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Biomedical subjects

S Nolan

Publications and source records attributed to S Nolan.

50 records · Page 3Linked to original sources
PubMedDate not supplied

Remissions of diabetes mellitus after weight reduction by jejunoileal bypass.

Limited weight loss following jejunoileal bypass in 24 diabetic persons who were still distinctly overweight five to ten months after a mean weight decrease of 78 lbs. was accompanied by a return of normal fasting glucose and insulin levels, normal insulin responses, and a decrease in glucose intolerance. The glucose disappearance rate had improved in the majority of the subjects, but only three had attained values in the normal range. Concomitants of the undue hyperglycemia and/or obesity included labile and, rarely, sustained hypertension and/or cardiomegaly. The blood pressure returned to normal but heart size did not change. Electrocardiographic abnormalities noted in about one-half of the patients persisted after the operation. Triglyceride and cholesterol levels decreased. No patients had diabetic retinopathy visible on funduscopy. Proteinuria did not change in three patients. Neuropathy consisting of absent ankle reflexes and/or decreased vibration perception noted in one-half of the subjects persisted despite the improvement in carbohydrate metabolism.

Adult↗
PubMedDate not supplied

Malignant nonfunctioning pheochromocytoma occurring in a mixed multiple endocrine neoplasia syndrome.

OBJECTIVE: To present the first documented case of malignant nonfunctioning pheochromocytoma occurring in a mixed multiple endocrine neoplasia (MEN) syndrome. METHODS: We describe the personal and family history of a 34-year-old man with headaches, increased serum prolactin levels, and hyperparathyroidism and review the details of his clinical course and treatment. RESULTS: After diagnosis of a prolactinoma, bromocriptine therapy was implemented but eventually discontinued by the patient when severe headaches recurred. A transsphenoidal resection of a prolactinoma was performed; the patient continued to have abnormally high serum prolactin levels. Subsequent left lower flank pain prompted an exploratory laparotomy, and a left nephroad-renalectomy was performed. Pathologic examination disclosed a 1-cm tumor, consistent with malignant pheochromocytoma. Electron microscopy demonstrated neurosecretory granules. A hypercoagulable state complicated the course postoperatively. Despite chemotherapy, extensive metastatic disease ensued, and the patient died. CONCLUSION: Although pheochromocytomas are usually associated with MEN type IIA and type IIB, this patient had a malignant pheochromocytoma, without the usual clinical and biochemical manifestations, in the setting of MEN type I.

Journal Article↗
PubMedDate not supplied

Multiple endocrine neoplasia and polyglandular autoimmune syndrome: a new association.

OBJECTIVE: To report a new association between polyglandular autoimmune syndrome and multiple endocrine neoplasia. METHODS: We present a detailed case report and discuss the various types of polyglandular failure and multiple endocrine neoplasia. RESULTS: A 56-year-old woman with a past history of primary hypothyroidism and impaired glucose tolerance was admitted to the hospital for removal of renal staghorn calculi. In addition to the presence of mucocutaneous candidiasis, vitiligo, and macroglossia, the patient was found to have truncal obesity, a "buffalo hump," and supraclavicular fat pads. Subsequent workup confirmed the presence of Cushing's disease and primary hyperparathyroidism. CONCLUSION: A hitherto unreported association between polyglandular autoimmune syndrome type II and multiple endocrine neoplasia type I is documented in our current patient.

Journal Article↗
PubMedDate not supplied

Inappropriate counter-regulatory hormone levels in insulin treated diabetes.

The data herein presented describe, identify, and quantitate interrelationships among blood glucose and serum insulin, growth hormone, cortisol, and glucagon levels of hospitalized insulin-treated diabetic patients. The findings indicate that conventional diet and insulin therapy of diabetes mellitus is almost always accompanied by inappropriate counter-regulation by growth hormone, cortisol, and glucagon. The data are consonant with the hypothesis that a shortage of insulin is only one of the multihormonal defects of diabetes.

Blood Glucose↗
PubMedDate not supplied

Inappropriate counter-regulatory hormone levels in insulin treated diabetes.

The data herein presented describe, identify, and quantitate interrelationships among blood glucose and serum insulin, growth hormone, cortisol, and glucagon levels of hospitalized insulin-treated diabetic patients. The findings indicate that conventional diet and insulin therapy of diabetes mellitus is almost always accompanied by inappropriate counter-regulation by growth hormone, cortisol, and glucagon. The data are consonant with the hypothesis that a shortage of insulin is only one of the multihormonal defects of diabetes.

Blood Glucose↗
PubMedDate not supplied

Prolonged progestin (quingestanol) therapy of menopausal diabetic women.

The reduction of high serum LH levels toward or to normal in diabetic women in the menopausal range recorded during the first year of treatment with a synthetic progestin, 17-alpha-ethynyl-19-nortestosterone acetate, 3-cyclopentylenol ether (quingestanol acetate), was maintained during the second and third years of daily ingestion of this steroid. Normal LH and normal or high FSH levels prior to therapy were not affected. Other endocrine indices, including serum PBI and T4, plasma 11(OH) corticosteroids, serum growth hormone titers, insulin responses to oral glucose, and urinary excretion of 17-ketosteroids, Porter-Silber chromogens, and 11-desoxycortisol metabolites, estrogens, and creatinine remained relatively unchanged during quingestanol therapy. At the 36th month of treatment, a small increase in fasting blood glucose levels with greater hypoglycemia after oral carbohydrate was noted, but this probably reflected the natural history of treated diabetes mellitus. The decrease in urinary steroid responses to partial blockade of adrenal 11-beta hydroxylase by metyrapone observed in the 12th month of quingestanol therapy was not evident at the end of 24 and 36 months of treatment. Quingestanol therapy was associated with maintenance of the increase in serum sodium from low-normal to mid-normal concentrations noted during the first year of treatment. Serum chloride increases were less frequent. Other serum electrolytes, solutes, proteins and other nitrogenous constituents, lipids, and enzymes and formed blood elements generally fluctuated within the pre-therapy ranges. Body weight, blood pressure, pulse rate, electrocardiograms, and perception of vibrations were about the same prior to and at the completion of the three-year course of therapy. The steroid was well tolerated.

Adult↗
PubMedDate not supplied

Endocrine and metabolic indices during progestin (quingestanol) therapy.

Quingestanol at 300 y/day was well tolerated during 1 to 12 months of therapy of pre-menopausal and menopausal women with minimal changes, if any, in a battery of routine endocrine and metabolic indices. Serum inorganic phosphorus levels were slightly above the pre-therapy range but still within normal limits during the 12 months of treatment and the mean relative blood volume or hematocrit during the latter 6 months was slightly above the starting value.

Adult↗