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  • 1
    Electronic Resource
    Electronic Resource
    Mönckeberg's sclerosis after sympathetic denervation in diabetic and non-diabetic subjects (1983)
    Springer
    Diabetologia 24 (1983), S. 347-350 
    Details
    ISSN: 1432-0428
    Keywords: Mönckeberg's sclerosis ; sympathectomy ; diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Medial arterial calcification is frequently seen in diabetic patients with severe diabetic neuropathy. Sixty patients (19 diabetic and 41 non-diabetic) were examined radiologically for typical Mönckeberg's sclerosis of feet arteries 6–8 years after uni- or bilateral lumbar sympathectomy. Fifty-five out of 60 patients (92%) revealed medial calcification. This calcification was observed in both feet of 93% of patients, who had undergone bilateral operation. After unilateral sympathectomy the incidence of calcified arteries on the side of operation was significantly higher than that on the contralateral side (88% versus 18%, p〈0.01). Although diabetic patients showed longer stretches of calcificiation than non-diabetic subjects, the difference was not significant in terms of incidence and length. Of 20 patients who had no evidence of calcinosis pre-operatively, 11 developed medial calcification after unilateral operation exclusively on the side of sympathectomy. In seven patients calcinosis was detected in both feet after bilateral operation. In conclusion, sympathetic denervation is one of the causes of Mönckeberg's sclerosis regardless of diabetes mellitus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00251822
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  • 2
    Electronic Resource
    Electronic Resource
    Eosinophile Fasziitis (Shulman-Syndrom) (1982)
    Springer
    Journal of molecular medicine 60 (1982), S. 1319-1328 
    Details
    ISSN: 1432-1440
    Keywords: Eosinophilic Fasciitis ; Shulman Syndrome ; Eosinophile Fasziitis ; Shulman-Syndrom
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Sklerodermieähnliche Hautindurationen ohne Organmanifestationen, Gelenkskontrakturen, Bluteosinophilie und ein entzündliches Infiltrat der Faszie zwischen Subkutis und Muskulatur gelten als die Charakteristika der eosinophilen Fasziitis (EF). Wir berichten über einen 30jährigen Diabetiker mit dem von Shulman 1974 definierten Syndrom. Eine Kortikosteroidtherapie führte zur Remission der Krankheitssymptome, jedoch zeigte eine Rebiopsie, daß die Therapie keinen Einfluß auf den pathomorphologischen Befund hatte. Anhand einer Literaturübersicht unter Berücksichtigung von 118 Fällen werden die Gemeinsamkeiten und Unterschiede von EF und der systemischen Sklerodermie diskutiert.
    Notes: Summary Scleroderma like skin indurations without internal organ involvement, joint contractures, eosinophilia, and inflammatory infiltration of the fascia between subcutis and muscle are considered as characteristic features of eosinophilic fasciitis (EF). We report a further case of a 30 years old diabetic confirming to the syndrome defined by Shulman 1974. Corticosteroid therapy resulted in remission of disease symptoms, however a rebiopsy revealed no effect of therapy on histopathologic changes. A critical review of 118 cases in the literature is presented to explore the relationship of EF to scleroderma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716211
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  • 3
    Electronic Resource
    Electronic Resource
    Zur Früherkennung der diabetischen Nephropathie: Beta2-Mikroglobulin im Serum (1983)
    Springer
    Journal of molecular medicine 61 (1983), S. 1209-1215 
    Details
    ISSN: 1432-1440
    Keywords: Diabetes mellitus ; Nephropathy ; Serum beta2-microglobulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Detection of early diabetic nephropathy is necessary to postpone or even prevent progression of irreversible kidney damage by therapeutic measures. Beta2-microglobulin (β2-MG) as a parameter of the glomerular filtration rate has been measured by immunoassay in the serum of 100 diabetic subjects, 50 insulin-dependent (IDD), and 50 noninsulin-dependent (NIDD) patients. The results are compared with endogenous creatinine-clearance, serum creatinine concentration, and proteinuria and are related to different stages of diabetic retinopathy (RD). Normal values were obtained from 50 healthy age- and sex-matched subjects. A close correlation was found between β2-MG levels and endogenous creatinine clearance. Thirty-nine diabetics revealed an elevated β2-MG (2.5 mg/l or higher), only 16 of whom had increased serum creatinine levels (1.4 mg/dl or higher). Significant differences of β2-MG were obtained between each group of patients with different stages of RD. A relevant difference of serum creatinine was found only between patients with normal eye fundus and advanced proliferative retinopathy, respectively. Without RD 26% of the patients revealed elevated β2-MG but normal creatinine values demonstrating a “latent nephropathy”, just 8% showed an increase of both parameters. Of the diabetics with proliferative retinopathy 40% suffered from impaired kidney function proven by reduced creatinine clearance and by elevation of β2-MG and creatinine as well, 15% just revealed an increase of β2-MG with normal creatinine levels. The incidence and extent of nephropathy demonstrated by pathologic values of both β2-MG and serum creatinine were significantly higher in IDD patients with a smaller proportion of “latent nephropathy” as compared to NIDD patients (p〈0.02). This is also true for the markedly increased proteinuria in IDD subjects. In both groups, measurement of β2-MG disclosed more often decrease of renal function in diabetics than did concentrations of serum creatinine. The determination of serum β2-MG appears to be a reliable and sensitive method for the early detection of minor impairment of kidney function in diabetes mellitus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01537432
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  • 4
    Electronic Resource
    Electronic Resource
    Zur Pathogenese und klinischen Bedeutung der Mönckebergschen Mediaverkalkung (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 211-216 
    Details
    ISSN: 1432-1440
    Keywords: Mönckeberg's sclerosis ; Lumbar sympathectomy ; Doppler ankle pressures ; Peripheral vessel disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Medial calcinosis of Mönckeberg is frequently observed in peripheral arteries of diabetics with neuropathy. The cause of this vessel alteration is unknown and the clinical significance has been questioned. Six to eight years after uni- or bilateral lumbar sympathectomy 60 patients were investigated radiologically for medial calcinosis of foot arteries. Of 60 patients, 55 had Mönckeberg's sclerosis. In 93% of the patients who had undergone bilateral operation medial calcification was seen in both feet. After unilateral sympathectomy the incidence of medial calcinosis on the operated side was significantly higher than on the non-operated side (88% versus 18%,p〈0.01). There was no significant difference between diabetics and non-diabetics. These findings suggest that medial calcification is related to autonomic neuropathy of peripheral vessels. Fifty-two of 160 patients (32.5%) with severe arterial occlusive disease of the lower limbs showed medial calcification of foot arteries. Mönckeberg's sclerosis was significantly associated with the peripheral type of vascular disease (p〈0.025). Two groups of patients with the same stage of occlusive vascular disease but without (group A) and with (group B) medial calcification were examined by Doppler ultrasound. In group A the mean ankle pressure (pD) was 51 mm Hg lower than the Riva-Rocci pressure (pRR). In spite of the severe ischemia mean pD in group B exceeded pRR by 14 mm Hg. Of the patients of group B 63% had a pD-pRR value ≧0 mm Hg. In group A no positive difference pD-pRR could be shown. Thus medial calcification can cause pseudohypertensive Doppler pressures and mask vessel disease. It might play a role in the development of the peripheral type of arteriosclerosis of the lower limbs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01731171
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  • 5
    Electronic Resource
    Electronic Resource
    Renale und enterale Elimination der Koproporphyrin-Isomeren bei Rotor-Syndrom (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 953-956 
    Details
    ISSN: 1432-1440
    Keywords: Hyperbilirubinemia ; Rotor's syndrome ; Coproporphyrin isomers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Urinary and fecal total, isomer I, and isomer III coproporphyrin excretion of a Rotor's syndrome patient and his family were determined. The proprositus showed increased urinary total coproporphyrin excretion (248 µg/24 h) and a shift of the coproporphyrin isomer I/III relation (70%/30%). The propositus's father and two siblings also had elevated renal excretion of coproporphyrin I. Total coproporphyrin excretion was enhanced only in the propositus's father and one sibling, while being normal in another sibling. All family members that could be investigated showed considerably decreased fecal porphyrin excretion. In Rotor's syndrome porphyrin excretion is mainly renal. The coproporphyrin isomer I/III relation is shifted towards isomer I. Phenotypically normal relatives with normal bilirubin plasma levels may have alterations in both their renal and enteral coproporphyrin excretion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01738109
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  • 6
    Electronic Resource
    Electronic Resource
    Delaying carbohydrate absorption in noninsulin-dependent diabetes mellitus: Useful therapy? (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 395-399 
    Details
    ISSN: 1432-1440
    Keywords: NIDDM treatment ; Carbohydrates ; Delayed absorption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Epidemiological and psychological studies have revealed major difficulties in motivating diabetic patients to observe a long-term dietary regimen. Therefore, manipulation of intestinal digestion or absorption appears to be a feasible therapeutic approach in the management of diabetes. The addition of natural or chemically processed fiber has been shown to decrease both the postprandial and fasting blood glucose in type-2 diabetics by delaying carbohydrate absorption. Recently, selective enzyme inhibitors of glycoside hydrolases in the upper intestine have been found which create a moderate degree of malabsorption of carbohydrates. The postprandial blood sugar response can be reduced by 50%. However, both these forms of treatment may not be accepted by patients because of impalatability or gastrointestinal side effects. At present only short-term studies with each group of substances are available. Whether the reduction of hyperglycemia is sufficient for the prevention of complications must be clarified in long-term trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01715760
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  • 7
    Electronic Resource
    Electronic Resource
    Peptide YY in diabetics treated chronically with an intestinal glucosidase inhibitor (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 985-989 
    Details
    ISSN: 1432-1440
    Keywords: Peptide YY ; Glucosidase inhibitors ; Long-term treatment ; Impaired carbohydrate digestion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Peptide YY (PYY) is a recently discovered peptide found in the distal ileum and colon. It circulates in plasma and concentrations rise in malabsorptive conditions. The potential of PYY as an indicator of impaired carbohydrate digestion was studied in a pharmacological model of intestinal glucosidase inhibition. Thirteen type-2 diabetics on long-term treatment with the alpha-glucosidase inhibitor acarbose (3 × 100 mg per day) had test meals with and without acarbose 100 mg before and after the treatment period (mean 46 weeks), a test meal with acarbose after 20 weeks of continuous treatment and a final test meal without acarbose 6 weeks after cessation of treatment. Without acarbose mean plasma PYY concentrations rose from a mean basal value of 11.5±2.9 pmol/l to 19.5±3.9 pmol/l 120 min postprandially (P〈0.01). Acarbose treatment did not effect basal plasma PYY concentrations but significantly enhanced food stimulated PYY concentrations acutely, at 20 weeks and at the final treatment test meal. Mean incremental integrated plasma responses (area under curve) rose by 183%, 184% and 169%, respectively (P〈0.05). After cessation of treatment postprandial responses returned to pretreatment values within 6 weeks. Conversely, the integrated incremetal postprandial plasma responses of glucose and insulin were reversibly reduced by acarbose to 58%±9% and 60%±10% of controls, respectively. Self-assesed side effects of flatulence and more frequent bowel action showed no regular relationship to the PYY response. PYY seems to act as an indicator of the increased carbohydrate load to the distal intestine even in the absence of clinical symptoms. It may contribute to the hypoglycaemic effect of alpha-glucosidase inhibitors by slowing down intestinal transit.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01738114
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  • 8
    Electronic Resource
    Electronic Resource
    Treatment of secretory diarrhea in AIDS with the somatostatin analogue SMS 201-995 (1989)
    Springer
    Journal of molecular medicine 67 (1989), S. 452-455 
    Details
    ISSN: 1432-1440
    Keywords: AIDS ; Diarrhea, treatment ; Somatostatin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We have observed two patients with AIDS suffering from severe watery diarrhea refractory to conventional medical treatment. In the first patient the reason for the diarrhea could not be revealed in spite of extensive investigations; however, the clinical picture suggested cryptosporidia infection. In the second patient cytomegalovirus could be shown in colonic biopsy specimens. After failure of several attempts of symptomatic, antibiotic, and antiviral therapy, the long-acting somatostatin analogue SMS 201-995 was administered to the patients subcutaneously in a dose between 2 × 50 µg and 3 × 100 µg/day. This treatment resulted in a prompt reduction of stool volume and bowel motions. Somatostatin may be a useful addition to the symptomatic treatment of refractory diarrhea in AIDS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01725142
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  • 9
    Electronic Resource
    Electronic Resource
    Rheumatoid nodules without rheumatoid arthritis (1982)
    Springer
    Rheumatology international 2 (1982), S. 183-187 
    Details
    ISSN: 1437-160X
    Keywords: Isolated rheumatoid nodules ; HLA-typing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Four female patients with rheumatoid nodules are described who had no other clinical manifestations of rheumatoid disease. Only one of the patients was seropositive for the rheumatoid factor and HLA-DR4. Nosologic aspects of such isolated rheumatoid nodules are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00286142
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  • 10
    Electronic Resource
    Electronic Resource
    Seronegative spondylarthropathies in HIV-infected patients: further evidence of uncommon clinical features (1994)
    Springer
    Rheumatology international 13 (1994), S. 211-213 
    Details
    ISSN: 1437-160X
    Keywords: Spondylarthropathies ; Reiter's syndrome ; Reactive arthritis ; HIV ; AIDS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Reiter's syndrome and reactive arthritis in individuals with human immunodeficiency virus (HIV) infection are characterized by severe and persistent arthritis, intense enthesopathy, and poor response to treatment. These uncommon clinical features suggest a direct role of HIV in the pathogenesis of seronegative spondylarthropathies. We report on widely differing clinical features in two HIV-infected patients with undifferentiated seronegative spondylarthropathy or reactive arthritis. Both patients were HLA-B27-positive. The first patient presented with heel swelling and dactylitis (“sausage” toes). Subsequently he developed polyarticular erosive arthritis. The clinical course was complicated by fulminant ulcerative colitis leading to hemicolectomy. After hemicolectomy, a temporary resolution of arthritis occurred. In the second patient, heel swelling and polyarticular arthritis occurred 2 months after Shigella dysentery. After 3 years of continuing joint inflammation, he presented with a Jaccoud-like arthropathy. In a cohort of 700 HIV-infected patients receiving continuous care in our department, these were the only patients with seronegative spondylarthropathy observed between 1984 and 1992.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00390270
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