ABSTRACT
BACKGROUNDS/AIMS: Postoperative diabetes mellitus (DM) after pancreaticoduodenectomy (PD) may compromise the long-term quality of life in survivors after the operative procedure due to the treatment difficulty and its related complications. The aim of this study is to determine the incidence of new-onset pancreatogenic DM after PD and investigate the risk factors for this complication. METHODS: Among 170 patients who had undergone PD between November 2003 and September 2009, 98 patients were selected for this study. The selected patients were non-diabetic prior to the operation and had undergone follow-up tests for glucose metabolism and an abdominal computed tomography (CT) scan 1 year after the operation. The clinical data of these patients were retrospectively analyzed by reviewing the medical records, radiologic images, and pathologic reports. RESULTS: Postoperative pathology confirmed malignant tumors in 91 patients, borderline malignancy in 5, and benign tumor in 2. The tumor locations included the pancreatic head (n=30), the common bile duct (CBD) (n=30), ampulla of Vater (n=30), and the duodenum (n=8). New-onset DM occurred in 17 (17.4%) of the 98 patients during the first year after the operation. The comparative analysis between postoperative DM (+) and DM (-) groups revealed that the atrophy of the remaining pancreas was the only significant risk factor for development of postoperative DM after PD. CONCLUSIONS: This study suggests that the atrophy of the remaining pancreas increases the risk of pancreatogenic DM after PD, and efforts to prevent pancreatic atrophy are needed to decrease this complication.
Subject(s)
Humans , Ampulla of Vater , Atrophy , Common Bile Duct , Diabetes Mellitus , Duodenum , Follow-Up Studies , Glucose , Head , Incidence , Medical Records , Pancreas , Pancreaticoduodenectomy , Quality of Life , Retrospective Studies , Risk Factors , Surgical Procedures, Operative , SurvivorsABSTRACT
BACKGROUND: Reactive perforating collagenosis is one of the perforating disorders that are characterized by transepidermal elimination of dermal materials. It can be associated with systemic disease such as chronic renal disease and/or diabetes mellitus. OBJECTIVE: We wanted to investigate the clinical and histopathological features of reactive perforating collagenosis. METHODS: We reviewed the medical records, clinical photographs and histopathologic slides of 14 cases of reactive perforating collagenosis that were seen in our department. RESULTS: The most common clinical features were flesh-colored, dome-shaped papules with a keratinous plug. Residual scarring was seen from the previously healed lesions. Half of the patients had skin lesions on the whole body except the face, palm and sole. Most of the patients (79%) had at least one systemic disease. Chronic renal failure (21%) and diabetes mellitus (29%) were the most commonly associated conditions. The other associated conditions were hypertension, acute pyelonephritis, non-small cell lung cancer, herpes zoster, transplantation and non-Hodgkin lymphoma. Three of the cases (21%) were otherwise healthy. Most patients benefited from topical steroid and oral antihistamine when their disease was regressing. CONCLUSION: This study demonstrated the clinicopathologic features of reactive perforating collagenosis. It is frequently associated with diabetes mellitus and chronic renal failure, but this may also develop in patients with other systemic disorders, and also in those patients who are without any medical problems.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Cicatrix , Diabetes Mellitus , Herpes Zoster , Hypertension , Keratins , Kidney Failure, Chronic , Lymphoma, Non-Hodgkin , Medical Records , Pyelonephritis , Renal Insufficiency, Chronic , Skin , TransplantsABSTRACT
Objective To investigated the changes of plasma NT-proBNP levels in patients with acute myocardial infarction(AMI),unstable angina pectoris(UAP)and non-insulin-dependent diabetes(NIDD).Methods Plasma NT-proBNP levels were determined with RIA in 32 patients with AMI,27 patients with UAP,12 patients with NIDD and 20 controls.Moreover,16 of the 32 AMI patients underwent precutancous transluminal coronary angioplasty(PTCA)and plasma NT-proBNP levels were again determined 12h before and 12h after the procedure.Results The plasma NT-proBNP levels in controls were(360.8±57.3)pg/ml with no significant difference between the sexes.In patients with AMI,UAP and NIDD,NT-proBNP levels were(554.1±195 9)pg/ml,(525.7±199.1)pg/ml and(552.6±141.9)pg/ml respectively;all of them were significantly higher than those in controls.AMI patients increased from(563.1±190.1)pg/ml to(774.7±238.9)pg/ml(P＜0.05).12 hours after PTCA.However,NT-proBNP levels did not differ statistically among AMI,UAP and NIDD patients(P＞0.05).Conclusion The plasma NT-proBNP levels in patients with AMI,UAP and NIDD were increased significantly and the result suggested that NT-proBNP might beauseful risk marker for these diseases.