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  • 1
    Electronic Resource
    Electronic Resource
    ß-endorphin-immunoreactivity in the ventricular CSF and plasma of comatose patients (1989)
    Springer
    Neurosurgical review 12 (1989), S. 416-419 
    Details
    ISSN: 1437-2320
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01790684
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Erhebung des Ernährungszustandes — ein Bestandteil der klinischen Routine-Diagnostik: Cholinesterase-Aktivität als Ernährungsindikator (1989)
    Springer
    Journal of molecular medicine 67 (1989), S. 1101-1107 
    Details
    ISSN: 1432-1440
    Keywords: Nutritional assessment ; Malnutrition ; Cholinesterase ; Albumin ; Transferrin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Nutritional assessment has not yet been established as integral part of basic clinical diagnostic procedures everywhere, eventhough the prognostic relevance of malnutrition is well known. One of the reasons is the the lack of nutritional indicators, which are specific of and sensitive for changes of the nutritional status on the one hand, and routinely analyzed on the other. We report on the utility of serum cholinesterase, which has the shortest half-life of all plasma proteins, to identify malnourished patients. 54 internal inpatients with malignant diseases or in septic state were followed up prospectively with respect to courses of cholinesterase (CHE), albumin (ALB), transferrin (TRA), and body weight over periods of 4 weeks. A correct correlation to malnutrition was defined as plasma concentrations 〈 reference ranges or continuous concentr. fall 〉10%. Based on 132 observations (65 with continuous weight loss, mean: −5.5% of original w.; 54 w. gain, mean +4,6%, 13 constant w.), changes of CHE had the highest correlation to weight changes (r=0.79,p〈0.001), compared to the courses of TRA-or ALB-levels (r=0.65/0.68). Incorrect positive results (conc. fall or conc. 〈 ref. range without weight loss): absolute levels — CHE 4%, ALB 4%, TRA 22%; conc. courses — CHE 0%, ALB 0%, TRA 6%. Incorrect negative: absolute c. — CHE 63%, ALB 30%, TRA 28%; courses — CHE 15%, ALB 19%, TRA 17%. The common determination of CHE and ALB-courses allowed a correct identification of malnutrition in 96% of all observations, with the same result as the courses of ALB + TRA. Because of its wide ref. ranges, the absolute CHE activity is useless for nutritional screening in contrast to ALB and TRA, but the follow-up of CHE-levels allows an excellent discrimination between good and bad nutritional status. The use of the CHE-course can be recommended as nutritional indicator, if TRA-analysis is not available.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01741785
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Management and efficacy of intensified insulin therapy — Starting in outpatients (1989)
    Springer
    Journal of molecular medicine 67 (1989), S. 60-65 
    Details
    ISSN: 1432-1440
    Keywords: Intensified insulin therapy ; Outpatient treatment ; Diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diabetic patients under multiple injection insulin therapy (i.e., intensified insulin therapy, IIT) usually start this treatment during hospitalization. We report here on the logistics, efficacy, and safety of IIT, started in outpatients. Over 8 months, 52 type I and type II diabetics were followed up whose insulin regimens consecutively had been changed from conventional therapy to IIT. Two different IIT strategies were compared: free mixtures of regular and intermediate (12 hrs)-acting insulin versus the basal and prandial insulin treatment with preprandial injections of regular insulin, and ultralente (24 hrs-acting) or intermediate insulin for the basal demand. After 8 months HbA1 levels had decreased from 10.6%±2.4% to 8.0%±1.3% (means±SD). There was no difference between the two regimens with respect to metabolic control; but type II patients maintained the lowered HbA1 levels better than type I patients. Only two patients were hospitalized during the follow-up time because of severe hypoglycemia. An increase of body weight due to the diet liberalization during IIT became a problem in one-third of the patients. Our results suggest that outpatient initiation of IIT is safe and efficacious with respect to near-normoglycemic control. Weight control may become a problem in IIT patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01735653
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  • 4
    Electronic Resource
    Electronic Resource
    Gel chromatographic characterization of immunoreactive adrenocorticotropin in patients with ACTH hypersecretion (1989)
    Springer
    Journal of molecular medicine 67 (1989), S. 1096-1100 
    Details
    ISSN: 1432-1440
    Keywords: ACTH ; Cushing's syndrome ; proopiomelanocortin ; Nelson's syndrome ; Addison's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We investigated the molecular size of circulating immunoreactive ACTH by gel chromatography in patients with ACTH hypersecretion due to various disorders of the hypothalamic-pituitary-adrenal axis. 4 patients with Addison's disease, 2 with Nelson's syndrome, 4 with Cushing's disease, 6 with the ectopic ACTH syndrome (2 bronchial carcinoma, 1 medullary carcinoma, 1 metastatic islett cell carcinoma, 1 benign bronchial carcinoid and 1 patient with occult ectopic Cushing's syndrome) and 1 patient with hypersecretion of ACTH from a clinically nonfunctioning pituitary adenoma were studied. Analysis of the molecular size of immunoreactive ACTH was performed by gel chromatography on a Sephadex G-75 column (superfine, 100×1.5 cm) equilibrated with 1% formic acid. 2 ml fractions were collected and evaporated to dryness. The ACTH content of the recovered samples was determined by RIA. In Addison's disease, Nelson's syndrome and Cushing's disease the plasma showed a single peak of ACTH immunoreactivity at the expected position of 1–39 ACTH. In the ectopic ACTH syndrome the plasma of 4 patients revealed at chromatography at least one other peak eluting between the void volume and 1–39 ACTH suggestive of a high molecular weight form of ACTH whereas plasma of 2 patients showed only a single ACTH peak at the position of labeled 1–39 ACTH. The patient with a clinically non-functioning pituitary adenoma revealed a gel filtration pattern similar to the patients with ectopic ACTH syndrom and secretion of high molecular weight ACTH. We conclude that secretion of high molecular weight forms of ACTH is not a unique feature of the ectopic ACTH syndrome. It may therefore not serve as a marker of the ectopic Cushing's syndrome in the differential diagnosis of the ACTH dependent Cushing's syndrome. Vice versa, lack of high molecular weight ACTH does not exclude an ectopic source of ACTH secretion as cause of Cushing's syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01741784
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Cardiac function in endocrine diseases: I. acromegaly (1989)
    Springer
    Journal of molecular medicine 67 (1989), S. 1126-1131 
    Details
    ISSN: 1432-1440
    Keywords: Acromegaly ; Cardiac function ; Echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of our echocardiographic study was to characterize cardiac function and anatomy of 14 acromegalics (A: 9 women, 5 men; mean age: 42.4 yrs) more closely. The duration of acromegaly in 4 of these patients was between 3 and 12 years; the disease was diagnosed for the first time in the other patients. Double M-mode echocardiography was performed in all patients and the results compared with data obtained from a control group of 24 healthy volunteers (N: 22 men, 2 women; mean age: 23 yrs). The mean left ventricular diameter at end-diastole was greater in the acromegalics than in the controls (A: 55±6 mm, N: 50±4 mm;p〈0.005, $$\bar x \pm SD$$ ). After correction for age and body surface area, it, however, was outside the 95% confidence interval in 5 patients. Left ventricular hypertrophy was present in 3 patients, one of whom had coexistent arterial hypertension. A total of 3 patients were hypertensive. Significantly higher values for the maximal velocity of systolic wall thickening (A: 6.1±0.6 cm/s, N: 4.2±0.6 cm/s,p〈0.001) and diameter change (A: 12.4±2.0 cm/s, N: 10.6±1.0 cm/s,p〈0.005) indicate increased contractility with concurrently increased relaxation; fractional shortening did not differ significantly (A: 38±5%, N: 37±5%, ns). The isovolumetric relaxation period at diastole was slightly longer in the acromegalics (A: 70±17 ms, N:61±13 ms,p〈0.05). Whereas the values for maximal diastolic velocity of wall thinning (A: 14.1±4.9 cm/s, N: 11.0±3.4 cm/s,p〈0.02) and diameter increase (A: 21.6±4.7 cm/s, N: 17.8±4.1 cm/s,p〈0.02) were significantly higher, those for the rapid filling period did not differ significantly (A: 115±24 ms, N: 102±30 ms, ns). We concluded that systolic and diastolic left ventricular function did not deviate from the norm in our patients, only a relatively small percentage of whom had coexistent arterial hypertension and left ventricular hypertrophy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01726113
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    Paper (German National Licenses)
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