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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is normally a layer of fat in the breast between the parenchyma of the breast and the skin. This is frequently thin and does not preclude the palpation of a tumor mass which involves the breast parenchyma. In patients suffering from obesity this fat pad becomes much thicker and obscures any underlying masses arising from the breast parenchyma. A case is reported in which a woman who was markedly obese lost a significant amount of weight and presented a bulge which was found to be carcinoma. This situation, in which fat obscures underlying breast lesion, has been observed in a number of patients. Attention is called to the limited value of physical examination of the breast in markedly obese patients. If any suspicion exists or if the patient is a candidate for cancer from a familial standpoint, mammograms are indicated.
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PMID:Obesity obscuring breast cancer: a case report. 19 Apr 79

The jet-wash technique is an efficient method for diagnosing the endometrium carcinoma. Among 750 women we detected 50 endometrium carcinomata all of which were diagnosed by the jet-wash method. Wrongly positive findings do not exist in our series of examinations. Of the pre-stages of the endometrium carcinoma, such as adenomatous hyperplasia and adenocarcinoma in situ, however, only scarcely 50 per cent of all cases were diagnosed. The jet-wash method is also suited for outpatient clinics. Thus, patients with risk-factors for the endometrium carcinoma might be controlled annually once in outpatient clinics in addition to the usual cancer prophylactic examinations. Above all, we consider 1. patients suffering from bleeding anomalies as from the 40th year of age, 2. patients free from any symptoms, but suffering from obesity, hypertension and diabetes mellitus, 3. patients with an increased narcosis risk, 4. patients of the perimeno-pause prior to an estrogen treatment and 5. cancer post-care patients suffering from a primarily radiated endometrium carcinoma. The direct smears and the cytocentrifuge preparations can be diagnosed right on the day of examination. The thrombin cell block technique requires more work for a cytological laboratory. For a histological laboratory it might not mean any additional essential burden.
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PMID:[The diagnostic reliability of the jet-wash technique with regard to the diagnostic of endometrium carcinoma (author's transl)]. 57 Aug 31

113 cases of pancreatic and renal disease studied by both ultrasound and computed tomography (CT) were analyzed retrospectively. CT provided a diagnosis when pancreatic ultrasound was unsuccessful due to overlying bowel gas or obesity and when renal ultrasound was unsuccessful due to obesity, reverberations from ribs, small lesions, or multiple lesions. Conversely, ultrasound provided a diagnosis when CT was unsuccessful due to lack of fat planes or respiratory motion. CT usualy distinguished carcinoma from pancreatitis when ultrasound showed a focal echogenic mass. CT resolved renal cyst from neoplasm when ultrasound showed a mixed echo pattern mass.
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PMID:Complementary use of ultrasound and computed tomography in studies of the pancreas and kidney. 61 98

Malignant disease of the female reproductive organs accounts for over 11,000 deaths annually in the United States in patients over 65 years of age. Hormonal treatment is being used in some cases in conjunction with more conventional methods of treatment. Synthetic progesterone is used in the palliation of patients with advanced adenocarcinoma of the endometrium. A significant increase in the incidence of ovarian cortical stromal hyperplasia, obesity, diabetes and hypertension is found in these patients. For treatment of carcinoma of the ovary, a massive dose of an experimental progesterone agent, dimethylprogesterone (NSC-123018) is being tested in a group study. The treatment is used only for patients for whom conventional therapy has been unsuccessful. Although a few patients have shown remission, it is too early for conclusive results. Patients with advanced breast cancer and estradiol receptors in their tissue may show a favorable clinical response to hormonal therapy in 40-60% of cases. Patients lacking estrogen receptors have only a minimal chance of responding to hormonal therapy.
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PMID:Geriatric malignancies and their hormonal aspects. 83 Feb 45

Vulvar neoplasia as seen at the Johns Hopkins Hospital during a 38-year period (1935-1972) is reviewed. Of 1385 tissue specimens, 1053 were benign and 332 were malignant lesions. Of the malignant lesions, 246 were squamous cell carcinoma, both in situ and invasive. Of these, 192 were treated and followed and are reported on. There were 71 cases of in situ and 121 of invasive cancer. Of the patients, 64% were white and 36% were nonwhite, which corresponds to the patient population treated at the hospital. Ages of patients ranged from 21 to 86 years, with a median of 50 years. Of those with invasive cancer, 75% were postmenopausal and none was under the age of 30 years. There was a 29% incidence of nulliparity and a 64% incidence of obesity. Diabetes was noted in 64%. Syphilis was discovered in 26%. These patients had a high risk of being exposed to other venereal infections, particularly herpes which is suspect as a precursor of neoplasia. Vurrucous carcinoma are also likely to be of viral origin. Other malignancies were also present in 20% of patients. There was 1 case of chronic clyphocytic leukemia. Presenting symptoms were a lump, a white patch, pruritus, or bleeding. Pruritus was present in 46%. A leukoplakialike appearance was noted in most of the in situ lesions. Multicentric foci of origin were demonstrated in 35%, mostly in the in situ cases. Of the invasive cancers 60% were well differentiated and 11% were verrucous. Multiple histologic patterns were present in many cases. In 167 patients (67%), the initial treatment was surgical. Postoperative radiation was used in 30% of those with invasive cancer. Local recurrences followed in 22%. In those with multicentric foci the recurrence rate was 48%. 44 patients were known to have died, mostly from other causes. Survival was directly related to the stage of the disease at the time of initial diagnosis and treatment.
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PMID:Primary vulvar neoplasia: a review of in situ and invasive carcinoma, 1935-1972. 85 43

Plasma levels of estrone (E1), estradiol-17beta (E2), and estriol (E3), as well as follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin were measured in 30 control subjects and in 20 postmenopausal patients with adenocarcinoma of the endometrium. Within the sensitivity of the assay (5 to 10 pg.), no E3 was found. Mean levels of E1 and E2 in the patients with carcinoma (42.64+/-3.8 (S.E.M.) and 17.3+/-1.7 (S.E.M.) pg. per mililiter) were significantly higher than those measured in the control subjects (E1=26.97+/-2.4 (S.E.M.) pg. per mililiter, p less than 0.001; E2=12.08+/-1.2 (S.E.M.) pg. per milliliter, p less than 0.02). Effects of age, diabetic status, and obesity were taken into consideration. Significant differences in FSH and marginally significant differences in prolactin levels were observed between the two groups. Mean levels of FSH, LH, and prolactin in the control group and the group with adenocarcinoma, respectively, were as follows: FSH=152.3+/-7.0 (S.E.M.) versus 98.1+/-8.9 (S.E.M.) mI.U. per milliliter, p less than 0.001; LH=64.7+/-3.1 (S.E.M.) versus 66.5+/-5.2 mI.U. per milliliter, difference not significant; and prolactin=14.3+/-0.9 (S.E.M.) versus 17.8+/1.7 (S.E.M.) ng. per milliliter, p less than 0.06. These results, as well as previously reported alterations in human growth hormone secretion, suggest aberrations in hypothalamic function in endometrial carcinoma.
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PMID:Plasma levels of fractionated estrogens and pituitary hormones in endometrial carcinoma. 98 36

In 182 cases the jet wash technique proved very suitable in the detection of malignant changes in the endometrium. It should in no way replace the curettage as a diagnostic tool. The jet wash offers the possibility of a regular endometrial investigation to larger numbers of patients. Those to be considered in particular are 1. symptom-free women with an increased risk of carcinoma of the body of the uterus, i.e. women over 40 with obesity, hypertension and diabetes mellitus, 2. patients with recurrent bleeding who have already had a curettage with negative histological results, 3. primary irradiated endometrial carcinoma patients in order to detect a recurrence early, 4. patients who pose a high anaesthetic risk. The exact detection reliability of the endometrial jet wash technique remains uncertain until results of larger investigation series are published. Good experience up to now with the jet wash technique should stimulate its wider use.
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PMID:[Cytological investigations of the endometrium using the jet wash technique (author's transl)]. 124 86

The influence of host age on estrogen (ER) and progesterone (PR) receptor status was studied in 603 tumors obtained from women with confirmed diagnosis of breast carcinoma. Both ER and PR analysis were performed in our own laboratory using standard techniques. Tumors were classified as positive if minimum receptor contents were greater than 10 fmol/mg cytosol protein and if dissociation constants were 1-9 x 10(-10) M or lower. Data from our study indicate that the incidence of receptor negative (ER-PR-) tumors was higher in women from 21 to 40 years of age than in women from 41 to 60 years of age. In women over 60 years of age, the incidence of ER+PR+ tumors was higher than in women under 40 years of age. Interestingly, women from 51 to 60 years of age had a significantly lower incidence (P less than 0.06, 0.0001) of ER+PR+ but higher incidence (P less than 0.01) of ER-PR- tumors than women 41-50 or greater than 60 years of age. Analysis of steroid receptor distribution in relation to host age and obesity showed a definite tendency: in obese women over 60 years of age, frequency of ER+PR+ was significantly greater than in non-obese women of similar age groups. This altered ER and PR distribution in tumors is probably a result of difference in the hormonal milieu associated with host menopausal status and obesity.
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PMID:Steroid receptors in breast cancer patients. Influence of obesity and age at diagnosis. 150 26

Cyclophosphamide and other alkylating agents suppress ovarian function in pre-menopausal women. However, endocrine details remain unknown regarding the influence of patients' age and obesity on CMF-induced hormonal changes. We studied changes in endocrine profile due to chemotherapy (CMF) in 70 pre-menopausal patients with axillary node positive, stage II and/or III breast carcinoma. Plasma levels of estrone (E1), estradiol (E2), androstenedione (A2), luteinizing hormone (LH), and prolactin (PRL) were determined on day 1 and 8 of each chemocycle for 12 cycles. After receiving therapy, 23% of the women continued to have regular menstrual cycles (non-amenorrheic group). In the remaining 77%, ovarian function was suppressed, as evidenced by the onset of amenorrhea within 0-11 months (amenorrheic group). The mean time to amenorrhea was 2.83 +/- 0.33 months (SE). The time required to develop amenorrhea inversely correlated to the patient's age. Both incidence of amenorrhea and time to amenorrhea remained unaffected by either patient's obesity or the timing of chemotherapy initiation in relation to menstrual cycle phase (progestational, follicular). Plasma hormone levels fluctuated widely in both groups during the first three chemocycles. During chemocycle months 4 to 10, in the amenorrheic group, plasma E1, E2, and P declined to their baseline levels with a concomitant rise in LH levels. At this time, E1, E2, and P levels were significantly lower in amenorrheics, despite menstrual cycle associated fluctuations in the non-amenorrheic group. Estrogens (E1 and E2) gradually declined further following the onset of amenorrhea in subsequent months. Further data analysis suggests that host age or obesity did not influence CMF-induced changes in the plasma endocrine profile.
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PMID:Endocrine profile in breast cancer patients receiving chemotherapy. 155 88

A rare case of ACTH-independent Cushing's syndrome due to carcinoma is described. A thirty-year-old woman presented with systolic-diastolic hypertension, unsuccessfully treated for several months with ACE and beta-blockers. During this period physical changes such as centripetal obesity, rubeosis, and hair loss were observed. Elevated urinary and plasmatic cortisol levels were essential for the diagnosis. Alterations of the circadian rhythm with higher levels in the evening compared to the morning were registered. ACTH was found to be suppressed in several tests. Ultrasound and abdominal CT scan showed a mass involving the left adrenal gland. While waiting for surgery, the patient underwent ketoconazole therapy. The operation was carried out by bilateral chest laparotomy and consisted in a left adrenalectomy with regional lymphadenectomy. At 18 months from the operation the patient is in excellent health, the classic signs of Cushing's syndrome have disappeared and laboratory tests are normal.
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PMID:[A case report of Cushing's syndrome due to an adrenal carcinoma]. 158 Nov 62


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