Blood flow in the foot, polyneuropathy and foot ulceration in diabetes mellitus.

Comparable groups of diabetic patients asymptomatic of neuropathy (Group A), with chronic painful polyneuropathy (Group B) and painless polyneuropathy causing recurrent foot ulceration (Group C) were studied for differences in pedal blood flow, peripheral somatic and autonomic neuropathy and vascular calcification. Blood flow abnormalities detected by doppler waveform analysis, and consistent with reduced peripheral vascular resistance, were found in all three diabetic patient groups. The abnormalities were of similar severity in Group A and B but generally more marked in Group C.

Immune changes associated with insulin dependent diabetes may remit without causing the disease: a study in identical twins.

Activation of T lymphocytes and islet cell antibodies were studied in two groups of insulin dependent diabetics and their non-diabetic identical cotwins. Group 1 comprised 12 "short term" twin pairs (diabetic twin diagnosed less than five years previously) in whom only a third of the cotwins were likely to develop diabetes; 10 of the 12 non-diabetic cotwins showed increased values of activated T lymphocytes, islet cell antibodies, or both. Group 2 comprised 10 "long term" twin pairs (diabetic twin diagnosed more than 11 years previously) in whom none of the non-diabetic cotwins was likely to develop diabetes; these pairs were selected because all the non-diabetic cotwins had shown islet cell antibodies at some time in the past, but only two still did so (one with an increased value of activated T cells).

Value of insulin autoantibodies as serum markers for insulin-dependent diabetes mellitus.

Insulin autoantibodies (IAA) were studied in newly diagnosed insulin-dependent diabetics before the start of insulin treatment and in unaffected identical twins of insulin-dependent diabetics. In 15 of the 40 (38%) diabetics and 27 of the 58 (47%) twins IAA levels exceeded those of 100 controls. Frequency of IAA in unaffected twins was not related to duration of diabetes in their affected twin.

Outpatient stabilization programme--an innovative approach in the management of diabetes.

An outpatient stabilization programme for diabetic patients was established to overcome the disadvantages of inpatient treatment. The day to day management of patients was carried out by experienced nurse/educators under the supervision of physicians. The telephone was used extensively for communication between the patients and staff of the Diabetes Centre.

Height at diagnosis of diabetes in children: a study in identical twins.

The height at diagnosis of 16 insulin dependent diabetics aged under 19 was compared with that of their unaffected identical cotwins measured at the same time. In eight pairs the diabetic was shorter, and in the remainder the cotwins were the same height. In those diabetics who were shorter than their cotwins at diagnosis the average period of growth delay before diagnosis was at least 35 weeks; by contrast, the mean duration of symptoms was only six weeks.

Pathogenesis of insulin-dependent diabetes: a role for activated T lymphocytes.

Expression of HLA DR antigens on T lymphocytes indicates that these cells are actively involved in an immune response. Raised levels of activated T lymphocytes were found in 14 of 15 recently diagnosed but in only 7 of 28 long-standing insulin-dependent diabetics. 9 of the recently diagnosed patients retested 6 months later still had high levels of activated T lymphocytes.

Development of the diabetes knowledge (DKN) scales: forms DKNA, DKNB, and DKNC.

The Diabetes Knowledge Assessment (DKN) scales were developed to meet a specific need for rapid and reliable knowledge assessment in diabetic patients. Item format and item selection from an initial pool of 89 items were determined by pilot-testing over 300 diabetic subjects. Reliability analysis of the resulting 40 multiple-choice items, with a further sample of 56 subjects, gave a Cronbach's alpha coefficient of 0.

Angiographic patterns of involvement in renal and perirenal lymphoma.

Ten patients with renal lymphoma studied by selective angiography are reported. Seven patients had unilateral and 3 had bilateral involvement. A localized mass was seen in 6 patients and diffuse infiltration in 3.

Ring-shaped calcification of renal mass.

A case of peripherally calcified renal mass is presented which was interpreted as being a benign, calcified, developmental nephrogenic cyst. A differential diagnosis of calcified renal masses is presented.

Retroperitoneal cystic lymphangioma.

A case of a large retroperitoneal tumor in a previously asymptomatic twenty-two-year-old white female is presented. A review of the literature confirms the rarity of this tumor. Its histologic and embryologic derivation as well as its subtle and bizarre method of presentation are discussed.

Radionuclide cerebral angiographic evaluation of a diploic extracranial meningioma: case report.

A case of a diploic extracranial meningioma whose true vascularity was more significantly defined by radionuclide angiography than by selective contrast angiography is presented. The radionuclide angiogram clearly demonstrated large venous channels draining the tumor.