Current status of non-insulin-dependent diabetes mellitus (type II): management with gliclazide.

Non-insulin-dependent diabetes mellitus (NIDDM) is a major cause of morbidity and mortality worldwide, with a prevalence of 3-7% in most Western countries. Decreased insulin secretion and diminished tissue insulin sensitivity are both implicated in the pathogenesis of the disease; both may be exacerbated by persistent hyperglycemia and improved by normalization of blood sugar levels. Measures to control hyperglycemia, hypertension, and hyperlipidemia are important in the management of NIDDM and prevention of its long-term complications.

Calcification in an insulinoma of the pancreas.

Calcifications in islet cell tumors of the pancreas are rarely seen radiologically. We are reporting a case of an insulinoma with "sunburst" type calcification that has been previously described as specific for cystadenoma or cystadenocarcinoma of the pancreas.

Recognition and complications of diabetes in the older patient.

An international classification of diabetes and other disorders of glucose intolerance is presented. The disorder is subdivided into insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus (NIDDM), and various forms of impaired glucose tolerance (IGT). Diagnostic criteria are discussed in detail, as are guidelines in management, including emotional support, nutritional requirements, and patient education.

Large retroperitoneal cysts in children and adolescents.

Retroperitoneal cysts may be divided into those of urogenital origin: pronephric, mesonephric, metanephric and müllerian; mesocolic; teratoma; lymphatic; parasitic, and traumatic blood cysts. Müllerian cysts are thought to originate from the specialized mesothelial cells of the genital ridge and present as fimbrial cysts or broad ligament wolffian cysts. Symptoms may be absent, or the result of pressure or displacement of an organ.

Progress in limb salvage by reconstructive arterial surgery combined with new or improved adjunctive procedures.

In the past nine years, 1196 patients whose lower extremity was threatened because of infrainguinal arteriosclerosis have been treated at Montefiore Hospital. In the last six years, limb salvage was attempted in 679 or 90% of 755 patients. Femoropopliteal (318), small vessel (204) and axillopopliteal (29) bypasses were used along with transluminal angioplasty (128) and aggressive local operations to obtain a healed foot.

Why control diabetes?

The concept that appropriate therapy for diabetes should achieve levels of fasting and postprandial blood, serum, or plasma glucose values as close to those of the nondiabetic as possible may be philosophically correct, but in practice is most difficult to obtain.

Long-term effects of pancreatic transplant function in patients with advanced juvenile-onset diabetes.

Present methods of management of juvenile-onset diabetes mellitus do not prevent serious and debilitating complications affecting multiple organ systems. In an effort to reverse advanced forms of these complications, segmental transplantation of the pancreas has been performed on 10 patients, seven of whom simultaneously or subsequently received renal transplants. Long periods of normoglycemia (two to four and one-half years) were achieved in two patients who also maintained transplant kidney function.