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

Tractional retinoschisis and tractional retinal detachment are both complications of proliferative diabetic retinopathy. The two conditions are frequently confused because they are similar in diagnostic features. We determined the respective incidence of tractional retinoschisis and tractional retinal detachment in 200 eyes with tractional elevations of the retina in patients with diabetes. In 39 eyes, the diagnosis was unequivocally tractional retinoschisis because the retinal elevation maintained its concave contour despite the development of retinal holes. In 65 eyes, tractional retinal detachment was diagnosed with equal certainty, either because pigment lines were present or because the elevation, after a retinal hole developed, rapidly became convex and extended to the ora serrata. The remaining 96 eyes, in which retinal holes or pigment lines were absent, were classified by other features that had been tested for significance in the already diagnosed eyes. On that basis, the diagnosis was retinoschisis in 46 eyes and retinal detachment in 50 eyes.
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PMID:Tractional elevations of the retina in patients with diabetes. 154 16

Heart transplantation (HTx) has now become an accepted treatment modality for end-stage heart disease. The limited supply of suitable donor organs imposes constraints upon the decision of who should be selected for transplantation. Usually patients are candidates for HTx, who remain NYHA functional class III or IV despite maximal medical therapy. Further criteria are low left ventricular ejection fraction (less than 20%) with heart rhythm disturbances class IIIA-V (LOWN), which are associated with poor prognosis. Additionally, the suffering of the patient and also the course of heart failure are essential for judging the urgency of HTx. Contraindications are absolute in patients with untreated infections, fixed pulmonary vascular resistance (PVR) above 8 WOOD-degrees, severe irreversible kidney and liver disease, active ventricular or duodenal ulcers and acute, psychiatric illness. HTx is relatively contraindicated in patients with diabetes mellitus, age over 60 years, PVR above 6 WOOD-degrees and an unstable psychosocial situation. To prevent rejection of the transplant heart, live-long immunosuppressive therapy is needed. Most immunosuppressive regimes consist of Cyclosporine A and Azathioprine (double drug therapy) or in combination (tripple drug therapy) with Prednisolone. For monitoring of this therapy, control of hole blood cyclosporine A level and white blood count is needed. Rejection episodes can be suspected if there is a greater than 20 mmHg decrease of systolic blood pressure, elevated body temperature, malaise, tachycardia or heart rhythm disturbance. The diagnosis of cardiac rejection can be established by endomyocardial biopsy. Measurement of the voltage of either the surface or intramyocardial ECG, echocardiography with special consideration to early left ventricular filling time as well as immunological methods are additionally used tools. Graft sclerosis as the main risk factor of the late transplant period remains an unsolved problem.
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PMID:[Therapy of terminal heart failure using heart transplantation]. 192 Dec 33

Effects of constant and pulsatile i.v. insulin delivery were examined in seven healthy subjects by means of euglycemic clamp technique. Each subject received constant insulin infusion (0.175 mU/kg.min) or insulin pulses at 12-min intervals (2.1 mU/kg) in randomized order for 8-h periods (08.00-16.00 h). Endogenous secretion of insulin was inhibited by concomitant administration of somatostatin (300 micrograms/h). Serum insulin concentrations during constant infusion (12 +/- 1 microU/ml) did not differ from basal values (11 +/- 1 microU/ml). Pulsatile insulin delivery resulted in oscillations of mean concentrations between values of about 10 and 20 microU/ml. Mean blood glucose concentrations during experiments were kept at 80 +/- 1 mg/dl, irrespective of the mode of insulin administration. Moreover, dextrose requirements for maintenance of these glucose concentrations did not differ over the hole periods of examination. We conclude that effects of constant and pulsatile delivery of basal amounts of insulin are not different. This at least applies to peripheral, short-term insulin administration in somatostatin-treated normal man, during an euglycemic clamp.
Diabetes Res Clin Pract 1988 Apr 06
PMID:Similar effects of pulsatile and constant intravenous insulin delivery. 328 66

Of 52 patients (39 women and 13 men; mean age, 65 years) with idiopathic macular cysts or holes, 17 had bilateral involvement. During a mean follow-up period of 28 months, 50% of the macular cysts progressed to holes. Eight of nine eyes with cysts and visual acuities of 6/15 (20/50) or worse at the initial examination developed holes. No holes developed in eyes that had not had cysts at the initial examination. This demonstrated the importance of examining the fellow eye when making a prognosis. Posterior vitreous detachment was present in all the eyes with macular holes and absent in all the eyes with macular cysts at the initial examination. Whenever a cyst progressed to a hole, posterior vitreous detachment also developed. Twenty-five patients had systemic hypertension, 31 had undergone a hysterectomy, taken systemic estrogen, or both, three had adult-onset diabetes mellitus, and 12 smoked cigarettes.
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PMID:Clinical features of idiopathic macular cysts and holes. 709 Dec 63

The tumoral lesions proceeding of ovary in the newborns are the 3-6% of all abdominal tumors. The most frequent tumor is ovarian follicular cyst which will be diagnosed prenatally. As a result of ovarian stimulation by fetal gonadotrophins, maternal estrogen and placenta + gonadotrophins. Maternal antecedents reported diabetes, toxemia and isoimmunization. The most frequent complication is torsion. We present the case of one female newborn, with abdominal mass present by abdominal palpation referred of the first gestation of mother with 27 years of age, with primary sterility of 11 years without treatment, with toxemia during the pregnancy. The abdominal x-film show a intraperitoneal mass the ultrasound show cystic and solid mass, without determined origin, and the scan magnetic resonance (MR) a tumoral mass with origin in the pelvic hole with extension to the infrahepatic zone. The surgical finding was left ovarian cyst with left oophorectomy and salpingectomy.
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PMID:[A giant follicular cyst of the ovary in a newborn infant]. 842 51

The chronic subdural hematoma (CSH) is a disease in elderly patients beyond the 5th decade. Treatment of CSH is normally a burr hole trephination and subdural drainage. Although this technique is simple, lethality is reported to be up to 20% in literature. The records of 314 patients with CSH were analyzed. Attention was focussed on complicating diseases and distribution of age. Patients were categorized neurologically before and after trephination using the Bender scale. The portion of patients suffering from cardiological diseases was 14.3%, 6.7% were treated by anticoagulants because of cardiac valve implant. Alcoholics were found in 15.9% of patients and hypertension in 12.8%. Complicating diseases were found in 51.3% of patients. Multiple internal diseases are likely to affect prognosis more than hematoma thickness. These patients also brought about a higher rate of infection (4.8%), secondary hemorrhages (2.5%), pneumonia (3%) and seizures (5%) after trephination. Lethality was highest in patients with diabetes mellitus, cardiogenic diseases and hypertension as well as in elderly patients. The latter have also a poor post-operative outcome: 22 patients died. In contrast to hematoma thickness and midline shift, which do not have any influence on outcome, prognosis is mainly determined by age, complicating diseases, hypertension and diabetes mellitus. The chronic subdural hematoma is often found in multi-morbid patients.
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PMID:[Treatment outcome in patients with chronic subdural hematoma with reference to age and concurrent internal diseases]. 917 74

Recurrence of chronic subdural hematoma after burr-hole craniostomy and closed system drainage is not uncommon. We sought to identify risk factors for recurrence. In 121 patients, various factors including age, initial neurologic status, hematoma thickness, computed tomographic density of the hematoma, midline shift, multiplicity, systemic disease, and drainage volume were compared retrospectively between nonrecurring cases and recurring cases. Recurrence was noted in 10 cases (8.3%). In recurring cases, the drainage volume was significantly larger than in nonrecurring cases, and the recurrence rate increased in proportion to drainage volume. Other factors significantly influencing recurrence were hematoma thickness and associated diabetes mellitus. Drainage contents mainly derived from either exudate within the subdural membrane or cerebrospinal fluid leakage. Entry of cerebrospinal fluid into the hematoma cavity or continuing leakage of serum components through opened endothelial gap junctions are considered to be major causes of increased drainage volume, leading in turn to recurrence of the hematoma.
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PMID:Recurrence factors for chronic subdural hematomas after burr-hole craniostomy and closed system drainage. 1031 36

Recent studies demonstrated that engagement of cytotoxic T lymphocyte antigen 4 (CTLA-4)/(CD152) generates an inhibitory signal to T cells which arrests an on-going immune response. Since aberrant CD152 activity is thought to contribute to autoimmunity, we examined the effect of CD152-mediated inhibitory signals on the response to self and foreign antigens in autoimmune, diabetes-prone NOD and non-autoimmune BALB/c mice. The interaction of CD152 with its ligand B7 was prevented by treating the mice with anti-CD152 blocking antibody, before and following immunization of the mice with the self-antigen, syngeneic islet cells, or the foreign antigen, key-hole limpet hemocyanin (KLH). CD152 blockade in BALB/c mice stimulated a robust islet-specific T cell-mediated immune response compared to control antibody-treated mice. The augmentation of T cell responses in BALB/c mice was consistent with the role proposed for CD152 as a down-regulator of T cell activation responses. Furthermore, CD152 blockade unmasked islet cell specific autoreactive T cells in the non-autoimmune BALB/c mouse. Conversely, CD152 blockade in NOD mice failed to regulate islet-specific auto-reactive T cell responses. However, CD152 blockade enhanced the T cell response to the exogenous, foreign antigen KLH in both non-autoimmune BALB/c and autoimmune NOD mice. Collectively, these results suggest that there is not a global defect in CD152-mediated regulation of peripheral T cell immune responses in NOD autoimmune mice but rather, a defect specific to T cells recognizing self antigen.
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PMID:Cytotoxic T lymphocyte antigen 4 (CD152) regulates self-reactive T cells in BALB/c but not in the autoimmune NOD mouse. 1067 43

Susceptibility to murine and human insulin-dependent diabetes mellitus correlates strongly with major histocompatibility complex (MHC) class II I-A or HLA-DQ alleles that lack an aspartic acid at position beta57. I-Ag7 lacks this aspartate and is the only class II allele expressed by the nonobese diabetic mouse. The crystal structure of I-Ag7 was determined at 2.6 angstrom resolution as a complex with a high-affinity peptide from the autoantigen glutamic acid decarboxylase (GAD) 65. I-Ag7 has a substantially wider peptide-binding groove around beta57, which accounts for distinct peptide preferences compared with other MHC class II alleles. Loss of Asp(beta57) leads to an oxyanion hole in I-Ag7 that can be filled by peptide carboxyl residues or, perhaps, through interaction with the T cell receptor.
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PMID:A structural framework for deciphering the link between I-Ag7 and autoimmune diabetes. 1077 8

The effect of diabetes on the emotional behavior of mice was examined using an automatic hole-board apparatus. Changes in the emotional state of mice were evaluated in terms of changes in exploratory activity; i.e., total locomotor activity, numbers and duration of rearing and head-dipping, and latency to the first head-dipping. The number and duration of head-dipping in diabetic mice were less than those in non-diabetic mice. Diazepam (0.1-0.56 mg/kg, i.p.) dose-dependently increased the number and duration of head-dipping at doses that did not produce sedation in both diabetic and non-diabetic mice. In contrast, methyl-beta-carboline-3-carboxylate (1 and 2 mg/kg, i.p.) decreased the number and duration of head-dipping in non-diabetic mice, but not in diabetic mice. The number and duration of head-dipping in diabetic mice were increased by treatment with flumazenil (0.1 and 0.3 mg/kg, i.v.). These doses of flumazenil did not affect the number or duration of head-dipping in non-diabetic mice. The present data indicate that diabetic mice exhibited anxiety in the hole-board test and that a benzodiazepine receptor antagonist affected the attenuated number and duration of head-dipping in diabetic mice. The heightened anxiety in diabetic mice may be due to the dysfunction of the benzodiazepine receptor and/or of central inhibitory systems.
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PMID:Modification of the effects of benzodiazepines on the exploratory behaviors of mice on a hole-board by diabetes. 1143 Apr 72


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