Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Insulin-dependent diabetes mellitus causes microangiopathic changes in many tissues, including skin and muscle. It is not known if such changes are detrimental to free flap transfer, particularly after extended ischemia. To address this issue, we used an experimental design by using a syngeneic rat strain (Lewis) for free groin flap and muscle flap transplantations from streptozotocin-induced diabetic rats (2 month's duration of symptoms) to normal rats. Flaps from age-matched normal donors were transplanted to normal recipients for control comparisons. Groin flaps were stored ischemically for 12 or 18 hours at room temperature, or for 48 hours in the cold (4 degrees C) before transplantation. Flap survival and vascular patency were assessed at 7 days. Cutaneous maximus muscle flaps were transplanted to the groins of recipients after 6 hours of room temperature ischemia. Vascular patency, muscle viability, flap weight change (edema), and dehydrogenase activity were assessed after 2 days of reperfusion. Seventy percent, 67%, and 73% of diabetic groin flaps survived after 12, 18, or 48 (cold) hours of ischemia, respectively, in comparison with 90%, 73%, and 87% of normal flaps undergoing the same respective ischemia periods. The differences were not significant, even when the data were pooled (p greater than 0.1). Muscle flaps also showed no significant differences for the parameters studied. These results support the use of microvascular reconstructive surgery in diabetic patients, suggesting that moderate ischemic challenges do not compromise free flap transfer or extremity replantation.
 ...
PMID:The influence of diabetes on free flap transfer: II. The effect of ischemia on flap survival. 149 98

In an attempt to identify novel pancreatic beta-cell surface antigens, mouse monoclonal antibodies (MoAbs) were raised against rat insulinoma (RIN5F) cells with standard techniques. Several clones were identified whose antibodies bound specifically to RIN5F cells but not to other rat, mouse, and human target cells. Each of these MoAbs was radiolabeled, and the specificity of binding of each MoAb was determined by the ability of excess cold homologous MoAb to displace the labeled MoAb. Six RIN5F cell-specific MoAbs of different epitopic specificities were identified. The relevance of these beta-cell epitopes to human insulin-dependent diabetes (IDDM) was demonstrated by the differential ability of human serums from control and diabetic children to displace the radiolabeled MoAbs from the RIN5F cells. Serums from 333 children without diabetes or a family history of diabetes and from 156 newly diagnosed IDDM patients were tested. Only one IgM MoAb was specifically displaced by the IDDM serums, i.e., 146 of 156, compared to serums from control children, i.e., 10 of 333. With immunofluorescence, the serum component responsible for the displacement of the mouse MoAb was identified as IgG. Most of the positive control serums were from children with active autoimmune thyroiditis. Serums from children with other forms of glucose intolerance did not displace MoAb 1A2. There was no correlation between age and the degree of displacement of 1A2. Thus, the displacement of 1A2 is a specific and sensitive marker of diabetes susceptibility easily applicable to mass screening.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Strong association between diabetes and displacement of mouse anti-rat insulinoma cell monoclonal antibody by human serum in vitro. 169 75

Hand skin blood flow in 32 insulin-dependent (IDDM) diabetics was compared with 13 healthy controls at room temperature and after immersion of the hands in warm and cold water. Subjects were examined for limited joint mobility (LJM) to analyse the association between this and blood flow. Digital arteries remained patent in IDDM compared to controls after cold challenge (p = 0.0001), and the difference persisted to a lesser degree 15 min (p = 0.009) and 30 min (p = 0.03) after recovery. Capillary blood flow was reduced in IDDM at room temperature at the finger nailbeds (p less than 0.02) and the palms (p = 0.004) and remained so after warm water immersion in the palms (p = 0.002), where further vasoconstriction was observed immediately after cold water immersion (p less than 0.001) and 15 and 30 min into recovery (p = 0.07 and p = 0.009 respectively). Thermographic analysis confirmed a pattern of predominantly distal rewarming after cold challenge in IDDM with a greater mean index finger temperature than the controls. Together, these features suggested enhanced arteriovenous anastomotic blood flow. All IDDM and IDDM males with LJM had reduced palm capillary flow immediately after cold challenge (p less than 0.05). After warm water (p less than 0.03) and 30 min after cold challenge (p less than 0.05) IDDM males with LJM had reduced palm capillary flow compared to those IDDM without. A microvascular aetiology for LJM is proposed by virtue of reduced nutritional blood flow and evidence of enhanced arteriovenous shunting in the hands of insulin-dependent diabetics.
 ...
PMID:Skin blood flow and limited joint mobility in insulin-dependent diabetes mellitus. 273 Sep 81

Platelet and clotting abnormalities have been described in diabetes, but little is known about their relationship to daily stresses. In order to evaluate whether states of abnormal carbohydrate metabolism modify the hemostatic response to stress, 12 subjects with type I diabetes mellitus, 9 with type II, 7 with impaired glucose tolerance and 10 healthy controls were exposed to a cold pressor test. Plasma concentrations of beta-thromboglobulin (index of platelet activation) and of fibrinopeptide A (index of thrombin formation) were measured before and 15 minutes after forearm immersion in melting ice. Basal levels of both proteins were significantly elevated (p less than 0.02) in the combined group of patients with diabetes and impaired glucose tolerance. While in healthy controls cold exposure failed to modify plasma concentration of either protein, obvious changes occurred in the diabetic and impaired glucose tolerance groups. In the combined patients group, beta-thromboglobulin levels decreased from 1.37 +/- 0.44 nmol/l to 1.03 +/- 0.39 (mean +/- SD, p less than 0.01), after the cold test, possibly in consequence of enhanced vascular permeability; while fibrinopeptide A levels increased from 1.52 +/- 1.03 nmol/l to 3.45 +/- 4.19 (p less than 0.02). The degree and pattern of abnormalities observed in basal as well as stimulated levels of fibrinopeptide A differed somewhat among the three groups of patients. These studies indicate that, in the basal state, patients with diabetes or simple carbohydrate intolerance are more susceptible than controls to platelet activation and that after stress thrombin formation can occur although some variability exists among and within groups of patients. The consequences of such increased thrombotic activity may have a bearing on the pathogenesis of large vessel disease, a complication common to diabetes and impaired glucose tolerance.
 ...
PMID:Platelet and clotting activities after cold stress in diabetic patients. 297 Jun 90

Disturbed upper limb skin blood flow has been described in insulin-dependent (Type 1) diabetes mellitus, but the pathophysiological mechanism remains unclear. Hand skin blood flow was therefore measured at room temperature and following immersion of hands in cold and warm water in 13 healthy control subjects, in 10 patients with Type 1 diabetes mellitus and cardiovascular autonomic neuropathy, and a further 10 Type 1 diabetic patients with normal cardiovascular autonomic tone. Following cold challenge there was failure of digital artery clampdown in all diabetic patients in comparison with healthy control subjects (p less than 0.005), and the index finger temperature fell less (p less than 0.05). Laser Doppler flow was reduced at the palms at room temperature or following the warm challenge (p less than 0.008), as well as on the dorsum at room temperature (p less than 0.05), in all diabetic patients. In addition laser Doppler flow in the diabetic patients was reduced at the palms and dorsum immediately following cold water challenge (p less than 0.004) and this reduction persisted 15 min (p less than 0.05) and 30 min (p less than 0.01) into the recovery phase. In comparison to those diabetic patients with normal cardiovascular tone, those with cardiovascular autonomic neuropathy had reduced laser Doppler flow at the pulp 15 min after cold water immersion (p less than 0.05), at the nailbed immediately after cold water immersion (p less than 0.01), and at the palms immediately after warm water challenge (p less than 0.01).
 ...
PMID:Altered hand skin blood flow in type 1 (insulin-dependent) diabetes mellitus. 297 48

Nine insulin-dependent diabetic (IDDM) patients (aged 25-37 yr) with no symptoms of autonomic neuropathy and 15 healthy control subjects (aged 26-39 yr) were studied at rest and during tests of Valsalva maneuver, deep breathing, cold pressor, and postural change from sitting to standing. Continuous (beat-to-beat) measures were taken of heart rate, systolic blood pressure, diastolic blood pressure, and skin conductance. The diabetic patients were differentiated from the control group by the following: less variability in diastolic blood pressure during deep breathing, failure to exhibit diastolic blood pressure decreases during recovery from a cold pressor stimulus, a flatter blood pressure response pattern when changing from sitting to standing, and a smaller standing ratio (maximum/minimum) for R-R interval. Among the patients, age was negatively correlated with systolic and diastolic standing ratios and diastolic blood pressure variability during deep breathing. By use of the tracking cuff, a method of continuously recording blood pressure noninvasively, we have been able to assess subtle blood pressure changes, thereby revealing signs of sympathetic dysfunction in a group of relatively young diabetic patients with no symptoms of neuropathy. The tracking-cuff method of recording blood pressure has potential in further research on autonomic functioning in diabetic patients.
 ...
PMID:Beat-to-beat blood pressure response in asymptomatic IDDM subjects. 324 97

Transplantations of pancreas grafts are performed in patients with juvenile onset of diabetes to halt the progression of secondary microangiopathic organ lesions. The treatment of the exocrine secretion of pancreas grafts remains problematic. Duct occlusion seems to be the safest approach but results in fibrosis of the gland. Therefore more recently drainage is directed to a hollow organ, generally performed as pancreaticojejunostomy. New immunosuppressive therapies improved the transplant results. The diagnosis of occurring rejection is difficult since monitoring of plasma glucoses is not very sensitive. Cold storage of grafts in SGF-solution is a reliable preservation procedure. Islet cell transplantation might be a promising alternative technique in the future.
 ...
PMID:[Pancreas transplantation: status of the problem in experimental and clinical medicine]. 393 92

The brachial artery pressure and retinal artery pressure responses to a one-minute cold pressor test were evaluated simultaneously in 14 patients with type I diabetes mellitus (six with and eight without diabetic retinopathy) and 10 age-matched control subjects. Five patients with type I diabetes had autonomic neuropathy. Mean baseline brachial artery pressure and retinal artery pressure were similar in patients with type I diabetes and control subjects. After cold pressor testing, the brachial artery pressure increased significantly (p less than 0.01) compared with baseline values in both groups. Retinal mean arterial pressures increased significantly (p less than 0.001) after cold pressor testing compared with the baseline values only in patients with type I diabetes. Positive correlation was found between the brachial and retinal mean arterial pressures after cold pressor testing (r = 0.48; p less than 0.05) in the diabetic patients but not in the control subjects (r = 0.10; p = NS). No correlation was found between the retinal artery pressure and age of onset of diabetes, duration of diabetes, the presence or absence of diabetic retinopathy, and glycemic control. Four patients with autonomic neuropathy and low retinal artery pressures, which remained unchanged after cold pressor testing, had no diabetic retinopathy. The fifth patient with autonomic neuropathy and exaggerated systolic brachial artery pressure (175 mm Hg) and retinal artery pressure (more than 80 mm Hg) responses had severe background diabetic retinopathy. In conclusion, abnormal retinal artery responses to stress are present in patients with type I diabetes. This may be modified by the presence or absence of both autonomic neuropathy and hypertension. The biologic significance of these findings is yet to be determined.
 ...
PMID:Abnormal retinal artery responses to stress in patients with type I diabetes. 398 37

Two kidneys were removed from a cadaveric donor with 17-year history of type 1 diabetes. At the time of death the donor had proteinuria but normal serum creatinine, and on histological examination the kidneys showed features of established diabetic nephropathy including diffuse glomerulosclerosis and thickening of mesangial matrix and capillary basement membranes. After transplantation into non-diabetic recipients (cold ischaemia times 46 h and 52 h) the kidneys functioned well with standard immunosuppression. Renal biopsy specimens taken 7 months after transplantation showed almost complete resolution of the nephropathy and both patients remain free from proteinuria after a further 7 months. As well as indicating that longstanding type 1 diabetes need not always contraindicate kidney donation, these observations are relevant to the pathogenesis and management of diabetic nephropathy.
 ...
PMID:Reversal of diabetic nephropathy in human cadaveric kidneys after transplantation into non-diabetic recipients. 613 20

Both islet cytoplasmic and cell surface antibodies (ICA and ICSA) were studied from the onset of diabetes to the honeymoon in an insulin-dependent diabetic patient. The patient, a 24-year-old male, was admitted to the hospital because of ketoacidotic hyperglycemic precoma. Continuous subcutaneous infusion of a small dose of insulin was carried out for a couple of days followed by NPH-insulin injection. The dose was gradually decreased and on the 45th day after the onset, an oral hypoglycemic agent was substituted for insulin. The patient was followed up after discharge from the hospital and his disease was controlled well by diet and a hypoglycemic agent until he caught a common cold. He was then admitted again to the hospital because of hyperglycemia, and insulin injection was performed. Both ICA and ICSA were found independently of each other during the course of the disease. The ICSA, which was quantitatively determined by immunoassay using 125I-protein A, closely paralleled the clinical profile. However, the levels of quantitative ICSA were higher than normal, even though the patient's diabetes reached the honeymoon stage. These results suggest that quantitative ICSA has a strong association with the clinical profile in IDDM, and it may be a "marker" of islet cell damage during the diabetic period or a parameter for diabetic prognosis.
 ...
PMID:A clinical profile of insulin-dependent diabetes with islet cell cytoplasmic and cell surface antibodies. 639 2


1 2 3 4 5 6 7 8 Next >>