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E Standl

Publications and source records attributed to E Standl.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Results of local thrombolysis with special reference to diabetic metabolism].

The influence of diabetes on the primary and long-term success rate after 145 local thrombolyses in peripheral arterial disease stages III and IV was evaluated. 75 patients suffered from thrombotic, 62 patients from embolic occlusions, with eight patients suffering from thrombangitis obliterans. Regarding the localisation of vascular occlusion 0.6% suffered under an occlusion of the iliacal artery, 21% of the femoral artery, 16% of the popliteal artery, 7% of the vessel of the lower limb and 55.4% showed a combined occlusion of the femoral- and popliteal artery and the artery of the lower limb. In cases of embolic occlusions only marginal differences could be observed, while the primary success-rate of thrombotic occlusions showed greater differences between both groups (75% vs. 91%). During the follow-up, no differences between both groups could be established (patency-rate of 79% for both groups). The same applies to the prognostic factors: peripheral run off, length, duration of occlusion and the clinical stage (Fontaine IIb to IV). The remarkable differences between diabetic and non-diabetic patients in cases of occlusions of more than 16 cm (66% vs. 88% in primary and 55% vs. 77% in long-term success) can be explained by the high percentage of diabetic patients with poor run-off and microangiopathy. Regarding the above parameters, primary and long-term results seemed to be less in diabetic patients, even though a long-term patency could be observed in 2/3 of diabetic patients in stages IIb and IV with primary success.

Adult↗
PubMed1990

Risk of progression to diabetes of low titer ICA-positive first-degree relatives of type I diabetics in southern Germany.

In a prospective study to evaluate the prevalence and predictive potential of circulating cytoplasmatic islet cell antibodies (ICA) and competitive insulin autoantibodies (CIAA), we screened 406 non-diabetic first-degree relatives of patients with Type I diabetes mellitus (n = 154 for CIAA). The prevalence of ICA was 2.5% (10/406) and of CIAA 0.6% (1/154) in ICA- and 10% (1/10) in ICA+ relatives at initial screening. The titer of ICA positivity in all relatives varied between 1:1 and 1:4. Values of elevated CIAA were 256 nU/ml of the CIAA+/ICA+, and 97 nU/ml of the CIAA+/ICA- relatives (normal range less than or equal to 39 nU/ml). Sera for repeat ICA and CIAA determination was obtained, and 70% of relatives were found to be again ICA+ after 1.5 years, 40% after 3 years, and 10% after 5.7 years. Both CIAA+ relatives were found to be again CIAA+ on follow-up. Intravenous glucose tolerance tests (IVGTT) were performed in all antibody-positive relatives. No decrease in first-phase insulin secretion (1 + 3 min) below the 1st percentile was observed in any of the ICA+ relatives during follow-up. No ICA+, but one CIAA+/ICA- relative had developed Type I diabetes after 5.6 years of follow-up. In summary, these results indicate that low titer ICA (less than 40 JDF units) are often transient and relatives with low titer ICA rarely progress to Type I diabetes. Elevated CIAA appear to be constant over time and associated with increased progression to overt diabetes.

Adolescent↗
PubMed1990

Low-pigment skin type and predisposition for development of type I diabetes.

To ascertain whether skin pigmentation type and sensitivity to ultraviolet (UV) light are associated with susceptibility to type I (insulin-dependent) diabetes, 55 type I diabetic patients were examined, 38 new-onset and 17 long-term cases. They were compared to 72 control subjects of the same geographic region and nationality. To evaluate the individual skin pigmentation type, a standardized questionnaire was developed. Reactivity to UV light was determined by a stepwise-graded UV irradiation. Significantly more diabetic patients in southern Germany had blue eyes than nondiabetic control subjects (55 vs. 26%, P less than 0.01), and significantly more diabetic patients had a low-pigment eye color (blue or green) than control subjects (66 vs. 38%, P less than 0.01). In addition, more fair skin color was noted among diabetic versus control subjects (84 vs. 60%, P less than 0.01). In response to UV irradiation, diabetic patients more often showed an increased UV-light sensitivity than control subjects (83 vs. 23%, P less than 0.001). The relative risk for susceptibility to type I diabetes in subjects with low-pigment eye color was 3.1, in subjects with fair skin type 3.4, and in subjects with increased UV-light sensitivity 5.8. The highest risk for the development of diabetes was seen in subjects who had low-pigment eye color and/or increased UV-light sensitivity (95 vs. 51%, P = 0.00002, odds ratio 17.4). We conclude that a low-pigment skin type may predispose for the development of type I diabetes.

Adult↗
PubMed1990

[Risk profile and macroangiopathy in type II diabetics in medical practice].

The risk profile and the macro-vascular complications of patients with type II diabetes mellitus (NIDDM) was investigated in general practice patients for the first time in the FRG. It was the aim of the study to evaluate the efficacy of the therapy and possible improvements after detailed instructions in a random sample of well defined NIDDM in the greater Munich area. 290 NIDDM (187 female, 103 male) out of a total of 1500 patients treated by 22 general practitioners were randomly recruited for the study. First results indicated an excess morbidity of the NIDDM, e.g. 43.5% with HbA1c greater than 8%, hypertension in 73.8%, hypertriglyceridemia in 75%, hypercholesterolemia in 36.3% adipositas in 78%, and a micro/macro-albuminuria in 44.5%. A similar risk profile could be determined in cases with recently diagnosed NIDDM. The remarkable risk profile documents itself in the incidence of macro-vascular complications: 40.8% of the male and 43.2% of the female showed a peripheral arterial disease (pAVD), in 8% of all patients a carotid artery stenoses could be detected by means of doppler ultrasound technique; 46.6% of the male and 59.3% of the female patients showed symptoms of CHD. With the exception of the incidence of CHD in patients less than 64 years the duration of NIDDM had no influence on the macro-vascular complications as demonstrated in previous studies. The age however always had a significant influence on all three vascular regions examined. Albuminuria correlated as such with a number of risk factors showed a significant correlation with the incidence of pAVD and occurred more often in males with carotid artery stenoses. Other correlations established were: Hypercholesterolemia and FVIII ass. Ag respectively, and the incidence of carotid artery stenoses; blood pressure, F VIII ass. Ag and pAVD. In the female a negative correlation could be seen between the pAVD and the HDL-level. In patients with CHD sex specific correlations could be determined to blood pressure, HbA1c, c-peptide and triglyceride levels.

Adult↗
PubMed1989

[Menarche, menstrual cycle and fertility in diabetic patients].

From observations of female type I diabetics, we collected data on menarche, menstrual cycle and fertility. 337 women answered our questionnaire which had been published in journals for diabetic patients. The data were correlated with age, diabetes duration, and the onset of diabetes. The mean age at menarche was inversely correlated with the age of the patients; in diabetics it was 0.8-2 years higher than in the population in which diabetes developed after menarche. As compared to a population of non-diabetics we observed an increase in mean age at menarche of 0.4-1.3 years. The increase was most pronounced if diabetes developed between the age of 3-8 years. The prevalence of primary amenorrhoea in diabetics was 3.6%, in the controls and in diabetics with late onset 1.5%. Irregularities of the menstrual cycle were observed more often in diabetics than in the controls. The prevalences of oligomenorrhoea and secondary amenorrhoea were 14 and 7% in the group of patients with diabetes onset before menarche. In the group with late onset of diabetes the prevalence of secondary amenorrhoea was 12%. Irregularities of the menstrual cycle were found more frequently at the time of diabetes onset, although 76% of the patients had not remarked any change in the frequency of menstrual bleedings. With increasing diabetes duration, the frequency of bleedings normalized. 70.5% of the patients aged 35 or more had spontaneous conceptions, 2.1% were sterile. Both values are not significantly different from the data of the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Flow-cytometric detection of human anti-rat insulinoma antibodies in relation to anti-human islet cell and anti-insulin antibodies. Recognition of distinct antigens by antibodies in early type I diabetes.

Flow cytometry was recently introduced for the detection of antibodies in human serum to a cultured insulin-secreting rat insulinoma cell line (RINm5F) to investigate humoral immune reactivity in newly diagnosed type I (insulin-dependent) diabetic patients. Fifty-three patients were observed for 6-20 mo after clinical onset of diabetes with a reported duration of symptoms of less than 6 wk. Human anti-RINm5F antibodies were detected in 28%, human anti-islet cell antibodies in 62%, and anti-insulin autoantibodies in 36% of patients before initiation of insulin therapy. Occurrence of human anti-RINm5F antibodies at this stage was correlated with human anti-insulin autoantibodies rather than with the formation of anti-islet cell antibodies. Incidence of anti-RINm5F antibodies in individuals with duration of diabetes greater than 6 wk was 38%, whereas human anti-islet cell antibodies and anti-insulin antibodies became detectable in 72 and 61% of the patients, respectively. These findings are in line with previous reports of immunoprecipitation by human diabetic serums of a 64,000-Mr antigenic structure in freshly prepared rat islet cells. The results suggest a reactivity of distinct classes of antibodies in serums of patients with type I diabetes to disparate antigens on human islet cells and cloned rat insulinoma cells and, moreover, reactivity to insulin as the secreted product. Further characterization of the reacting RINm5F antigens and prospective studies in subjects at risk for diabetes are required to validate the application of RIN cells to the investigation of immune mechanisms involved in the pathogenesis of human type I diabetes.

Adenoma, Islet Cell↗
PubMed1988

[5-year follow-up after endarterectomy of carotid artery thrombosis].

The long-term results of carotid endarterectomy were analysed in 119 patients, operated on between January 1979 and December 1980 (135 endarterectomies; preoperative data analysed retrospectively). 43 patients had been in stage I, 39 in stage IIa, 13 in stage IIb, 4 in stage III, and 20 in stage IV. Perioperative mortality was 0.8%, while hospital mortality was 2.5%. Transitory perioperative neurological deficits occurred in 4.2% of all patients, but no permanent ones. Five years postoperatively 44.5% had died, nearly half (43.4%) of cardiovascular disease. Cerebrovascular disease and tumour each caused 15% of deaths. During the five-year follow-up period 12% of all patients had had transitory ischaemic attacks; 16% had suffered a stroke (in 63% on the operated side). With a high prevalence of risk factors, only the quality of diabetic control (mortality rate of well controlled diabetes 38%, of poorly controlled 70%) and the risk factors heart failure and vascular occlusive disease had a significant influence on the mortality rate. But the mortality rate was significantly lowered with the use of platelet aggregation inhibitors (41.6% vs 72.7%).

Adult↗
PubMed1988

Loss of Ia-positive epidermal Langerhans cells at the onset of type 1 (insulin-dependent) diabetes mellitus.

Immunocompetent antigen-presenting Langerhans cells were investigated in skin biopsies of 20 short-term Type 1 (insulin-dependent) diabetic patients and compared with 17 matched normal control subjects. Langerhans cells in epidermal sheet preparations were visualized with a monoclonal anti-HLA DR antibody using indirect immunofluorescence. A significant decrease of Langerhans cells/mm2 body surface area was found in 10 patients immediately at the onset of diabetes compared to 10 patients with 6 months duration of diabetes and to normal control subjects (401 +/- 30 vs 559 +/- 43 vs 611 +/- 33, p less than 0.01 and p less than 0.002). There was no significant difference in the number of Langerhans cells between patients with 6 months duration of diabetes and control subjects. Examination of the most likely precursor of Langerhans cells, the blood monocytes, indicated an increase of monocyte counts in Type 1 diabetic patients after 6 months duration (344 +/- 37 cells/microliters vs 191 +/- 31 in control subjects, p less than 0.05) and an inverse correlation between the number of Langerhans cells in skin with the number of monocytes in peripheral blood (at onset: r = -0.73, p less than 0.01, after 6 months of diabetes: r = -0.61, p less than 0.05). In addition, a positive correlation between Langerhans cells and daily insulin dose was noted in patients after 6 months of diabetes (r = 0.76, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Cell-mediated autoimmunity at the onset of insulin-dependent diabetes mellitus (IDDM).

Peripheral blood lymphocytes have been investigated in 20 newly diagnosed type-I diabetics and 10 healthy subjects using monoclonal antibodies. Mononuclear cells were marked with anti-T-lymphocytes (Leu2, 3, 4, 12) and anti-Ia-antibodies (K14, L243) using indirect immunofluorescence. The percentage of circulating K14- and L243-positive cells was significantly higher in all diabetics than in normal controls. An increase in the number of K14-bearing cells was found in newly diagnosed patients with duration of less than 7 days (n = 10) compared with diabetics of longer duration (1 to 8 months; n = 10). Using dual-color immunofluorescence with fluorescein-conjugated anti-T-lymphocytes and rhodamin-conjugated anti-Ia-antibodies it was not possible to identify Ia-antigen bearing cells (Ia cells) as helper or suppressor lymphocytes. In addition, there was no significant difference in the number of Ia cells in diabetics with and without islet cell antibodies. It is concluded that there is evidence of activation of cellular immune response in type I diabetes, particularly in the early days of manifestation. However, previous assumptions that Ia cells represent T-cell activation have to be questioned.

Adolescent↗
PubMed1987

Daily insulin dose as a predictor of macrovascular disease in insulin treated non-insulin-dependent diabetics.

In the longitudinal Schwabing study, unselected insulin-treated diabetic patients were followed for major vascular complication (MVC) (stroke, myocardial infarction, gangrene) and asymptomatic, early detectable peripheral vascular disease (PVD). In the group of insulin-treated NIDDM multiple logistic regression analysis revealed the number of daily injected insulin units as a significant predictor for MVC and PVD (t = 1.98; p less than 0.04; x +/- S.D.: PVD yes 57.6 +/- 21.4 U/d; PVD no 44.3 +/- 17.7; age-adjusted univariate p less than 0.001). Daily insulin dose correlated highly significantly with serum triglycerides (r = 0.40, p less than 0.001) as well as with blood glucose (r = 0.33, p less than 0.001). These data suggest that insulin resistance is characteristic for atherosclerotic disease in NIDDM and the hyperinsulinemia-hypertriglyceridemia-syndrome might be a powerful cardiovascular risk factor in diabetes mellitus.

Adolescent↗