Changing the natural history of diabetic neuropathy: incidence of ulcer/amputation in the contralateral limb of patients with a unilateral nerve decompression procedure.

The natural history of diabetes neuropathy is progressive and irreversible loss of sensibility in the feet, leading to ulceration and/or amputation in 15% of patients. The prevalence of neuropathy is more than 50% in those who have been diabetic for 20 years. Decompression of the tibial and peroneal nerves in those with diabetic neuropathy improves sensation in 70% of patients.

Teens' images of smoking and smokers.

The authors used qualitative and quantitative data to identify and interpret specific images teens have about smoking and smokers. Qualitative data were collected in 1996 from 793 teenagers participating in 125 focus groups at eight different sites across the United States. Most focus groups were homogeneous with respect to gender, ethnicity, and smoking status.

The social context of smoking among African-American and white adolescents in Baltimore City.

Objective: To describe and understand variations in social influences on smoking behavior among African-American and white male and female adolescents in Baltimore City, USA.

Design: A qualitative study where adolescents, both smokers and non-smokers, were interviewed individually (n = 21) and participated in focus groups (n = 18 focus groups, 3-10 participants per group).

Results: Social contexts emerged as most relevant and salient themes related to smoking behavior.

Experimental model of pyridoxine (B6) deficiency-induced neuropathy.

A pyridoxine (B6) dietary deficiency was studied in female adult Sprague-Dawley rats by hind-limb walking-track analysis. Serum levels of pyridoxine and three metabolites were quantified by high-pressure liquid chromatography with fluorescence measurement. Morphometric analysis of the sciatic and posterior tibial nerves (from within the tarsal tunnel) was performed after 1 year on a diet deficient in vitamin B6.

Associations of tibia lead, DMSA-chelatable lead, and blood lead with measures of peripheral nervous system function in former organolead manufacturing workers.

Background: The goals of the present study were to compare and contrast associations of blood lead, DMSA-chelatable lead, current tibia lead, and back-extrapolated "peak" tibia lead with four peripheral nervous system (PNS) sensory and motor function measures in older males with past exposure to organic and inorganic lead.

Methods: Data were collected from former organolead manufacturing workers with an average of 16 years since last occupational lead exposure. Current tibia lead levels were measured by (109)Cd x-ray fluorescence.

Utility of decompressive surgery in the prophylaxis and treatment of cisplatin neuropathy in adult rats.

Cisplatin produces a dose-dependent and dose-limiting peripheral neuropathy in patients. This study tested the hypothesis that this clinical neuropathy results from the chronic compression of peripheral nerves rendered susceptible to injury because of cisplatin-induced microtubular dysfunction. A quantitative model of cisplatin neurotoxicity was developed by administering cisplatin to rats and measuring the neuropathy by hindlimb walking track assay.

Pressure perception in the normal lower extremity and in the tarsal tunnel syndrome.

For quantitative sensory testing to be useful for the management of peripheral nerve problems, a normative database must be developed. The Pressure-Specified Sensory Device (PSSD), a handheld instrument whose hemispherical metal probe tips are connected via a force transducer to a computer, has been found reliable and valid for the upper extremity. In the present study, the PSSD was used to measure the cutaneous pressure threshold at four lower extremity sites in 34 normal adults and in 22 patients with tarsal tunnel syndrome (6 bilateral).

Computer-assisted measurement in diabetic patients with and without foot ulceration.

Computer-assisted measurement of sensibility was done at four anatomical sites of the foot of patients with diabetes with (19) and without (40) foot ulceration. Cutaneous pressure threshold measurements of patients with diabetes were compared with measurements on 30 patients without diabetes who had nonulcerated feet. Both groups had mean one-point static and moving touch, and two-point discrimination thresholds significantly different from the general population.

Correlation of measurements of pressure perception using the pressure-specified sensory device with electrodiagnostic testing.

Quantitative sensory testing of pressure threshold has been recommended for diagnosis and monitoring of peripheral nerve problems, yet there has been no validation of the results of such testing with electrodiagnostic testing (EDT), the "gold standard." The Pressure-Specified Sensory Device (PSSD) was used to measure the pressure threshold in 72 clinical nerve entrapment syndromes (23 carpal, 23 cubital, and 16 tarsal tunnel syndromes, and 10 common peroneal nerve entrapment at the fibular head), each of which also had EDT. There was diagnostic agreement between both EDT and PSSD in 54 of the 72 nerve entrapments (75%).

Identification of elastic fibres in the peripheral nerve.

Traditional histological staining techniques, as well as elastin-specific antibodies and electron microscopy, have been used to assess the distribution of elastin within the peripheral nerve. The location of the elastin identified by the VerHoeff-VanGiesen or Weigert stains has been shown to coincide with the unambiguous identification of elastin by immunospecific stains and electron microscopy. Elastin is located in all three connective layers of the peripheral nerve.