[Cutaneous mucormycosis in a diabetic woman. Diagnostic and therapeutic problems]. / Mucormycose cutanée chez une diabétique. Problèmes diagnostiques et thérapeutiques.

We report a new case of cutaneous mucormycosis in a diabetic woman. The major favouring circumstances are found in this patient: ketoacidosis diabetes, use of bandages, local corticosteroid applications, renal insufficiency. The diagnosis, rarely made on the clinical aspect, is based on the histological and mycological data. A trial of treatment by ketoconazole has been carried out, but without success. The usual treatment by intravenous amphotericine B has been successful.

Distribution of fibronectin in diabetic skin.

Distribution of the fibronectin (FN) present in the forearm skin was studied in 23 controls and 34 insulin dependent diabetics. All the subjects were lean males under 50 years. After biopsy FN was studied by an indirect immunofluorescence technic. A semi-quantitative evaluation was attempted by giving a score to the fluorescent intensity read at the three following sites: vascular basement membranes, papillary dermis, and the dermo-epidermal basement membranes. We found an increased amount of FN-immunofluorescence in diabetic skins. This increase was seen not only in vascular basement membranes but also at the two other sites. No correlation was found between apparent FN levels and the duration or equilibration of diabetes. These results are consistent with other findings of the literature concerning the involvement of the intercellular matrix in diabetes.

[Glycosylated hemoglobin and diabetes mellitus]. / Hémoglobines glycosylées et diabète sucré.

Properly estimated glycosylated hemoglobin A1c (HbA1c) is a good objective indicator of diabetic control over the previous eight weeks. It is essential to eliminate the labile fraction (pre-HbA1c). A valuable tool in diabetes research, prospectives studies using this index will permit clarification of the relationships between the complications of diabetes and chronic hyperglycemia. Glycosylation of hemoglobin is an example of a reaction secondary to hyperglycemia which can also occur with numerous circulating or tissue proteins. This may explain pathogenesis of some diabetic complications. Its value as a prognostic indicator depends critically upon methodology and this report summarises the current'state of the art in this respect.

[Contact (prekallikrein) and fibrinolytic (plasminogen/antiplasmin value) system in the physiopathology of vascular complications of diabetes]. / Apport de l'étude du système contact (prékallicréine) et fibrinolytique (rapport plasminogène/antiplasmine) à l'approche physiopathologique des complications vasculaires du diabète.

Both micro and macro-angiopathy involve interaction of blood vessel and plasma factors which may be altered in diabetes. Little is known concerning changes in contact and fibrinolysis factors as prekallikrein, plasminogen and fast antiplasmin in diabetes. We tested also the plasminogen/antiplasmin ratio in 151 diabetics and 64 normal subjects (18 to 74 years old). Our conclusion is:--the absence of correlation between the clinical characteristic of diabetes and prekallikrein level,--the decrease of plasminogen/antiplasmin ratio in complicated diabetes,--in complicated diabetes, correlation between antithrombin III, VIII factor and fibrinogen levels, perhaps, in relation with inflammation signs.

A micromethod for the evaluation of hemoglobin A1c: technique and preliminary results.

A microtechnique of column chromatography on a Biorex 70 resin monitored by permanent recording of the effluent o.d., permits to obtain the percent of Hb A1C in an hemolyzate within 1.5 hr (in the place of 6 hrs in the usual techniques). This evaluation was carried out in 18 normal subjects and 32 patients suffering from diabetes mellitus and was repeated several times in 10 patients. The average level in the normal subjects was 5.01% (3.2 to 6.1%), in the equilibrated patients with a glycemia under 2 g/l: 6.44% (5.74 to 7.14%) and in the poorly equilibrated patients: 8.9% (5.5 to 15.3%). Hemoglobin A1C appears as a valuable index of sugar metabolic equilibrium.