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Biomedical subjects

D Luft

Publications and source records attributed to D Luft.

At least 19 recordsLinked to original sources
PubMed1999

Analysis of volatile organic compounds in human urine by headspace gas chromatography-mass spectrometry with a multipurpose sampler.

A multipurpose sampler (Gerstel MPS), designed for liquid large volume, gaseous and headspace samples was used for the GC-MS analysis of organic volatiles in human urine. Headspace sampling with a volume-, temperature- and speed-controlled gas-tight syringe was combined with a temperature-controlled cold injection system (CIS) for cold trapping, enrichment and focusing of analytes. Regular 2-ml GC vials filled with 1 ml acidified urine were used as headspace sampling vials. A 100-vial autosampler tray was equipped with an additional temperature and heating time controlled "preheating station" for five vials. Profiles of organic volatiles in human urine were determined and 34 components identified. Trimethylamine (TMA) and 4-heptanone as two metabolites of medical interest were quantified. Calibration curves and intra assay imprecision for 4-heptanone concentrations in the range of 40 to 800 ng/ml showed a correlation coefficient of r = 0.9980 and a relative standard deviation (RSD) between 3.0 and 3.4%. Calibration curves and intra-assay imprecision for TMA concentrations in the range of medical interest from 0.5 to 20 micrograms/ml showed a correlation coefficient of r = 0.9968 and a RSD between 4.1 and 6.8%. The high practicability of the multipurpose sampler for both gaseous and liquid samples together with the here shown good reproducibility and sensitivity make this single CIS-GC-MS system very attractive for routine clinical use in metabolic profiling of organic volatiles (headspace) and non-volatiles (liquid).

Gas Chromatography-Mass Spectrometry↗
PubMed1999

Correlation of imaging techniques to histopathology in patients with diabetic foot syndrome and clinical suspicion of chronic osteomyelitis. The role of high-resolution ultrasound.

OBJECTIVE: To investigate the role of ultrasound in the diagnosis of osteomyelitis in the diabetic foot compared with magnetic resonance imaging (MRI), bone scintigraphy (BS), and plain film radiography (PFR). RESEARCH DESIGN AND METHODS: We investigated 19 consecutive diabetic patients (2 women, 17 men, age 60.7 +/- 9.8 years, BMI 27.0 +/- 3.8 kg/m2) with clinical suspicion of bone infection of the foot. A high-resolution ultrasound system (Esaote/Biosound, Munich) with a linear array transducer up to 13.0 MHz was used. The prospective and blinded results of each method were compared with histopathology as the reference method after metatarsal resection. RESULTS: In 14 of 19 patients, histopathology confirmed osteomyelitis. Ultrasound showed a sensitivity of 79% (PFR, 69%; BS, 83%; MRI, 100%), a specificity of 80% (PFR, 80%; BS, 75%; MRI, 75%), a positive predictive value of 92% (PFR, 90%; BS, 91%; MRI, 93%), and a negative predictive value of 57% (PFR, 50%; BS, 60%; MRI, 100%). CONCLUSIONS: Our data indicate that ultrasound might have a better diagnostic power for detecting chronic osteomyelitis in the diabetic foot than PFR and has similar sensitivity and specificity as BS. MRI is superior to the other three methods. We conclude that the use of ultrasound in the management of the diabetic foot is worthy of further investigation.

Diabetic Foot↗
PubMed1998

Evaluation of polarographic measurements of basal muscle oxygen tension in type I diabetic patients.

Microcirculatory changes occur early in insulin-dependent diabetes mellitus (IDDM) and are believed to be an early feature of late diabetic complications, leading to reduced oxygen pressure and hypoxia in the skin and other tissues. Whether muscle oxygen supply is also altered is unknown. Therefore, the authors analyzed polarographic measurements of muscle oxygen tension in 44 healthy type I diabetic patients (mean age 28 years; mean diabetes duration 7 years) and in 57 healthy controls, matched for age, sex, and body mass index, and the corresponding influencing factors. Two measurements were taken at rest 60 minutes apart in the anterior tibial muscle. Muscle oxygen tensions did not differ between IDDM patients and controls (23.0 +/- 8.6 vs 25.3 +/- 9.0 mmHg) and were reproducible on repeated measurements (25.3 +/- 9.7 vs 25.5 +/- 7.4 mmHg). Coefficients of variation were 13.5 +/- 10.8% in IDDM patients and 13.1 +/- 9.3% in controls. Compared with controls, in IDDM patients hemoglobin A1c (HbA1c) and blood glucose concentrations were elevated, and arterial oxygen pressure was significantly lower. Muscle oxygen tensions were positively correlated with blood glucose concentrations in IDDM patients (Rho=0.48, P=0.002) but not with HbA1c or with insulin concentrations. The authors conclude that the polarographic measurement of muscle oxygen tension is a reliable method with good reproducibility. Hypoxia in the anterior tibial muscle of type I diabetic patients can be excluded. In IDDM patients the level of muscle oxygen tension is correlated with the level of blood glucose concentration.

Adult↗
PubMed1996

Pain intensity and blood pressure reactions during a cold pressor test in IDDM patients.

OBJECTIVE: To determine the contribution of altered pain perception to the impaired blood pressure reactions during a cold pressor test in diabetic patients. Reduced blood pressure increases have been observed in diabetic patients during a cold pressor test and have been attributed to an impaired efferent sympathetic function. RESEARCH DESIGN AND METHODS: We investigated pain intensities and blood pressure reactions simultaneously during a cold pressor test in 30 IDDM patients (diabetes duration 12 +/- 6 years, HbA1c 7.5 +/- 1.4%) and in 30 normal control subjects with comparable sex distribution, age, height, BMI, physical fitness, and smoking habits. RESULTS: Initial pain intensities and respective time courses did not differ between the two groups. The initial blood pressure response was significantly smaller in diabetic patients (P < 0.002). Correlations of diastolic blood pressure increases in diabetic patients with initial pain intensity, standard cardiovascular reflex tests, age, clock time, smoking habits, disease duration, and actual blood glucose concentrations did not reach statistical significance. Pain intensity and diastolic blood pressure increases, however, were correlated to HbA1c concentrations in diabetic patients. CONCLUSIONS: Impaired pain perception is not the cause of the impaired reactions of blood pressure in diabetic patients during the cold pressor test, leaving very early deterioration of either cerebral processing of pain stimuli, cardiac function, efferent sympathetic nerves, or decreased vascular reactivity as possible explanations.

Adult↗
PubMed1996

[Diabetic cardiovascular neuropathy].

Impairment of the autonomic nervous system is frequently detectable in diabetic patients. Symptoms and signs are less often observed but if present may be very important with regard to quality of life, metabolic control, and prognosis. Currently used methods to detect disturbances of the autonomic innervation of the cardiovascular system are easily performed, noninvasive, reliable and reproducible. They are not very time consuming and require only standard technical equipment allowing the quick identification of patients at risk. Damage of the cardiovascular autonomic nerve function may explain apparently disparate complaints and signs, i.e. orthostatic hypotension, painless myocardial ischemia, complications during anesthesia, postprandial hypotension and development of the diabetic food syndrome. The diagnosis of asymptomatic cardiovascular neuropathy should always induce attempts to intensify diabetes treatment because better metabolic control may improve or at least stop deterioration of nerve function.

Autonomic Nervous System Diseases↗
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↗