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Biomedical subjects

J Beyer

Publications and source records attributed to J Beyer.

At least 307 records · Page 17Linked to original sources
PubMed1990

[Preoperative localization in organic hyperinsulinism--useful or superfluous].

In our own patient material (n = 43) the percutane sonography had a sensitivity of 61.9%, the CT 73.3%, the angiography 66.6% and the PTP 76.9%. Intraoperatively 95.2% of all insulinomas were palpable and the intraoperative sonography (IOS) had a sensitivity of 81.2%. In Germany all clinics except for one recommended a sonography and a CT and 83.8% an angiography prior to the first operation. A preoperative localization diagnostic is therefore not absolutely necessary, but may however be helpful in single cases.

Diagnostic Imaging↗
PubMed1990

[Surgical therapy of insulinoma].

From 12 Patients surgically explored because of suspected insulinoma, the diagnosis was correct in 11. In 8 patients there was a solitary insulinoma, which was diagnosed in every case by preoperative ultrasonography, computed tomography or angiography. In one patient with three adenomas, only one was diagnosed preoperatively, the second by palpation and the third by intraoperative sonography. One patient had a diffuse hyperplasia. The intraoperative frozen section was correct in 9 from 11 patients. The preoperative localisation of insulinoma assisted in the intraoperative identification. The intraoperative pancreatico sonography is an useful help in localisation of insulinoma. For treatment the enucleation of tumor is preferable.

Adenoma, Islet Cell↗
PubMed1990

[Hepatitis C virus (HCV) antibodies in German blood donors--a pilot study].

A new EIA-test to detect Hepatitis C antibody (ORTHO Diagnostic Systems) has been evaluated in four blood transfusion services in FRG (Hamburg, Hannover, Springe, Frankfurt). Among 3,123 specimens, 18 (0.58%) reacted initially positive, 13 (0.42%) remained positive after repeat testing. A detailed analysis revealed remarkable differences: blood donors from the northern part of Germany were less frequently positive than donors from the southern region (0.24% vs. 0.79%), repeat donors had a higher HCV-antibody incidence than first-time donors (0.48% vs. 0.29%). Similar differences were observed between remunerated and non-remunerated donors (0.24% vs. 0.53%), as well as between donors from rural and urban areas (0.34% vs. 0.46%). In contrast to other investigators, only a weak correlation between elevated ALT-levels (greater than 50 IU/ml) and anti-HCV seropositivity rate has been found.

Antigens, Viral↗
PubMed1990

Treatment of severe reactive hypoglycemia with a somatostatin analogue (SMS 201-995).

Reactive (or postprandial) hypoglycemia can sometimes represent a severe disorder refractory to conventional therapeutic measures. We present in this first individual trial, to our knowledge, that the administration of a somatostatin analogue (SMS 201-995) may alleviate the severity of complaints and does not appear to be diabetogenic. The effects of the somatostatin analogue were documented in a 5-hour oral glucose tolerance test, where not only the glucose-induced and C-peptide rise was clearly attenuated, but also the blood glucose concentration did not fall low enough to induce hypoglycemic symptoms.

Blood Glucose↗
PubMed1990

Computer assisted insulin dosage adjustment--perspectives for diabetes control.

Pocket computers provide the physician's (expert's) advice at home and by that may increase the number of self-adapting diabetics and alleviate documentation and evaluation of therapy data. By a more complex quantitative approach metabolic control may be improved beyond the range which is attained by optimal intensified education, as clinical trials showed. By their reproducible measures a learning process seems to be induced in the patients. Risks like hyperinsulinisation may be overcome by watch dog functions and suitable algorithms. In addition to these patient-oriented functions the automatic data acquisition may be used for secondary PC-assisted data interpretation and more complex advice at the physicians office. For compliance reasons the system concept has to be user-friendly considering size, easy handling and compensating for the loss of a written log book by adequate display.

Algorithms↗
PubMed1990

Assessment of insulin needs in insulin-dependent diabetics and healthy volunteers under fasting conditions.

It is known from clinical observations, theoretical investigations as well as from data patients with intensified insulin therapy and wearers of insulin pumps that the body also requires insulin under fasting conditions. Therapeutic studies as well as the investigations carried out using the artificial pancreas indicate that just under half of the daily insulin requirement is not meal-related, and the other half is dependent on food. The question arose as to whether there are any differences in the basal insulin requirement depending on the time of day and whether differences can be detected between type I diabetics and healthy reference subjects. The results show that analogous changes occur in the early hours of the morning in type I diabetics and healthy normal subjects: these correspond to the clinical familiar dawn phenomenon. The different courses of blood glucose and insulin requirement as measured on the basis of the release of insulin by the Biostator as well as the insulin secretion profile in healthy normal volunteers under fasting conditions do not show any further differences which depend on the time of day.

Adult↗
PubMed1990

[Diabetic coma].

Explore the source record for details and available documents.

Combined Modality Therapy↗
PubMed1990

[Tumor histogenesis and macrophage content in lymphomas in Marek's disease of chickens].

Histological and to some extent additional enzyme-histochemical studies were conducted into 28 cases of Marek's disease with minor, moderate, and intensive lymphoma formation. The investigations were undertaken with a view to differentiating T-lymphocytes and macrophages by differentiated activity on acid unspecific alpha naphthylacetate esterase. Lymphoma specimens were cytologically evaluated under semi-quantitative or quantitative aspects. Evidence was provided to the existence of correlations between intensity of Marek's disease lymphomas and their relative contribution to lymphocytes, lymphoblasts, and macrophages. The amount of lymphoblasts was found to go up along with advancing lymphoma proliferation, while the amounts of lymphocytes and macrophages went down. Moderately pronounced lymphomas contained 16 percent macrophages on average, whereas only about 8 percent were recordable from highly pronounced lymphomas. The high presence of macrophages in less developed lymphomas is considered to reflect unspecific defence reaction against neoplastic lymphatic cells in the phase of low tumour malignancy.

Animals↗
PubMed1989

[Osteoporosis: a case report].

A 56-year-old female patient was admitted to our hospital because she was suffering from severe osteoporosis. The patient had experienced repeated spontaneous fractures for 1.5 years such as serial rib fractures, fractures of the sternum and most recently fracture of the neck of the femur after a minimal trauma. Histology revealed a low-turnover-osteoporosis. Subsequent radiologic examination showed extreme osteoporosis of the skeleton with numerous compression fractures of the vertebral bodies as the most outstanding finding. The bone histology and the relatively short history of spontaneous fractures led us to investigate endogenous hypercortisolism as a possible cause although clinical signs were absent. An attenuated diurnal variation of cortisol levels and lack of suppressibility of cortisol was found. Furthermore, magnetic resonance tomography showed a microadenoma of the pituitary gland. Computerized tomography of the adrenals was normal. Transsphenoidal surgery confirmed the tentative diagnosis and histological examination revealed a bilateral adenoma of the pituitary gland.

Adenoma↗
PubMed1989

[Diagnosis and therapy of hypercalcemic crisis].

Between September 1985 and July 1988 at the Surgical Department of University Mainz 113 patients with primary or tertiary hyperparathyroidismus were operated. In four patients a hypercalcemic crisis developed. At the same time two patients with a hypercalcemia as a metabolic complication of cancer were treated. Within a few hours an involution of the life-threatening symptoms could be achieved by rehydration and diuresis at our intensive care unit. The treatment with mithramycin, calcitonin, a hemodialysis or a phosphate infusion were necessary in none of our patients. Because of the prompt starting of those therapeutical treatments at the intensive care unit no patients died as a result of the hypercalcemic crisis. After ending the hypercalcemic crisis the patients with hyperparathyroidismus were operated. In the patients with a hyperparathyroidismus associated with carcinoma a therapy to lower serum calcium with cortisone and calcitonin was performed.

Adult↗
PubMed1989

[Petit mal status in hyperthyroidism].

A 68-year-old woman who, for the first time, had a generalized tonic-clonic seizure and persisting confusional state was found to have nodular enlargement of the thyroid and a tachycardic arrhythmia. Electroencephalography (EEG) demonstrated a continuous irregular polyspike wave pattern. Total T4 concentration was elevated to 23 micrograms/dl. Consecutive Administration of 250 mg phenytoin, 4 mg clonazepam and 7.5 mg midazolam changed neither the clinical nor the EEG findings. But after general intensive care measures and high-dose thyrostatic treatment (40 mg thiamazole intravenously every four hours) the clinical and neurological status became normal. Serial EEGs over the subsequent weeks and months showed gradual disappearance of the abnormal changes with increasingly prolonged periods of normal activity.

Aged↗
PubMed1989

Comparison of glycemic response and insulin requirements after mixed meals of equal carbohydrate content in healthy, type-1, and type-2 diabetic man.

The postprandial insulin requirements after three mixed meals of equal carbohydrate and energy content were assessed in 10 type-1 and 12 type-2 diabetics by a glucose-controlled insulin infusion system. These were compared with the glycemic response to the same meals of 10 healthy individuals (glycemic index). In type-1 diabetics, we found the highest insulin requirements after consumption of a continental breakfast (low fibre, low protein, high fat). Ten percent less insulin was infused after milk (low fat, high protein) and 30% less after an English breakfast (high fibre, high protein). Type-2 diabetics showed no significant differences in insulin requirements between the three test meals. The glycemic response in healthy individuals had no relation to these insulin requirements. Continental and English breakfast had a similar glycemic effect, whereas milk produced only 30% of the blood glucose response observed after the continental breakfast. These results indicate that neither the carbohydrate content (exchange lists) nor the glycemic index enable prediction of postprandial insulin requirements in insulin-deficient diabetes. For this purpose, we propose the insulin-need index, elaborated by testing whole meals in closed-loop experiments with type-1 diabetics.

Adult↗
PubMed1989

[Value of diagnostic localization of insulinoma].

The value of diagnostic localization of insulinoma The value of diagnostic localization statements are contradictory. Basing on our own patient material (n = 41) the preoperative localization of an insulinoma was correct with sonography in 57.7%, with computed tomography in 21.4%, with computed tomography with bolus injection of contrast medium in 73.3%, with angiography 63.9% and with percutaneous transhepatic portal vein catheterisation with selective test of hormones (PTP) in 76.9%. Intraoperative 38 of 41 insulinomas were palpable and twelve of 16 insulinomas were seen during intraoperative sonography. Although we palpate more than 90% of all insulinomas we support a preoperative diagnostic localization for easier intraoperative palpation.

Adenoma, Islet Cell↗
PubMed1989

[Type 2b multiple endocrine adenomatosis].

The case report presented here demonstrates the typical diagnostic and therapeutic problems in a young patient with a multiple endocrine adenomatosis type 2b. The patient exhibited the complete syndrome with its endocrine and non-endocrine organ manifestations (medullary thyroid cancer, bilateral pheochromocytoma, mucosal neuromas, marfanoid habitus, pes equinus, diverticulosis). First presenting symptom was a diverticulitis that led to an emergency surgical intervention because of perforation of the sigmoid colon. Perioperatively, blood pressure increases were noted that were then followed by further diagnostic measures leading to adrenalectomy, thyroidectomy and surgery for local metastases of the thyroid cancer. Family screening demonstrates so far a possible sporadic form of the disease.

Adrenal Gland Neoplasms↗
PubMed1989

Cardiac arrhythmias and heart rate in hyperthyroidism.

The arrhythmia profile and heart rate (HR) were analyzed by 24-hour Holter monitoring in 37 hyperthyroid patients before (triiodothyronine [T3] hormone level = 331 +/- 108 ng/dl), during (T3 level = 202 +/- 98 ng/dl) and after an antihyperthyroid therapy of 8 to 89 weeks' duration (T3 level = 149 +/- 41 ng/dl). The data were compared with those of 50 control subjects free from cardiac disease. Only 12 hyperthyroid patients (32%) had complex ventricular arrhythmias (Lown grade 3 or 4) as compared with 6 normal subjects (12%, p greater than 0.05). Three patients (8%) had repetitive ventricular arrhythmias (Lown grade 4A/B) as compared with 4 normal subjects (8%, p greater than 0.05). Supraventricular premature complexes occurred more often in hyperthyroid patients than in normal subjects before and after therapy (p less than 0.001). The prevalence of supraventricular tachycardia decreased from 8 patients to 1 during therapy (p less than 0.002). The HR decreased from 95 +/- 13 to 79 +/- 9 beats/min after therapy, but was still increased as compared with the normal subjects (72 +/- 8 beats/min, p less than 0.001). A day/night difference in HR greater than 10% was found in 32 patients (86%) and was more pronounced than in the normal group (p less than 0.001). Compared with the normal HR profile, the HR curve of hyperthyroid patients was shifted to a higher level (about 20 beats/min). Serum T3 level correlated best with HR at night in hyperthyroid patients (r = 0.74, p less than 0.001). Thus, hyperthyroid patients show frequent supraventricular arrhythmias that might be reversible during therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗