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Biomedical subjects

W Berger

Publications and source records attributed to W Berger.

At least 253 records · Page 14Linked to original sources
PubMed1980

[Daily blood sugar and hemoglobin A1 or A1c profile for the surveillance of diabetes therapy].

Two new diagnostic tools to assess blood glucose control in ambulatory diabetics have recently been introduced. The first represents a self-monitoring of ambient blood glucose levels by the patient who prepares capillary blood samples during a day of regular activities. Blood glucose is determined by the laboratory on the following day. Self-monitoring of 24 hr blood glucose profiles is valuable to assess blood glucose excursions, and particularly, to detect unrecognized hypoglycemias. The second new tool is the determination of hemoglobin A1 or A1c which represents an indicator of blood glucose control during the last 3-4 months. We noted in stable non insulindependent diabetics a highly significant correlation between fasting blood glucose levels and hemoglobin A1c content. Since in these patients there is also a close correlation between fasting blood glucose and average daily blood glucose levels, a correlation was calculated between the mean daily blood glucose level and HbA1c content. Derived from this correlation, the average daily blood glucose level can be estimated from the HbA1c value in insulin-dependent diabetics in whom the casual blood glucose may not be representative for their overall blood glucose control. Thus HbA1 resp. HbA1c represents a reflection of the mean blood glucose level during the last 3-4 months. Particularly, it allows the detection of metabolic decompensation which is not clinically evident and which remained undiscovered by single blood glucose measurements.

Blood Glucose↗
PubMed1980

A simple test for urinary lactic acid.

A new simple rapid test for the detection of increased urinary lactic is described. The method depends on the transformation of lactic acid to acetaldehyde by cesium IV. Acetaldehyde reacts with sodium nitroprusside prducing a blue color. Patients from an emergency ward and patients with experimentally induced hyperlactatemia have been screened with this test. The results confirm that there exists a correlation between blood and urinary lactate levels and that a clinically relevant hyperlactemia is associated with an increased urinary lactate concentration which can be reliably detected with this test.

Acidosis↗
PubMed1980

[Vitamin status in diabetic neuropathy (thiamine, riboflavin, pyridoxin, cobalamin and tocopherol)].

Investigations on the vitamin pattern of diabetic neuropathy: thiamine, riboflavin, pyridoxine, cobalamin and tocopherol. The contents of the vitamins mentioned above have been measured in the blood of 119 patients (53 diabetic neuropathies, 66 diabetics without neuropathy). The incidence of neuropathy shows a strong correlation with the duration of the diabetic state, but not with sex, nor with concomitant diseases such as adipositas, hypertension, heart and circulatory diseases, except retinopathia diabetica. Most of the diabetics in our study are well supplied with vitamins B1, B2, and E; B6 and B12 are occasionally low, but there is no statistically relevant difference between diabetic controls and neuropathies. Adipose patients have neither a markedly different vitamin content nor a different calory uptake from non-adipose patients. A general trend towards reduced total calory uptake is seen in old age, men (lower protein intake) and women (lower carbohydrate intake) obviously differing somewhat in their habits. The influence of therapy on the vitamin pattern is not clear cut, except for patients under diet and biguanide-therapy showing a higher proportion of low or subnormal B12 values. The increased frequency of neuropathies in patients treated with sulfonyl-urea approaches only the limits of significance and needs further investigations.

Diabetes Complications↗
PubMed1980

The colorimetric determination of HbA1c in normal and diabetic subjects.

The parameters which influence the determination of the major glycosylated haemoglobin fraction (HbA1c) with the thiobarbituric acid (TBA) method are described. Conditions for an optimal determination method are given. The correlation with the fast haemoglobin determination by column chromatography is greater than 0.9. The influence of storage on blood, washed erythrocytes and haemolysate in respect to HbA1c values obtained with the method described, was also investigated. Normal and pathological values from 78 patients correlate well with the fasting blood sugar levels (r greater than 0.9).

Blood Glucose↗
PubMed1979

[Advantages and disadvantages of insulin therapy in elderly diabetics with asymptomatic hyperglycemia].

15 elderly diabetic patients with fasting blood glucose levels above 160 mg/100 ml, without hyperglycemic symptoms and previously treated with oral antidiabetic agents, were put on insulin. The change of treatment regimen was made in the outpatient department. Frequent clinical and laboratory controls were performed and the patients were given full instructions for injection technique and diet. On the insulin regimen a prompt and lasting improvement was observed in the metabolic parameters (blood glucose levels both fasting and after food intake, Hb A1c, serum insulin, glucagon and serum lipid concentrations). The so-called "asymptomatic" patients noticed a marked improvement in their general status and performance. Three months after insulin therapy was started 13 of our 15 patients preferred the insulin treatment to oral agents. However, weight gain and a tendency to hypoglycemia were noticed in less disciplined patients. In addition, considerable time was spent on instruction of the patients. Bearing these factors in mind, insulin therapy in elderly diabetics with so-called "sysmptomatic hyperglycemia" can be regarded as worthwhile.

Aged↗
PubMed1979

[Mortality from diabetic coma at the Basle Cantonal Hospital during 2 consecutive observation periods 1968-1973 abd 1973-1978, using conventional insulin therapy and treatment with lose dose insulin].

163 patients were admitted to the Cantonal Hospital, Basel, during the decade 1968--1978 with severe diabetic ketoacidosis or non-ketotic coma. The hospital mortality rate was 28% in the first period (1968--1973) but decreased to 14% (p less than 0.025) in the second period (1973--1978). The lower mortality rate in the second period was due to diminished early mortality within 3 days after admission. The decline in the mortality rate during the second period was assumed to be due to a general improvement of treatment and possibly to a direct effect of low-dose insulin therapy. The latter conclusion followed from the fact that the remaining recompensation therapy, such as fluid and electrolyte replacement, was similar during both periods. However, in the non-ketotic patients low-dose insulin therapy resulted in a delayed fall in blood glucose and distinctly diminished potassium retention. The fatalities in the second period of treatment were mainly due to thromboembolic complications. This points to the need for a search for preventive measures against thromboembolism in order to resuce mortality in severe diabetic coma further.

Blood Glucose↗
PubMed1979

Action potentials can propagate along small strands of smooth muscle.

Bundles of taenia coli muscle as small as 25 micrometers in diameter were dissected from guinea pigs and incubated in an organ culture media for several days. We found that use of an organ-culture bathing solution greatly extended the in vitro responsiveness as well as survival of such small bundles. Electronmicrographs showed that surviving strands of cells constituted only a very small fraction of the cross section of these bundles. Nonetheless, still they supported propagating nondecrementing action potentials. This means that in some cases strands, only a few cells in cross section, supported propagating action potentials. The long length constant and parallel orientation of cells provide a basis assuming cells act as parallel core conductor segments. For these reasons we have called into question the notion that for propagation to occur there must be a facilitating cooperation between large numbers of smooth muscle cells in parallel. Indeed we suggest that the limiting size for propagation is a strand of single cells.

Action Potentials↗
PubMed1979

[Fiftieth anniversary of Hans Berger's publication of the electroencephalogram. His first records in 1924--1931 (author's transl)].

For the fiftieth anniversary of Berger's first EEG publication, some of his early recordings obtained between 1924 and 1931 are discussed and illustrated. Examples of his protocols from the Freiburg Berger Archives are reproduced. Three types of Berger's early investigations are described: (1) String-galvanometer recordings obtained between 1924 and 1926, mainly from trephined patients with cerebral diseases, which usually showed brain waves slowed to 6--8 per second; (2) Direct recordings from the cortex and white matter proving the cortical origin of the EEG in 1930; (3) Typical unpublished EEG recordings of epileptics and of petit-mal attacks obtained in 1930 and 1931. Berger's first six papers published between 1929 and 1933 described nearly all the main EEG findings of cerebral diseases and the EEG alterations of normals during attention, sleep, and narcosis, but they did not report on convulsive potentials in the EEGs of epileptics. Berger had, however, obtained excellent records of epileptic EEG features, here depicted in Figs. 4 through 7. These remained unpublished until 1933 and 1938, because Berger suspected that they contained artifacts caused by blinks and facial movements which he had recorded in his controls (Fig. 4). Only in 1933, after other authors had described large amplitudes of convulsive potentials in the cortex of animals, did Berger publish parts of the EEGs of a petit-mal attack and of focal attacks in progressive paresis. In 1938, Berger presented the EEG of the beginning of a petit-mal attack with large 3/s spikes and waves recorded in 1931 which were similar to those described by Gibbs and coworkers in 1935. In 1933 and 1938, Berger interpreted the abnormal brain potentials of epileptics as signs of a preconvulsive state of the forebrain and suggested that the periods of 3/s waves were cortical correlates of an epileptic absence.

Electroencephalography↗
PubMed1978

[Hyponatremia and hypoglycemia after treatment with chlorpropamide. Case histories with review of the literature on 18 cases of chlorpropamide induced hyponatremia].

A case of chlorpropamide-induced, symptomatic hyponatremia in a diabetic patient is reported. The hyponatremia was associated with loss of appetite, nausea, and vomiting. These symptoms caused reduced food intake which provoked severe hypoglycemia with disturbed consciousness. The hyponatremia developed when the chlorpropamide doses were increased from 400 to 600 mg/day. Withdrawal of chlorpropamide was followed by remission of hyponatremia. Chlorpropamide-induced hyponatremia is a rare complication and is due to an antidiuretic effect of chlorpropamide caused by increased secretion of adiuretin and potentiation of the effect of chlorpropamide caused by increased secretion of adiuretin and potentiation of the effect of adiuretin in the tubuli of the kidney. This case report and the analysis of 18 published cases in the literature show the following characteristics for chlorpropamide-induced hyponatremia: (1) Hyponatremia is a rare complication in the treatment of diabetics with chlorpropamide. The patients typically are female and over sixty. The dosage of chlorpropamide usually was 500 mg daily or even more. (2) Hyponatremia is often unrecognized for a long time because the symptoms are not specific. The characteristic symptoms include loss of appetite, nausea, vomiting, abdominal pain, confusional state and, rarely, convulsions and coma. Recovery occurs spontaneously after withdrawal of the drug. (3) The incidence of this type of hyponatremia is increased in cases of preexisting tendency to water retention such as heart failure and renal failure, and in cases of diuretic therapy. In the light of these findings, the authors believe that chlorpropamide is no longer a drug of choice in the treatment of diabetic women, especially in cases of preexisting tendency to water retention and in diuretic therapy. In such cases, a sulfonylurea without antidiuretic effect is to be preferred.

Adult↗
PubMed1978

Interaction of peripheral and central respiratory drives in cats. I. Effects of sodium cyanide as a peripheral chemoreceptor stimulus at different levels of CSF pH.

In cats anesthetized with chloralose-urethane, the central respiratory chemoreceptors were exposed to mock CSF of pH 7.02, 7.02, or 7.57. The right carotid body was simultaneously stimulated by intracarotid injections of 40, 80, or 160 microgram sodium cyanide in 200 microliter Ringer solution. The left carotid nerve and, in some animals, both vagosympathetic truncs were dissected. It could be demonstrated that the increase in ventilation produced by application of NaCN to the peripheral chemoreceptors is significantly larger at high than at low mock CSF pH (i.e. at low than at high central stimulus intensity). In vagotomized cats the responses of VT and V to NaCN similarly depend upon CSF pH; they are somewhat larger, though, than in intact animals. These results are discussed as compared with results reported by different authors.

Animals↗