Survey of diabetic patients in a podiatric clinical setting.
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Biomedical subjects
Publications and source records attributed to R C Ross.
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A pharmacologic revolution has occurred over the past 10 years with regards to antiviral therapy, specifically medications directed against HIV. This plethora of new information must be disseminated effectively throughout the medical community. HIV infection and its numerous manifestations, both pedal and systemic, are challenging and often difficult to treat. The well-informed physician will have a distinct advantage with regard to the treatment of the patient with AIDS. The information presented here, although transient, represents a solid knowledge base, a starting point on which the clinician can build effectively.
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Ultrastructure of 55 liver biopsies obtained from 52 patients, all but 1 with psoriasis and all but 5 treated with methotrexate (MTX), have been studied. In MTX-treated psoriatics, liver cell nuclei showed reduced electron opacity with frequent cytoplasmic invaginations and glycogen inclusions. In the mitochondria nonspecific changes, such as pleomorphism, gigantism, paracrystalline inclusions, compartmentalization, signs of division and sequestration via autophagosomy were noted. The pericanalicular ectoplasm exhibited widening with accumulation of microfilaments. Detachment of desmosomal plaques between hepatocytes was common. A striking finding was the hyperplasia of fat-storing perisinusoidal (Ito) cells. No definite correlation was found between morphology, duration of disease, treatment as well as cumulative dose of MTX.
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Electron microscopy of the liver of methotrexate-treated psoriatic patients revealed junctional abnormalities consisting of detachment of desmosomal plaques between hepatocytes. Mitochondria anchoring desmosomal microfilaments were frequently noted.
A 61 year old man had chronic renal failure because of oxaluria and renal calculi. Two years before death, while on hemodialysis, he developed severe progressive peripheral neuropathy. At autopsy calcium oxalate crystals were found in the peripheral nerves and other tissues. Nerve lesions included segmental demyelination, axonal degeneration and crystalline deposits within the myelin sheath. Ultrastructurally there were foci of osmiophilic granular material within myelin lamellae and endoneurium, and pleomorphic lamellar bodies in the perinuclear Schwann cell cytoplasm. It is probable that chronic hemodialysis favors the deposition of oxalate in the Schwann cells and the development of neuropathy in patients with primary hyperoxaluria and renal failure.
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