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

One hundred and forty-five patients with confirmed endometrial carcinoma treated at Kumamoto University Hospital were studied from the clinicopathological point of view. As risk factors, the incidence of high age, postmenopause, atypical genital bleeding, sterility, nulliparity, diabetes mellitus, hypertension and obesity was showed to be high. These factors may be expected to assist in screening for early diagnosis by using each factor or combination of factors. As prognostic factors, we examined the relationship between stage, depth of myometrial invasion, histological grade, histological type and survival rate. The stage was shown to be a most important predicator of survival. The depth of myometrial invasion and the histological grade closely correlated with the stage. The relationship between the histological subtype, especially papillary serous carcinoma (PSC) and prognosis, was investigated in our series of studies. PSC found in an incidence of 9.4% had a relatively poor prognosis compared with endometrioid carcinoma. Its 5-year survival rate was only 30%. Because PSC has a potential for aggressive invasion and rapid metastasis as compared to endometrioid carcinoma, careful histological examination and aggressive treatment are warranted.
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PMID:[Clinical studies of 145 cases of endometrial carcinoma--analysis of prognostic factors, especially pathological types]. 377 1

This review of the epidemiologic and endocrinologic literature aims to improve understanding of the etiology of premalignant breast disease. Although there are inconsistencies regarding the clinical symptoms defined as benign breast disease, there are 2 major clinical categories: cysts treated by aspiration and solid lesions treated by excision or incision biopsy. A necessary research approach is to determine which patients with benign breast disease have an increased risk of breast cancer and study them to determine whether they carry any endocrine or biologic stigmata. Epithelial hyperplasia is the lesion with greatest premalignant potential. Both population and case-control studies have examined the association between benign breast disease and the risk factors of age, reproductive history, family history of breast cancer, obesity, socioeconomic status, race, oral contraceptive use, and methylxanthines. No clear or consistent endocrine or hormonal abnormalities have been detected in women with benign breast disease. On the other hand, cyst fluid studies have revealed high amounts of androsterone sulfate and DHA-sulfate compared with serum levels. Carcinoembryonic antigen levels are highest in women with fibrocystic disease. At this point, it is unclear whther the progression from normal epithelium through atypia and hyperplasia and then in in situ carcinoma or invasive carcinoma is under hormonal control. Inconsistencies within the research literature may reflect the heterogeneity of conditions encompassed within the benign breast disease category. Since epithelial hyperplasia is likely a forerunner of breast cancer, such patients should be monitored to determine whether they exhibit a consistently abnormal pattern of hormonal production, e.g., subnormal androgen levels or elevation of free estradiol.
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PMID:Epidemiology and endocrinology of benign breast disease. 390 25

Fat has been used in many studies on magnetic resonance (MR) imaging as the tissue of reference in comparing regional signal intensities from various tissues using different imaging parameters. This is a retrospective study of 78 patients selected to assess the influence of different factors such as age, gender, obesity, and weight loss on the T1 and T2 relaxation parameters of fat in different areas of the body. The T1 values of fat were not influenced by the factors studied or by anatomic location of the fat. The T2 values were significantly lower in patients older than 65 years and in patients with significant weight loss caused by carcinoma or chronic disease. Nevertheless, these variations were small, with considerable overlap of the mean and rather large standard deviation values. In conclusion, fat is a valuable reference tissue for MR studies and is relatively uninfluenced by the factors studied.
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PMID:MR imaging of fat. 394 Mar 97

Pulmonary resection was performed electively through a median sternotomy in 174 patients. The first 61 of these patients were compared with an equal number having pulmonary resection through a lateral thoracotomy. Both groups were similar in regard to sex, age, pathological condition, and type of resection. The patients undergoing median sternotomy had a shorter operative time and less postoperative pain, and were discharged from the hospital sooner than the patients having resection through a lateral thoracotomy. The cardinal technical essentials to expeditious pulmonary resection through a median sternotomy involve unilateral pulmonary ventilation with a double-lumen endotracheal tube, arterial pressure and gas monitoring, and proper lung packing and retraction. Two patients died, 1 of infection and 1 of bleeding; neither death was related to the incision. Certain pulmonary procedures are better performed through a lateral thoracotomy, and these include resection of a superior sulcus carcinoma, pulmonary resection with posterior chest wall extension, and left lower lobe resection in patients who demonstrate obesity, cardiomegaly, or an elevated diaphragm.
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PMID:Median sternotomy as a standard approach for pulmonary resection. 394 62

The clinical records and pathologic specimens from 150 patients with endometrial carcinoma were reviewed to test the hypothesis that constitutionally predisposed patients with evidence of endogenous hyperestrinism (i.e., obesity, hypertension, diabetes, nulliparity, leiomyomata, adenomyosis) have a more benign form of carcinoma than do patients who do not fit this profile. Our results do not support this hypothesis, but do reveal certain other prognostic indicators, in addition to factors relating to the tumor itself, including stage, grade, histologic type, and extent of invasion. These indicators include: (a) age and menopausal status--women over 50 years of age, and more impressively, postmenopausal women of any age, have less favorable histology, staging, and survival; (b) race--black women have higher-grade tumors, higher-stage tumors, and poorer survival rates than white women; (c) hyperplasia--when hyperplasia is found in the biopsy, curettage, or hysterectomy specimen, the accompanying carcinoma is of a much more favorable type and extent, and survival rates are significantly better. The reasons for these correlations are not fully understood, and possible explanations are discussed. There may be two distinct patterns of endometrial carcinoma: a prognostically favorable one arising on a background of hyperplasia predominantly in premenopausal women, and a prognostically unfavorable one, occurring principally in postmenopausal women without hyperplasia. Empirically, we advise pathologists to comment on the presence or absence of hyperplasia in any specimen in which endometrial carcinoma is diagnosed.
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PMID:Endometrial carcinoma: nontumor factors in prognosis. 401 9

There is a 'futile' cycle of unknown significance operating at a very rapid rate (about 40 percent that of the total central fat droplet's daily turnover rate) in white adipose tissue of normal mice. The futile cycle may be measured and studied because it occurs in a region of the adipose tissue that has poor anatomical contact with the capillaries coupled with a high affinity of the adipocytes, plasma membranes for the FFA in the ECF. The cycle is drastically inhibited in mice bearing the Ehrlich ascites carcinoma, a transplantable tumor; the inhibition is associated with a 20-fold increase in the FFA pool size of the epididymal fat pad (measured directly) and a 70 percent reduction in the TGFA pool that is involved in the cycle (estimated indirectly from kinetic measurements). However, the mass of TGFA in the central lipid droplet was being conserved in the tumor-bearing mice during this study. The TGFA pool involved in the cycle represents only about 1 percent of the total adipose tissue TGFA. The relation of this futile cycle to adipose TGFA turnover, plasma FFA turnover and oxidation to CO2, dietary sources of TGFA, and the loss (and preservation) of body fat in cancer-bearing animals was considered in terms of a simple model. Although the significance of the altered futile cycle is unknown, the new approach described here, coupled with other quantitative tracer and non-tracer measurements, may prove useful in understanding factors that lead to obesity or body fat loss.
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PMID:In vivo tracer studies of perturbed fatty acid transport and metabolism in adipose tissue. 406 21

This prospective study determines the presence of a consistent endocrine disturbance in patients with endometrial carcinoma. A major requirement of the study was an unbiased control group matched as to age, race, economic status, and primary reason for referral. All patients with untreated endometrial carcinoma or postmenopausal bleeding were studied and grouped into: 1) endometrial carcinoma (n=56), and 2) atrophic endometrium (n=83), or the "bleeding" controls. Average age of patients with carcinoma was 63.9 years and that of controls, 61.3 years. Factors studied were glucose metabolism, estrogenic activity, gonadotropin excretion, obesity, hypertension, time of climacteric, fertility, and menstrual history. By averaging deviations from ideal weight, cancer patients were found to be 13.1 pounds heavier than the control group (49.8 pounds vs. 36.7 for the controls). Analysis of fertility data showed that age at time of marriage in patients who were parous compared with those who were nulliparous was 20.1 and 26.8 years respectively for the carcinoma group, and 20.4 and 27.5 years for the bleeding controls. Of parous cancer patients, 6.3% used contraception vs. 13% of the controls. These data do not suggest that pregnancy prevention by late marriage or contraception plays a significant role in the later development of endometrial carcinoma. Hypertension, time of menopause, diabetes, estrogenic activity, and gonadotropin excretion did not exhibit significant effects in the development of carcinoma. The findings support those of Corscaden, Fertig, and Gusberg that obesity and infertility are statistical concomitants with endometrial carcinoma but contradict current belief that there is direct evidence of abnormal endocrine state (e.g., glucose metabolism, estrogen stimulation, or anterior pituitary activity).
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PMID:Endocrine factors in endometrial carcinoma. A preliminary report. 601 48

Three patterns of hepatocyte injury in man, direct, immunological, and cholestatic, are described. The characteristics of the direct pattern are predominantly mitochondrial damage, central (zone 3) necrosis, and, usually, fatty change. It can be subdivided into the alcohol type (also seen with obesity, in diabetes, as a reaction to perhexiline, in Wilson's disease, and in Indian childhood cirrhosis) and the Reye's syndrome type (also seen with tetracycline toxicity, fatty liver of pregnancy, and cytotoxic drugs). Reactive drug metabolites, metal poisoning, and anoxia are also associated with the direct pattern of hepatocyte injury. The immunological pattern is characterised by damage to cell membranes with piecemeal necrosis of periportal (zone 1) hepatocytes and mononuclear-cell infiltration. Examples include chronic active hepatitis, primary biliary cirrhosis, and drug reactions such as those to halothane. In the cholestatic pattern there is disturbance of the bile-secretory mechanism with retention of bile within the hepatocytes. Cholestatic liver injury may be intrahepatic, as in sex-hormone cholestasis, or extrahepatic, as in choledocholithiasis or carcinoma of the bile ducts. Identification of the type of hepatocyte injury is valuable in diagnosis, in assessing prognosis, and in selecting treatment.
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PMID:Patterns of hepatocyte injury in man. 612 Dec 33

Serum beta 2-microglobulin was determined in 53 patients with chronic liver diseases. No elevation was shown in fatty liver due to obesity or alcoholism. Serum beta 2-microglobulin was abnormal only in 4% of the patients with chronic hepatitis. Determination of serum beta 2-microglobulin seems not useful for the differential diagnosis between chronic hepatitis and fatty liver due to obesity or alcoholism. Serum beta 2-microglobulin was elevated in 29% of the patients with alcoholic liver cirrhosis, in 41% of those with non-alcoholic liver cirrhosis, and in 75% of those with primary liver carcinoma. The average serum beta 2-microglobulin concentration was significantly higher in non-alcoholic liver cirrhosis than in alcoholic liver cirrhosis. There was a significant correlation between serum beta 2-microglobulin and gamma-globulin concentrations in liver cirrhosis.
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PMID:Serum beta 2-microglobulin in chronic liver diseases. 617 12

Adrenocortical tumors can be divided into two groups based on their histopathological characteristics, i.e., benign (adenoma) and malignant (carcinoma), and also classified as functioning (or hormonal) and non-functioning (or non-hormonal) tumors, depending on the presence or absence of recognizable clinical syndromes due to excessive steroids. The syndrome of functioning adrenocortical tumors includes Cushing's syndrome, primary aldosteronism and the adrenorge genital syndrome, of which a minority presents most of the specific clinical features: Cushing's syndrome; red face, typical moon face, truncal obesity, and purplisch red striae, primary aldosteronism; muscle weakness, noctural polyuria, hypertension and hypokalemia, adrenogenital syndrome; virilization or feminization, but many of them present complete clinical picture. The diagnosis of these syndromes needs to measure urinary 17-OHCS and 17-KS and plasma concentrations of cortisol, aldosterone, dehydroepiandrosterone (DHEA) and the other steroids. Dexamenthasone suppression test, various stimulation tests and the measurement of plasma ACTH are also useful for diagnosis. Usually, adrenocortical tumors can be detected preoperatively by physical examination or radiographic studies. Some are massive enough to be palpable through the abdominal wall. Some are large enough to cause displacement of the kidney, as seen intravenous urography. Most are visible by adrenal scintigraphy using 131I-iodocholesterol, computerized tomography, or adrenal arteriography. The standard treatment for adrenocortical tumors are surgical resection. Unresectable adrenocortical carcinomas may be treated with an adrenocorticolytic drug, o'p'-DDD. Metyrapone and aminoglutethimide can be also employed to inhibit the production of steroids.
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PMID:[Diagnosis and treatment of adrenocortical tumors]. 631


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