The magnitude of the health problem from diabetic neuropathies remains inadequately estimated due to the lack of prospective population-based studies employing standardized and validated assessments of the type and stage of neuropathy as compared with background frequency. All Rochester, Minnesota, residents with diabetes mellitus on January 1, 1986, were invited to participate in a cross-sectional and longitudinal study of diabetic neuropathies (and also of other microvascular and macrovascular complications). Of 64,573 inhabitants on January 1, 1986 in Rochester, 870 (1.3%) had clinically recognized diabetes mellitus (National Diabetes Data Group criteria), of whom 380 were enrolled in the Rochester Diabetic Neuropathy Study. Of these, 102 (26.8%) had insulin-dependent diabetes mellitus (IDDM), and 278 (73.2%) had non-insulin-dependent diabetes mellitus (NIDDM). Approximately 10% of diabetic patients had neurologic deficits attributable to nondiabetic causes. Sixty-six percent of IDDM patients had some form of neuropathy; the frequencies of individual types were as follows: polyneuropathy, 54%; carpal tunnel syndrome, asymptomatic, 22%, and symptomatic, 11%; visceral autonomic neuropathy, 7%, and other varieties, 3%. Among NIDDM patients, 59% had various neuropathies; the individual percentages were 45%, 29%, 6%, 5%, and 3%. Symptomatic degrees of polyneuropathy occurred in only 15% of IDDM and 13% of NIDDM patients. The more severe stage of polyneuropathy, to the point that patients were unable to walk on their heels and also had distal sensory and autonomic deficits (stage 2b) occurred even less frequently--6% of IDDM and 1% of NIDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Objectives-i) to assess the diagnostic specificity of MRI-defined hippocampal atrophy for Alzheimer's disease (AD) among individuals with a variety of pathologically confirmed conditions associated with dementia as well as changes attributable to typical aging, and, ii) to measure correlations among pre-mortem MRI measurements of hippocampal atrophy, mental status exam performance, and the pathologic stage of AD. Methods-An un-selected series of 67 individuals participating in the Mayo Alzheimer's DiseaseResearch Center/Alzheimer's Disease Patient Registry were identified who had undergone a standardized antemortem MRI study and also post-mortem examination. Hippocampal volumes were measured from antemortem MRI. Each post-mortem specimen was assigned a pathologic diagnosis, and in addition, the severity of AD pathology was staged using the method of Braak and Braak.Results-Individuals with an isolated pathologic diagnosis of AD, hippocampal sclerosis, frontotemporal degeneration, and neurofibrillary tangle-only degeneration usually had substantial hippocampal atrophy while those with changes of typical aging did not. Among all 67 subjects, correlations (all p<0.001) were observed between hippocampal volume and Braak stage (r = −0.39), between hippocampal volume and MMSE score (r = 0.60), and between MMSE score and Braak stage (r = −0.41).Conclusions-Hippocampal atrophy, while not specific for AD, was a fairly sensitive marker of the pathologic AD stage [particularly among subjects with isolated AD pathology (r = −0.63, p = 0.001)] and consequent cognitive status.

Presurgical identification of unilateral hippocampal formation atrophy, or of interictal epileptiform discharges that are all concordant with the location of ictal onset, predict excellent outcome of ATL. However, the probability of excellent outcome is highest (94%) when both factors are present.

MRI-based hippocampal volumetry accurately depicts the structural-functional relationships between memory loss and hippocampal damage across the spectrum from normal aging to dementia.

Although PMP is an indolent disease, aggressive surgical debulking followed by intraperitoneal radioisotopes and/or chemotherapy should be considered because of the diffuse peritoneal involvement.