The dorsal root ganglia was the most vulnerable neural structure. This is consistent with the clinical presentation of sensory neuropathy in cisplatin neurotoxicity. Central structures of the spinal cord and brain were protected from platinum accumulation. The increasing histopathologic toxicity, with an index of exposure to platinum, suggests that it is retained indefinitely in an actively neurotoxic form. The pharmacologic parameters examined correlate with the development of and are consistent with the clinical and laboratory features of cisplatin neurotoxicity.

We have studied risk factors for diabetic foot ulceration by comparing diabetic patients who had active foot ulcers (n = 86) with diabetic patients who had no history of foot ulcers (n = 49). Whereas there was a strong association of diabetic foot ulceration with abnormal vibratory perception (Odds Ratio = 10.77; p less than 0.001, which increased with worsening vibratory perception), there was little association with abnormality of the ankle-pressure index (Odds Ratio = 2.84, p = n.s.). Although foot ulceration and limited joint mobility were associated (Odds Ratio = 3.57, p less than 0.001), this relation was not significant when allowances for abnormal vibratory perception and diabetes duration were made. These data suggest that sensory neuropathy is of greater aetiological importance than peripheral vascular disease in the development of diabetic foot ulceration. The measurement of the vibratory perception threshold is clinically useful in identifying those diabetic patients at high risk of foot ulceration.

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We have examined associations between height and quantitative sensory, nerve-conduction, and clinical indices of diabetic peripheral neuropathy in adult diabetic patients. Vibratory sensitivity was strongly related to height when measurements were made with either the vibration sensitivity tester (P = .02) or the biothesiometer (P less than .01); however, there was no relation between thermal sensitivity (as measured with the thermal sensitivity tester) and height. The peroneal and posterior tibial motor nerve-conduction velocities were inversely related to height (P less than .05 for both). When age and diabetes duration were included as variables in multiple regression analyses, the associations with height became stronger. Clinical indices of peripheral neuropathy were also related to height in these analyses. Glycosylated hemoglobin was significantly related to thermal sensitivity and the peroneal and posterior tibial motor nerve-conduction velocities but not to vibratory sensitivity. These data indicate that height has a marked influence on quantitative sensory, nerve-conduction, and clinical indices of diabetic peripheral neuropathy.