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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Zygomycosis of the basal ganglia should be recognized as a syndrome in intravenous drug users associated with a culture-negative cellular CSF, fever, lethargy, and lesions apparent on contrast-enhanced CT scans of the head. The infection is most likely the result of intravenous inoculation of fungal spores. This entity is different from the rhinocerebral zygomycosis seen with diabetes mellitus and other diseases. In the rhinocerebral form, there are external signs of the disease with involvement of the orbit, paranasal sinuses, and palate. In these drug users, infection was directed to areas deep within the brain.
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PMID:Zygomycosis of the basal ganglia in intravenous drug users. 264 54

Neurochemical alterations in several rodent models of insulin-dependent diabetes are compared and their relevance to behavioral and physiological pathology in the clinical disorder is discussed. In the majority of rodent models, reductions in metabolism of norepinephrine (NE), dopamine (DA) and serotonin (5HT) in the central nervous system (CNS) have been reported. While there are two reports of increased 5HT turnover in CSF or post-mortem brains of diabetic humans experiencing severe ketoacidosis, these patients were receiving insulin therapy. Insulin appears to have effects on monoamines opposite to that of chronic hyperglycemia. Both in rodent models and in clinical populations, there is widespread evidence of enhanced hormonal and behavioral responsiveness to stress. There are findings in rodent models indicating that hormonal responses to stress are related to CNS monoamine activity. The mechanisms responsible for both hormonal and CNS alterations in diabetes, as well as their involvement in behavioral pathology, can best be investigated further using animal models.
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PMID:Diabetes mellitus: stress, neurochemistry and behavior. 269 27

A review of 15 cases of pancreas transplantation at the Presbyterian University Hospital in Pittsburgh showed that all of the neurologic complications occurred outside of the pancreas transplantation surgery itself. Major CNS complications included hypoxic encephalopathy (20 per cent), cerebral and spinal-cord infarction (7 per cent), and seizures (13 per cent). These appeared to be closely associated with cardiovascular collapse or cardiac arrest that often occurred following septic, hemorrhagic, or additional surgical-anesthetic stresses, removed in time from the transplantation. When patients who died of sudden cardiorespiratory arrest were included, the overall frequency of global cerebral ischemia was 33 per cent. The occurrence of herpes zoster neuritis (13 per cent) was contrasted with the lack of CNS infections. The possible associations of visual hallucinations with cyclosporine therapy (7 per cent), CSF pleocytosis with OKT3 therapy (7 per cent), and compressive neuropathy with operative-anesthetic monitoring (7 per cent) were discussed in relation to previous reports in the literature. Randomized controlled clinical studies were suggested to distinguish more clearly the complications due to pancreas transplantation from those due to the natural history of the underlying diabetes and to distinguish the beneficial and adverse effects of pancreas transplants from those of coexisting renal transplants.
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PMID:Neurologic complications of pancreas transplants. 304 46

The existence of myelopathy as a complication of diabetes is debatable and, in the few reported cases, spinal involvement has been diffuse. We describe 2 cases of focal myelopathy. Two insulin-dependent, middle-aged men with adult-onset diabetes presented with gradually ascending lower limb pain and numbness without sphincteric symptoms. Examination showed mixed upper and lower motor signs in the lower limbs, with a severe impairment of cutaneous sensation below a sharply demarcated band at the T9-10 level with relative preservation of posterior column function. Myelography was normal. CSF showed mild elevation of protein and in one case showed 23 x 10(6) white cells/L. Nerve conduction studies showed a co-existing, mild sensorimotor neuropathy. There was no evidence of truncal radiculopathy on paraspinal EMG. Extensive investigation for other causes of myelopathy was negative.
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PMID:Diabetic focal myelopathy. 326 39

Techniques of in vitro receptor autoradiography were used to visualize binding of 125I-insulin on slices of frozen rat brain. Slide-mounted sections of frozen rat brain were incubated in 0.05 nM porcine 125I-monoiodoinsulin, alone or mixed with 1 microM unlabeled porcine insulin, ribonuclease, or glucagon, for 2 h at 22 degrees C. The labeled brain slices were apposed to LKB Ultrofilm to generate autoradiograms. The method permitted equal access of labeled insulin to both sides of the blood-brain barrier and localization of insulin binding sites in small anatomic regions. Quantitative estimates of specific iodoinsulin binding were made by computer digital image densitometry of the autoradiographic film images. High concentrations of specific binding sites for iodoinsulin were present in the choroid plexus of the lateral (26.9 +/- 2.0 X 10(-3) fmol/mm2), fourth (18.3 +/- 3.0 X 10(-3) fmol/mm2), and third (13.2 +/- 1.5 X 10(-3) fmol/mm2) ventricles (insulin binding is expressed per unit area of autoradiographic image). Binding to the third ventricular choroid plexus was similar to the concentrations observed for liver slices and the external plexiform layer of the olfactory bulb. Specific binding of iodoinsulin in the cingulate cortex and other surrounding regions was less than in choroid plexus. Ribonuclease or glucagon had no measurable effect on binding when mixed with labeled insulin. The results support the hypothesis that the choroid plexus has a high density of receptors for insulin, and suggests that the choroid plexus may be a target of CSF insulin action and/or a site of insulin transport into the CSF.
Diabetes 1986 Feb
PMID:Quantitative autoradiographic evidence for insulin receptors in the choroid plexus of the rat brain. 351 Sep 31

We have reported an unusual case of Candida glabrata meningitis causing acute changes in mental status in a chronically ill, elderly patient with non-insulin-dependent diabetes mellitus. Candida glabrata was identified by Gram stain, culture, and fermentation pattern from the CSF. Although the patient died of foreign body aspiration, an excellent clinical response was initially obtained with amphotericin B and 5-flucytosine. This is the first report of a symptomatic Candida glabrata meningitis.
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PMID:Candida glabrata meningitis. 372 96

Insulin is a known growth factor in nonneural tissue, and recent studies have shown that there are insulin receptors throughout the adult and fetal central nervous system. Since insulin has only limited access to the adult brain, this study was undertaken to determine if insulin has increased availability to the newborn brain where it may act as a neonatal brain growth promoter. In vivo brain uptake of 125I-insulin after a single-pass carotid injection was measured in newborn, 3-wk-old and 11-wk-old (adult) rabbits. The brain uptake index (BUI) relative to a 3HOH reference was 22.0 +/- 1.1% (mean +/- SEM) for newborn, 12.8 +/- 0.6% for 3-wk-old, and 6.5 +/- 0.1% for adults. Specific 125I-insulin binding to isolated cerebral microvessels was similarly increased in the newborn (60.6 +/- 3.3%/mg protein) compared with the 3-wk-old (23.8 +/- 1.7) and adult animals (13.6 +/- 1.9). Scatchard analysis revealed that the difference was due to an increase in receptor number with only minimal changes in the affinity. The increased availability of circulating insulin to the newborn brain was further corroborated by elevated CSF/serum and brain/serum insulin ratios in the newborn versus adult. These results suggest that insulin has increased access to the newborn brain where it may function as a growth factor.
Diabetes 1985 Aug
PMID:Enhanced insulin binding to blood-brain barrier in vivo and to brain microvessels in vitro in newborn rabbits. 389 16

Lactate concentrations in the cerebrospinal fluid of 104 patients were determined by the Monotest Lactate Kit. Lactate values were found higher in cases of bacterial meningitis than in patients not suffering from acute CNS disorders. Elevated lactate levels were also found in patients suffering from aseptic meningitis, septicemia, CNS trauma and cerebrovascular accidents, seizures and diabetes mellitus. The highest levels were found in cases of bacterial meningitis, but there was considerable overlapping between the groups. CSF lactate thus appears to have limited diagnostic value in the differential diagnosis between bacterial meningitis and other diseases with meningeal involvement.
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PMID:Value of CSF lactate in the differential diagnosis between bacterial meningitis and other diseases with meningeal involvement. 398 42

Patients studied during recovery from an episode of ketoacidotic diabetes had raised blood glucose, plasma free fatty acid and plasma free tryptophan concentrations. Plasma total tryptophan was decreased. Well controlled diabetics showed normal values. The ketoacidotic patients had increased lumbar CSF tryptophan and 5-hydroxyindoleacetic acid concentrations. Plasma tyrosine and CSF tyrosine and homovanillic acid concentrations were normal in both diabetic groups. The results are discussed in relation to somewhat similar findings in uraemic and hepatic encephalopathy and to changes in rats with streptozotocin diabetes.
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PMID:Brain transmitter precursors and metabolites in diabetic ketoacidosis. 618 Dec 9

The authors give a very complete description of the Kearns and Sayre syndrome : external ophthalmoplegia, pigmentary retinitis, cardiac conduction disorders, cerebellar syndrome, hypacusis, reduced height, raised CSF protein levels, mitochondrial anomalies in muscle, skin, and conjunctivae, and low density zones on scanning. They emphasize the not-infrequent association of endocrine anomalies : hypoparathyroidism, which may be the first manifestation of the disease, and diabetes. The etiology of this syndrome, which occurs sporadically and starts in infancy, is still unknown.
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PMID:[Kearns and Sayre syndrome with hypoparathyroidism and diabetes (author's transl)]. 625 52


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