[Oral antidiabetics].
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Biomedical subjects
Publications and source records attributed to W Bachmann.
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Red blood cells (RBC) were labeled with 99mTc in vitro after in vivo pretreatment with a stannous solution. The whole in vivo/in vitro procedure took 30-40 min. Pretinning was carried out by injection of either 6 mg DTPA and 0.6 mg Sn++ (Sn-DTPA) or 5 mg pyrophosphate and 0.7 mg Sn++ (Sn-PYP). The results of 1,356 patients were evaluated. The labeling yield was 89.7% (mean) after pretinning with Sn-DTPA and 88.2% following Sn-PYP pretreatment, the median values being 94% and 92%, respectively. The new method was successfully used in over 2,000 patients who had a radionuclide-ventriculography and in 38 patients studied for localization of occult gastrointestinal bleeding. Adverse side effects have never been observed.
The quality of clinical functional diagnostic concerning obstructed nasal respiration is subject to the diagnostic unity of anamnesis, inspection and rhinomanometry. Only then one can understand the pathological value of a respiratory obstruction, which consists of the objectifiable permeability and one subjective factor. Indispensable for making the permeability objective are a standardized functional measuring gauge, the application of the laws of physics concerning flux and rhinomanometry. This is the only way in which we shall succeed in getting definite diagnoses and in reaching the comparability of our diagnostic and therapeutical actions.
The assessment of the degree of intensity of obstructed nasal respiration has so far involved considerable errors in anamnesis and inspection, and hence an integration of objective rhinomanometry into a common diagnostic scheme has been impossible. This is by no means inevitable, since all three parameters are based on the same anatomical and physiological facts and on the same flow characteristics. These are shown in order to obtain correct diagnoses and objective possibilities of comparing our diagnostic and therapeutical efforts.
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Nowadays the therapy of inhalation can be considered the most effective physical therapy in the field of ENT. However the basic requirements are the following ones: --A clear basic knowledge of medicine and physics. --An exact instruction and control of the patient concerning the procedure of inhalation. --The availability of appropriate inhalation equipment (UDV) and of trained personnel.
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A woman with normal metabolism but addictive tendency injected insulin, as was proven by the presence of insulin antibodies in serum. Another woman with a normal metabolism caused hypoglycaemia by taking sulphonylurea preparations, apparently from self-destructive motives. After all laboratory and other tests had at first pointed to organic hyperinsulinism, the diagnosis of self-inflicted hypoglycaemia was finally made by demonstrating the drug in plasma. A young diabetic who required insulin caused hypoglycaemia by injecting additional insulin. The complete absence of C-peptide and especially the strict supervision confirmed the diagnosis.
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In view of controversial findings regarding the mechanism for the increased intracellular hepatic cyclic 3':5' adenosine monophosphate levels in diabetic rats, we studied the dose-response relationship of the adenylate cyclase to glucagon stimulation in severely diabetic and in diabetic, insulin-treated rats. An enhanced response to glucagon and an additional augmenting effect of guanosine triphosphate on hormonal stimulation of the adenylate cyclase activity were found in diabetes which were reversible with insulin treatment. The results suggest a role of the regulatory guanyl nucleotide-binding protein in diabetes leading to an increased dose response relationship of the hepatic adenylate cyclase system to glucagon.
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Intracutaneous testing was done in 85 patients with allergic reactions during insulin treatment. Six patients showed immediate reactions (type I), 76 showed allergic late reactions (type IV) and three showed combined allergy (type I/IV) to intracutaneous undiluted insulin. Whereas immediate and combined allergies were exclusively pure insulin allergies, several allergens were shown to be responsible in late reactions: nine patients had pure surfen allergy, 34 patients pure insulin allergy (against all insulins) and 11 pure bovine insulin allergy. A further 22 patients reacted to various allergens, 16 of them to surfen and all insulins, and 6 to surfen and bovine insulins. Estimation of the diameter of the erythema showed a significantly better skin tolerance of neutral than of acid insulins. Intracutaneous pig insulin led to less erythema than bovine insulin. Neutral pig insulins thus have the least antigenicity.
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