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Biomedical subjects

C A Robinson

Publications and source records attributed to C A Robinson.

15 recordsLinked to original sources

Microalbuminuria associated with diabetic neuropathy.

OBJECTIVE: To test the hypothesis that microalbuminuria may show an independent statistical association with diabetic neuropathy. RESEARCH DESIGN AND METHODS: An observational study of a prospectively identified cohort was conducted at the University Medical Center. The cohort consisted of 78 consecutive diabetic patients who fulfilled the criteria of having diabetes for greater than 10 yr, a normal serum creatinine, urine negative for macroalbuminuria by a commonly used dipstick method, a blood glucose less than 13.8 mM (less than 250 mg/dl), and an HbA1 less than 11% (normal range 5.5-8.5%). Medical record review established the presence of chronic complications of diabetes. Urine albumin level was measured by radioimmunoassay. Albumin concn greater than or equal to 15 mg/L was used as a cutoff value for microalbuminuria. RESULTS: Twenty-five of 78 patients (32%) showed microalbuminuria. Of these, 51% had neuropathy, 39% had retinopathy, 35% arterial hypertension, 17% peripheral vascular disease, and 15% ischemic heart disease. After adjusting for age, sex, and type and duration of diabetes, diabetic neuropathy and hypertension showed a significant association with microalbuminuria. After adjusting for other diabetic complications, diabetic neuropathy showed a significant association with microalbuminuria. CONCLUSIONS: Microalbuminuria is independently associated with diabetic neuropathy. This association lends support to the theory of a vascular etiology for diabetic distal symmetrical neuropathy.

Albuminuria

Computed tomographic evaluation of pear-shaped bladder.

Computed tomography (CT) was used to distinguish between pelvic lipomatosis and idiopathic inferior vena caval thrombosis as a cause of a pear-shaped bladder seen on intravenous urography. The findings on CT were explicit in explaining the patient's clinical problem.

Adult

Histologic grading of Wilms' tumor as potential prognostic factor: results of a retrospective study of 26 patients.

A histologic grading system based on tumor differentiation was applied in a retrospective study of 26 patients with Wilms' tumor to determine if it might provide an index to prognosis. The results were compared to those obtained by applying a histologic classification based on the presence or absence of individual histologic structures to the same tumors. Low grade tumors with predominance of differentiated structures--glomeruli and tubules--were associated with a better cure rate than high grade tumors composed mainly of undifferentiated spindle elements. The presence of undifferentiated large cells correlated with poor cure rate. The findings suggest that histologic grading may be valid as a prognostic factor in Wilms' tumor.

Adolescent

Selective involvement of the first carpometacarpal joint in scleroderma.

Selective involvement of the first carpometacarpal joint is described in four women with scleroderma. Radiographic abnormalities at this site included osseous erosion, radial subluxation of the metacarpal base, and (in two patients) intraarticular calcification. Perlarticular osseous erosions were noted at adjacent locations in three patients. The cause of this distinctive wrist finding in scleroderma is unknown, but its similarity to alterations in other connective tissue diseases suggests that muscular and tendon imbalance may be important in producing bone erosion and subluxation at this articulation.

Aged

Association of diffuse idiopathic skeletal hyperostosis (DISH) and calcification and ossification of the posterior longitudinal ligament.

Diffuse idiopathic skeletal hyperostosis (DISH) is a common ossifying diathesis in middle-aged and elderly patients characterized by bone proliferation along the anterior aspect of the spine and at extraspinal sites of ligament and tendon attachment to bone. Four patients with DISH revealed extensive calcification and ossification of the posterior longitudinal ligament in the cervical spine. Review of cervical spine radiographs in 74 additional patients with DISH demonstrated bony hyperostosis of the posterior aspect of the vertebrae in 41%, posterior spinal osteophytosis in 34%, and posterior longitudinal ligament calcification and ossification in 50%. These ligamentous findings, which have previously been described almost exclusively in Japanese people, appear to be an additional skeletal manifestation of DISH.

Aged

Pitfalls of the alcohol dehydrogenase procedure for the emergency assay of alcohol: a case study of isopropanol overdose.

We describe a case of ethanol and isopropanol ingestion that resulted in coma. The concentration of ethanol and isopropanol was 0.90 and 1.65 g/liter in serum and 3.12 and 5.34 g/liter in gastric contents. With an enzymatic (alcohol dehydrogenase) method for ethanol determination we obtained erroneous analytical results. Because of partial cross reactivity with isopropanol, ethanol concentration was overestimated and total alcohol (i.e., the contribution of isopropanol) was underestimated. This was recognized by measuring serum osmolality. Differences between measured and calculated serum osmolality that are not accounted for by the serum ethanol concentration as determined by an enzymatic ethanol method must be further investigated by specific methods to see if other alcohols are present.

1-Propanol

Simple method for estimating glycosylated hemoglobins, and its application to evaluation of diabetic patients.

Recent reports have suggested that determination of glycosylated hemoglobin may serve as a clinical aid for long-term blood glucose control in diabetes mellitus. We describe a simple procedure for measuring it by ion-exchange chromatography. Hemolysates were subjected to Bio-Rex 70 chromatographic separation on small columns. Percentages in the normal group ranged from 4.7 to 8.8% of total hemoglobin; the mean +/- standard error was 6.61 +/- 0.31%. Values in the diabetic group ranged from 6.9 to 17.4%; the mean was 10.83 +/- 0.34. Plasma glucose concentrations after fasting, plotted vs. the percent of glycosylated hemoglobin, revealed a linear relationship at normal or moderately high glucose concentrations. However, the values for glycosylated hemolgobin approached a plateau with grossly higher plasma glucose concentrations after fasting. Our results support the view that, due to its long half-life, the estimation of glycoylated hemoglobin reflects the integrated glucose concentrations to which the erythrocytes have been previously exposed.

Adult

Evaluation of narcotic and narcotic antagonist interactions in primates.

Multiple and single drug interactions were studied in morphine-dependent monkeys whose dependency was maintained by self-infusion. Naloxone, naltrexone, and cyclazocine precipitated abstinence syndrome which the animals generally controlled with increased morphine intake. Methadone and L-alpha-acetylmethadol (LAAM) initially reduced, then increased, the morphine intake. Multiple interactions were studied using ethanol, seconal, diazepam, amphetamine, and diphenylhydantoin.

Animals

Evaluation of an automated glucose-oxidase procedure.

We evaluated a slight modification of the automated oxidase/peroxidase method for glucose determination in blood with use of 4-aminophenazone [J. Clin. Pathol. 22, 246 (1969)]. Nonsugar reducing substances did not interfere, except for ascorbic acid in very high concentrations. Lipemic sera gave slightly lower values. Values for reproducibility, specificity, and sensitivity were closer to such values for the hexokinase method than was the case for some other commonly used methods.

Aminopyrine