Histopathological analysis of peripheral nerve lesions in diabetic foot

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概要

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• Objectives: We investigated 25 peripheral nerve biopsy specimens obtained from amputated lower extremities in 20 patients suffering from diabetic foot (DF), which was the final advanced stage of severe diabetic lower extremity lesions. Histopathological observation of the fine structures of peripheral nerves was performed mainly by electron microscope. Methods: During operation, we identified the nerve trunk at two sites such as the proximal stump and peripheral part of the amputated section. The nerve was dissected at these sites and nerve specimens were obtained. Specimens were then immediately soaked in a 2% glutaraldehyde solution. Following a process of dehydration and staining with toluidine, entire images were examined by light microscope. Thereafter, ultrathin sections stained with lead citrate were observed by electron microscopy. Results: The peripheral nerve lesions in the DF were histopathologically classified into three types: diabetic neuropathy, ischemic neuropathy and mixed type. The characteristic finding was a combination of retrograde Wallerian degeneration and severe ischemic nerve lesion at the proximal side in patients with multiple amputations. Conclusion: In conclusion, the ultrastructural study of peripheral nerve lesions in severe DF may be very useful in finding an effective way to prevent the progress of nerve ischemia and diabetic neuropathy, and may be helpful in understanding the pathogenesis of this problematic disease.

• 一般社団法人 日本ペインクリニック学会の論文

一般社団法人 日本ペインクリニック学会 | 論文

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