[Certain types of endocrine gland diseases of hypothalamic origin].
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Disease↗
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[Diabetes mellitus in connection with a hereditary disease].
Diabetes mellitus is usually subdivided into type I (insulin-dependent) and type II (relative insulin shortage and reduced sensitivity to insulin). Diabetes may also be related to pregnancy, malnutrition, pancreatic disease, pharmaceuticals, endocrine diseases and hereditary disorders. The hereditary diseases which may be associated with diabetes mellitus or impaired glucose tolerance can be subdivided into syndromes (such as maternally inherited diabetes and deafness, Down, Turner and Klinefelter syndrome), metabolic diseases (like cystic fibrosis and haemochromatosis) and endocrine diseases (like polyglandular autoimmune insufficiency syndrome and familial phaeochromocytoma). Although diabetes mellitus as part of a hereditary disorder is infrequent, the possibility should be kept in mind with a view to a correct diagnosis. In patients with diabetes mellitus a hereditary disorder may be involved, while patients with a hereditary disorder run a higher risk of developing diabetes mellitus.
Cystic Fibrosis↗
[RELATIONSHIP BETWEEN SKIN DISEASES AND ENDOCRINE IMBALANCE ACCORDING TO OUR OBSERVATIONS].
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Endocrine System Diseases↗
Gender differences in GAD antibody-positive diabetes mellitus in relation to age at onset, C-peptide and other endocrine autoimmune diseases.
BACKGROUND: Females have an increased incidence of autoimmune diseases. However, no gender difference in the incidence of type 1 diabetes is found. The frequency of antibodies against glutamic acid decarboxylase (GADA) in diabetes mellitus depends on age at diagnosis and also gender. Several studies have shown that high GADA levels can predict future beta-cell failure and need for insulin treatment. The aim of this study was to investigate possible gender differences in relation to GADA levels, fasting plasma C-peptide levels and frequency of other autoimmune endocrine diseases in GADA-positive patients with different age at diabetes diagnosis. METHODS: GADA were screened in 4974 patients from a local diabetes registry, and plasma C-peptide was measured and a history of other autoimmune endocrine diseases was recorded. Of these patients, 822 were GADA positive and were further divided into four groups depending on the age at diagnosis of diabetes; Group 1: <20 years, Group 2: 20-39 years, Group 3: 40-59 years and Group 4: > or =60 years. RESULTS: Female patients in Group 3 had lower fasting plasma C-peptide levels (median 0.21[0.00-0-56] vs. 0.41[0.00-0.73] nmol/L, p=0.02), higher GADA levels (median 7 [4-9] vs. 5 [2-7] Arbitrary Unit (AU), p=0.0003) and higher frequency of other autoimmune endocrine diseases (22.4 vs. 5.3%, p=0.0001) than male patients. In a stepwise logistic regression analysis, diabetes duration (p<0.000001), high GADA levels (Exp (B) 3.68 CI 1.69-7.98, p=0.001) and low BMI (p=0.00002) were associated with total beta-cell failure in Group 3. CONCLUSIONS: GADA-positive female diabetic patients with an age at diagnosis between 40 and 59 years have higher GADA levels and a more severe loss of beta-cell function than male patients with the same age at diagnosis. This could be due to the effect of sex steroids and/or GnRH on the regulation of the immune system. Female patients with high GADA levels also had a high prevalence of other autoimmune endocrine diseases, especially autoimmune thyroid disease, which further emphasises the need for screening of thyroid function in female patients with high GADA levels.
Adolescent↗
Endocrine profile and seminal plasma composition in Hansen's disease.
Endocrine profile and seminal plasma composition in 45 patients with tuberculoid-type Hansen's disease are reported. There was marked reduction in sperm count and motility (p less than 0.01, p less than 0.01, respectively) with an increase in abnormal forms of spermatozoa (p less than 0.05). The levels of serum prolactin and oestradiol-17B were increased significantly (p less than 0.05, p less than 0.05, respectively) with a marked reduction in serum FSH, LH and testosterone (p less than 0.05, p less than 0.05, p less than 0.05, respectively). The possible significance of these findings may help further to understand male reproductive function in Hansen's disease.
Adult↗
The surgeon as a prognostic factor in endocrine surgical diseases.
As with all subspecialties, the endocrine surgeon offers more than just improved technical expertise in the treatment of endocrine surgical disease. An understanding of the disease, and an ability to interpret investigations and surgically intervene with minimal morbidity allow for better patient care. Outcomes of endocrine surgical diseases are measured by the success of the operation at relieving the endocrinopathy and the ability of the surgeon to find the tumor, while at the same time minimizing the postoperative morbidity. Each of these factors has been considered when assessing the role of specialized expertise in endocrine surgical disease. The recurrence and survival data for these tumors, however, are not forthcoming and, therefore, the limitations of the existing literature must be acknowledged.
Clinical Competence↗
Group interventions for patients with cancer and HIV disease: Part II. Effects on immune, endocrine, and disease outcomes at different phases of illness.
There has been great interest in the potential impact of group interventions on medical outcomes. This article reviews the effects of professionally-led groups on immune activity, neuroendocrine function, and survival among patients with cancer or HIV disease. We examine findings concerning different types of group services at different phases of illness. Results are mixed, but the most prominent changes in immune and endocrine activity were associated with structured group interventions for patients with early-stage disease. These findings offer provocative illustrations of relevant mind-body interactions, but their clinical importance has yet to be demonstrated empirically. Group interventions have not been tied consistently to improved survival rates for patients with advanced cancer; few studies as yet have focused on survival outcomes among patients with early-stage cancer or HIV disease.
CD4 Antigens↗
Endocrine autoimmune diseases.
A considerable proportion of endocrine disorders (Graves' disease, primary hypothyroidism, type 1 diabetes, Addison's disease, and some forms of ovarian failure) are due to aberrant reactions of the immune system, viz. exaggerated reactions towards self-structures (autoantigens). Autoreactive T-cells are mainly responsible for the elicitation of destructive inflammatory responses in the target endocrine glands. Autoantibodies play a minor role in such reactions, but are useful in clinical practice as markers of the disease. A special type of autoantibody is formed by those autoantibodies that have endocrine functional activity, viz. autoantibodies capable of stimulatory or blocking the hormone synthesis and/or the growth of endocrine cells. These autoantibodies interfere with receptors, e.g. the TSH receptor or the IGF-I receptor. Antibodies stimulating the TSH receptor are responsible for the hyperthyroidism of Graves' disease.
Autoantibodies↗
[Recent aspects of the pathogenesis of endocrine autoimmune diseases in the human: what role does expression of class II HLA molecules in the endocrine target cell play?].
The inappropriate expression of HLA Class II molecules by the target cells of endocrine autoimmune diseases is a recent observation that has been intensively studied in thyroid autoimmunity and type I diabetes mellitus. In vitro studies have shown that interferon-gamma can induce Class II expression, either alone, as in thyrocytes, or in combination with other mediators like tumour necrosis factor or lymphotoxin, as in islet cells, pointing to possible mechanisms operating in vivo. Endocrine cells expressing Class II molecules are able to present their autoantigens to helper T cells, thus possibly inducing the autoimmune process. However, until now it is still unclear if the expression of Class II molecules by the target cells is the primary immune phenomenon, which might possibly be triggered by a latent viral infection of the endocrine cell. Alternatively, it might be a secondary response in an ongoing autoimmune process. Particularly data obtained in the diabetic pancreas favour the first possibility, but only progress in our understanding of the role of HLA antigens in immunoregulation will make it possible to interpret the phenomenon properly.
Autoimmune Diseases↗
[A case from practice (214). Basedow disease with florid hyperthyroidism. Low-degree endocrine orbital disease. Atrial tachycardia due to the hyperthyroidism].
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Aged↗
The breast as a mirror of systemic diseases.
This paper reemphasizes that xeromammographic changes in the skin, parenchyma, and vascular structures of the breast may be manifestations of a host of systemic diseases. Xeromammographic examples of such diseases as congestive heart failure, diabetes mellitus, collagen vascular diseases, and endocrine diseases are presented and discussed.
Adult↗
[DNA diagnosis in endocrinological disease--pituitary disease].
Endocrine disorders have long been diagnosed by symptoms, before hormones were able to be measured by immunoassays. Recently, as molecular biological methods developed, DNA diagnosis has become available in many diseases including endocrine disorders. We present here DNA diagnosis in connection with anterior pituitary hormones. Our studies on thyrotropin (TSH) producing pituitary adenomas showed that TSH beta-subunit mRNAs of the adenomas were the same as those from normal pituitary tissues. Congenital isolated TSH deficiency is rare disease causing hypothyroidism including cretinism, severe mental and growth retardation. We have studied 3 families with consanguineous marriage and 2 families which were descendants of closed colonies. The molecular pathogenesis were elucidated in the cases of 3 Japanese families with consanguineous marriage. They had a same missense mutation in the 2nd exon of the TSH beta-subunit gene which made a restriction enzyme site, and could be analyzed either by genomic Southern blot analyses or by restriction enzyme digestion after amplification of genomic DNA by PCR. Congenital deficiency of growth hormone, prolactin, and TSH was first described in Snell dwarf mice. The gene encoding the nuclear factor Pit-1/GHF-1, which transactivates promoters of both growth hormone gene and prolactin gene, was shown to be the cause of Snell dwarf mice. A similar human case arose from a family with consanguineous marriage, and the relation with the pit-1/GHF-1 gene is now under study.
DNA↗
[CLINICAL CONSIDERATIONS ON ENDOCRINE BLADDER DISEASES].
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Endocrine System Diseases↗
HLA-DR patterns in pernicious anaemia.
The pattern of HLA-DR antigens was studied in a group of 66 patients with Addisonian pernicious anaemia, comprising a subgroup of 18 patients with associated endocrine disease and a subgroup of 48 patients with no associated endocrine disease. Compared with a control group of 120 subjects all 66 patients showed an increase in HLA-DR2 and DR4 and a decrease in DR3 (p less than 0.02). Significant differences were also found between the endocrine and non-endocrine subgroups for patterns of HLA-DR antigens (p less than 0.005) and for pairwise combinations of HLA-DR antigens (p less than 0.01). Relative to controls, the endocrine subgroup showed an increase of HLA-DR3/DR4 (relative risk 4.0), contrasting with an increase of HLA-DR2/DR4 (relative risk 6.85) and DR4/DR5 (relative risk 5.38) in the non-endocrine subgroup. These observations suggest that HLA-DR antigens or closely linked genes may interact to influence susceptibility to pernicious anaemia (or endocrine disease, or both). Thus interactive effects related to HLA-DR2/DR4 and DR4/DR5 may predispose to pernicious anaemia without endocrine disease, whereas interactive effects related to HLA-DR3/DR4 may predispose to pernicious anaemia in association with endocrine disease.
Adult↗
Factors related to the choice between traditional Chinese medicine and modern Western medicine among patients with two-method treatment.
BACKGROUND: The aim of this paper is to investigate the different factors influencing patients' choice of traditional Chinese medicine or modern western medicine, applying Andersen's health-service utilization model to analyze the basic demographic, enabling and need factors related to the choice of clinics by patients who use two-method treatment (i.e. both Chinese medicine and western medicine). METHODS: Systemic sampling was done and a structured questionnaire survey was carried out among patients from the outpatient departments of 13 teaching hospitals accepting reimbursement by Labor Medical Insurance in Taiwan. RESULTS: The total number of valid respondents was 549. Of them 181 (33%) were visiting western medicine clinics and 368 (67%) visiting Chinese medicine clinics. There were 279 (51%) males and 270 (49%) females, whose age distribution was in the range from 16 to 87 years old, with a mean of 42.7 years. Under univariate analysis, the significant variables (p < 0.05) related to visiting the two types of clinics were: applicability of medical insurance, bed rest from discomfort in recent years, the amount of discomfort from this disease episode, respiratory disease, circulatory disease, endocrine or metabolic disease, and sense organ and skin disorders. By logistic regression analysis, the significant variables (p < 0.05) related to visiting the two types of clinics were religion, bed rest during the past year, discomfort associated with the episode, respiratory disease, and endocrine or metabolic diseases. CONCLUSIONS: Patients with folk-religion beliefs or respiratory diseases favored Chinese medicine; patients with illness requiring bed rest in the past year, who experienced discomfort in this episode, or who suffered from endocrine or metabolic diseases were likely to visit western medicine clinics.
Adolescent↗
Increased deaths due to endocrine system diseases and allergies among mothers of dizygotic twins.
To test the hypothesis that mothers of DZ twins, who seem to represent a separate population from mothers of singletons in terms of levels of pituitary gonadotropins, height and weight, and reproductive and menstrual characteristics, have different patterns of disease and mortality, causes of non-cancer deaths were examined. Study subjects were 3,982 mothers of unlike-sexed (DZ) twins and other polyzygous multiple births, and a matched comparison group of 3,982 mothers of singletons only. A significantly increased risk of death due to diseases in ICD Group III, Allergic Endocrine System, Metabolic and Nutritional Diseases, was found among mothers of DZ twins (relative risk (RR) = 2.4, exact two-tail P = 0.024, exact 95% confidence limits 1.11 to 5.62). Of the 24 deaths among mothers of DZ twins, 18 were due to diabetes, 2 to diseases of the adrenal glands, 1 to a thyroid gland and, 3 to asthma. Of the ten deaths in the comparison group, nine were due to diabetes and one to asthma. Excluding the asthmas, the RR for endocrine system diseases is 2.33, exact two-tail P = 0.042, exact 95% CL 1.02 to 5.79. These observations are consistent with evidence in the literature which shows an association between endocrine system diseases and twinning, and between gonadotropic hormones and diabetes.
Connecticut↗
The pituitary dwarf mouse: a model for study of endocrine immunodeficiency disease.
Pituitary dwarf mutants of the Snell-Bagg and Ames mouse strains develop severe immunodeficiency of the thymus-dependent system which frequently leads to a fatal wasting syndrome. This immunodeficiency is a consequence of defective pituitary influences which will cause 1) an inadequate production of immunocompetent cells due to a central developmental defect primarily affecting the thymus and 2) the inability of immunocompetent cells to undergo a rapid and efficient antigen-induced proliferation and differentiation into antibody-forming cells. The relevance of the dwarf mouse model to a possible association between human immunodeficiency and endocrine disease is briefly discussed.
Adrenocorticotropic Hormone↗
Polyendocrine autoimmunity.
Autoimmune polyendocrine disorders are characterized by the presence of more than one autoimmune endocrine disease. Study of such disorders has provided unique insight into the pathogenesis of autoimmunity and the development of tolerance in the normal individual. Autoimmune polyendocrine syndromes I and II have distinctive inheritance patterns, genetic causes, component diseases, and implications for follow-up. Care for individuals with these diseases requires monitoring for additional autoimmune disorders and aggressive treatment of identified diseases to prevent morbidity and mortality in affected individuals.
Autoimmune Diseases↗