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

Diagnostic significance of a simple and rapid screening procedure for determining the relative amounts of pancreatic and salivary isoamylase using an amylase inhibitor was evaluated in 242 subjects (controls 84, acute pancreatitis nine, chronic pancreatitis 28, pancreatic cancer 14, peptic ulcer 25, liver cirrhosis 15, cholelithiasis 24, irritable colon syndrome 13, diabetes mellitus 13, mumps seven, and chronic renal failure 10). Electrophoretically separated isoamylases of saliva and pure pancreatic juice were all inhibited at similar degrees to the corresponding unfractionated amylases. Total amylase and pancreatic isoamylase were elevated in all nine patients with acute pancreatitis. Pancreatic isoamylase was decreased in 12 of 28 patients (43%) with chronic pancreatitis and increased in nine of 14 patients (64%) with pancreatic cancer. The mean pancreatic isoamylase activity in the patients with acute pancreatitis was significantly higher (p less than 0.01), while that of chronic pancreatitis was significantly lower (p less than 0.05) when compared with controls. The inhibition method offers simple, rapid, and specific analysis of serum isoamylase for the differential diagnosis of hyperamylasemia in cases of emergency.
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PMID:Differential determination of serum isoamylase using an amylase inhibitor and its clinical application. 396 56

The association between a prior diagnosis of diabetes mellitus and cancer was examined in a large multisite case-control study based on interviews of 8220 white males and 6690 white females aged 30-89 who were admitted to Roswell Park Memorial Institute between 1957 and 1965 for the diagnosis and treatment of cancer. A prior history of diabetes mellitus as diagnosed by a physician was examined as a risk factor for cancer by conducting sex- and site-specific comparisons with a common control group of 2363 white males and 2475 white females who were admitted to the same hospital during the same years, but were found not to have cancer. The findings are consistent with previous studies which have shown diabetes to be a risk factor for cancer of the uterine corpus. A positive association was also noted between diabetes and cancer of the vulva and vagina. The evidence for excess estrogen levels as the underlying mechanism for increased risk of uterine and vulvo-vaginal cancer is reviewed. No consistent association between diabetes and pancreatic cancer was observed in this study, except when those cases in which diabetes was diagnosed within a year before the diagnosis of pancreatic cancer were included. This suggests that diabetes may be an early presenting sign of pancreatic cancer rather than a risk factor. A positive association between prior diagnosis of diabetes was noted for kidney cancer and nonmelanoma skin cancer in females only. No association between type of treatment (i.e. insulin, oral agents) and cancer risk was noted.
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PMID:Diabetes mellitus and cancer risk: a multisite case-control study. 399 58

Workers in the corn wet-milling industry are exposed to grain dusts, pesticides and fumigants, acids, solvents, sulphur dioxide, and other chemicals used in the manufacture of starch, oil, syrup, and dextrins. In a preliminary investigation of the long-term health effects of occupational exposures in this industry, deaths among active and retired corn wet-milling workers were identified from records of a trade union. Underlying cause of death for workers who died between 1947 and 1981 was determined from death certificates. Cause-specific Proportionate Mortality Ratios (PMR's) were computed for white and black males using US males as a comparison with adjustments for age, race, and calendar year of death. There were deficits of deaths from respiratory and digestive diseases. Among whites, mortality from chronic nephritis, bladder cancer, and lymphatic and haematopoietic malignancies was elevated. There was an elevated frequency of deaths due to diabetes and a threefold excess of pancreatic cancer deaths among blacks. Crude work history information indicated a small cluster of pancreatic cancer deaths among whites and blacks who had worked in production processes that convert corn starch to syrup and dextrins. An elevated frequency of deaths from leukaemia was seen among white maintenance workers.
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PMID:Proportionate mortality among male corn wet-milling workers. 405 10

In a series of 6,500 patients with diabetes mellitus there were 37 cases of primary carcinoma of the pancreas which significantly exceeded the expected number for the patient years at risk in both males and females (p less than 0.01). There was no evidence that pancreatic cancer was more common in patients with long-standing diabetes. The increased incidence of pancreatic cancer in diabetic patients is probably the result of patients presenting with the symptoms of diabetes as long as four years before the cancer becomes manifest. An underlying pancreatic tumour should be suspected when an elderly diabetic proves difficult to control and loses weight despite adequate treatment.
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PMID:Pancreatic cancer and diabetes mellitus. 624 87

Since May 1980 total duodenopancreatectomy for pancreatic cancer, which caused an operative mortality of 25% in former years, was replaced by a subtotal duodenopancreatectomy. This new technique is discussed in detail. Altogether 30 patients were operated since then without postoperative mortality. The procedure is tolerated by the patients much better than a total pancreatectomy. Only 40% developed diabetes postoperatively. At present 4/24 patients with ductal carcinoma of the cephalic pancreas are alive longer than 20 months. It seems, that subtotal duodenopancreatectomy is as an effective radical operation as total pancreatectomy, with a much lower operative risk for the patient.
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PMID:[Subtotal duodenopancreatectomy. A new surgical technic for cancer of the pancreas head]. 632 14

The precision of CA 19-9 RIA kit was evaluated by recovery, reproducibility and dilution test with very satisfactory results. The CA 19-9 value in sera from 52 healthy individuals and from 224 patients with gastric intestinal cancer and other benign disease, showed an increased positive rate in several cases of gastric intestinal cancer. For example, the positive rate in pancreatic cancer, bile duct cancer, colo-rectal cancer, gastric cancer, esophagus cancer, primary biliary cirrhosis diabetes mellitus, liver cirrhosis and chronic hepatitis was 60%, 75%, 55.6%, 45.6%, 20%, 28.6%, 22.7%, 13.7% and 1.7% respectively. By contrast, values from patients with acute hepatitis, fulminant hepatitis, fatty liver, gastric duodenal ulcer, pancreatitis, and primary liver cancer were within the normal range. In this study, CA 19-9 RIA were found to be significant as an adjunct in the management of patients with gastrointestinal cancer, especially pancreatic cancer, and bile duct cancer.
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PMID:[Serum determination of CA 19-9 in patients with digestive cancers and its diagnostic evaluation]. 658 10

A retrospective analysis of factors influencing short-term and long-term survival after total pancreatectomy for pancreatic cancer was done in 86 patients. Among the 41 factors studied, hospital mortality was significantly affected by age over 70 years, preoperative diabetes, pain as presenting symptom, S-bilirubin, preoperative bile drainage, prophylactic antibiotic treatment, stage of the tumor, and experience of the surgeon. The only factors which had a statistically significant influence on long-term survival were stage of the tumor and sex of the patient. It is concluded that improvement of long-term survival can mainly be achieved by earlier identification and removal of the tumors and by introduction of more efficient adjuvant therapy. Whereas these goals probably will require a long time to be reached, the majority of factors associated with worsening of hospital mortality may be avoided by a strict selection of the patient, the tumor and the surgeon.
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PMID:Factors influencing survival after total pancreatectomy in patients with pancreatic cancer. 663 61

The incidence of pancreatic cancer has increased recently. The average age of pancreatic cancer patients in our series was 60.6 years; the male to female ratio was 2.3:1. As for tumor location, the head (45.5%) was the most frequent followed by the body (32.7%) and the tail (20%). Pancreatic cancers were histologically classified as duct carcinoma (88.2%), acinar cell carcinoma (0.9%), islet cell carcinoma (1.8%) and undifferentiated carcinoma (9.1%). In 17 cases (15.5%), diabetes mellitus was an accompanying complication.
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PMID:[Evaluation of autopsy cases in pancreatic cancer]. 666 9

The prognosis of pancreatic adenocarcinoma is still very poor. Research activities have, however, been instituted recently in all fields. Epidemiologic studies indicate etiologic roles of diabetes mellitus, smoking, and meat and coffee consumption. Sonography of the pancreas is at present the best screening method. The significance of computerized tomography, endoscopic retrograde cholangiopancreatography (ERCP), arteriography and tumor markers is discussed. A TNM staging system and prognostic factors are presented. Resection is the treatment of choice for organ-limited pancreatic cancer. The development of new radiation modalities (e.g. pi-mesons) promises improved loco-regional tumor control. The most effective chemotherapy consists of combinations containing 5-fluorouracil, adriamycin and mitomycin-C. Intensive future research in the field of pancreatic cancer is essential if the prognosis of this devastating disease is to be improved.
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PMID:[Pancreatic cancer. Epidemiology, etiology, diagnosis and therapy]. 685 93

Hyperosmolar diabetic coma revealed the presence of a pancreatic cancer in two patients. The first case was a 59-year-old man, without a history of diabetes, treated with prednisone for jaundice and marked weight loss over the last month, and admitted in hyperosmolar coma (346 m0sm/l). After recovery from the acute episode, a diagnosis of adenocarcinoma of the head of the pancreas was established following operation. The patient died six months later. The second case, a 71-year-old man also without a history of diabetes, was admitted in hyperosmolar coma (315 m0sm/l) during the course of a pulmonary infection. Rapidly fatal cholostatic jaundice appeared one year later. An adenocarcinoma of the head of the pancreas was demonstrated at autopsy. The diagnostic criteria in both cases were those of hyperosmolar diabetic coma. Though cases of combined diabetes and pancreatic cancer are well documented, only one case of hyperosmolar coma and cancer of the pancreas has been reported in the published literature. The pathogenesis of hyperosmolar diabetic coma is discussed. The fact that it developed during the course of a pancreatic affection could be explained by a functional reduction in insulin secretion, associated with a triggering factor such as dehydration, infection, hypoglycemic agent administration, etc... The onset of hyperosmolar diabetic coma in an elderly patient without a history of diabetes, especially with associated marked weight loss, should lead to investigation for a possible pancreatic cancer.
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PMID:[Pancreatic cancer revealed by hyperosmolar coma: report on two cases (author's transl)]. 701 54


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