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Biomedical subjects

R Engerman

Publications and source records attributed to R Engerman.

8 recordsLinked to original sources

Ocular complications.

Ocular complications of diabetes in humans are reviewed briefly, and experimental models available for study of the complications are described. Potentially suitable models include not only diabetic animals, but also nondiabetic animals in which analogous lesions have been demonstrated. Many abnormalities of the lens, cornea, iris, and retina comparable to those of diabetes in humans may be observed in diabetic animals, although all abnormalities are not necessarily observed in every species. Retinal changes, in particular, may occur in diabetic animals of several species, but only in large animals (dogs, primates) have saccular capillary aneurysms been reproduced consistently, together with other retinal changes typical of diabetes in humans. A few examples of the uses of animal models are offered, and attention is called to a lack of animal models of proliferative diabetic retinopathy and of rubeosis iridis.

Animals↗

Optical monitor of glucose.

Methods have been described to noninvasively monitor the glucose of the aqueous humor, a fluid with glucose in constant equilibrium with the bloodstream. A feasibility study has been performed showing that the optical rotation of the aqueous humor reflects aqueous humor glucose concentration in the range of hypo- and moderately hyperglycemic conditions. Preliminary data show that specificity for glucose may be enhanced by simultaneously measuring the optical rotation at 984 nm and 775 nm.

Animals↗

Endocrine cells in oxyntic mucosa of a dog 5 years after pancreatectomy.

Immunofluorescence shows that the oxyntic mucosa of a dog depancreatized for 5 years and having a poorly-controlled diabetes has more glucagon- and somatostatin-containing cells than the mucosa of a control dog. At the ultrastructural level, 4 endocrine cell types are identified: A-, A-like, D- and enterochromaffin-like (ECL) cells, with increased numbers of A-, A-like and D-cells in gastric glands of the depancreatized dog, together with a higher concentration of immunoreactive glucagon in the gastric mucosa. The increase in A-, A-like and D-cells is compatible with: a) a change induced by the diabetic state itself; b) a hyperplasia secondary to the loss of corresponding pancreatic cells. At any rate, the fact that A-, A-like and D-cells increase parallely may indicate that these three cell types are functionally related one with another.

Animals↗

Relationship of microvascular disease in diabetes to metabolic control.

Dogs were made alloxan-diabetic and randomly distributed into either of two prospective treatment groups. In one group it was intended that the metabolic signs of diabetes be controlled poorly, and commercial insulin was administered in doses inadequate to prevent chronic, severe hyperglycemia and glucosuria. In the other group it was intended that the metabolic disorder be well controlled, and the animals received food and commercial insulin twice daily such that the hyperglycemia and glucosuria became mild or infrequent. Experimental improvement of the carbohydrate disorder was accompanied by amelioration of hyperlipemia and other clinical signs of deficient insulin activity. By 60 months of diabetes, retinal capillary aneurysms, pericyte ghosts, obliterated vessels, and other microvascular abnormalities typical of diabetes were apparent in each animal of the poor-control group. Better control was found to reduce significantly the incidence and severity of microvascular lesions. The data suggest that the mechanism responsible for diabetic retinopathy is initiated as a result of deficient insulin activity and that the development of the microvascular complications of diabetes are preventable and may be inhibited by careful control of the metabolic disorder.

Animals↗

Clinicopathologic correlations in diabetic retinopathy. I. Histology and fluorescein angiography of microaneurysms.

A patient with adult-onset diabetes mellitus was referred with a diagnosis of malignant melanoma of the choroid of the left eye. A nonproliferative type of diabetic retinopathy was present, which was studied and documented by stereoscopic fundus photographs and fluorescein angiograms. Following enucleation, the microangiopathies were correlated histologically, using the retinal trypsin digest technique. Four types of microaneurysms were seen histologically that were believed to represent stages in the development of this lesion. Most thin-walled aneurysms tightly packed with erythrocytes did not fluoresce. Aneurysms that were hypercellular and those with thick walls showed early and late fluorescence. Intraretinal microvascular abnormalities were hypercellular dilated channels. Those that take origin from terminal arterioles are believed to represent attempts at neovascularization.

Aneurysm↗