[The place of diabetic children in society].
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Biomedical subjects
Publications and source records attributed to M Molnár.
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Ion sensitive potassium selective double barrel micropipettes were used to measure simultaneously the changes in extracellular potassium and extracellular field potentials at identical locations in the cerebral cortex of head restrained cats. Field potential changes were evoked by direct electrical cortical stimulation, by electrical stimulation of the mesencephalic reticular formation, by painful cutaneous shock and by presenting meaningful stimuli like food. Field potential changes that may occur during the spontaneous oscillations of alertness were also recorded. The surface negative field potentials evoked by electrical stimulation of the cortex, mesencephalic reticular formation or by painful cutaneous shock were accompanied by marked extracellular potassium increases. Conspicuously large potassium increases (nearing the 10 mM levels) accompanied the "event-related" potentials elicited by meaningful stimuli, while no consistent relationship could be observed between the changes of extracellular field potential and potassium. Compared to these events, minor extracellular potassium shifts were seen during the spontaneous oscillations of alertness, although marked potassium increases could be observed in the absence of any provoking stimuli as well. It is suggested that both neuronal and glial elements are involved in the genesis of slow cortical potentials.
A total of 108 diabetic children and 153 controls has been examined by explorative methods and questionnaires. According to the results the relationship between the diabetic child and his surroundings is not satisfactory. The sporting possibilities of the diabetic child are scanty, often without reason. All this may be in relation with the erroneous knowledge on diabetes of the child and his environment. The diabetic children familiar with their disease are in a more advantageous position. In consequence diabetic children need more attention and care. Well-trained experts and teams have to direct their way of life.
Epilepsy was induced by making freeze lesions bilaterally in the mesencephalic reticular formation of cats. The convulsive activity was an equivalent of the generalized status epilepticus, devaloping 15-20 min after the freeze lesions had been made. The animals died in this state 16-20 h after it had developed. The generalized seizure activity may have spread to rostra1 structures from the lesioned mesencephalic reticular formation generalizing instantenously, or have been triggered and maintained by a local irritative zone, surrounding the necrotized tissue caused by freezing. The cooling of the same cryoprobes, by which the freeze lesions had been made, had no effect on the status epilepticus, probably because only the necrotized tissue was cooled. The cooling of the inferior thalamic peduncles changed the pattern of epileptic discharges, indicating that thalamocortical structures played a role in sustaining it.
The analysis of intracortical field potentials in freely moving animals may help to reveal the origin of evoked potential components displaying characteristic changes in behavioral experiments. The authors describe a chronically implantable multielectrode made of 7 teflon insulated platinum wires of 75 microns diameter. The novelty of this multielectrode is that the wires are not glued together but penetrate into the cortex independently. In the final position the cut ends serving as recording surfaces are situated in the cortical tissue below each other at equal distances of 300-400 microns. This arrangement made possible the artifact free recording of the evoked field potentials from the different depths of the auditory cortex for months. Phase reversal, known from the classical studies, could be observed only in the first surface positive component, while the late waves appeared homogeneously throughout the whole depth of the cortex.
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The cortisol level was studied during and after delivery in the mothers and their newborns after normal deliveries, elective Caesarean sections, and steroid pre-treated vaginal deliveries. The suppressive effect of Caesarean section, and steroid pre-treated vaginal deliveries. The suppressive effect of exogenous steroid was observed in both the mother and the newborn but its extent was not significant and its duration transitory; in 48 hours it disappeared. In the newborns delivered by elective Caesarean section, an extreme increase in the cortisol level was observed. The cortisol level in the amniotic fluid was not suitable for evaluating the function of the hypophysis-adrenal axis, especially not after steroid prophylaxis.
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The clinical and pathological data of a 48 year old patient who survived 40 days are reported. Her disturbance of consciousness corresponded to an apallic syndrome, which 12 days later bacame akinetic mutism. Symmetrical softening involving the medial thalamic nuclei from the plane of the corpora mamillaria to the red nuclei was found. The ischemic lesion might be explained by transient circulatory collapse combined with hypoplasia of the vertebrobasialr arteries. On the EEG slight irregular alpha activity was recorded (alpha coma) and external stimuli elicited theta-delta waves (paradox activation). A survey of the literature of akinetic mutism is included and the correlation between non-hypnoid unconsciousness and EEG is discussed.
In diabetic children, the effect on serum lipids of insulin by itself and combined with glucose of with Aminosol + glucose has been studied. The level of serum free fatty acids decreased significantly in every case. The cephalin level decreased under the effect of insulin and insulin + Aminosol, whereas it rose after insulin and glucose infusion. The triglyceride level remained unchanged when insulin was applied by itself, and decreased significantly under the effect of insulin + Aminosol, while it showed a rising tendency after insulin + glucose infusion.
The authors have carried out fluorescein angiography in infantile diabetics--negative by ophthalmoscopy,--looking for the earliest symptoms of microangiopathy. The study concerned 161 diabetics in the age between 3-18, and 50 non-diabetic children in the same age. There is no significant difference between diabetics and control-group in the frequency of symptoms, described in literature as early signs of microangiopathy, as multiple capillary-, and peripapillary-filling and early venous dilatation. Increased capillary filling was found at anxious children with strained cervical muscles during the examination. In 54% of the 161 diabetic patients-negative by ophthalmoscopy,-solitary or multiple microaneurysms were found fluorescence angiographically. The increase of number of the microaneurysms is correlated to the duration of the diabetics and advance in age. In the authors opinion the presence of microaneurysms is in some cases due to genetic factors and is independent from the metabolic changes of diabetes.
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