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  • 1
    Electronic Resource
    Electronic Resource
    Impaired blood flow and arterio-venous shunting in human diabetic neuropathy: a novel technique of nerve photography and fluorescein angiography (1993)
    Springer
    Diabetologia 36 (1993), S. 1266-1274 
    Details
    ISSN: 1432-0428
    Keywords: Diabetic neuropathy ; sural nerve ; nerve blood flow ; epineurial vessel photography ; fluorescein angiography ; arterio-venous shunting ; vasa nervorum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary New techniques of sural nerve photography and fluorescein angiography which are able to provide an index of nerve blood flow have been developed. Under local anaesthetic, 3 cm of sural nerve was exposed at the ankle using an operating microscope. Without disturbing the epineurium, vessels were identified and photographed at a standard magnification (× 30). These were independently graded by an ophthalmologist not otherwise involved with the study. Fluorescein angiography was then carried out on the exposed nerve. The fluorescein appearance time and intensity of fluorescence were quantified, using computer analysis of digitised images. Thirteen subjects with chronic sensory motor neuropathy, five non-neuropathic diabetic and nine normal control subjects were studied. The mean epineurial vessel pathology score of the neuropathic group was significantly higher than the combined normal control and non-neuropathic diabetic groups (p 〈0.01). Direct epineurial arteriovenous shunting was observed in six neuropathic and one non-neuropathic diabetic patients and not in any of the normal control subjects. The nerve fluorescein appearance time was significantly delayed in subjects with chronic sensory motor neuropathy (51.5 ± 12 s) compared to both normal (34.7 ± 9 s, p 〈0.01) and non-neuropathic diabetic subjects (33.4 ± 11 s, p 〈0.025). The mean intensity of fluorescence at 96, 252 and 576 s, was significantly lower in subjects with chronic sensory motor neuropathy compared with both of the other groups (p 〈0.05). The epineurial vessel pathology score was significantly related to reduced sural (p 〈0.01) and peroneal (p 〈0.001) nerve conduction velocities, elevated vibration (p 〈0.01) and thermal (p 〈0.001) perception and the severity of retinopathy (p 〈0.002). The fluorescein appearance time was significantly related to reduced sural sensory (p 〈0.02) conduction velocity, elevated vibration (p 〈0.01) perception and epineurial vessel (p 〈0.002) pathology score, but it failed to relate to peroneal motor (p = 0.06) conduction velocity, thermal (p = 0.1) perception and the severity of retinopathy (p = 0.3). Intensity of fluorescence was significantly related to fluorescein appearance time (at 96 s, p 〈0.001; at 576 s, p 〈0.05) but did not relate to measures of neuropathic severity. These techniques have enabled us to observe that epineurial vessel anatomy is abnormal and that nerve blood flow is impaired in subjects with chronic sensory motor neuropathy. In addition epineurial arterio-venous shunting may be a feature of diabetic neuropathy. These techniques may further be applied to study nerve blood flow in early diabetic neuropathy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400804
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  • 2
    Electronic Resource
    Electronic Resource
    Arterio-venous shunting and proliferating new vessels in acute painful neuropathy of rapid glycaemic control (insulin neuritis) (1996)
    Springer
    Diabetologia 39 (1996), S. 329-335 
    Details
    ISSN: 1432-0428
    Keywords: Insulin neuritis ; diabetic neuropathy ; sural nerve ; nerve blood flow ; arterio-venous shunting ; nerve ; hypoxia ; new vessel formation ; fluorescein angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin neuritis, or painful neuropathy following rapid improvement in glycaemic control, is well recognised but its aetiology is unclear. An understanding of the processes involved in the genesis of acute painful neuropathy of rapid glycaemic control may give an insight into the early pathogenetic factors leading to diabetic nerve damage in general. We have identified five subjects with insulin neuritis including one who developed severe autonomic neuropathy following treatment with insulin. Subjects underwent: 1) assessment of neuropathic symptom and deficit scores; 2) quantitative sensory and electro-physiological studies and 3) sural nerve epineurial vessel photography and fluorescein angiography in vivo. The sural nerve photographs were independently graded by an ophthalmologist. All subjects with insulin neuritis presented with severe sensory symptoms but clinical examination and electrophysiological tests were normal except in the subject with the severe autonomic neuropathy in whom all the tests were abnormal. On nerve photography, there was an abundance of epineurial nutrient vessels although these showed severe abnormalities including arteriolar attenuation, tortuosity and arterio-venous shunting in all subjects. Proliferating neural ‘new vessels’ which bear striking similarities to those found in the retina and that were more leaky to fluorescein than normal vessels, were observed in three subjects. Venous distension and/or tortuosity was also observed in three subjects and this was most marked in the subject with severe autonomic neuropathy. This study shows that epineurial nutrient vessel anatomy is abnormal in subjects with acute painful neuropathy of rapid glycaemic control, a condition previously thought to be purely metabolic in origin. The presence of epineurial arterio-venous shunting and a fine network of vessels resembling the new vessels of the retina, may lead to a ‘steal’ effect rendering the endoneurium ischaemic. This process may be important in the genesis of neuropathic pain, and further supports the importance of vascular factors in the pathogenesis of diabetic neuropathy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00418349
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Arterio-venous shunting and proliferating new vessels in acute painful neuropathy of rapid glycaemic control (insulin neuritis) (1996)
    Springer
    Diabetologia 39 (1996), S. 329-335 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Insulin neuritis ; diabetic neuropathy ; sural nerve ; nerve blood flow ; arterio-venous shunting ; nerve ; hypoxia ; new vessel formation ; fluorescein angiography.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin neuritis, or painful neuropathy following rapid improvement in glycaemic control, is well recognised but its aetiology is unclear. An understanding of the processes involved in the genesis of acute painful neuropathy of rapid glycaemic control may give an insight into the early pathogenetic factors leading to diabetic nerve damage in general. We have identified five subjects with insulin neuritis including one who developed severe autonomic neuropathy following treatment with insulin. Subjects underwent: 1) assessment of neuropathic symptom and deficit scores; 2) quantitative sensory and electrophysiological studies and 3) sural nerve epineurial vessel photography and fluorescein angiography in vivo. The sural nerve photographs were independently graded by an ophthalmologist. All subjects with insulin neuritis presented with severe sensory symptoms but clinical examination and electrophysiological tests were normal except in the subject with the severe autonomic neuropathy in whom all the tests were abnormal. On nerve photography, there was an abundance of epineurial nutrient vessels although these showed severe abnormalities including arteriolar attenuation, tortuosity and arterio-venous shunting in all subjects. Proliferating neural ’new vessels' which bear striking similarities to those found in the retina and that were more leaky to fluorescein than normal vessels, were observed in three subjects. Venous distension and/or tortuosity was also observed in three subjects and this was most marked in the subject with severe autonomic neuropathy. This study shows that epineurial nutrient vessel anatomy is abnormal in subjects with acute painful neuropathy of rapid glycaemic control, a condition previously thought to be purely metabolic in origin. The presence of epineurial arterio-venous shunting and a fine network of vessels resembling the new vessels of the retina, may lead to a ’steal' effect rendering the endoneurium ischaemic. This process may be important in the genesis of neuropathic pain, and further supports the importance of vascular factors in the pathogenesis of diabetic neuropathy. [Diabetologia (1996) 39: 329–335]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00418349
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    A critical appraisal of the prognostic and predictive factors for uveal malignant melanoma (2004)
    Oxford, UK : Blackwell Science Ltd
    Histopathology 45 (2004), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2559.2004.01874.x
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  • 5
    Electronic Resource
    Electronic Resource
    Investigation of the role of signal transduction in attachment of ocular melanoma cells to matrix proteins: inhibition of attachment by calmodulin antagonists including tamoxifen (1994)
    Springer
    Clinical & experimental metastasis 12 (1994), S. 375-384 
    Details
    ISSN: 1573-7276
    Keywords: calmodulin antagonists ; ocular melanoma ; signal transduction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated the role of signal transduction systems in the attachment of human uveal melanoma cells to matrix proteins. Ocular melanoma cells established from primary tumours attached rapidly to all substrates examined. Preferred substrates of attachment were collagens type I, III and IV and fibronectin rather than laminin, gelatin, arginine-glycine-aspartine, vitronectin, poly-I -lysine or plastic. All cells showed rapid attachment to the preferred substrates (80% within 10 min). Manipulation of intracellular cyclic AMP or protein kinase C activity had relatively little effect on cell attachment. In contrast, attachment was significantly reduced by manipulating either intracellular calcium or calmodulin. After 15 min at 37°C, the calcium ionophore ionomycin (5 μm) reduced attachment to 25%, and TMB8 (50 μM), which can reduce intracellular calcium, reduced attachment to 60%. The experimental calmodulin antagonist J8 (25 μm), a substituted naphthalene sulphonamide, reduced attachment to 40%. Similarly tamoxifen (25 μM), which has calmodulin antagonist activity in vitro,reduced attachment to 55%. Both J8 and tamoxifen inhibited cell attachment to a wide range of matrix proteins, suggesting that this effect on attachment is not dependent on the presence of specific adhesion receptors. Reduction of ocular melanoma tumour cell/matrix interactions through manipulation of intracellular calcium or calmodulin may therefore merit further investigation as a possible approach to reducing metastatic spread.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01755881
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  • 6
    Electronic Resource
    Electronic Resource
    The morphology of uveal malignant melanomas (1982)
    Springer
    Graefe's archive for clinical and experimental ophthalmology 219 (1982), S. 282-286 
    Details
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Scanning electron microscopy (S.E.M.) has been performed on tissue cultures obtained from four choroidal malignant melanomas. The morphology of these cells has been demonstrated using this technique. Microvilli were found to present on the surfaces of all cells studied. These microprocesses often formed a connection between the cell and the cover slip, or other tumour cells. Rounded vesicles were demonstrated on the surfaces of some cells. It is possible that some of the larger vesicles contained melanosomes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00231414
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    Paper (German National Licenses)
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