1/25. Prostaglandin E1 for renal papillary necrosis in a patient with diabetes mellitus.We report a case of renal papillary necrosis with diabetes mellitus which was treated with prostaglandin E1. An intravenous infusion of 40 mg/day prostaglandin E1 was given for 14 days in an attempt to improve renal circulation. Treatment resulted in an improved creatinine clearance, renal plasma flow and renogram, and proteinuria was decreased. The administration of prostaglandin E1 produced an improvement in renal haemodynamics and can be considered as a possible therapy for renal papillary necrosis in diabetic patients.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/25. Type II diabetes mellitus and primary sjogren's syndrome complicated by pleural effusion.A 73-year-old man was admitted to our hospital because of pleural effusion and nephrotic syndrome. sjogren's syndrome (Sjs) was diagnosed based on a positive test for antibodies to Ro and La, and the result of labial salivary gland biopsy. The pleural effusion showed a high number of lymphocytes and high titers of antibodies to Ro and La. By immunohistochemistry, it was determined that infiltrating CD3 cells predominated over infiltrating CD20 cells in the pleura. nephrotic syndrome was also present, which, as confirmed by renal biopsy was due to advanced diabetic nephropathy. Here, we report a case of Type II diabetes mellitus and primary Sjs complicated by pleural effusion, discuss the available treatment for pleural effusion.- - - - - - - - - - ranking = 0.14285714285714keywords = gland (Clic here for more details about this article) |
3/25. growth hormone overproduction in a patient with multiple endocrine neoplasia type I.In a 69-year-old woman with a complicated history of multiple endocrine neoplasia type I (MEN 1), growth hormone overproduction was found without clinical features of acromegaly. zollinger-ellison syndrome was diagnosed at the age of 36 years. Total gastrectomy and partial pancreatectomy were performed. Two years later hypercalcaemia occurred, hyperparathyroidism was suspected and three hyperplastic parathyroid glands were removed. In 1994 the plasma gastrin level was elevated and a computerized tomography of the abdomen revealed a 1.5-cm large pancreatic tumour. Screening of the pituitary functions was unremarkable and a magnetic resonance scan of the pituitary gland showed no abnormalities. In 1995 type II diabetes mellitus was diagnosed. In 1997 basal plasma growth hormone levels were raised and plasma IGF-I levels were alternately high and normal. The patient had no clinical signs of acromegaly, but glucose tolerance testing resulted in a paradoxical rise in growth hormone concentration compatible with the diagnosis of growth hormone overproduction. magnetic resonance imaging of the pituitary gland revealed a microadenoma.- - - - - - - - - - ranking = 0.42857142857143keywords = gland (Clic here for more details about this article) |
4/25. An unusual presentation of calciphylaxis due to primary hyperparathyroidism.We present the case of a 69-year-old woman with calciphylaxis due to primary hyperparathyroidism. A 0.5-g parathyroid adenoma was surgically removed, which resulted in complete recovery of the patient. review of the literature revealed 7 other cases of calciphylaxis due to primary hyperparathyroidism and showed that prompt surgical removal of the autonomous parathyroid gland lesion results in clinical recovery of calciphylactic skin lesions.- - - - - - - - - - ranking = 0.14285714285714keywords = gland (Clic here for more details about this article) |
5/25. Type 2 diabetes in obese white children.We report four white adolescents aged 13 to 15 years (three females, one male) from the south and west region of england who presented with type 2 diabetes mellitus associated with significant obesity (body mass index more than 3SDS) in the past two years. Although these are the first reported obese, white cases from the UK to present with diabetes, we believe this clinical scenario will become more prevalent given the epidemic of childhood obesity in this country.- - - - - - - - - - ranking = 0.14285714285714keywords = gland (Clic here for more details about this article) |
6/25. Possible participation of a prostaglandin E1 analogue in the aggravation of diabetic nephropathy.A relation between the progression of diabetic nephropathy and glomerular hyperfiltration has been speculated. We describe two cases of non-insulin-dependent diabetic males aged 55 and 59 years in whom diabetic nephropathy was aggravated during the administration of limaprost, a a prostaglandin E1 analogue with a vasodilatory action. We also observed a short-term effect of limaprost on renal hemodynamics in three cases with diabetic nephropathy. In case 1, one year after limaprost administration the serum albumin level fell from 3.6 to 2.6 g/dl and the serum creatinine level rose from 1.0 to 1.6 mg/dl. In case 2, 9 months after limaprost administration the serum albumin level fell from 3.6 to 2.9 g/dl and the serum creatinine level rose from 1.8 to 2.3 mg/dl. In the latter stages of limaprost administration, the downslopes of reciprocal serum creatinine against time appeared to be augmented in the two cases. After the 3-day administration of limaprost, the peripheral and renal blood flows, and the glomerular filtration rate (GFR) were observed to rise, but the filtration fraction (FF) and urinary protein output were elevated. Keeping in mind the pre-existing renal damage, the increases in GFR and FF suggested acceleration of compensatory glomerular hyperfiltration in less damaged surviving glomeruli. The sustained acceleration of hyperfiltration with long-term administration of limaprost as an exogenous vasodilatory prostaglandin was assumed to eventuate in the aggravation of diabetic nephropathy. attention should be paid to drugs which increase GFR in patients with established diabetic nephropathy.- - - - - - - - - - ranking = 0.85714285714286keywords = gland (Clic here for more details about this article) |
7/25. Cushing's syndrome caused by unsupervised use of ocular glucocorticoids.OBJECTIVE: To report a case of Cushing's syndrome in an adult patient caused by prolonged and unsupervised use of glucocorticoid ocular drops. methods: We present the clinical and laboratory findings and describe the clinical course of our patient. RESULTS: A 33-year-old man with extensive ophthalmologic complaints and procedures, who had used glucocorticoid ocular drops for an extended period, was referred to the endocrinologist for new onset of type 2 diabetes mellitus. Clinically, the patient appeared cushingoid with a buffalo hump, thin skin, bruises, and purple striae, and his blood pressure was 130/90 mm Hg. Laboratory evaluation revealed a very low serum cortisol level with a concomitantly low-normal level of adrenocorticotropic hormone (corticotropin). In addition, the response to a corticotropin stimulation test was abnormal, an indication of suppression of the adrenal glands. After the patient discontinued the use of the glucocorticoid eyedrops, his cushingoid features gradually faded, and his blood pressure and serum glucose levels normalized. CONCLUSION: Prolonged unsupervised use of glucocorticoid ocular drops may result in Cushing's syndrome and its numerous associated complications. physicians and pharmacists should be aware of this possibility and must educate patients about the potentially serious adverse effects of such use.- - - - - - - - - - ranking = 0.14285714285714keywords = gland (Clic here for more details about this article) |
8/25. Cutaneous mucormycosis of the head and neck with parotid gland involvement: first report of a case.Cutaneous mucormycosis is an uncommon, life-threatening, opportunistic fungal infection that is a distinctly different entity from the more frequent although still uncommon rhinocerebral form that is better known to otolaryngologists. We describe what to our knowledge is the only reported case of cutaneous mucormycosis of the face with parotid gland involvement, which occurred in a 56-year-old man. The diagnosis was established by tissue biopsy. The patient was treated with antifungal medications and wide local debridement, including a total parotidectomy with sacrifice of the inferior division of the facial nerve. At the 2-year follow-up, he remained free of disease. Familiarity with the risk factors associated with the development of cutaneous mucormycosis is critical to determining the need for early tissue biopsy to confirm the diagnosis. Generally favorable clinical outcomes are associated with prompt and aggressive medical and surgical therapy.- - - - - - - - - - ranking = 0.71428571428571keywords = gland (Clic here for more details about this article) |
9/25. Adenoid cystic carcinoma of Bartholin's Gland. Case report with review of the literature.Adenoid cystic carcinoma of Bartholin's gland is characterized by slow growth, local invasion, and sometimes distant metastasis. There is no consensus regarding the optimal treatment. We report herein a rare case of stage II adenoid cystic carcinoma of Bartholin's gland that was successfully treated by wide local excision of the tumor and ipsilateral inguinal and pelvic lymphadenectomy. A 54-year-old Japanese woman was admitted complaining of painless, gradually increasing vulvar mass existing from ten years before. Local examination revealed a 3 x 2-cm hard mass in the left labium major. Pathological examination of subsequent excisional biopsy revealed adenoid cystic carcinoma originating in the Bartholin's gland. A wide local resection of the tumor with inguinal and pelvic lymphadenectomy was performed. The tumor was completely excised with free margins. There was no metastasis in the resected lymph nodes. The patient was diagnosed as having stage II vulvar cancer according to the International Federation of Gynecologists and Obstetricians classification (1988). The patient is now healthy without evidence of recurrence at 5 years after surgery. Adenoid cystic carcinoma of Bartholin's cyst at early stage can be treated by wide local excision as a primary surgery.- - - - - - - - - - ranking = 0.42857142857143keywords = gland (Clic here for more details about this article) |
10/25. Endometrial adenocarcinoma without prior hormone replacement in a diabetic patient with gonadal dysgenesis.patients with dysgenetic gonads and turner syndrome are unlikely to develop endometrial carcinoma unless they have received unopposed estrogen replacement therapy. This case describes a 54-year-old woman with turner syndrome and primary amenorrhea who developed adenocarcinoma of the endometrium without having received hormone replacement. Vaginal bleeding, a pelvic mass, and sepsis were the presenting symptoms. The patient also had diabetes mellitus and hypothyroidism. Polyglandular endocrine patterns are known to occur with a high frequency in these patients. The woman's chromosome studies revealed a modified 46,X,i(Xq) (isochromosome X). This is the first report of an isochromosome X patient to develop endometrial cancer without receiving estrogen replacement. The etiology of this rare case may be an increased propensity for patients with X-chromosome deletions to develop neoplasms in general, or extragonadal estrogen production.- - - - - - - - - - ranking = 0.14285714285714keywords = gland (Clic here for more details about this article) |
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