Is resistance to ischaemia of motor axons in diabetic subjects due to membrane depolarization?

The reasons for the resistance to ischaemia of peripheral nerves in diabetics are not well understood. We have now explored whether axonal depolarization underlies this phenomenon, as has previously been proposed. Resistance to ischaemia was determined by the new method of “threshold tracking”. This method revealed an increase in excitability of the peroneal nerve at the popliteal fossa during ischaemia, and a decrease in excitability in the post-ischaemic period. The extent of these alterations in 28 type 1 diabetics without peripheral neuropathy showed a strong correlation with the mean blood glucose concentrations during the last 24 h before examination. To test whether the ischaemic resistance was related to membrane potential, we also measured axonal superexcitability in 11 selected diabetics, since it has been shown that post-spike changes in excitability depend on membrane potential. Changes in excitability of the peroneal nerve were measured in the period between 10 and 30 msec following a conditioning supramaximal compound action potential. Under resting conditions, no differences in the post-spike superexcitability were found between controls and diabetics, despite striking differences in their responses to a 10-min pressure cuff. These observations indicate that membrane depolarization is not involved in the resistance to ischaemia of motor axons in diabetic subjects

DT‐PACE/ESHAP chemotherapy regimens as salvage therapy for multiple myeloma prior to autologous stem cell transplantation

Routine use of novel agents to treat newly diagnosed and relapsed multiple myeloma (MM) produces high response rates and improved survival. However, 15–20% of patients have suboptimal responses and their management remains challenging.1 Traditional regimens, such as DT‐PACE (dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide, etoposide) and ESHAP (etoposide, methylprednisolone, cytarabine, cisplatin) are employed in patients with relapsed/refractory (RR) disease, and may bridge patients to autologous stem cell transplantation (ASCT).2-4 Originally developed to improve responses to traditional chemotherapy regimens, and enable stem cell mobilization,5-7 the role of infusional regimens in the context of novel agents is unclear, especially as recently reported series indicate relatively poor outcomes.8, 9 These regimens can be associated with significant toxicity,2 placing a burden on healthcare resources.10 We undertook a single‐centre retrospective analysis to assess the role of infusional regimens in RR MM patients to explore and identify features associated with clinical benefit. Relevant clinical information was obtained from electronic records. Overall response rate (ORR) and cytogenetic risk were assessed as per International Myeloma Working Group (IMWG) criteria (Table I).11 [Progression‐free (PFS) and overall survival (OS) were estimated using Kaplan–Meier and Cox regression methods (time‐dependent where appropriate)]

Impact of timing of stem cell return following high dose melphalan in multiple myeloma patients with renal impairment: a single center experience

High dose melphalan (HDM) followed by autologous stem cell transplantation (ASCT) remains the standard consolidation in transplant eligible multiple myeloma (MM) patients. The timing between HDM administration and hematopoietic stem cell return (HSCR) varies among institutions, with a 'rest period' of 48 hours (h) employed by some for patients with renal impairment (RI). We investigated the differences in hematopoietic recovery and HDM toxicity between MM patients with RI who had HSCR after 24 vs 48 h from HDM. Fifty MM patients with RI (48 h group; n = 31 and 24 h group; n = 19) were included. No statistically significant differences were noted in surrogates for hematopoietic recovery and HDM toxicity between both groups. Only one death occurred in the 24 h group. No patients required renal replacement therapy. Therefore, a 24 h period between HDM and AHSC infusion appears safe for MM patients with RI

The Aetiology of Diabetic Neuropathy: the Combined Roles of Metabolic and Vascular Defects

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75362/1/j.1464-5491.1995.tb00544.x.pd

The theme of disappearance and renewal in the poetry of Wilhelm Lehmann : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in German at Massey University

Some German throughout.Since the beginning of time, Man has been preoccupied with the fleetingness of physical existence. Although concerned by the inevitability of the passing of materiality, he accepted it as a part of a permanent world order. However, as a result of the gradual disintegration of belief in a divinely based system, from the end of the Middle Ages until the present day, Man has become increasingly conscious of the transitoriness of material existence. Accompanying this disintegration, a growing feeling of isolation from the "Whole" has arisen. This sense of alienation is shared and articulated by the German poet Wilhelm Lehmann. Lehmann comments upon the position of Man in his critical essay Kunst als Jubel der Materie: Wir wurden aus dem Paradies der alten Einheit vertrieben. Diese Vertreibung bedeutet den Beginn des Dichtens, des Schreibens. Wir verloren das Ganze, wir wurden selbst Teil, um uns als Teil des Ganzen zu erinnern und uns seiner in der Sehnsucht zu vergewissern. Hesiodisch gesprochen: das Halbe ist mehr als das Ganze. Welches ist das Geschäft der Welt? Da zu sein. Welches ist das Geschäft der Dichtung? Der welt bei diesem Vorhaben zu helfen. Dichtung ist nicht Flucht, sondern Vorhandenheit, sie ist Kraft, also Gegenwart. Daher Schall, Metrum, Rythmus, Keim innerhalb der Zeile so gut wie an ihrem Ende, Formwille, also Sprache innerhalb der Sprache als Tag innerhalb des Tages. Der Welt als der Welt innezuwerden, erfand sich die Natur die Sprache, die Dichtung. ¹ Wilhelm Lehmann: Sämtliche Werke in drei Bänden. Bd. III, Gutersloh, 1962. p.159. Henceforth referred to as SW III.) As a precondition for Man's reintegration into the "Whole", physical existence must be re-endowed with the permanence it has lost through conceptualisation. This can be achieved, according to Lehmann, through poetry. He believes poetry to be "die Blutspenderin des verfallenden Lebens."² Ibid. p.374) Within the poem, the things of Nature, although having ceased to exist as physical entities, can live once more. The Poet, through his art, can rescue them from oblivion. [From Introduction

in|form: the performative object: the exploration of body, motion and form

Through the sculptural object, this thesis, in|form: The per formative object, explores the relationships between body and object, viewer and artist, performance and the per formative. By exploring the performativity of an object (and questioning how an object performs in relation to the body), the documented performances activate an inter-relational act between artist and object (I perform the object, the object performs me simultaneously). The work that unfolds from this investigation considers the placement of the viewer’s body in relation to the artist’s. A dialogue is formed between the three bodies: object, artist and viewer, creating a sense of embodiment within the work through this relationship. in|form explores this embodiment through the role of video documentation. The performances are constructed to be viewed solely through the documentation, which creates a discussion between the ‘live’ moment and the documented event, and how the viewer then relates to this. The performances take place as solo acts, but are constructed with the viewer in mind. As the viewer watches the documented performance of the action between artist and object in space, the relational nature of the work creates a second performance which embodies the viewer. This sole action, recorded and then viewed, considers the relational value of the body, specifically engaging with the abstraction of bodily formlessness within the object to reveal a bodily nature. Using the object to trace the movement of the body creates a language that communicates to, and about, both viewer and artist: through the awareness of passing time, through the large scale projection of the documentation, through the bodily nature of the object, and through the performativity of the object’s responsive nature to the artist’s body as the pair navigate through space. in|form explores how the absence of the body (in a literal sense) considers the body as an object bound by time, at once physical yet transient. By tracing the motion of the body through object, the viewer experiences the body through sensibility. Ultimately, the function of the body negotiating as a time-bound object is imitated through the performativity of the object with artist, and the elusiveness of this action emphasized by its documentation