis, or 0 or more, by the prediction formula, the operative procedure should be changed to a less radical one for improved prognosis. The introduction of this semi-quantitative analysis for postoperative risk reduced the incidence of complication death from 6% to 3%, and of hospital mortality from 13% to 3%.
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PMID:A prediction of hospital mortality after surgical treatment for esophageal cancer. 805 89

We studied 15 resected cases with a history of apoplexy (2.5%) among 599 cases of esophageal cancer admitted between 1972 and 1993. Fourteen were male, and female, aged 48 to 77 years. Twelve had suffered from cerebral infarction, 2 intracerebral hemorrhage, and one subarachnoid hemorrhage. Duration from apoplexy to operation was between 2 months and 19 years in the cerebral infarction cases, between 8 and 10 years in the intracerebral hemorrhage cases and 4 years in the subarachnoid hemorrhage case. Preoperative neurological disturbance was found in 7 of the 12 cerebral infarction cases, and in both intracerebral hemorrhage cases. Four cases showed hemiplegia, and the other 5 cases showed partial paralysis of limbs. Preoperative complications were found in 7 of the 15 cases, and consisted of diabetes mellitus in 5, hypertension in 4, bronchial asthma in one, and renal dysfunction in one case. Intra- and postoperative complications were found in 11 of the 15 cases, and consisted of anastomotic leakage in 5, delirium in 3, apoplexy in 2, peritonitis in one, ARDS in one, intraoperative cardiac arrest in one, and wound infection in one. Postoperative disorders of consciousness were found in 5 cases, consisting of delirium in 3, and excitation at awakening of anethesia in 2 cases. Rate of direct operative death was 6.7% in preoperative apoplectic patients, and 8.5% in non-apoplectic patients, and there was no significant difference between the 2 groups. On the other hand, rate of postoperative apoplexy was 13.3% in the preoperative apoplectic patients, and 0.4% in non-apoplectic patients. There was a significant difference between them (p < 0.01). But they were cured of it, and left our hospital. It is concluded that active surgical treatment can be indicated for esophageal cancer patients with a history of apoplexy, if more attention is given to the management of diabetes mellitus or hypertension.
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PMID:[Analysis of specificity of resected esophageal cancer patients with a history of apoplexy]. 866 64

The care of esophageal cancer patients with diabetes mellitus is described. The main points are as follows. 1. Prevention and control of infection. 2. Sufficient nutritional support (2000 Kcal/day) and hydration. 3. Control of plasma glucose level (150 mg/dl-250 mg/dl) by means of insulin. 4. An absence of ketone bodies and minimum glucose level (< 10 g/day) in the urine. 5. Prevention and control of hypoglycemia. Good control of diabetes mellitus in esophageal cancer patients may contribute to reduced surgical rislcs.
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PMID:[Care of esophageal cancer patients with diabetes mellitus--preoperative management and treatment]. 877 7

Etiology of esophageal intramural pseudodiverticulosis is still unknown but several accompanying diseases have been reported, for example, reflux esophagitis, esophageal cancer, diabetes mellitus and so on. We have experienced a case of esophageal intramural pseudodiverticulosis with cancer improved by radiation therapy. In this case, there were esophageal cancer in the cervical esophagus, with intramural spreading in whole esophagus. This case was delivered irradiation to the entire esophagus by target rotation method. After irradiation, intramural pseudodiverticula, intramural spreading and primary site of esophageal cancer were improved. This is an interest case report that esophageal intramural pseudodiverticula with cancer was disappeared by radiation therapy.
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PMID:Esophageal intramural pseudodiverticulosis with esophageal cancer improved by target rotation irradiation: case report. 926 44


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