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  • 1
    ISSN: 1432-0428
    Keywords: Keywords Diabetic nephropathy ; risk factors ; ACE polymorphism ; glycaemic control ; hypertension.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diabetic nephropathy represents a major complication in patients with insulin-dependent diabetes mellitus (IDDM). Intervention trials using angiotensin-converting enzyme (ACE) inhibitors have pointed towards the important pathogenetic role of the renin-angiotensin system. Recently an insertion/deletion (I/D) polymorphism for the gene encoding the ACE has been described, the deletion type being associated with higher plasma ACE levels. As the intrarenal renin-angiotensin system might also be activated in this setting, we determined the ACE genotype together with other risk factors for the development of diabetic nephropathy in 122 patients with IDDM from a single centre with (n = 63) and without (n = 59) nephropathy. Long-term glycaemic control was evaluated using mean HbA1c values from the last 10 years. The two patient group were comparable with regard to duration of diabetes and glycaemic control as assessed by current HbA1c values. However, mean long-term HbA1c values were significantly higher in patients with diabetic nephropathy as was systemic blood pressure. The DD genotype was more prevalent in patients with renal disease. In the subgroup of patients who had had diabetes for more than 20 years (n = 90), the DD genotype was even more frequent in patients with nephropathy, and blood pressure and long-term HbA1c values were also higher in patients with renal disease. Logistic regression analysis revealed long-term glycaemic control, blood pressure and the ACE genotype to be independent risk factors for the prevalence of diabetic nephropathy. [Diabetologia (1997) 40: 327–331]
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 1 (1951), S. 478-516 
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary After a microscopic examination of the compressed roots, the following report is given of 8 cases of sciatica or lumbago in consequence of a posterior disc prolapse: 1. An acute inflammatory infiltration with perivascular leucocytes with polimorphic nuclei and cells rich of fat granulations inSchwanns sheath (acute neuritis or interstitial radiculitis). 2. Rather seldom little cellular nodules (lymphocytes, fibroblasts...) as a sign of chronic inflammation which extend into the little scars of the endoneural septum. 3. A complete degeneration of the isolated bundles of the compressed root which remindsWallers degeneration, but differs from it due to the scarcity of neutral fat substances. 4. Finally it could be observed that in some cases of severe and relapsing sciatica no histological modifications were found in the roots.
    Abstract: Résumé Dans 8 cas des sciatiques et lombalgies par hernie postérieure des disques intervertébraux on a révélé, à l'examen microscopique, les altérations suivantes dans les racines comprimées: 1 Infiltrations d'une inflammation aiguËe périvasculaire avec des leucocytes polynucléaires, une dégénérescence graisseuse discrète des gaines myéliniques et une formation des corpuscules graisseux dans les cellules deSchwann (nevrite ou radiculite interstitielle aiguËe). 2 Des petits nodules cellulaires (lymphocytes, fibroblastes...) assez rares, signe d'une inflammation chronique, s'etendant jusqu'aux des cicatrices minimes endoneurales. 3 Une dégénérescence complète des faisceaux isolés de la racine comprimée, rappellant le type de dégénérescence deWaller, cependant les substances graisseuses neutres sont, moins fréquemment rencontrées dans la radiculite par hernie discale. 4 Dans certains cas, aucune altération histologique ne peut Être révélée malgré une durée excessive de la maladie.
    Notes: Zusammenfassung Bei 8 FÄllen von Ischias oder Lumbago infolge dorsolateralen Diskushernien wurden bei der mikroskopischen Untersuchung der komprimierten Wurzeln folgende Befunde erhoben: 1. Akut entzündliche Infiltrationen mit perivaskulÄren polymorphkernigen Leukozyten und Fettkörnchen in den Zellen der Schwannschen Scheide. (Akute Neuritis oder interstitielle Radiculitis.) 2. Kleine Zellknötchen (Lymphozyten, Fibroblasten...) ziemlich selten, als Zeichen einer chronischen Entzündung, bis zu kleinen Narben in den endoneuralen Septen sich entwickelnd. 3. Eine völlige Degeneration isolierter Bündel der komprimierten Wurzel, an die Wallersche Degeneration erinnernd, doch unterscheiden sie sich von dieser durch die Seltenheit der Neutralfettsubstanzen. 4. Schlie\lich konnte festgestellt werden, da\ trotz schwerer und Jahre anhaltender Ischias, auch wenn sie mehrfach rezidiviert, eine mikroskopische VerÄnderung der Wurzel fehlen kann.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 2 (1952), S. 354-368 
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The A. reports on 12 ependymomas of the cauda equina (out of 175 tumors of the medulla), two of which were intramedullary. According to the A. it is sometimes possible to mistake the ependymoma of the cauda equina with the neurinoma, be it clinically or histologically. Besides, it is very often difficult to classify these tumors. The A. follows the classification ofKernohan. Three of his cases belong to the classic type, similar to the tumors originating from the ventricular ependyma; one belongs to the myxo-papillary type, the others were difficult to classify. The A. divides these tumors into two groups: the first includes those cases similar to neurinomas. Here the removal is extremely easy. It is more difficult in the other three cases because they are sometimes of a considerable size, often only a little or not at all capsulated, adherent to the roots of the cauda equina, or to the medullar cone.
    Abstract: Résumé Rapport sur 12 cas d'épendymome de la queue de cheval observés parmi 175 tumeurs de la moëlle épinière dont 2 étaient intramédullaires. L'auteur est d'avis que les épendymomes de la queue de cheval sont assez souvent confondus avec les névrinomes soit cliniquement qu'histologiquement. Fréquemment, il est très difficile de classifier les tumeurs en question. En adoptant la classification deKernohan, l'auteur divise ses cas observés comme voici: 10 type classique, c'est-à-dire ressemblant aux tumeurs orginaires de l'épendyme ventriculaire (3 cas), 20 type myxopapillaire (1 cas), 30 tumeurs dont la classification ne réussit pas de manière satisfaisante. Au point de vue chirurgical, les tumeurs semblables aux névrinomes sont très aisément éliminables, tandis que les autres types exposent le chirurgien aux difficultés plus ou moins considérables étant donné que les tumeurs en queslion sont parfois gigantes et souvent peu ou nullement encapsulées et adhérentes à une racine en correspondance de la queue de cheval ou au cône médullaire.
    Notes: Zusammenfassung Der Verfasser berichtet über 12 Ependymome der Cauda equina (von 175 Tumoren der Medulla), von denen zwei intramedullär waren. Dem Verfasser zufolge ist es nicht selten, daß Ependymome der Cauda equina mit Neurinomen verwechselt werden, sei es klinisch wie histologisch. Es ist sehr oft schwer, diese Tumoren zu klassifizieren. Der Verfasser folgt der Klassifizierung vonKernohan. Drei seiner Fälle gehören dem klassischen Bild an, das den vom ventrikulären Ependym herstammenden Tumoren ähnelt, einer gehört zum Bild des Myxopapilloms; die übrigen waren sehr schwer zu klassifizieren. Vom operativen Standpunkt aus teilt der Verfasser diese Tumoren in zwei Gruppen: Die erste umfaßt die den Neurinomen ähnlichen Fälle, wobei die Entfernung einfach ist. Schwieriger ist es in den anderen Fällen, denn zuweilen sind diese Tumoren wenig oder gar nicht gekapselt und der Wurzel der Cauda equina oder dem Conus anhaftend.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Keywords Type I diabetes mellitus ; apo(a) gene ; apo(a) polymorphism ; Lp(a) ; susceptibility gene ; atherosclerosis ; risk factor.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. High lipoprotein(a) [Lp(a)] plasma concentrations are a genetically determined risk factor for atherosclerotic complications. In healthy subjects Lp(a) concentrations are mostly controlled by the apolipoprotein(a) [apo(a)] gene locus which determines a size polymorphism with more than 30 alleles. Subjects with low molecular weight apo(a) phenotypes on average have higher Lp(a) concentrations than those with high molecular weight apo(a) phenotypes. There are many opinions about whether and why Lp(a) is raised in patients with Type I diabetes (insulin-dependent) mellitus. Methods. We investigated Lp(a) plasma concentrations and apo(a) phenotypes in 327 patients with Type I diabetes mellitus (disease duration 1–61 years) and in 200 control subjects matched for age and sex. Results. Patients with a disease duration of up to 15 years had significantly higher Lp(a) concentrations (24.3 ± 34.0 mg/dl vs 16.7 ± 22.6 mg/dl, p = 0.014) compared with control subjects. This increase can be explained by a considerably higher frequency of low molecular weight apo(a) phenotypes (38.9 % vs 23.5 %, p 〈 0.005). The frequency of low molecular weight apo(a) phenotypes decreased continuously with disease duration from 41.7 % in those with disease duration of up to 5 years to 18.2 % in those with the disease lasting more than 35 years. Conclusion/interpretation. Our data show that an increase of Lp(a) in Type I diabetic patients can only be observed in groups with short diabetes duration and that this elevation is genetically determined. Therefore, the apo(a) gene, located at 6q26–27, might be a susceptibility gene for Type I diabetes mellitus which is supported by recently published studies reporting evidence for linkage of this region (6q27) with Type I diabetes mellitus. Furthermore, the decreasing frequency of low molecular weight apo(a) phenotypes with disease duration suggests a survivor effect. [Diabetologia (1999) 42: 1021–1027]
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 268 (1951), S. 493-505 
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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