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

A 3 year old girl was admitted to hospital in an emaciated condition and with polydipsia in October 1974. Following the diagnosis of diabetes mellitus, she received treatment with insulin. On the first admission, a systolic murmur was noted at the apex of the heart. In 1981, the murmur was found to be continuous with a systolic click, and echocardiography demonstrated a mitral valve prolapse. In 1982, electrocardiography revealed left ventricular hypertrophy, and the patient's X-ray showed vertebral kyphoscoliosis. Ophthalmological examination revealed slightly impaired visual acuity and a mild case of cataracts in 1986. The patient grew to be tall and thin with arachnodactylia of the hands, fingers, feet and toes. These symptoms and findings were compatible with Marfan syndrome, although the ophthalmological findings are not specific for this disease. This patient is the first case in Japan of Marfan syndrome associated with insulin-dependent diabetes mellitus, although the relation between Marfan syndrome and IDDM remains unclear.
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PMID:Report of a Japanese girl with Marfan syndrome associated with insulin-dependent diabetes mellitus. 144 30

A recent report claimed that an amine in human skin (believed to be pyridinoline) was deficient in specimens from patients with abdominal aortic aneurysms (AAA). Further studies suggest that this work was erroneous in two respects. First, the amine has been isolated and partially characterized; the major component of the peak of interest is a deoxyanalogue of pyridinoline. It may be a collagen cross-link of some biologic importance, because it is not detectable in skin from a patient with Marfan's syndrome. Second, further studies in an additional 19 patients with AAA and an additional 13 controls suggest that this amine is abnormally abundant in skin from patients with AAA. This difference cannot be accounted for by any potential source of artifact that has been traceable. The effects of age, diabetes, sex, race, site of biopsy, and source of specimen (autopsy versus surgery) have been studied; none of these variables can account for the high ratio of pyridinolines to hydroxylysine found in skin from patients with AAA.
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PMID:Further studies of a putative cross-linking amino acid (3-deoxypyridinoline) in skin from patients with abdominal aortic aneurysms. 406 67

A 50-year-old Japanese woman with annuloaortic ectasia was found to have total coronary artery ectasia without evident atherosclerosis. The coronary ectasia may have been secondary to or of similar etiology to the annuloaortic ectasia. There was neither stigmata of Marfan's syndrome nor any sign of dissection of the ascending aorta or coronary arteries. Furthermore, the patient was not elderly, and had no hyperlipidemia, diabetes mellitus, or history of smoking. There was a marked blood pressure difference between the arms, and linear calcification was present in the aortic wall. A stenotic lesion was present in the right mid-subclavian artery. Although it is impossible to rule out atherosclerosis as the etiology of these findings, the possibility that they may be a manifestation of Takayasu's arteritis is discussed.
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PMID:Coronary artery ectasia with annuloaortic ectasia. 793 56

A non-invasive pulse-wave-velocity Doppler ultrasound technique for the assessment of aortic compliance is described. A computational approach for correcting for the effect of non-chronic changes in blood pressure is considered and applied to compliance measurements performed on an age-select cohort of 70 normotensive, normal healthy volunteers. In order to permit the wider availability of the pulse-wave-velocity Doppler ultrasound technique, the authors have developed a MkII system based on a standard 80486/33 MHz IBM compatible WINDOWS based personal computer; real-time spectral analysis being achieved using a relatively inexpensive but fast analogue to digital signal processing card. An overview of the new apparatus is provided and verification work to compare the repeatability of the MkI and MkII systems is described. Medical disorders such as atherosclerosis, diabetes mellitus, familial hypercholesterolaemia, growth hormone deficiency, and Ehlers-Danlos and Marfan's syndromes have all been shown to affect arterial wall compliance. We suggest that the in vivo clinical measurement of blood pressure corrected aortic distensibility using the MkII system may be a useful, reproducible, non-invasive tool for assessing such patients' susceptibility to atheromatous arterial disease as well as for monitoring their response to therapeutic interventions. Measurements in the aorta may be especially pertinent since the natural history of fatty streaks there tends to parallel that in the coronary vasculature thereby potentially affording a convenient surrogate estimate of coronary heart disease.
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PMID:Aortic compliance measured by non-invasive Doppler ultrasound: application of a personal computer based MkII system and its repeatability. 806 7

A potential role of homozygous or heterozygous alpha-1-antitrypsin deficiency alleles Pi*Z or Pi*S in the pathogenesis of aortic aneurysms has been debated in recently published papers. Therefore, we have determined the alpha-1-antitrypsin phenotype in 103 patients with aortic aneurysms using isoelectric focusing. The vast majority of patients (92.2%) had one or more of the established risk factors: hypertension (65.0%), lipometabolic dysfunction (34.9%), smoking (65.0%), hyperuricemia (16.5%) or diabetes mellitus (8.7%). In our patients, the deficiency alleles Pi*Z and Pi*S were more frequent than in the general population of our region, but these differences did not reach statistical significance (PiMS 6.7 versus 3.4%, PiMZ 3.8 versus 2.5%, PiSS 0,9 versus 0.2%). Furthermore, the patients with heterozygous or homozygous antitrypsin deficiency had similar patterns of risk factors to those of the patients with normal phenotypes. In one patient we found a heterozygous PiMZ antitrypsin deficiency associated with Marfan's syndrome. These data do not support the results of recently published studies of fewer cases that suggest a higher prevalence of antitrypsin deficiency alleles in patients with aortic aneurysms. A heterozygous alpha-1-antitrypsin deficiency as a cause or predisposing factor for the development of aortic aneurysms appears to be of little or no importance.
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PMID:[Is heterozygote alpha 1-antitrypsin deficiency a risk factor in the etiology of aortic aneurysm?]. 930 42

In a previous report we stated that two distinct types of aortic dissection exist, namely, the opened-communicated type (O type) which demonstrates communication between the true lumen and the false lumen, and the thrombosed type (T type, also known as aortic dissecting hematoma or as intramural hematoma). The latter, in its acute phase, shows no opacification of the false lumen through medical imagings such as computed tomography (CT) scans or angiography. We analyzed the pathoclinical features of the acute phase. Over a period of 14 years, a study was conducted of 371 patients who were classified as O type and 95 who were classified as T type. The mean age was significantly higher in T-type patients and the sex ratio showed a significantly higher proportion of males. As for atherosclerotic risk factors, such as hypertension and diabetes, hypertension was frequently evident and more frequently seen in T-type patients. The incidence of Marfan's syndrome was 11%, and was not observed in T-type patients. In 18 T-type patients (19%), complications such as cerebral ischemic episodes were observed. However, they were transient and not serious, sometimes indicating only minor surgery.
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PMID:The Thrombosed Type of Aortic Dissection-Its Clinical Features and Diagnosis. 971 98

This review attempts to interpret the basic science and more esoteric aspects of diseases associated with cataract, in the context of practical management and diagnostic implications. In the past year, the large epidemiologic Beaver Dam Eye Study has dismissed many putative relationships between cataract and cardiovascular risk factors. However, glycated hemoglobin and high density lipoprotein cholesterol levels still have an association. Cataract continues to be associated with a number of systemic diseases and syndromes such as atherosclerosis, diabetes mellitus, atopy, juvenile rheumatoid arthritis, Marfan's syndrome, and the Cronkhite-Canada syndrome. The unifying role of oxidative stress in the formation of these, as well as iatrogenically induced laser cataracts, is presented, together with a biochemical update on the pathogenesis. Finally, to bridge the gap between the basic science and clinical significance, recent controversial and practical management issues have been highlighted.
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PMID:Cataracts in systemic diseases and syndromes. 1017 26

Aortic stiffening is as much an important risk factor in cardiovascular morbidity and mortality, as it serves as reliable surrogate marker for clinical endpoints like myocardial and cerebrovascular incidents. Elevated aortic stiffness induces high systolic blood pressure, augmented pulse pressure with increased ventricular afterload, reduced subendocardial blood flow and augmented pulsatile stress in the peripheral arteries. Factors with relevant impact on the epidemiology of arterial stiffness are widely spread. 3 major groups of parameters influencing the stiffness of the aorta and the large arteries have been studied and described up to now: (i) physiological properties like age, gender, body height, pressure, hormonal state, genetic factors; (ii) environmental factors like nutrition (fish-, salt-, garlic consumption), smoking, performance of sports and aerobic capacity; (iii) diseases like hypertension, hypercholesterolemia, diabetes, coronary heart disease, cerebrovascular disease, renal failure, Marfan-syndrome, growth hormone deficiency. Close association between several of these factors impedes analyzing them independently from each other. Age and blood pressure were found to be the most prominent predictors of arterial stiffness in normal as well as in disease populations. Physiological and environmental factors can modulate these effects of aging, diseases generally seem to amplify them.
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PMID:Epidemiology of the arterial stiffness. 1047 71

The changes of reproductive functions, fertility and genetic risks of ageing females have been investigated relatively intensively. The state of knowledge about endocrine and reproductive changes in ageing men as well as possible age-related paternal genetic risks lags far behind. In general serum testosterone levels decrease with increasing age. In ageing men testis morphology and semen production can be absolutely normal. However, in some testes degenerative forms of germ cells can be observed. Fertility may be maintained up to a very high age. The genetic quality of sperm produced by older men may be reduced for several reasons, among which age-related increases in germ cell mutations, impairment of DNA-repair mechanisms and apoptotic processes are the most likely. The incidence of several autosomal dominant diseases, such as achondroplasia, polyposis coli, Marfan syndrome, Apert syndrome or basal cell naevi is associated with advanced paternal age, whereas there is no clear evidence for a paternal effect on structural or numeric chromosome anomalies. Hence even if offspring of older men have a slightly increased incidence of certain genetic diseases, the individual risk of such a new disease must be considered as extremely small, as the incidence of these diseases is very low.
Exp Clin Endocrinol Diabetes 2001
PMID:Reproductive functions, fertility and genetic risks of ageing men. 1134 1

The physiological infrarenal aortic diameter varies between 12.4 mm in women an 27.6 mm in men. As defined, an aneurysmatic dilatation begins with 29 mm. According to that, 9% of all people above the age of 65 are affected by an abdominal aortic aneurysm (AAA). Compared with the female sex, the male sex predominates at a rate of about 5:1. The disease is predominant in men of the white race. In black men, black and white women the incidence of AAA is identical. 38 to 50 percent of the AAA patients (patients) suffer from hypertension, 33 to 60% from coronary, 28% from cerebrovascular and 25% from peripheral occlusive disease. The AAA expansion rate varies between 0.2 and 0.8 cm per year and is exponential from a diameter of 5 cm on. In autopsy studies, the rupture rates with AAA diameters of < 5 cm, between 5.1 and 6.9 cm, and of > 7 cm were below 5%, 39% and 65%, respectively. 70% of the AAA patients do not die of a rupture, but of a cardiac disease. Serum markers, such as metalloproteinases and procollagen peptides are significantly increased in AAA patients. Thoraco-abdominal aneurysms (TAA) make up only 2 to 5% of all degenerative aneurysms. 20 to 30% of the TAA patients are also affected by an AAA. 80% of the TAA are degenerative, 15 to 20% are a consequence of the chronic dissection--including 5% of Marfan patients--, 2% occur in case of infections and 1 to 2% in case of aortitis. The TAA incidence in 100,000 person-years is 5.9% during a monitoring period of 30 years. In case of TAA, an operation is indicated with a maximum diameter of 5.5 to 6 cm and more and, in case of a Marfan's syndrome (incidence of 1:10,000), with a maximum diameter of 5.5 cm and more. With regard to aorto-iliac occlusive diseases, there are defined 3 types of distribution. Type I refers to the region of the bifurcation itself. Type II defines the diffuse aorto-iliac spread of the disease. Type III designates multiple-level occlusions also beyond the inguinal ligament. Type I patients in most cases are female and more frequently suffer from hyperlipidaemia, while Type II patients are affected by hypertension and diabetes. Compared to Type II patients, Type I patients have a life expectancy that is 10 years higher. Type I and Type II patients often suffer from a pelvic claudication and, unlike Type III patients, are more frequently affected by arterio-arterial embolisms.
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PMID:[Epidemiology of aortic disease: aneurysm, dissection, occlusion]. 1155 76


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