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  • 1
    Electronic Resource
    Electronic Resource
    Limited benefit of treatment of diabetic polyneuropathy with an aldose reductase inhibitor: a 24-week controlled trial (1985)
    Springer
    Diabetologia 28 (1985), S. 323-329 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; polyneuropathy ; sorbitol accumulation ; aldose reductase inhibitor ; clinical trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of the aldose reductase inhibitor, sorbinil, on symptomatic symmetrical diabetic polyneuropathy were studied during a 6-month period in a double-blind parallel group placebo-controlled trial. Twenty-seven patients received sorbinil and 28 placebo. The patients were assessed by clinical examination, neurophysiological measurements, sensory threshold determinations and tests of autonomic nerve function. No major clinical benefit was seen in the sorbiniltreated patients and no differences in sensory thresholds were observed. In three out of nine neurophysiological tests (motor nerve conduction velocity of the posterior tibial nerve, F-wave latency and sensory distal latency of the ulnar nerve) and one out of five tests of autonomic nerve function (heart rate variation during deep breathing) significant differences between the patient groups evolved in favour of sorbinil treatment. An overall evaluation of the temporal development of these and remaining neurophysiological and autonomic variables suggested a small but significant benefit from sorbinil treatment. There was no evidence of continuing improvement throughout the treatment period and beneficial effects observed were no greater than those seen in previous trials of considerably shorter treatment periods. It is concluded that sorbinil treatment results in some improvement in peripheral nerve function in symptomatic diabetic polyneuropathy, but that the long-term effect may be of limited value.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00283137
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  • 2
    Electronic Resource
    Electronic Resource
    Microneurographic findings in diabetic polyneuropathy with special reference to sympathetic nerve activity (1982)
    Springer
    Diabetologia 23 (1982), S. 415-420 
    Details
    ISSN: 1432-0428
    Keywords: Diabetic polyneuropathy ; microneurography ; sympathetic recordings ; sympathetic dysfunction ; impaired muscular afferents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Microneurographic recordings of naturally occurring nerve activity in the median or peroneal nerve were made in 25 patients with diabetes mellitus, 17 of whom had signs of polyneuropathy. In patients without polyneuropathy, the electrical findings did not differ from those in healthy subjects. In patients with polyneuropathy, sensory afferent impulses were always normal qualitatively, whereas muscular afferent activity was weak or entirely absent in some patients. Sympathetic activity, if found, showed normal characteristics in muscle and skin fascicles, except that it was difficult to obtain a good signal-to-noise ratio. In 16 of 25 recordings with the electrode positioned intraneurally, sympathetic activity could not be detected in patients with polyneuropathy. The failures correlated with impaired skin sympathetic effector organ responses and reduction of motor nerve conduction velocity. The results suggest that impairment of sympathetic outflow occurs frequently in diabetic polyneuropathy and that sympathetic involvement occurs earlier than in many other types of polyneuropathy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00260954
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  • 3
    Electronic Resource
    Electronic Resource
    The sympathetic response to euglycaemic hyperinsulinaemia (1992)
    Springer
    Diabetologia 35 (1992), S. 873-879 
    Details
    ISSN: 1432-0428
    Keywords: Sympathetic nervous system ; catecholamines ; insulin ; blood pressure ; glucose metabolism ; hypertension ; insulin resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Sympathetic nervous system activation by insulin has been suggested as a mechanism explaining the association between insulin resistance and hypertension. We further examined the effect of insulin by direct microneurographic muscle and skin nerve sympathetic activity recordings during euglycaemic insulin clamps in healthy subjects. The mean plasma insulin level was elevated from 5.3±0.7 to 92.2±2.2 mU/l in seven subjects during a 90-min one-step clamp. In six other subjects plasma insulin was further raised from 85.7±4.0 mU/l to 747±53 mU/l between 45–90 min (two-step clamp). Four of the latter subjects received a sham clamp with NaCl infusions only on a second recording session. At the low dose of insulin muscle nerve sympathetic activity increased from a resting level of 22.7±5.0 bursts per min to 27.7±5.0 bursts per min at 15 min (p〈0.05). The increases in muscle nerve sympathetic activity were significant (p〈0.001; ANOVA) throughout insulin infusion, with a slight further increase (from 29.2±1.6 to 32.3±1.9 bursts per min) at the supraphysiological insulin concentration. During sham clamps muscle nerve sympathetic activity did not increase. Both insulin clamps induced minor, but significant, increases in forearm venous plasma noradrenaline concentrations. Skin nerve sympathetic activity (n=3) did not change during insulin infusions. Heart rate increased slightly but significantly (p〈0.005), during the insulin clamps. Blood pressure was not notably affected. In conclusion, hyperinsulinaemia was associated with increased vasoconstrictor nerve activity to skeletal muscle and with no change of sympathetic outflow to skin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00399935
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  • 4
    Electronic Resource
    Electronic Resource
    Peripheral Sympathetic Neural Activity in Conscious Humans (1988)
    Palo Alto, Calif. : Annual Reviews
    Annual Review of Physiology 50 (1988), S. 565-576 
    Details
    ISSN: 0066-4278
    Source: Annual Reviews Electronic Back Volume Collection 1932-2001ff
    Topics: Medicine , Biology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1146/annurev.ph.50.030188.003025
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  • 5
    Electronic Resource
    Electronic Resource
    Skin nerve sympathetic activity during insulin-induced hypoglycaemia (1986)
    Springer
    Diabetologia 29 (1986), S. 855-860 
    Details
    ISSN: 1432-0428
    Keywords: Hypoglycaemia ; sympathetic nervous system ; skin nerve sympathetic activity ; microelectrode recording ; thermoregulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Microclectrode recordings of skin nerve sympathetic activity, consisting of sudomotor and vasoconstrictor signals, were performed in the peroneal nerve in seven healthy subjects during insulin-induced hypoglycaemia. The nerve activity was recorded at rest and for 90 min after intravenous injection of 0.15 IIJ insulin/kg body weight. The net outflow of skin nerve sympathetic activity was increased during hypoglycaemia, with the exception of one subject who exhibited a high initial level of activity. In all subjects a change of the temporal pattern of the outflow was found, suggesting a shift from mixed (sudomotor and vasoconstrictor) to pure sudomotor activity. This change coincided with a sensation of warmth, sweating and varying degrees of cutaneous vasodilatation, and was followed by a fall in body temperature. It is concluded that hypoglycaemia has a differential effect on sympathetic activity in skin nerves, with a strong increase of sudomotor impulses and simultaneous inhibition of vasoconstrictor signals. Thus, neurally mediated thermoregulatory adjustment contributes to heat loss during hypoglycaemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00870140
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    The clinical effect and the effect on serum IgG antibodies to peripheral nerve tissue of plasma exchange in patients with Guillain-Barré syndrome (1982)
    Springer
    Journal of neurology 228 (1982), S. 59-64 
    Details
    ISSN: 1432-1459
    Keywords: Plasma exchange ; Guillain-Barré syndrome ; Auto-antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 18 Patienten mit Guillain-Barré Syndrom, die einem therapeutischen Plasmaaustausch (PA) unterzogen wurden, wurde das Serum mit Hilfe einer gemischten Hämagglutinations-Technik auf IgG-Antikörper (IgG-AK) gegen peripheres Nervengewebe untersucht. Einfluß der PA auf den klinischen Zustand und Titerverlauf wurden verglichen: Bei 11 Patienten wurden IgG-AK gefunden; sie zeigten unter der PA′ eine klinisch verifizierte Besserung, die in einigen Fällen auch elektromyographisch gesichert werden konnte; nach Beendigung der PA waren nur noch in 2 Fällen IgG-AK nach-weisbar. Bei den restlichen 7 Patienten fehlten IgG-AK; bei ihnen war die PA ohne Effekt.
    Notes: Summary The mixed haemagglutination technique was used to demonstrate IgG antibodies to peripheral nerve tissue in sera from patients with the Guillain-Barré syndrome. The clinical effect and the effect on the antibodies of plasma exchange were examined in 18 patients. Neurological examination with muscle testing and neurophysiological examination of the patients were performed before and immediately after plasma exchange. Before the exchange antibodies were detected in sera from 11 of the patients. These patients showed clinical improvement during the treatment. After plasma exchange, antibodies were detected in sera from only two of the patients. The seven patients without detectable antibodies showed no clinical improvement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00313410
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  • 7
    Electronic Resource
    Electronic Resource
    Serum antibodies to peripheral nerve tissue in acute Guillain-Barré syndrome in relation to outcome of plasma exchange (1988)
    Springer
    Journal of neurology 235 (1988), S. 285-289 
    Details
    ISSN: 1432-1459
    Keywords: Guillain-Barré syndrome ; Plasma exchange ; Nerve antibodies ; Mixed haemagglutination test ; Complement fixation test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Mixed haemagglutination and complement fixation tests were used to detect serum antibodies to peripheral nerve in 36 patients with acute Guillain-Barré syndrome. Twenty patients were treated with plasma exchange, 16 served as controls. A significant antibody titre was found in 19 patients with the haemagglutination test; 30 had complement-fixing antibodies. Patients lacking complement-fixing antibodies were less disabled at entry (P〈0.01). However, there was no correlation between the course of the disease and any of the antibodies in the two patient groups. The two tests were therefore not able to select patients for treatment by plasma exchange.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314175
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