Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two obese patients suffering from neurogenic claudication caused by lumbar epidural lipomatosis are described. Although lumbar epidural lipomatosis is most often related to prolonged use of steroid drugs, obesity has also been reported as a possible cause. Both CT and MRI can demonstrate excess epidural fat; because of the possibility of sagittal views MRI is to be preferred. In one of our patient with neurogenic claudication the excess epidural fat normalised completely after considerable weight reduction and symptoms resolved. Therefore weight reduction might be the initial therapy in an obese patient with symptomatic epidural lipomatosis. When weight reduction fails or when there are urgent clinical reasons, surgical removal of the excess amount of epidural fat should be considered.
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PMID:Lumbar epidural lipomatosis causing neurogenic claudication in two obese patients. 792 88

Spinal extradural lipomatosis is rare and is usually associated with long-term steroid administration or obesity. It is most commonly thoracic in situation. We present a unique case of spinal extradural lipomatosis in a 20-year-old non-obese, clinically normal man. The role of MRI in investigation and the management options are discussed.
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PMID:Idiopathic spinal extradural lipomatosis in a non-obese otherwise healthy man. 794 27

A 33-year-old man was prescribed amfepramone 75 mg o.i.d. for the treatment of obesity. One week after onset of therapy, he suddenly became agitated and aphasic for several h. A CT scan of the brain was normal. Amfepramone was discontinued. Three days later, there was a second period of agitation and aphasia with a discrete right hemiparesis lasting 12 h. A repeat CT scan and a MRI of the brain were normal. On EEG and brain mapping, alpha-activity was absent over the left hemisphere and a left fronto-temporal delta-focus was found. A Tc-99m HMPAO brain SPECT showed a severe hypoperfusion of the left hemisphere. The next day, the neurological examination was completely normal. Two weeks later, EEG and SPECT had completely normalized. Transient ischemic attacks due to vasospasm were considered to be the most probable clinical diagnosis.
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PMID:Transient ischemic attacks associated with amfepramone therapy: a case report. 814 62

We report herein a case of a 30 year old male patient who consulted for a long standing obesity since childhood. Clinical examination reveals the presence of hypogonadism and gynecomastia without galactorrhea. Endocrine assessment showed an hypogonadotrophic hypogonadism with a moderate insufficiency of the adrenocortical axis. Neuro-ophthalmological examination disclosed an inferior bitemporal quadranopsia. MRI showed an extra-axial suprasellar mass, lightly hypointense in T1 and hyperintense in T2. After craniotomy and conservative biopsy, pathological examination of the tumor showed regular cells surrounded with collagen and reticulin marked with immunoperoxidase against S100 protein and GFAP (glial fibrinolytic acidic protein) strongly suggesting the diagnosis of juvenile pilocytic astrocytoma.
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PMID:[Hypothalamic astrocytoma presenting as obesity with hypogonadism]. 836 17

A 62-year-old male with small cell lung cancer (SCLC) associated with Cushing's syndrome and diabetes insipidus (DI) is reported. The patient was referred to our hospital for treatment of SCLC. A diagnosis of paraneoplastic Cushing's syndrome was made on the basis of an elevated serum ACTH (623.5 pg/ml) level, elevated excretion of urinary 17-OHCS (18.01 mg/day), obesity, hypertension, hyperglycemia, persistent hypokalemia, alkalosis, and no history of diabetes mellitus. He was also diagnosed as having DI based on polyuria and polydipsia, low specific gravity of the urine (1.007-1.010), low serum ADH (1.4 pg/ml) level, normal plasma osmolarity (29 mOsm/kg H2O), and the results of water deprivation test. DI and a left visual field defect was suggestive of metastasis to the pituitary region, but no lesion was detected by either CT scan or MRI scan. The patient failed to show a good response to intensive chemotherapy, and died of the tumor five months after commencing chemotherapy. Post-mortem examination revealed metastases to the hypothalamic-neurohypophyseal region, lungs, liver, adrenal glands, bone, bone marrow, and hilar and mediastinal lymph nodes.
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PMID:[A case of small cell lung cancer associated with diabetes insipidus and Cushing's syndrome]. 839 May 89

A 29 year-old woman with SLE was admitted to our department due to severe remitting headaches. Following investigation a high degree of intra cranial pressure was determined. Several years ago a similar finding was diagnosed, and the disease was brought into remission by the administration of periodical pulses of high dose intravenous immunoglobulins. Benign intracranial hypertension (BIH) is an uncommon presentation of neuro-psychiatric SLE. In this patient several risk factors of BIH (obesity, steroid therapy, and SLE) assembled and elicited a severe presentation of the disorder which became more resistant to therapy. Several pathogenic pathways tie BIH with SLE as thrombotic obliteration of cerebral arteriolar and venous systems and immune complex deposition within the arachnoid villi (that are responsible for CSF absorption). As shown in this care report of BIH, clinical findings do not always parallel various imaging techniques as MRI and CT brain scans.
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PMID:Pseudotumour cerebri in SLE. 860 94

The high incidence of breast cancer in Western women has been linked to nutritional factors such as high-fat/low-fibre diet, obesity and timing of weight gain. A mechanism is postulated through which the Western diet could act in conjunction with inadequate exercise and excessive weight gain at the time of a major change in hormonal balance. All these factors favour the manifestation of insulin resistance, and the concomitants of hyperinsulinaemia might then synergise with oestrogen in promoting the development of breast cancer. The mechanism is compatible with the 'breast tissue age' model of mammary carcinogenesis. The concomitants of hyperinsulinaemia could also influence the growth of established disease subsequent to its promotion, and it is suggested that the hypothesis be tested by an adjuvant randomised trial of a high-fibre/low-fat diet in patients following primary surgery for early breast cancer. It has been suggested that the development of insulin resistance may link the Western lifestyle not only to an increased risk of hypertension and arteriosclerosis, but also to increased breast cancer risk. Large abdominal fat deposits in women are frequently a marker of the presence of insulin resistance and are generally associated with an increased level of bio-available oestrogen. There is evidence that predominantly abdominal distribution of fat in women may be a marker of increased breast cancer risk from puberty onwards. Abdominal obesity may however be hidden, and it is more reliably demonstrated by imaging techniques such as CAT or MRI scans, than by anthropometric measurements such as increased waist-to-hip ratio.
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PMID:Obesity and breast cancer. 869 16

Spinal epidural lipomatosis (SEL) is defined as the deposition of loose fat tissue in the epidural space. Two cases are reported which illustrate the main features of this uncommon disease. Most frequently SEL is revealed by neurologic manifestations such as an acute chronic spinal cord compression. Corticosteroid therapy and obesity are the main factors able to induce the disease. The common location of the SEL at the thoracic spine is explained by the physiologic abundance of fat and by the relative narrowness of the spinal canal at this level. An osteoporotic vertebral crush fracture which reduces the diameter of the canal frequently reveals the SEL. MRI confirms the diagnosis of SEL and shows the extent in the spinal canal. The treatment of SEL is difficult. The decrease or the stop of corticosteroid therapy has allowed the recovery in a few cases with chronic neurologic symptoms. The risks of a surgical procedure are important in these patients and the medical or surgical treatment should be discussed taking into account the clinical symptoms of SEL, its location and extent, and the risks of recurrence if corticosteroid therapy must go on.
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PMID:[Epidural lipomatosis: complication of long-term corticotherapy. Apropos of 2 cases]. 888 82

A 36-year-old man was admitted to Kanto Chuo Hospital because of hearing loss and dysphagia. On admission physical and neurological findings revealed obesity, hypertension, nystagmus, right hearing loss, dysarthria, and dysphagia. Routine laboratory findings disclosed leukocytosis, liver dysfunction, hypercholesterolemia, proteinuria, and glucosuria. Immunological, coagulopathic, and endocrinological findings, electrocardiogram, echocardiogram, and brain CT scan were unremarkable. He was diagnosed as brainstem infarction, and then conservative therapies were begun. Seven hours after admission, he suddenly fell into coma and apneutic state, requiring artificial ventilation. The next day he was fully conscious, but could'nt make any voluntary movements except for vertical eye movements, suggesting locked-in syndrome (LIS). Brain MRI showed infarction of pons, medulla oblongata, and right cerebellum. Cerebral angiography revealed hypoplasia of bilateral vertebral arteries, a persistence of right primitive trigeminal artery (PTA), and retrograde blood flow of basilar artery from the PTA. Then he made a rapid recovery, and on 80th day he was discharged only with right hearing disturbance and mild left cerebellar sign. We speculated that hypoplasia of the bilateral vertebral arteries caused the brain infarction, and that back flow of the basilar artery from the PTA, in part, contributed to the early recovery from the LIS.
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PMID:[Early recovery from locked-in syndrome due to brain infarction in a young patient with hypoplasia of bilateral vertebral arteries and a persistence of primitive trigeminal artery]. 895 55

We present the case of an 11 year-old boy, who asked for medical attention due to obesity and assumed underdeveloped external genitalia. He did not have genital anomalies, penile length was 5.3 cm, testicular volume 2 ml and pubic hair Tanner stage 1. His bone age was normal for chronological age. Endocrinological study showed normal results for his age. Karyotype revealed a 46 XX pattern. MRI of external genitalia showed bilateral scrotal testes which were normal in diameter for his age. The check of his historical growth chart and follow-up revealed normal growth with spontaneous pubertal development. However, hormonal studies showed progressive increase of FSH levels, indicative of failure of germinal epithelium. The presence of Y sequences, including SRY gene, was demonstrated by PCR. Our observation is in agreement with the view that 46 XX male subjects diagnosed at peripubertal age with the SRY gene in the genome have a good prognosis regarding growth and development, but the principal problem of these patients is infertility.
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PMID:Development in a 46 XX boy with positive SRY gene. 900 79


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