Yigal Katzman-1.Type 2 Diabetes mellitus, 2.Post-toes amputation pain in right lower limb-(Israel)

Patient Name: Yigal Katzman
Gender: Male
Age: 50 years old
Nationality: Israel
Diagnosis: 1.Type 2 Diabetes mellitus, 2.Post-toes amputation pain in right lower limb

Condition upon Admission:
The patient has had diabetes for 20 years, which has led to severe vascular damage in both lower limbs, particularly in the right lower limb. He has undergone two unsuccessful knee surgeries and has had the toes on his right foot amputated. He experiences severe pain in the right knee and right foot, resulting in difficulty walking. Local doctors informed him that due to severe vascular damage, recovery was unlikely, and he might require further above-knee amputation.

Physical Examination upon Admission:
The patient’s temperature was 36.2°C, blood pressure was 102/78 mmHg, and heart rate was 74 beats per minute. There were no petechiae or jaundice on the skin and mucous membranes. Cardiac and pulmonary examinations were unremarkable. The abdomen was soft, and there was no edema in his lower limbs. The skin temperature of his both legs was inconsistent, with the temperature of the affected right limb significantly higher than that of the left limb.

Neurological Examination:
The patient is alert and speaks clearly. His memory and calculation abilities are normal. No abnormalities are noted in cranial nerves. Muscle strength in all four limbs is graded at 5, and muscle tone is normal. Tendon reflexes in the limbs are diminished. No pathological reflexes are observed. There are no abnormalities in superficial or deep sensations in the left side of the body; however, there is a significant decrease in both deep and superficial sensations in the right lower limb, and sensation is absent below the calf. Meningeal signs are negative.

Treatment Process:
The patient was treated with mesenchymal stem cells for vascular repair and neural stem cells for peripheral nerve repair, along with adjuvant CAST therapy to regulate immunity, endocrine function, and provide nutritional support, in conjunction with rehabilitation therapy.

Post-Treatment Results:
Vascular reconstruction in his lower limbs was successful, with notable recovery of dorsalis pedis artery pulsation. His skin temperature has returned to normal. Most sensations in the lower limbs have significantly improved, his knee pain has resolved, range of motion in his knee joint has increased, foot pain has markedly alleviated, and he has begun to walk short distances.