The relationship between vitamin D level and organ­specific autoimmune disorders in newly diagnosed type I diabetes mellitus.

INTRODUCTION: The purpose of our study is to determine vitamin D levels in patients with newly diagnosed type 1 DM, and assess the association of type 1 DM with organ-specific autoimmune disorders, as well as their association with vitamin D. MATERIAL AND METHODS: We included a total of 160 patients, of whom 50 were newly diagnosed with type 1 DM (group I), 50 were formerly diagnosed with type 1 DM (group II), and 60 were healthy controls (group III). RESULTS: The mean level of 25(OH)D was 14.6 ng/dL in group I, 12.1 ng/dL in group II, and 16.1 ng/dL in group III. In all diabetic patients, the 25(OH)D levels were lower than those of controls. The 25(OH)D median level was 11.4 ng/ml in all cases included into the study with ATD. In subjects without ATD, the latter level was 15.3 ng/ml. The difference was found to be statistically significant. CONCLUSIONS: In this study, the vitamin D level was lower in (i) type 1 diabetic patients when compared with healthy subjects, (ii) all cases included to study with ATD when compared with patients without ATD, (iii) all APA-positive type 1 diabetic patients with ATD when compared with none (iv) APA-positive newly diagnosed type 1 diabetics when compared with those APA-negative (Tab. 7, Fig. 1, Ref. 30).

Pulmonary multinodular mucormycosis in type 1 diabetic patient with diabetic ketoacidosis.

We report a case of pulmonary multinodular mucormycosis in a Type 1 diabetic patient with diabetic ketoacidosis. He had a history of 20-pack-year tobacco use. The initial chest roentgenogram and thorax tomography (after the treatment of diabetic ketoacidosis) revealed multiple nodular lesions with cavitation in the upper lobes of pulmonary parenchyma. Resection of three nodular lesion demonstrated cheesy necrotic mass in the cavitating lesions. The diagnosis of pulmonary multinodular mucormycosis was made depending on the histopathologic examination yielding nonseptated right angle branching-shaped hyphae typical of mucormycosis. The patient was started on liposomal amphotericin B and discharged at the sixth week of therapy with a scheduled therapy of amphotericin B. When he came back after 33 months, he was metabolically unregulated under the insulin therapy. He confessed that he had been smoking heroin besides tobacco for the last 5 years. A new thorax computerized tomography showed that pulmonary nodules were slightly regressed but not resolved.

Frequency of angiotensin-converting enzyme gene polymorphism in Turkish type 2 diabetic patients.

We aimed to investigate the angiotensin-converting enzyme (ACE) gene polymorphism, ACE activity and their associations with diabetic complications in Turkish patients with type 2 diabetes mellitus. A total of 143 patients and 133 controls were screened for ACE gene I/D polymorphism by using polymerase chain reaction. Serum ACE activities were determined spectrophotometrically. There was no significant difference in the distribution of ACE I/D genotypes between patients and controls. The patients with DD genotype had a higher ACE activity than those with ID and II. Hypertensive diabetic patients with DD genotype had higher ACE activities than those with ID and II. There was no significant difference in the distribution of ACE I/D genotypes between patients with and without nephropathy, retinopathy and hypertension except for patients with and without neuropathy. In patients with DD genotype, creatinine clearance correlated with duration of diabetes. The grade of retinopathy was correlated with duration of diabetes in DD and ID genotypes. The highest ACE activity was measured in hypertensive diabetics with DD genotype. ID genotype was suggested to be a risk factor and II was suggested to be protective for diabetic neuropathy. The DD and ID genotypes might be a predictor for the development of retinopathy in relation to duration of diabetes.

Diffuse sclerosing variant of papillary thyroid carcinoma with primary squamous cell carcinoma.

A case of a very rare combination of diffuse sclerosing variant of papillary thyroid carcinoma (DSPC) and primary squamous thyroid carcinoma (PSC) is presented. A 25-yr-old woman with right-sided neck mass and hypothyroidism was admitted. US showed that the right lobe of the thyroid gland was enlarged with irregular margins and heterogen echogenity and there were multiple small punctate echogenic foci in the central portion. A scintigraphy with 99mTc showed decreased uptake in the right lobe. FNA of the right lobe induced us to consider the presence of follicular neoplasm. Chest roentgenogram was normal. Total thyroidectomy with right-sided modified radical neck dissection was performed. Findings related to Hashimoto's thyroiditis and abundant psammoma bodies were observed in the frozen sections. Histopathologic findings demonstrated the coexistence of DSPC and PSC in both lobes and 16 lymph nodes metastases and soft tissue infiltration. Radioiodine was administered to ablate residual thyroid tissue. She was given T4 suppression therapy. At the 44th month of follow-up, she remains well without recurrences and metastases. The coexistence of DSPC and thyroiditis or PSC is still under debate. Very few cases with the combination of papillary thyroid carcinoma and PSC have been reported previously, thus we discuss the clinico-pathologic features and possible explanation for this unusual coexistence of malignancies.

Effects of propylthiouracil, propranolol, and vitamin E on lipid peroxidation and antioxidant status in hyperthyroid patients.

OBJECTIVE: The purpose of this study was to examine lipid peroxidation and antioxidant states during hyperthyroidism states and after given different treatments. DESIGN AND METHODS: We examined 44 hyperthyroid patients and 19 euthyroid healthy controls. Patients were divided into three groups according to the treatment: Propylthiouracil (PTU) group, PTU + propranolol (PRP) group, PTU + PRP + vitamin E (vitE) group. RESULTS: In the hyperthyroid patients plasma malondialdehyde (MDA) levels were significantly high as compared to the control group (p < 0,001). There was a significant decrease in the MDA levels post-treatment (p < 0.001 in the PTU + PRP group and PTU + PRP + vitE group, p < 0.01 in the PTU group). In the hyperthyroidism, blood reduced glutathione (GSH) levels were lower, erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities were higher than in the control group, but these changes were not significant. Post-treatment in each of the three groups the GSH levels were increased significantly as compared to the pretreatment levels (p < 0.001). There was significant decrease in the SOD activity post treatment (p < 0.01 in all three groups). Post-treatment CAT activity was decreased (p < 0.05 in the PTU group, p < 0.001 in the other two groups). The erythrocyte glutathione peroxidase (Gpx) activity was lower significantly in the hyperthyroidism as compared to the control group (p < 0.001). Post-treatment, in the three groups Gpx activity increased significantly as compared to the pretreatment levels (p < 0.05 in the PTU group, p < 0.001 in the PTU + PRP group and PTU + PRP + vitE group). CONCLUSION: We considered that giving all three treatments would be useful to the prevention of oxidative stress in the hyperthyroidism states.