Abstract
An: 2011, Nr.2, Articol Nr. 16
Title: 

ANATOMOPATHOLOGICAL ABNORMALITIES OF THE MUSCLES IN DIABETIC FOOT

Authors: 

      Raluca Maria Popescu, Alina Popa - University of Medicine and Pharmacy “Gr.T. Popa” Iaşi, Department of Diabetes, Nutrition and Metabolic Diseases
      Oana Timofte - Clinical Hospital “St. Spiridon”, Iaşi, Department of Diabetes, Nutrition and Metabolic Diseases
      D. Popescu - University of Medicine and Pharmacy “Gr.T. Popa” Iaşi, Department of Anatomy
      C. Cotuţiu - University of Medicine and Pharmacy “Gr.T. Popa” Iaşi, Department of Histology
      ANATOMOPATHOLOGICAL ABNORMALITIES OF THE MUSCLES IN DIABETIC FOOT (Abstract): A general affectation of small muscles appears during the progress of diabetes, producing modifications of pressure points that, associated with neuropathy, lead to foot ulcerations. The aim of the study is to identify the changes in striate muscles of diabetic foot. Material and method. The study group consisted of 25 patients ( type 1 diabetes – 9 patients, 5 males and 4 females, type 2 diabetes – 16 patients, 10 males and 6 females), with a history of diabetes between 10 and 30 years. All patients had peripheral diabetic neuropathy and different stages of lesions in feet that needed surgical treatment (amputations limited to the inferior extremity of limbs). Fragments of tissue were processed and examined in usual stains (Haemalaun Eosine, trichromic Szekely and van Gieson staining). The CD34 marker was used to highlight the vascular endothelium. Results. In van Gieson stain, the edematous aspect of endomysium could be seen. Degenerated muscular tissue was replaced with adipose tissue. By argentic impregnation techniques was proven that endomysium is preserved in case of degenerative changes of striate muscles. In endomysium and perimysium, vascular lumens were noted with CD34 marker in fragments coming from deep ulcers. Conclusions. Diabetic foot associates all modifications produced in nerves, vessels, soft tissues and skeleton, causing biomechanical changes of foot, severe infections, dysfunction and amputations. Muscular modifications are progressive, from distancing fibers, destruction, disorganization, to replacement with adipose tissue. Myositis is present in cases of inflammation.
Key words: DIABETIC FOOT, NEUROPATHY, VASCULAR ENDOTHELIUM, ULCERATION
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