Diabetic Muscle Infarction

Inflammatory myopathies include a heterogeneous group of acquired and potentially treatable disorders caused by an autoimmune process (idiopathic inflammatory myosites) or infectious agents (pyo-myositis). Among ischemic conditions, we focus here mainly on diabetic muscle infarction and rhab-domyolysis. As previously stated, compartment syndromes are addressed in Chapter 15. 

Diabetic muscle infarction is a rare complication of patients with longstanding poorly controlled diabetes mellitus, who usually present with severe indexes of target organ damage, including neph-... 

Casillas J, Sais GJ, Greve JL (1991) Imaging of intra- and extraabdominal desmoid tumors. RadioGraphics 11 959-968 Chason DP, Fleckenstein JL, Burns DK et al (1996) Diabetic muscle infarction radiologic evaluation. Skeletal Radiol 25 127-132... 

Jelinek JS, Murphey MD, Aboulafia AJ et al (1999) Muscle infarction in patients with diabetes mellitus MR imaging findings. Radiology 211 241-247... 

The neuromuscular complications of diabetes mellitus are most often neuropathic in origin, with distal sensorimotor polyneuropathies being the most common. In addition, ischemic infarction of skeletal muscle may occur due to occlusive vascular disease, with small and medium-sized arterioles particularly affected. This occurs in poorly-controlled diabetes and affects thigh, muscles in most cases. In acute stages, muscle biopsy findings are those of widespread muscle necrosis, edema, and phagocytic cell infiltration. Muscle regeneration may be incomplete and increased fibrous connective tissue may replace lost muscle tissue. 

Angiotensin-II AT, Human cDNA Artherosderosis, cardiac hypertrophy, congestive heart failure, hypertension, myocardial infarction, renal disease, cancer, diabetes, obesity, glaucoma, cystic fibrosis, Alzheimer s disease, Parkinson s disease Smooth muscle contraction, cell proliferation and migration, aldosterone and ADH release, central and peripheral sympathetic stimulation, extracellular matrix formation, tubular sodium retention, neuroprotection... 

The ACE gene encodes two isozymes (somatic ACE isozyme and germinal ACE isozyme). ACE is a membrane-bound enzyme on the surface of vascular endothelial cells that also circulates in plasma and shows great individual variability determined by an I/D polymorphism in intron 16 of the ACE gene (ACE-I/D polymorphism). More than 160 ACE polymorphisms have been reported, 34 of which are located in coding regions, and 18 are missense mutations (606). ACE-related polymorphic variants have been associated with hypertension, atherosclerosis, stroke, left ventricular hypertrophy, chronic renal failure in IgA nephropathy, Henoch-Schonlein purpura nephritis, mechanical efficiency of skeletal muscle, intracranial aneurysms, susceptibility to myocardial infarction, diabetic nephropathy, AD, and longevity (12,606,607). 

Receptor for advanced glycation end products (RAGE) RAGE is expressed by many cells in the body (e.g., endothelial cells, smooth muscle cells, or cells of the immune system). When binding AGEs, RAGE contributes to age- and diabetes-related chronic inflammatory diseases such as atherosclerosis, asthma, arthritis, and myocardial infarction. 

A series of article abstracts about various magnesium-deficiency symptoms, syndromes, conditions, or diseases are supplied at http //www.mgwa-ter.com/abstract.shtml. These include the following alcohol-related hypertension and strokes, alcohol-induced contraction of cerebral arteries, amyofrophic lateral sclerosis and aluminum deposition in the central nervous system, cardiac arrhythmias, asthma therapy, attention deficit disorder (ADD), cerebral artery disorders, constipation, diabetes, heart muscle disorders or myocardial infarction, hypertension, HIV, kidney stones, menopause, migraine, multiple sclerosis, osteoporosis, and premenstrual syndrome. In all cases, an increase in magnesium levels had beneficial effects. 

Two types of subunits are distinguishable M (muscle) type and H (heart) type- Lactate dehydrogenases of heart and muscle are mainly H4 and M4 all other possible hybrids have been found in various tissues. Elevations of lactate dehydrogenase activity have been found in myocardial infarction, hepatocellular necrosis, metastatic carcinoma, diabetic ketosis, sickle cell anemia, malignant lymphoma, infectious mononucleosis, and cerebral infarction Standjord el of., J. Am. Med. Assoc. 182, 1099 (1962). Comprehensive reviews Everse, Kaplan, Ad van. Enzymol. Helot. Areas Mol BioL 37, 61 (1973) Holbrook et of, in The Enzymes, vol. XI (part A), P. D. Boyer, Ed. (Academic Press, New York. 3rd ed 1975) pp 191-292. 

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