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  • 1
    Electronic Resource
    Electronic Resource
    Apo E 2 phenotypes in type II diabetics with and without insulin therapy (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 690-693 
    Details
    ISSN: 1432-1440
    Keywords: Atherosclerosis ; Type III-hyperlipoproteinemia ; Apo E-phenotypes ; Diabetes mellitus ; Peripheral vascular disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 106 type II diabetics with persisting hyperlipidemia (i.e persistently increased triglycerides 〉200 mg/dl during intensive diabetes therapy) the Apo E polymorphism was examined in relation to IDDM (n=68) and NIDDM (n=38). It was shown that Apo E2 phenotypes are more (22.6% vs. 14.5%,p〈0.05) and Apo E3 phenotypes less frequent in type II diabetics than in non-diabetic controls (86.8% vs. 94.7%,p〈0.001). Looking at the increase in Apo E2 phenotypes it could be proved that the phenotype composition was distinctly different between diabetics with and in those without insulin therapy. While in NIDDM the increase was consequent to a higher concentration of Apo E2 homozygotes (p〈0.005) it was caused by Apo E2 heterozygotes in IDDM (p〈0.025) accompanied by a simultaneous decrease in Apo E3 homozygotes (p〈0.025). Regarding blood lipids there was an increase in total cholesterol due only to VLDL cholesterol in IDDM as well as in NIDDM. It is concluded that in spite of similar hyperlipidemias in type II diabetics the increase in Apo E2 phenotypes is different; it is induced by heterozygotes in IDDM and by homozygotes in NIDDM.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01726928
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  • 2
    Electronic Resource
    Electronic Resource
    Hypoxia of diabetic feet with abnormal arterial blood flow (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 466-470 
    Details
    ISSN: 1432-1440
    Keywords: Doppler ultrasound ; Oximetry ; Peripheral vascular disease ; Diabetic foot ; Neuropathy ; Reactive hyperemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Necrotic ulcers of the feet are a dangerous complication of the diabetic foot syndrome. Besides peripheral vascular disease (PVD) peripheral neuropathy is an important factor in the pathogenesis of necroses. We examined whether the reserve of circulation during reactive hyperemia at the feet of patients with type I diabetes mellitus with abnormal blood flow (n =17) is decreased compared with diabetic (n =14) and nondiabetic (n = 20) controls. Further we analyzed whether there is a correlation with the oxygen supply of the foot. PVD was excluded by clinical check-up, oscillography, and Doppler ultrasound. The reserve of circulation of the foot was measured during reactive hyperemia and oxygen supply of the foot by oximetry. Abnormal blood flow of the foot was diagnosed by the pulsation index. On examination it was found that the reserve of circulation of diabetic feet with abnormal blood flow is about 52% less than in diabetic and about 50% less than in nondiabetic controls (P〈0.005). The decreased reserve of circulation correlates with the oxygen supply of the feet; this is about 21% less compared to diabetic feet with normal blood flow and about 16% less in comparison to nondiabetic feet. The present study shows that diabetic feet suffer from disturbed circulation although there is no evidence of PVD. This disturbed circulation is correlated with a decreased oxygen supply of the feet. Hypoxia during strain could be of great importance in the pathogenesis and treatment of necrotic ulcers of diabetic feet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00180061
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  • 3
    Electronic Resource
    Electronic Resource
    Decrease of macrovascular hyperemic response of blood flow in diabetics with arterial neuropathy (1990)
    Springer
    Journal of molecular medicine 68 (1990), S. 588-593 
    Details
    ISSN: 1432-1440
    Keywords: Doppler sonography ; Peripheral vascular disease ; Diabetic foot ; Neuropathy ; Reactive hyperemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Doppler sonographic examination of 51 diabetic subjects showed that the macrovascular hyperemic response of the pedal blood flow was negatively correlated to the duration of the disease (p〈0.01). In comparison with non-diabetic controls (n=20), the response was increased by more than 210% in newly detected diabetics, but decreased by more than 20% in long-term diabetics. Vascular response was correlated also not only to the duration of the diabetes, but to peripheral neuropathy (p〈0.001). The hyperemic response was reduced in patients with reduced nerve conduction time, or somatic neuropathy (142+152%,p〈 0.005), and in patients with reduced arterial pulsation, or autonomic neuropathy (152+88,p〈 0.005), both in comparison with non-diabetic controls (293±108%). The frequency of decreased macrovascular hyperemic response was in agreement with somatic neuropathy in 69.7% and with autonomic neuropathy in 75.8% of all patients. The results demonstrate that the macrovascular hyperemic response of blood flow in diabetic feet is already reduced at an early stage of peripheral neuropathy without peripheral vascular occlusive disease. The functional reduction of pedal blood flow may be important for the development of diabetic foot gangrene.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01660955
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  • 4
    Electronic Resource
    Electronic Resource
    Die dopplersonographische Bestimmung der maximalen Blutströmungsgeschwindigkeit in der Diagnostik peripherer arterieller Verschlußkrankheiten bei Diabetes mellitus (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 713-718 
    Details
    ISSN: 1432-1440
    Keywords: Diabetes mellitus ; Peripheral vascular disease ; Mediasclerosis ; Peak flow velocity ; Doppler ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Seventy-five diabetic and 40 nondiabetic subjects who where suffering from peripheral vascular disease were studied in order to determine whether the degree of the severity of their disease can be better calculated by Doppler ultrasound examinations of the peak velocity than by the systolic pressure of the peripheral bloodstream. In 46 examinations of normal controls the mean value of the peak velocity was 13.3±3.3 cm/s with a standard deviation of 15.4%±13.2% on one day and 16.1%±15.9% on different days. Considering patients with or without diabetes mellitus the velocity was significantly decreased in correlation to an increasing degree of severity of the vascular disease (P〈0.001); however, the decrease was lower in diabetic than in nondiabetic subjects (6.9±2.8 vs 4.6±6.2,P〈0.05). The systolic pressure hardly decreased, but remained higher in all stages of peripheral vascular disease of diabetics than in the nondiabetic subject (P〈0.05 toP〈0.005). There was a significant decrease of the systolic pressure only in diabetic subjects with the most advanced degree of the disease, i.e. stage IV (P〈0.05). It is concluded from this study that Doppler ultrasound measurements of the peak velocity of the peripheral bloodstream are a useful parameter to calculate the degree of severity of the peripheral vascular disease. In addition, it is concluded than peak velocity is an even better prognostic indicator of peripheral vascular disease than is measurement of the systolic blood pressure at the feet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01736806
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  • 5
    Electronic Resource
    Electronic Resource
    Doppler sonographic examination of reactive hyperemia in the diagnosis of peripheral vascular disease (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 970-975 
    Details
    ISSN: 1432-1440
    Keywords: Doppler ultrasound ; Peripheral vascular disease ; Reactive hyperemia ; Reappearance time ; Atherosclerosis ; Ankle pressure index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Fifty-four patients with angiographically confirmed peripheral vascular disease (PVD) were examined in order to find out whether the occlusive form of this disease can be better diagnosed by measuring the reappearance time and mean velocity of the blood flow during reactive hyperemia than by determining the peripheral systolic blood pressure, using Doppler ultrasound for both measurements. It was shown that the Doppler pressure was only reliable for a screening diagnosis of PVD. However, using the reappearance time of reactive hyperemia, it was possible to distinguish specific localization types of sclerosis; while reactive hyperemia already reached its half maximum in controls in 4.6 s this occurred in the stenosis type of PVD after 6.9 s, in the upper leg occlusion type after 21.6 s, in the lower leg occlusion type after 46.6 s, and in the multilevel disease after 70.1 s. The delay in the half-maximum reappearance time was significantly different, not only in comparison with controls (P〈0.001) but also in the specific types of occlusive PVD as compared with one another (P〈0.01). Regarding the intensity of velocity it could also be shown that the mean velocity of blood flow during reactive hyperemia was lower in all patients with PVD than in controls. Again this alteration during reactive hyperemia was significant, not only in comparison with controls (P〈0.001), but also when the specific stages of severity according to Fontaine were compared with one another (P〈0.05). On the basis of these findings it can be stated that in addition to providing a screening diagnosis of PVD on the basis of the Doppler pressure, the Doppler ultrasound measurement of reactive hyperemia is useful for a specific diagnosis of the localization and severity of PVD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01738112
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  • 6
    Electronic Resource
    Electronic Resource
    Die Lipide der Hautxanthome (1965)
    Springer
    Archives of dermatological research 222 (1965), S. 43-56 
    Details
    ISSN: 1432-069X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Es wird über chromatographische Untersuchungen der Lipide an 8 Xanthompatienten berichtet. Es handelt sich um 7 Patienten—davon 2 mit Diabetes—mit einer tuberösen Xanthomatose, und um 1 Patientin mit einer cytomykotischen Granulomatose. Die qualitative und quantitative Zusammensetzung der Xanthomlipide wird den Werten der normalen haut und des Hautoberflächenfettes gegenübergestellt. 1. Methodisch wurden elektrophotometrisch im Zuge der Dünn-schichtchromatographie die Cholesterinester bestimmt. Bei Xanthomen der Haut als Cholesterinspeichertumoren nimmt der Triglyceridgehalt der Hautfette etwa in gleichem Maße ab wie ihr Cholesterinanteil zunimmt. Das deponierte Cholesterin ist vorwiegend verestert. 2. Trotz ausgeprägter Triglyceridvermehrung im Serum werden bei hyperlipämischen Xanthomatosen keine Neutralfette in die Haut abgelagert. Die Beziehung zum Hautfett zeigt sich nur in der Verteilung der freien Fettsäuren. Sie sind in Gewebe und Serum in annähernd gleichem Verhältnis verteilt und betreffen ausschließlich die gesättigten Fettsäuren (Laurin-, Myristin-und Palmitinsäuren). 3. Ein gemeinsames Kennzeichen aller Xanthomatosen war die den Serumwerten entsprechende Vermehrung der Phospholipoide im Xanthomgewebe. 4. Als Sonderfall zeigt eine cytomykotischen histiozytären Granulomatose bei einer Hyperlipidämie (Ges. Cholesterin 600 mg-%) im Gegensatz zu den tuberösen Xanthomen nur eine geringe Cholesterinspeicherung, vornehmlich des freien extracellulären Cholesterins.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00518413
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  • 7
    Electronic Resource
    Electronic Resource
    Persistierende Hyperlipidämien als Risikofaktoren der diabetischen Makroangiopathie (1986)
    Springer
    Journal of molecular medicine 64 (1986), S. 506-511 
    Details
    ISSN: 1432-1440
    Keywords: Diabetes mellitus ; Macroangiopathy ; Hyperinsulinism ; Hypertriglyceridemia ; Arterial occlusive disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Severe forms of arterial occlusive diseases occurred more frequently in 11 insulin-treated diabetics with persisting hyperlipidemia than in 10 control subjects who were 11 years older. Triglycerides and cholesterol of total serum and of VLDL were 2–7 times higher (P〈0.01); however, LDL-cholesterol was 2 times lower than in control subjects (P〈0.025). HDL-cholesterol was not significantly different in either group. After insulin administration (81 U/die vs 37 U/die,P〈0.00251), the increased lipids were only insignificantly reduced, while LDL-cholesterol and the ratio of LDL-/HDL-cholesterol was even increased (P〈0.0025 andP〈0.05). In contrast to control subjects, VLDL-cholesterol was positively correlated to the tolbutamid-induced insulin reserve (before insulin administration) and to the diurnal insulin dosage (after insulin administration) (P〈0.01 andP〈0.001). The results show that the atherosclerotic risk in diabetics with persisting hyperlipidemia is higher than in control subjects and that the risk is distinguished by increased VLDL-cholesterol in correlation with increased insulin concentrations. Since the atherosclerotic risk is even more accentuated by the fact that insulin administration increases LDL-cholesterol, insulin therapy must be observed carefully in these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01713057
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  • 8
    Electronic Resource
    Electronic Resource
    Angiokeratoma corporis diffusum (fabry) — lipoid-thesaurismose — (1971)
    Springer
    Archives of dermatological research 240 (1971), S. 394-403 
    Details
    ISSN: 1432-069X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über ein 15jähriges Mädchen berichtet, das die typischen Hautveränderungen eines Angiokeratoma corporis diffusum Fabry zeigt, ohne daß sich bisher Veränderungen an den inneren Organen nachweisen ließen. Die Lipoidanalyse des Urins und die histologische Untersuchung der Hautveränderungen zeigten jedoch eine Vermehrung der Ceramidhexoside (CTH, CDH und CMH) bzw. Lipoidablagerungen, so daß kein Zweifel an der Lipoidthesaurimose bestehen kann. Die Befunde der Lipoidanalyse werden diskutiert. Es wurde bisher mit befriedigendem Erfolg eine Behandlung der Angiokeratome durch hochtouriges Schleifen durchgeführt.
    Notes: Summary A 15-year-old girl with the typical skin lesions of angiokeratoma corporis diffusum Fabry but without any symptoms in other organs is described. The lipoid analysis of urine and the histologic examination of a skin lesion demonstrate an increase of the ceramide-hexosides (CTH, CDH and CMH) and a lipoid deposition in the skin. Because of these findings there is no doubt about the diagnosis thesaurismosis. The results of the lipoid analysis are discussed. A therapy of the angiokeratomas by dermabrasio was successfull.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00584593
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  • 9
    Electronic Resource
    Electronic Resource
    Apolipoprotein AIMarburg: Studies on two kindreds with a mutant of human apolipoprotein AI (1982)
    Springer
    Human genetics 〈Berlin〉 61 (1982), S. 329-337 
    Details
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Three probands heterozygous for a mutant of apolipoprotein AI (apo AIMarburg, Utermann et al. 1982a) were detected by screening of 2282 unrelated individuals resulting an a frequency estimate of about 1/750 in the German population. All three probands with apo AIMarburg had hypertriglyceridemia (triglyceride above 250 mg/dl) and subnormal HDL-cholesterol (below 30 mg/dl), but no other lipoprotein abnormalities. The kindreds of two probands with AIMarburg were studied. The family data are consistent with an autosomal codominant inheritance of the trait. A total of 16 heterozygous blood relatives with the mutant AIMarburg were detected in these kindreds. Analysis of the plasma lipid and lipoprotein levels in relation to the apo AI phenotype was complicated by the high prevalence of diabetes mellitus and thyroid disease in one kindred and of hyperlipidemia in both kindreds. No consistent relationship between plasma lipid and lipoprotein levels, and the mutant apo AI could be demonstrated. Instead the mutant apo AI and the dyslipoproteinemia seem to co-exist independently in these kindreds. Three sibs with the homozygous apo E-2/2 phenotype were detected in one kindred, and all three sibs had subnormal LDL-cholesterol and beta-VLDL, e.g., the lipoprotein abnormality characterizing primary dysbetalipoproteinemia. Genetic apo E phenotypes and the apo AI mutant segregated independently, indicating that the structural gene loci for apo E and apo AI are not closely linked.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00276597
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  • 10
    Electronic Resource
    Electronic Resource
    Effect of neomycin sulphate alone and in combination with d-thyroxine on serum lipoproteins in hypercholesterolaemic subjects (1982)
    Springer
    European journal of clinical pharmacology 22 (1982), S. 33-38 
    Details
    ISSN: 1432-1041
    Keywords: hypercholesterolaemia ; neomycinsulphate ; thyroxine ; serum lipoproteins ; side effects ; HDL-cholesterol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Treatment with neomycin sulphate 1.5 g/d for 8 weeks significantly lowered total serum cholesterol by an average of 19% in 15 out of 19 patients with primary hypercholesterolaemia and LDL-cholesterol by 21%, without significantly changing the corresponding triglyceride and HDL-cholesterol concentrations. Combined treatment with neomycin sulphate 1.5 g/d and d-thyroxine 6 mg/d for 8 weeks lowered total serum cholesterol in the same patients by an average of 30%, LDL-cholesterol by 27% and serum triglycerides by 18%, without significantly changing the HDL-cholesterol concentration. Continued treatment of 10 patients with neomycin sulphate 1.5 g/d for up to 13 months did not further change the reduced serum cholesterol level. 10 of 19 patients complained of side effects after 4–8 weeks of treatment with neomycin: 8 of recurrent diarrhoea, abdominal pain or poor appetite, and 4 of acute attacks of vertigo with nystagmus. All side effects were reversed a few days after stopping the neomycin treatment. No additional serious side effects due to d-thyroxine were observed. These serious side effects of neomycin sulphate limit its use to selected high risk patients with hypercholesterolaemia, who have failed to respond successfully to other LDL-cholesterollowering drugs. They stress the necessity for frequent monitoring for the side effects described.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00606422
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