RESUMO
OBJECTIVE: To evaluate the relationship between the type and duration of diabetes and pancreas size by ultrasonography. RESEARCH DESIGN AND METHODS: Pancreas images of 40 IDDM and 36 NIDDM patients with 0.3-34 yr of disease were compared with those of 60 normal healthy control subjects. RESULTS: The diameters +/- SD of the head, body, and tail of the pancreas in IDDM patients (1.9 +/- 0.3; 0.9 +/- 0.2; and 1.4 +/- 0.2 cm, respectively) were smaller than in NIDDM patients (2.7 +/- 0.4; 1.2 +/- 0.3; and 1.8 +/- 0.4 cm, respectively) and control group subjects (2.4 +/- 0.4; 1.1 +/- 0.3; and 1.8 +/- 0.4 cm, respectively). The pancreatic shrinkage in IDDM patients was clearly evident after 10 yr of the disease. NIDDM patients and control subjects had similar pancreatic dimensions, except for a greater body thickness in NIDDM patients with > 10 yr of disease (1.2 +/- 0.4 vs. 1.1 +/- 0.3 cm). These results were not related to differences in age, sex, and body size. Pancreas image was hypoechogenic in 72.5% of IDDM patients and hyperechogenic in 83.3% of NIDDM patients. CONCLUSIONS: Smaller pancreases in IDDM patients in comparison with NIDDM patients and control subjects were clearly demonstrated only after 10 yr of disease. Patients with NIDDM were not affected by pancreatic dimensions, except for a greater body thickness after 10 yr of disease. Pancreatic echogenicity increased with age.
Assuntos
Diabetes Mellitus Tipo 1/diagnóstico por imagem , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Pâncreas/diagnóstico por imagem , Adulto , Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 2/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/anatomia & histologia , Pâncreas/patologia , Valores de Referência , UltrassonografiaRESUMO
OBJECTIVE: To study the relation between plasma gonadotropin pulsatility, androgen levels, and estrogen levels in patients with polycystic ovary syndrome (PCOS), in hirsute women with normal menstrual cycles, and in healthy women. DESIGN: Prospective study. SETTING: University medical center-based cellular and molecular endocrinology laboratory. PATIENT(S): Eight healthy women (group 1), 9 hirsute women with normal menstrual cycles (group 2), and 19 women with PCOS (group 3). INTERVENTION(S): Plasma concentrations of LH and FSH were measured by RIA every 15 minutes for 12 hours. MAIN OUTCOME MEASURE(S): Rhythmic parameters of 12-hour LH and FSH secretion. RESULT(S): Rhythmic parameters of 12-hour LH secretion were significantly higher in patients with PCOS (group 3) than in controls (group 1) or in hirsute women with normal menstrual cycles (group 2). The frequency of LH pulses was statistically higher in patients with PCOS (group 3) than in controls (group 1). Statistically significant correlations were found when the frequency of LH pulses was plotted against basal LH concentrations and rhythmic parameters of 12-hour LH secretion. CONCLUSION(S): Luteinizing hormone pulse amplitude was higher in patients with PCOS than in hirsute women with normal menstrual cycles or in healthy women. The LH pulse frequency was increased only in patients with PCOS compared with healthy women and not in hirsute women with normal menstrual cycles.
Assuntos
Hormônio Foliculoestimulante/metabolismo , Hirsutismo/fisiopatologia , Hormônio Luteinizante/metabolismo , Ciclo Menstrual , Periodicidade , Síndrome do Ovário Policístico/fisiopatologia , Adolescente , Adulto , Reações Falso-Positivas , Feminino , Hormônio Foliculoestimulante/sangue , Hirsutismo/patologia , Humanos , Hormônio Luteinizante/sangue , Ovário/patologia , Síndrome do Ovário Policístico/patologia , Estudos Prospectivos , Análise de Regressão , Testosterona/sangueRESUMO
Endoscopic ultrasonography has been applied in gastro enterology for more than 10 years in large medical centers as a special diagnostic tool. Such a technique has applications in tumoral and inflammatory processes and gives important information of the superior gastrointestinal tract. The objective of this study is to show a 2-year experience with linear echoendoscope in 200 operated patients. The equipment is a Toshiba 250 model with a Machida endoscope 7.5 MHz, electronic linear transducer. Endoscopic ultrasonography is successful in obtaining accurate diagnostic images, mainly of submucosal lesions, precise staging of a variety of gastrointestinal tumors, and detection small pancreatic masses and choledochal calculi.
Assuntos
Doenças do Sistema Digestório/diagnóstico , Endoscopia do Sistema Digestório/métodos , Ultrassonografia/métodos , Humanos , TransdutoresRESUMO
Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method can be used in gallbladder emptying studies, we investigated the reproducibility of the ultrasound method for measurement of gallbladder volume. The ultrasonographic method was highly reproducible (r = 0.97) and, due to its safeness and lack of use of radioactive agents, it is attractive option for gallbladder motility studies in conditions associated with increased frequency of cholelithiasis.
Assuntos
Vesícula Biliar/diagnóstico por imagem , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , UltrassonografiaRESUMO
In order to gain some insight into the possible influence of gastric emptying on gallbladder hypomotility in patients with Crohn's disease, the gastric emptying time (GET) was measured by means of ultrasonography in 10 healthy controls and 10 patients with Crohn's disease. No significant difference was observed between both mean values for GET studies (GET: controls, 165.0 min +/- 12.8; Crohn, 142.0 min +/- 11.5; p = 0.208) after ingestion of a liquid meal. Thus, the gallbladder hypomotility described in patients with Crohn's disease, after a liquid fatty-meal stimulus, can not be explained by prolonged gastric emptying time.
Assuntos
Doença de Crohn/diagnóstico por imagem , Esvaziamento Gástrico , Adulto , Doença de Crohn/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , UltrassonografiaRESUMO
For the purpose of shedding some light upon the possible mechanisms involved in gallstone formation in patients with Crohn's disease, we have investigated gallbladder emptying by means of ultrasonography in two groups of subjects: controls (n = 40) and Crohn's disease (n = 30). Diminished gallbladder emptying after a liquid fatty-meal stimulus was observed in patients with Crohn's disease when compared with controls (p < 0.001). Also, the values for the residual gallbladder volume (RGV) and maximal decrease in gallbladder volume (MDGV), both in milliliters and percentage were, respectively, increased (RGV = 9.6 ml) and diminished (MDGV = 14.8 ml; MDGV = 60.9%) in patients with Crohn's disease when compared with controls (RGV = 5.9 ml, p < 0.001; MDGV = 19.9 ml, p = 0.003; MDGV = 77.8%, p < 0.001). Hence, reduced gallbladder emptying with consequent stasis might be a contributory factor to the increased prevalence of gallstones in Crohn's disease.
Assuntos
Doença de Crohn/fisiopatologia , Esvaziamento da Vesícula Biliar/fisiologia , Adulto , Estudos de Casos e Controles , Colelitíase/etiologia , Doença de Crohn/complicações , Doença de Crohn/diagnóstico por imagem , Feminino , Vesícula Biliar/diagnóstico por imagem , Vesícula Biliar/fisiopatologia , Esvaziamento Gástrico/fisiologia , Humanos , Masculino , UltrassonografiaRESUMO
In order to gain insight into the possible mechanisms involved in gallstone formation in colectomized ulcerative colitis patients, we studied gallbladder motility by means of ultrasonography in three groups of subjects: controls (N = 40) and ulcerative colitis patients without (N = 30) and with (N = 20) colectomy. Impaired gallbladder emptying after a liquid fatty meal stimulus was observed in ulcerative colitis patients with colectomy compared with those obtained in ulcerative colitis patients without colectomy and controls (P = 0.001). The maximum percentage of gallbladder emptying also, was significantly lower (59.8%) than those seen in ulcerative colitis patients without colectomy (74.5%) and controls (77.8%) (P = 0.001). Diminished gallbladder emptying with ensuing stasis might be a contributory factor to the increased prevalence of gallstones in colectomized patients.
Assuntos
Colectomia/efeitos adversos , Colite Ulcerativa/cirurgia , Esvaziamento da Vesícula Biliar , Adulto , Colite Ulcerativa/patologia , Colite Ulcerativa/fisiopatologia , Feminino , Esvaziamento Gástrico , Humanos , MasculinoRESUMO
A ultra-sonografia endoscópica (USE) vem sendo aplicada em gastroenterologia desde há mais de dez anos, inicialmente de forma experimental e hoje, em grandes centros médicos, como método de diagnóstico do arsenal propedêutico, sobretudo dos processos tumorais e inflamatórios do tubo digestivo alto, pâncreas e vias biliares. O objetivo deste trabalho é a apresentaçäo da experiência pioneira de dois anos com a USE e transdutor linear em 200 casos comprovados cirurgicamente. Utilizou-se ultra-som Toshiba 250, com endoscópio acoplado, Machida, sonda eletrômica linear de 7,5 Mhz. Os resultados comprovaram uma boa sensibilidade do método, principalmente para estudo de lesöes submucosas, estadiamento de tumores esofágicos, gástricos e pancreáticos, diagnósticos de massas pancreáticas e cálculos coledocianos.