Search PubMed⌕ Search

Biomedical subjects

D Luft

Publications and source records attributed to D Luft.

At least 19 recordsLinked to original sources
PubMed1994

Differential diagnosis of neuropathic lesions in diabetic and alcoholic patients.

Cardiovascular reflex tests are used extensively to screen diabetic patients for autonomic cardiac neuropathy. Since alcohol abuse must often be considered the cause of nerve damage in internally ill patients, we examined 66 nonalcoholic type 1 (insulin-dependent) diabetics and 63 nondiabetic alcoholics matched for age, weight, and duration of disease to determine whether specific patterns of complaints, symptoms, signs, and results of the cardiovascular reflex tests can differentiate between alcoholic and diabetic nerve damages. In these carefully selected diabetic and alcoholic patients the medical history, clinical neurological assessment, and reflex test results all showed significant differences, resulting in different patterns which allow the correct allocation of nerve damage to either diabetic or alcoholic origin with easily available clinical means.

Adolescent↗
PubMed1994

Long-term changes of body weight and cardiovascular risk factors after weight reduction with group therapy and dexfenfluramine.

The aim of this work was to investigate the long-term changes of body weight and cardiovascular risk factors after weight reduction with dexfenfluramine (dF) compared to placebo (pI) and additional group therapy. There was a 3 year follow-up of obese patients after 1 year double-blind, randomized treatment with 30mg dF or pI and group therapy. The work was carried out at the outpatient clinic of University Hospital, Tübingen. Forty-eight (24 dF, 24 pI) patients were investigated with more than 120% of ideal body weight. Body weight, blood pressure, blood glucose, serum cholesterol and triglycerides were measured. During 1 year of treatment body weight fell by 11.2% (dF) and 9.1% (pI) (P < 0.001 for time, n.s. for dF/pI), systolic blood pressure by 7.3 and 9.9 mm Hg (P = 0.044/n.s.). There were no significant changes of serum cholesterol, triglycerides, and blood glucose. At the follow-up of 22 (11/11) patients 3 years later, the dF group had regained more than the lost weight; the placebo group had lost 2.4% of the initial body weight. Serum cholesterol (dF + 0.64/pI + 0.65 mmol/l, P = 0.010/n.s.), triglycerides (+0.74/+0.59 mmol/l, P = 0.002/n.s.), and blood glucose (+0.56/+0.81mmol/l, P < 0.001/n.s.) increased significantly. Systolic blood pressure increased slightly, diastolic blood pressure did not change significantly. Without appropriate prevention of weight regain even combined weight reduction therapy over a period of one year results in weight regain and deterioration of cardiovascular risk factors.

Adult↗
PubMed1990

Urinary excretion patterns of endogenously produced alcohols in type 1 (IDDM) and type 2 (NIDDM) diabetes mellitus compared with healthy control subjects.

Urinary excretion patterns of various endogenously produced alcohols, such as ethanol, propanol, isobutanol, butanol, and isopentanol, were evaluated in 17 type 1 (IDDM) and 15 type 2 (NIDDM) diabetic patients, and in two different groups of healthy control subjects (n = 12, n = 8, respectively) matched for sex, age and weight. In addition to the urinary alcohol excretion determined by gas-chromatography and mass-spectrometry, four cardiovascular reflex tests were performed, and the motor and sensory conduction velocities of three different peripheral nerves were measured. In the type 1 diabetic patients, urinary excretions of ethanol and propanol were significantly higher than in the control subjects (P less than 0.0001, P less than 0.00001, respectively), whereas the control subjects exhibited significantly higher urinary excretion rates of the other three alcohols (P less than 0.007, P less than 0.02 and P less than 0.002, respectively) compared with the type 1 diabetic patients. In the type 2 diabetic patients, only the urinary excretion of propanol was significantly elevated (P less than 0.002) compared with the control subjects, while the urinary excretion rates of butanol and isopentanol were significantly lower (P less than 0.02, P less than 0.05, respectively) than in the controls. Urinary alcohol excretions were not related to diabetic peripheral neuropathy in both groups studied. The clinical meaning of the urinary excretion patterns of different endogenously produced alcohols in diabetes mellitus has to be further evaluated.

Adult↗
PubMed1990

[Lung cancer in the DDR with special reference to histological types and cigarette consumption].

By an analysis in detail of incidences of lung cancer of the years 1971 to 1984 and of the data of consumption of cigarettes per head in GDR during the years 1960 to 1984 we discussed the further trends of morbidity and mortality in lung cancer in our country. We pointed out: 1. From 1972 to 1985 the mortality of lung cancer in males dropped from 6,023 per year to 5,213, while that of females increased from 698 to 959. 2. In the time from 1971 to 1983 the over-all incidence (crude rates) of lung cancer in males decreased from 87.1 per 100,000 to 75.5 per 100,000, but came up to 77.2 per 100,000 in 1984. The females rose from 9.7 to 12.3 per 100,000 in the same interval. 3. The age related incidences showed different courses not regarding the different levels of both sexes. In the age group of 30-59 we found a significant incidence rise. The incidence of the 60-69 year old males dropped in a range of 10%; that of the females with the same age had an undulating course with rising trend. Males and females of an age of 70 years and older also had an undulating course with increasing trend. 4. Between 1970 and 1979 the proportions of histological types moved. The adenocarcinomas of males rose significantly from 10.0 to 12.6% and that of large cell carcinomas from 3.6 to 6.0%. In the females the proportions of large cell cancers rose also from 4.2 to 7.5%. 5. The histological types of lung cancer have a significant age relation: Undifferentiated cancers and adenocarcinomas decrease with the age while proportions of squamous cell cancers rise with the age. 6. During 1960 to 1969 the market share of filter cigarettes changed from less than 10% to 79% and rose to 91% until 1975. In the same time the cigarette consumption per head of population increased continuously until now (1984: consumption of cigarettes per head 1,845). 7. In the age group of 18-25 the proportions of smokers is 50% and their middle consumption of cigarettes per day amounts to 11 cigarettes. In the age group of 45-55 the proportion of smokers runs to 34% and their cigarette consumption per day comes to 15 cigarettes. The proportion of male smokers amounts to 47%. The proportion of female smokers amounts to 18%.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma↗
PubMed1990

[The relationship of histological type and tumor location to prognosis in 1000 patients with lung resection with special reference to adenocarcinoma].

On the basis of clinical investigations of 1,000 resected lung cancer patients we comment on the prognostic implications of histological type and tumour localisation with special regard to adenocarcinoma. 1. 198 patients, resected for primary adenocarcinoma of the lung, had 5- and 10-year survival rates of 42% and 25.3% respectively, similar to the survival rate of patients who had been operated on for squamous cell carcinoma. 2. Of 6 patients suffering from central adenocarcinoma according to WHO classification of 1967, or 10 patients according to WHO classification of 1981, not a single patient survived for more than 3 years. In patients with peripheral adenocarcinoma the survival rates after 5 and 10 years amounted to 42.4% and 26.6%. The 5-year survival rates of all patients with peripheral cancers were significantly better than those of central tumour patients. 3. The survival rates after 5 and 10 years among patients resected for primary adenocarcinoma dropped steeply in relation to tumour stage. While adenocarcinoma patients in stage I had the highest survival chances in comparison to other types, the survival curve of stage III patients with this type fell below that of small-cell and large-cell cancer patients. 4. The prognosis of patients resected for adenocarcinoma whose x-ray pictures showed a large infiltration, had a bad prognosis. Patients with peripheral coin lesions had good survival chances. 5. It was impossible to demonstrate a correlation between survival rate and grade of differentiation in adenocarcinoma patients. There were also no prognostic differences between papillary and acinar subtype. Patients with bronchiolo-alveolar carcinoma had the significantly highest survival rates.

Adenocarcinoma↗
PubMed1989

Gallbladder emptying in diabetic patients and control subjects assessed by real-time ultrasonography and cholescintigraphy: a methodological comparison.

Gallbladder motor function was studied in nine diabetic patients and nine control subjects matched for sex, age, and weight. None of the subjects had gallstones. Two different techniques were employed: real-time ultrasonography and cholescintigraphy using 99mTc-HIDA as imaging agent. Gallbladder volumes were determined sonographically by using three dimensions: length, lateral, and anterior-posterior diameters. Gallbladder emptying was stimulated by a standard test drink (Biloptin). Ejection fraction was computed and the results obtained by both techniques were compared. Fasting and residual gallbladder volumes after contraction were significantly larger in the diabetic patients than in the control subjects (15.9 +/- 7.6 cm3 vs. 2.3 +/- 1.3 cm3, p less than .0007; and 9.2 +/- 9.8 cm3 vs. 0.7 +/- 0.7 cm3, p less than .0007). Ejection fractions (ultrasonography/cholescintigraphy) were lower in the diabetic patients compared with the control subjects (59.9 +/- 26.6% and 63.1 +/- 23.2% vs. 73.2 +/- 23.8% and 75.3 +/- 24.8%), however, this difference was not statistically significant. Sonographically and scintigraphically determined ejection fractions were closely correlated (r = 0.90, p less than .00005).

Diabetes Mellitus, Type 1↗
PubMed1988

[Significance of ultrasonics in the placement of a central venous catheter].

An ultrasound investigation was undertaken of the neck region of 42 patients with normal neck anatomy in order to determine whether the results of ultrasound-gained topographical data provided pointers to the choice of entry site to the internal jugular vein (IJV). In addition, the IJV was punctured under ultrasound control in 23 patients in an intensive care unit in whom there was a problem of increased bleeding tendency, anatomical difficulty or previously failed "blind" puncture. In all of them a central venous catheter was placed without complication by the Seldinger technique via the primary chosen point for puncture. An approach through the sternocleidomastoid muscle, between the cricoid level and the "central" place of puncture between the two bellies of the sternocleidomastoid muscle proved to be the most satisfactory compromise between easy application of the ultrasound head, large vein diameter and reduction of any risk of mistakenly puncturing artery or pleura. This approach has to be varied according to the ultrasound findings. It is concluded from this experience that ultrasound is suitable for the placement of central venous catheters. But since the equipment is bulky it cannot be used in an emergency.

Adult↗
PubMed1988

[Evaluating 2 simple procedures for ultrasound assessment of gastric emptying].

For evaluation of 2 simple methods gastric emptying was studied simultaneously by ultrasound and scintigraphy. In 12 patients (25-76 years-old) gastric emptying was quantified by scintigraphy after ingestion of 300 ml Tc-99m-labelled orange juice; simultaneously, the region of the gastric antrum was measured in 5-minute intervals in the aortic longitudinal section. In the following day gastric emptying was studied after ingestion of the identical volume of orange juice by planimetry of the maximal gastric area in an anatomical long-axis section in dextro-decline position. By linear regression analysis a significant correlation coefficient (r = 0.83, p less than 0.001) was obtained between the results of the sonographic antrum method and scintigraphy and between scintigraphy and the sonographic dextro-decline method (r = 0.83, p less than 0.001). These results imply that gastric emptying of fluids can be quantified by both simple sonographic methods. The sonographic dextro-decline method is less influenced by air and hence easier to perform.

Adult↗
PubMed1987

Effects of continuous subcutaneous insulin infusion and intensified conventional therapy on peripheral and autonomic nerve dysfunction.

The objective of this study was to determine whether a favorable effect of short term continuous sc insulin infusion (CSII) therapy on the peripheral and autonomic nervous system could be maintained by subsequent intensified conventional treatment (ICT). Nine type I diabetic patients, aged 18-32 yr, who had been diabetic for 4-23 yr and had reduced nerve conduction velocities received CSII for 4 weeks and subsequently ICT for up to 26 weeks. Motor and sensory nerve conduction velocities (MNCV and SNCV) and heart rate variations during deep breathing (E/I ratio), during lying and standing (30/15 ratio), and during the Valsalva maneuver (Valsalva ratio) were measured before CSII and at intervals of 1, 2, 4, 6, 10, and 26 weeks. During CSII, MNCV and SNCV increased significantly (P less than 0.01), the E/I ratio improved in seven patients (P less than 0.05), the Valsalva ratio increased in eight patients (P less than 0.01), and the 30/15 ratio increased in five patients. The E/I ratio increased significantly earlier than the Valsalva ratio (P less than 0.025). During ICT, nerve conduction velocity slightly, though not significantly, decreased, and the results of the cardiovascular reflex tests also gradually declined. The hemoglobin A1 concentration before initiation of CSII and the diminution of the hemoglobin A1 concentration during CSII therapy were inversely correlated to the increase in MNCV (P less than 0.01 and P less than 0.05, respectively). In conclusion, CSII improved peripheral and autonomic nervous system function, but the improvement diminished somewhat during ICT.

Adolescent↗
PubMed1985

[Electrically activated blood].

By means of direct current electrically activated blood (EAB) is an endogenous thrombogenic substance. One vessel is occluded permanently by an agglutinative thrombus after injecting such blood. So the thrombosis can be simulated in experiment. In face of the endogenous fibrinolysis EAB proved more resistant than spontaneously coagulated blood and also after adding thrombus in vitro. An iodinated X-ray contrast medium (Visotrast 370) prevents the thrombosis of an artery by EAB.

Animals↗
PubMed1983

Definition of clinically relevant lactic acidosis in patients with internal diseases.

In order to define clinically relevant lactic acidosis, 12 biochemical variables, eight clinical symptoms and signs, leading diagnoses, and mortality were evaluated prospectively in approximately 2,000 unselected patients with internal diseases, consecutively admitted to the hospital. Patients with incomplete data sets were not considered. Of those patients who repeatedly were admitted to the hospital during the time of the study, only the first admission was included for statistical analysis. In addition to 11 definitions of lactic acidosis given in the literature, sequential cluster analyses of the biochemical variables were used to estimate the incidence of lactic acidosis in 1,467 patients. Depending upon which definition was used, 0.5-3.8% of all patients were classified as suffering from lactic acidosis, with a mortality rate ranging from 30-88%. From this study it is concluded that a limit of less than or equal to 7.35 for pH and of greater than 5-6 mmol/L for the concentration of lactate in whole blood will minimize false-negative or false-positive classifications.

Acidosis↗
PubMed1981

["Hyperthyroiditis" (author's transl)].

Typical signs of so-called hyperthyroiditis are hyperthyroidism, low iodine uptake by the thyroid, absence of local, general or humoral signs of inflammation, and absence of significant antibody titres against thyroid tissue. These features are illustrated by the case report of a 51-year-old man. Since the course of hyperthyroidism is short and has a good prognosis, the importance of the diagnosis lies in avoiding unnecessary therapeutic measures. This cause of hyperthyroidism can be recognized only by including tests of intrathyroid iodine metabolism among diagnostic procedures.

Antibodies↗
PubMed1981

[Carbohydrate infusion in internal diseases. A comparative study in metabolically healthy patients, patients with liver diseases and diabetic patients. I. Physiopathologic aspects in the parenteral administration of monosaccharides].

The biochemical basis of the metabolism of glucose and non-glucose-carbohydrates (fructose, sorbitol, xylitol) is presented. The potential draw backs of the parenteral application of large doses of these carbohydrates in internally ill patients, based on the results of experiments with isolated perfused livers or animals and case reports, are reviewed. These considerations form the basis for investigations in internally ill patients (liver cirrhosis, diabetes mellitus) and healthy controls in order to find out if low dose, long term, parenteral infusion of glucose or mixtures of glucose with non-glucose-carbohydrates are applicable to these patients without major side effects. The results of these investigations will be published in following papers.

Blood Glucose↗