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  • 1
    Electronic Resource
    Electronic Resource
    Altered pattern of insulin receptor isotypes in skeletal muscle membranes of Type 2 (non-insulin-dependent) diabetic subjects (1993)
    Springer
    Diabetologia 36 (1993), S. 628-632 
    Details
    ISSN: 1432-0428
    Keywords: Insulin receptor isotypes ; Type 2 (non-insulin-dependent) diabetes mellitus ; insulin receptor antibody
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The human insulin receptor exists in two isoforms (HIR-A α-subunit 719 amino acids and HIR-B α-subunit 731 amino acids) which are generated by alternative splicing of a small exon and display distinct patterns of tissue-specific expression. Using the polymerase chain reaction we have recently shown that skeletal muscle of non-diabetic individuals contains predominantly mRNA encoding HIR-A while in skeletal muscle derived from subjects with Type 2 (non-insulin-dependent) diabetes mellitus similar amounts of each mRNA are expressed. We used a polyclonal antibody which discriminates between HIR-A and HIR-B to assess the isoform expression at the protein level. The antibody showed clearly distinct displacement of insulin binding in skeletal muscle membranes of non-diabetic subjects compared to Type 2 diabetic subjects (displacement of specific 125I-insulin binding: 13 non-diabetic subjects 70.0%±14.34, 12 Type 2 diabetic subjects 32.6%±17.45). A control antibody which does not discriminate between both isoforms showed similar displacement of 125I-insulin in membranes of non-diabetic and Type 2 diabetic subjects. These data suggest that the altered expression of receptor isotype mRNA in the skeletal muscle of Type 2 diabetic subjects leads to an altered receptor isoform pattern in the plasma membrane. While skeletal muscle membranes of non-diabetic subjects contain predominantly HIR-A, membranes of Type 2 diabetic subjects show an increased level of HIR-B in addition to HIR-A.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00404072
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  • 2
    Electronic Resource
    Electronic Resource
    Exercise-induced myalgia in hypothyroidism (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 999-1001 
    Details
    ISSN: 1432-1440
    Keywords: Hypothyroidism ; Myalgia ; Myopathy ; Rhabdomyolysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Recurrent rhabdomyolysis is very uncommon in hypothyroid myopathy. A 30-year-old woman is reported, who presented with exercise-induced myalgias and high levels of serum creatine kinase but no muscle weakness. Muscle biopsy showed signs of a recurrent rhabdomyolysis. Hypothyroidism was diagnosed by serum hormone levels. The myopathy rapidly improved with thyroxine treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00180031
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  • 3
    Electronic Resource
    Electronic Resource
    Morphologic aspects of fibromyalgia (1998)
    Springer
    Zeitschrift für Rheumatologie 57 (1998), S. S47 
    Details
    ISSN: 0340-1855
    Keywords: Key words Fibromyalgia ; type II fiber atrophy ; lipid and mitochondria accumulation ; ragged red fiber ; mitochondrial genoma ; Schlüsselwörter Fibromyalgie ; Typ II-Faser-Atrophie ; Neutralfett- und Mitochondrienakkumulation ; ragged red fiber ; mitochondriales Genom
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei der Fibromyalgie finden sich morphologisch, insbesondere in längergehenden Krankheitsstadien, mit konventionellen muskelbioptischen Methoden überwiegend unspezifische Befunde, wie eine Typ II-Faser-Atrophie, wie sie auch bei Inaktivitätsatrophie, Affektionen der kortikospinalen Bahnen, steroidbedingter Atrophie und anderen neuromuskulären Störungen vorkommen, eine Mikroangiopathie und eine leichte Neutralfett- sowie Mitochondrienvermehrung. Einige der akkumulierten Mitochondrien zeigen eine abnorme Struktur. In eigenen Untersuchungen ließen sich in einem Teil der Fälle einzelne, sog. ragged red fibers nachweisen, denen in einigen Fällen Deletionen der mitochondrialen DNA zugeordnet werden konnten.
    Notes: Summary The most common morphological finding in muscle biopsis in longstanding fibromyalgia is type II fiber atrophy. This can be found in many other conditions such as disuse atrophy, affections of the corticospinal tracts, steroid atrophy, and other different neuromuscular disorders. An increase in lipid droplets and a slight proliferation of mitochondria in type I muscle fibers are correlated with the duration of fibromyalgia. In some cases we could find some ragged red fibers (RRF) which histochemically show a pronounced accumulation of lipids and mitochondria and single fiber defects of cytochrome-c-oxidase. In some fibromyalgia patients with RRF, we could find deletions of the mitochondrial genoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003930050234
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  • 4
    Electronic Resource
    Electronic Resource
    Borrelia burgdorferi myositis: report of eight patients (1993)
    Springer
    Journal of neurology 240 (1993), S. 278-283 
    Details
    ISSN: 1432-1459
    Keywords: Borrelia burgdorferi ; Lyme disease ; Myositis ; Immunohistology ; Culture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Myositis is a rare manifestation of Lyme disease of unknown pathogenesis. This study describes the course of disease in eight patients with Lyme disease, aged 37–70 years, all of whom were suffering from histologically proven myositis. The Clnical, electrophysiological, and myopathological findings are reported. One patient showed signs and symptoms of myositis of all limbs. In six patients myositis was localized in the vicinity of skin lesions, arthritis or neuropathy caused byBorrelia burgdorferi. In another patient suffering from pronounced muscle weakness of the legs and cardiac arrest, inflammation of the myocardium, the conducting system and skeletal muscles was revealed at autopsy. Muscle biopsy revealed lymphoplasmocellular infiltrates combined with few fibre degenerations in three patients. The lymphoplasmocellular infiltrates were found predominantly in the vicinity of small vessels. Several spirochetes were stained in six of seven muscle biopsy samples by means of the immunogold-silver technique. Culturing ofB. Burgdorferi from the muscle biopsy samples was, however, unsuccessful. Antibiotic treatment succeeded in curing the myositis in four of six patients. In one patients signs and symptoms improved. One patient died from cardiac arrest caused by myocarditis and Guillain-Barré syndrome. The outcome is unknown in one patient. Clinical and myopathological findings indicate that Lyme myositis can be caused either by local spreading ofB. burgdorferi or an unknown antigen or toxin from adjacent tissues or haematogenously.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00838161
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  • 5
    Electronic Resource
    Electronic Resource
    Fasziitis bei granulomatöser Myositis — eine atypische Manifestation einer Sarkoidose? (1990)
    Springer
    Journal of molecular medicine 68 (1990), S. 335-341 
    Details
    ISSN: 1432-1440
    Keywords: Fasciitis ; Granulomatous myositis ; Sarcoidosis ; Muscular imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report about two female patients with a histopathological proven granulomatous myositis associated with a fasciitis. One patient showed noncaseating granulomas in the muscle fascia. She suffered from symmetrical contractures of the digital flexors and ankles. The second patient showed uveitis and polyneuropathy, too. In addition, increased activities of the angiotensinconverting-enzyme and lysozyme in the sera suggested that both cases represent a new form of sarcoidosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01649028
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  • 6
    Electronic Resource
    Electronic Resource
    Magnetic resonance imaging of skeletal muscles in idiopathic inflammatory myopathies of adults (1994)
    Springer
    Journal of neurology 241 (1994), S. 306-314 
    Details
    ISSN: 1432-1459
    Keywords: Myositis ; Skeletal muscles ; Magnetic resonance imaging ; Creatine kinase ; Electromyography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of the study was to describe typical MRI findings in various types of idiopathic inflammatory myopathies in adulthood and to correlate the MRI with histopathological and electromyographic findings, and the serum creatine kinase (CK) activity. A third goal was to assess the diagnostic value of the use of gadolinium-DTPA (Gd-DTPA). Fifty-eight patients (35 women, 23 men), aged 21–83 years (median age 59 years), suffering from idiopathic myositides (13 with acute and 45 chronic diseases; 25 with polymyositis, 14 with dermatomyositis, 8 with granulomatous and 11 with inclusion body myositides) were examined with MRI. Seventeen of them received an intravenous infusion of Gd-DTPA. Histopathological and MRI findings of 21 muscles of 18 patients were compared. MRI of skeletal muscles showed abnormal signal intensities in 56 (96.6%) of the 58 patients. MRI abnormalities were found more often than elevated CK activity (P 〈 0.001). The hyperintensity of T2-weighted images was more conspicuous than on T1-weighted images in 26 (44.8%) patients, indicating oedema-like abnormalities. MRI of 50 (86.2%) patients showed fat replacement. In acute myositides, oedema-like abnormalities were more often visible and in muscle lipomatosis less often visible than in chronic diseases (P 〈 0.05 each). In dermatomyositis oedema-like abnormalities were more and lipomatosis less frequent than in the other types of myositis (P 〈 0.005) and correlated with the acuteness of the disease. In 3 of 17 patients in whom contrast-enhanced T1-weighted images were obtained in addition to plain T1- and T2-weighted images, T2-weighted images were more sensitive in the detection of oedema-like abnormalities than the contrast-enhanced T1-weighted images. In no patient was the opposite true. Thus, contrast-enhanced T1-weighted images did not provide more information than T2-weighted images. Nine patients with poly-, dermato- and inclusion body myositis showed clearly asymmetrical findings. Imaging of the thighs and legs was of similar sensitivity. The different types of myositides showed typical but not specific distributions of the mesenchymal abnormalities in MRI. The findings indicate that MRI of skeletal muscles in myositides can visualize the presence and distribution of oedema-like abnormalities and intramuscular lipomatosis and is suitable for the assessment of the chronicity and severity of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00868438
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  • 7
    Electronic Resource
    Electronic Resource
    Gedanken zur Aufklärung bei amyotropher Lateralsklerose (ALS) (1997)
    Springer
    Der Nervenarzt 68 (1997), S. 1004-1007 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Amyotrophe Lateralsklerose ; Aufklärung ; Palliativtherapie ; Terminalphase ; Nichtinvasive Heimbeatmung ; Key words Amyotrophic lateral sclerosis ; Breaking the news ; Palliative therapy ; Terminal phase ; Noninvasive ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Given the relentless progression of amytrophic lateral sclerosis (ALS) and the lack of causative therapy, breaking the news to ALS patients and their families is a daunting task for any physician. Obviously, such a task cannot be standardized. However, it is now recognized to be the first and one of the most sensitive and important steps in palliative care. Information should be offered in a stepwise fashion, in the presence of the patient’s family. All questions from the patient should be discussed openly, with emphasis on the positive aspects. Available therapeutic options should be reviewed, pointing out the fact that all symptoms of ALS can be alleviated by palliative therapy. At the onset of dyspneic symptoms, the terminal phase of the disease and the option of mechanical ventilation should be discussed.
    Notes: Zusammenfassung Die Aufklärung bei amyotropher Lateralsklerose (ALS) ist angesichts der schlechten Prognose eine Herausforderung für den betreuenden Arzt. Eine frühzeitige und offene Aufklärung stellt den ersten Schritt zu einer erfolgreichen palliativen Therapie dar. Die Aufklärung bei ALS ist nicht standardisierbar. Sie sollte stufenweise und unter Einbeziehung der Angehörigen erfolgen. Alle Fragen des Patienten zu seiner Erkrankung sollten – unter Betonung der positiven Aspekte – besprochen werden. Die vorhandenen Behandlungsmöglichkeiten sind in den Vordergrund zu stellen, zumal praktisch alle Symptome der ALS einer palliativen Therapie zugeführt werden können. Bei den ersten Zeichen der Atemnot ist eine Aufklärung über die Terminalphase und die verschiedenen Möglichkeiten der künstlichen Beatmung angezeigt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050231
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