Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In an effort to establish diagnostic criteria for rejection and recurrent disease in transplanted pancreas, a comparative study was performed based on clinical diagnosis. Clinical rejection was diagnosed in patients who had decreased urinary amylase or increased blood glucose; they were treated for rejection and improved. A clinical diagnosis of recurrent diabetes was made in syngeneic transplant recipients with islet dysfunction. In addition, two control groups were used--nontransplant, nondiabetic pancreatitis patients and pretransplant normal biopsies from patients in the study. Morphologically, tissues were assessed for acinar inflammation, ductal changes, islet and nerve inflammation, and vascular changes. Immunohistochemical staining for insulin and glucagon was also performed to quantitate differences between the groups. Vascular changes (endothelialitis, vasculitis, obliterative endarteritis) were specific for rejection. Also, rejection was characterized by a lymphocytic or mixed infiltrate that involved the ducts. Recurrent diabetes was characterized by selective loss of beta cells with isletitis. Leukocyte common antigen and UCHL1 staining was helpful in identifying islet inflammation. An insulin/glucagon ratio of less than 1.0 appears to be specific for recurrent disease and in the absence of isletitis is a reasonable method for detecting recurrent disease at an early stage.
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PMID:Pancreas transplant pathology. A morphologic, immunohistochemical, and electron microscopic comparison of allogeneic grafts with rejection, syngeneic grafts, and chronic pancreatitis. 199 30

Temporal (giant cell) arteritis is a systemic granulomatous vasculitis primarily involving branches of the carotid arteries in patients aged 50 years and greater. Its classic symptoms and signs are headache and elevated erythrocyte sedimentation rate (ESR), but this is not the only presentation. This case is the first reported in a Korean, whose chief complaint was pain in the tongue and headaches and whose ESR was normal. The diagnosis was confirmed by biopsy. Her symptoms abated when treated with prednisone, but she developed diabetes mellitus, osteoporosis, and compression fracture of lumbar vertebrae while being treated. Primary physicians should become aware of the atypical features of this disease, as well as the potential complications of treatment.
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PMID:Temporal arteritis: an atypical presentation. 202 22

The value of plasma renin and its inactive precursor, prorenin, were examined as a marker for vasculitis in rheumatoid arthritis (RA). Plasma renin and prorenin rise when the renin-angiotensin system is activated; an isolated increase of prorenin may be a marker for microvascular complications in diabetes mellitus. Renin concentrations in plasma obtained from 34 patients with RA (seven with vasculitis, 27 controls) were measured under standard conditions, before and five days after stopping non-steroidal anti-inflammatory drugs; creatinine clearance was also measured. At first the median renin concentration in the patients with vasculitis was 19 (range 12-63) mU/l (normal less than 61 mU/l) and in the controls 9 (3-43) mU/l. The median prorenin concentration in patients with vasculitis was 233 (144-428) mU/l (normal less than 358 mU/l) and in the controls 144 (25-364) mU/l. Renin and prorenin concentrations increased significantly in both groups after withdrawal of nonsteroidal anti-inflammatory drugs. The creatinine clearance was similar in both groups and did not correlate with renin concentrations. In conclusion, it was found that, unlike patients with diabetes mellitus, patients with RA with vasculitis had slightly raised concentrations of both renin and prorenin. These findings signal activation of the renin-angiotensin system and might indicate early cardiac or renal involvement by vasculitis.
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PMID:Raised plasma renin and prorenin in rheumatoid vasculitis. 220 Mar 59

The Cellular and Molecular Age of Nephrology has dawned and the future is remarkably exciting. The successful attack on the major causes of renal disease, including genetic diseases, glomerulonephritis, diabetes, vasculitis, acute renal failure, and hypertension, will necessitate improved knowledge about pathogenesis. This new knowledge will allow early detection and target-specific therapies, the array of which is only limited by our imagination. The challenge to be an active player in this exciting future as a physician-scientist in the field of nephrology is indeed a rare opportunity.
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PMID:The future of nephrology. 223 60

Mucormycosis is an uncommon infection caused by fungi of the order Mucorales. During an 8-year period, mucormycosis was diagnosed in 13 patients from three Madrid hospitals. There were 8 males and 5 females, with ages ranging from 21 to 75 years (mean 45 years). There were several underlying diseases, and 4 patients had more than one. Five had diabetes mellitus, 4 chronic renal failure, 2 acute myeloblastic leukemia, 2 were narcotic abusers and were infected by the human immunodeficiency virus (HIV), 1 had non-Hodgkin's lymphoma, 1 was a carrier of a renal allograft and 1 had systemic necrotizing vasculitis. There were different clinical presentations: rhino-orbital in 3, paranasal in 2, cutaneous in 2, pulmonary in 2, primary cerebral in 2, rhinocerebral in 1, and peritoneal in 1. The diagnosis was made during the first week in 6 patients, in the second week in 4, and it was delayed for more than one month in 2. Fresh examination of clinical samples was carried out in 3 patients and hyphae were visualized in all 3. Cultures were taken in 10 patients and they were positive in 7. All isolates were identified as Rhizopus sp. One patient died within 24 hours without being treated, 12 were treated with amphotericin B and 9 received surgical therapy. Six patients (46%) died. The involvement of central nervous system and the absence of surgical therapy were associated with a poor outcome. These results indicate that mucormycosis can develop in several clinical contexts and has a varying clinical presentation. It is a potentially curable infections when early diagnosed and appropriately treated.
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PMID:[Mucormycosis. The disease spectrum in 13 patients]. 239 7

Optic disc neovascularization, anterior and posterior ischemic optic neuropathy (AION and PION), diabetic papillopathy and Wolfram's syndrome are known conditions affecting the optic nerve in diabetics. Analysis of frequencies of AION in diabetes and two cases with and without background diabetic retinopathy are reported. The literature concerning the pathogenesis of diabetic papillopathy and its clinical similarity to optic disc vasculitis are briefly discussed.
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PMID:Diabetic optic neuropathies: clinical features. 245 85

Nailfold capillaries may be visualized in vivo using a simple non invasive microscopic technic. The assessment of capillary flow disturbances and organic microangiopathies is therefore rendered possible through capillary microscopy. Three kinds of clinically significant morphological abnormalities can be easily recognized: megacapillaries are huge capillaries with a diameter greater than 50 microns. They are mainly found in progressive systemic sclerosis and dermatomyositis, together with avascular areas and pericapillary edema; ramified capillaries are neovessels, most frequently related to subclinical cutaneous vasculitis; capillary hemorrhages may be induced either by active microangiopathies, or by deep vasomotor changes. The semiological consistency of these abnormalities makes capillary microscopy a valuable procedure for the early recognition of connective tissue diseases and the evaluation of vasomotor disturbancies in children as well as in adults. Further investigation of other microangiopathies like purpura rheumatica and diabetes are needed.
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PMID:[Peri-ungual capillaroscopy in pediatric practice]. 245 85

We placed 20 bypass grafts to the lateral plantar artery in 18 extremities to salvage feet with wet (12) or dry (six) gangrene; 15 grafts were implanted in men (75%), and five were implanted in women (25%). The median age was 65 years. All except two patients had diabetes; eight were treated with insulin. One patient had Buerger's disease, and another had vasculitis with chronic lymphocytic leukemia. History of smoking (65%), hypertension (53%), heart disease (71%), and osteomyelitis in the foot (35%), were noted. Cultures were positive in 15 gangrenous feet, 11 with gram-negative bacilli. Four long femoroplantar bypasses were placed. Ten short grafts were placed from the popliteal artery, and six jump grafts were placed distal to a femoropopliteal or tibial bypass. Hospital stay ranged from 8 to 38 days (median 16 days), and there were two in-hospital deaths. Transmetatarsal or button toe amputations were performed in nine feet. There were two below-knee amputations, one with a patent graft, for a foot salvage rate of 89% at 2 months. In four instances the gangrenous ulcers took longer than 6 months to heal; all other wounds healed within 6 months. The primary and secondary patency rates were 85% at 1 month, and 73% at 3 months and thereafter. Four of five graft failures occurred in the two legs with repeat bypass graftings. All patients with successful revascularization are able to walk, and seven returned to work full time.
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PMID:Lateral plantar artery bypass grafting: defining the limits of foot revascularization. 281 May 37

Infants of diabetic mothers are considered to be at increased risk of fetal distress. We suggest that umbilical vasculitis is strongly associated with abnormal fetal rate patterns, which indicate fetal tissue hypoxia even in the absence of clinical evidence of intrapartum infection. In the present series, 132 term deliveries with Class A diabetes mellitus were compared with 159 uncomplicated term deliveries. Umbilical vasculitis and gestational age greater than 281 days were both highly correlated with abnormal fetal heart rate patterns in diabetic pregnancies (p less than 0.001). These effects were shown to be independent by multiple logistic regression. There was no difference in mean birthweight between infants of diabetic mothers and those of uncomplicated pregnancies, but infants of diabetic mothers had heavier placentas (p less than 0.01). These data further support our hypothesis that umbilical vasculitis may affect umbilical hemodynamics and predispose to development of fetal heart rate patterns.
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PMID:Placental pathology and abnormal fetal heart rate patterns in gestational diabetes. 281 98

We studied risk factors and presumed causes of infarct in 100 consecutive patients with a first stroke, who had an appropriate CT-proven infarct in the territory of the deep perforators from the carotid system (ITDPCS). The infarct involved the territory of the lenticulostriate arteries in 65 cases, the anterior choroidal artery in 23 cases, watershed zones between these two territories in four cases, and another territory in eight cases. In 42% of the patients, we felt the cause of the infarct to be small-artery disease. In 36%, at least one source of embolism was present (in 27% from the internal carotid artery, in 17% from the heart), either with (25%) or without (10%) associated hypertension (HT) and diabetes mellitus (DM). Other possible less common etiologies included migraine, syphilitic angiitis, and systemic diseases. We have confirmed that HT or DM are the most common etiologic factors of ITDPCS. However, large-artery disease and cardioembolism may be more important than previously assumed.
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PMID:Infarcts in the territory of the deep perforators from the carotid system. 292 74


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