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Biomedical subjects

F D Goebel

Publications and source records attributed to F D Goebel.

At least 199 records · Page 11Linked to original sources
PubMed1985

[Pathogenesis and clinical significance of Mönckeberg medial calcinosis].

Medial calcinosis of Mönckeberg is frequently observed in peripheral arteries of diabetics with neuropathy. The cause of this vessel alteration is unknown and the clinical significance has been questioned. Six to eight years after uni- or bilateral lumbar sympathectomy 60 patients were investigated radiologically for medial calcinosis of foot arteries. Of 60 patients, 55 had Mönckeberg's sclerosis. In 93% of the patients who had undergone bilateral operation medial calcification was seen in both feet. After unilateral sympathectomy the incidence of medial calcinosis on the operated side was significantly higher than on the non-operated side (88% versus 18%, p less than 0.01). There was no significant difference between diabetics and non-diabetics. These findings suggest that medial calcification is related to autonomic neuropathy of peripheral vessels. Fifty-two of 160 patients (32.5%) with severe arterial occlusive disease of the lower limbs showed medial calcification of foot arteries. Mönckeberg's sclerosis was significantly associated with the peripheral type of vascular disease (p less than 0.025). Two groups of patients with the same stage of occlusive vascular disease but without (group A) and with (group B) medial calcification were examined by Doppler ultrasound. In group A the mean ankle pressure (pD) was 51 mm Hg lower than the Riva-Rocci pressure (pRR). In spite of the severe ischemia mean pD in group B exceeded pRR by 14 mm Hg. Of the patients of group B 63% had a pD-pRR value greater than or equal to 0 mm Hg. In group A no positive difference pD-pRR could be shown.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

IgG-antibodies to HTLV-III in patients with AIDS, LAS, and persons at risk of AIDS in West Germany.

In a first seroepidemiological study on the prevalence of the human T-lymphotropic retrovirus HTLV-III in West Germany, sera of 26 patients with acquired immunodeficiency syndrome (AIDS), 33 patients with lymphadenopathy syndrome (LAS) or AIDS related complex (ARC), and 113 homosexual men at risk of AIDS were screened for IgG antibodies to HTLV-III by an enzyme linked immunosorbent assay (ELISA). 22 out of 26 AIDS-patients (84.6%), 24 out of 33 LAS-patients (72.7%), and 44 out of 113 healthy homosexual men with increased risk of AIDS (38.9%) were found positive for antibodies to HTLV-III. Heterosexual controls including healthy laboratory workers and medical personnel with contact to AIDS patients did not show antibodies to HTLV-III. The HTLV-III antibodies analyzed predominantly recognize a protein of molecular weight 41,000 (p41).

Acquired Immunodeficiency Syndrome↗
PubMed1985

Prevalence of antibodies to human T-lymphotropic virus-III (HTLV-III) in hemophiliacs and other patients chronically substituted with blood products.

The prevalence of antibodies to human T-lymphotropic virus III (HTLV-III) was determined in a total of 140 hemophiliacs and 36 polytransfused patients from three medical centers by an enzyme linked immunosorbent assay (ELISA) and confirmatory tests. 58 hemophiliacs (41.4%) were seropositive. In all instances where the origin of the coagulation factors given to these patients could be determined, blood products came from the United States. In addition, 2 of 36 polytransfused patients, mostly with acute leukemias, who were transfused with blood products from local donors were positive for HTLV-III antibodies. No HTLV-III antibodies were detected in 237 blood donors selected in part from the donor pool of the polytransfused patients.

Antibodies, Viral↗
PubMed1984

[Effect of alcoholic hyperlipoproteinemias on the deformability and viscosity of erythrocytes].

This pilot study set out to evaluate the influence of the metabolic disorder due to acute alcohol toxicity on red blood cell (RBC) deformability. RBC deformability was measured optoelectronically by microcomputer-assisted polymicroviscometry (filtrometry). Chronic alcoholic patients (n = 12) with transient haemolytic anaemia, jaundice and hyperlipoproteinaemia were studied during the acute and the remittent phase of alcoholic disease. RBC obtained from patients in the acute phase revealed a markedly impaired deformability as compared with RBC suspensions studied when the alcoholic symptoms had subsided. The study lends further support to the hypothesis that predominantly during acute alcohol toxicity patients experience a marked impairment of the adhesive and rheological properties of RBC, which may finally impair the peripheral microcirculation of the whole blood.

Adult↗
PubMed1984

Relapsing acute febrile neutrophilic dermatosis and essential thrombocythemia.

Relapsing acute febrile neutrophilic dermatosis ( AFND ) is reported in a patient with essential thrombocythemia representing the first case of this kind described in the literature. The patient presented with fever, malaise, neutrophilic leukocytosis, dysproteinemia, and coalescing bluish-red painful plaques and papules at palms, forehead, lid, forearm, and thigh. There was a dramatic response to steroids, or indomethacin, with no scarring. AFND was preceded by sore throat and an upper respiratory infection and was accompanied by conjunctivitis and arthritis of knees and ankle-joint. The association of AFND with essential thrombocythemia and with other neoplastic disorders is discussed.

Dermatitis↗
PubMed1983

[Pathologic fluidity, glycohemoglobin and erythrocyte metabolism disorder in Fontaine II diabetic macroangiopathy].

This pilot study set out to evaluate the influence of metabolic disorders due to diabetes mellitus on red blood cell (RBC) substrates, deformability and glycohaemoglobin (HbA1) levels. RBC deformability was measured optoelectronically by microcomputer-assisted polymicroviscometry (filtrometry) following separation of RBC into old (dense) and young (buoyant) fractions by means of density-layer centrifugation. 20 adult patients with type II diabetes mellitus associated with Fontaine II macroangiopathy underwent RBC investigations before and after diabetic therapy. Those RBC fractions containing older cells exhibited impaired metabolism, increased HbA1 levels and markedly altered deformability which significantly differed from values obtained from young RBC fractions. However, old RBC fractions only of patients treated for diabetes persistently displayed a slight increase in HbA1 levels associated with a still altered deformability, in contrast to the young RBC fractions which showed normal values again after diabetic treatment. The preliminary results suggest an adaptive alteration of RBC metabolism and function in diabetes, predominantly existing in old RBC, which still persists only in old RBC fractions after diabetic therapy. Thus, a prolonged pathologic effect of older RBC on the peripheral microcirculation may occur in diabetes, resulting in a further persistent maintenance of diabetic vascular disease.

Adult↗
PubMed1983

[Clinical variability of autosomal-dominant juvenile diabetes (MODY)].

Occurrence prior to the age of 25 years, dominant inheritance, metabolic control without insulin for more than two years and mild course without late complications are considered characteristic of maturity-onset diabetes of young people (MODY). Diabetes or glucose tolerance disturbance was observed in 30 members of a family in five successive generations. The course of the disease within the family was variable: even after disease for several decades no diabetes-specific late complications were seen in 20 diabetics, six, in contrast, had serious complications such as proliferative retinopathy, nephropathy and coma. The different clinical course is expression of the considerable variability of this genetically uniform metabolic disorder. Our observations demonstrate that vascular complications in MODY are less frequent than in type II diabetes, however are not excluded. Thus, also MODY diabetics require life-long careful metabolic surveillance.

Adult↗
PubMed1983

[Early detection of diabetic nephropathy: serum beta 2-microglobulin].

Detection of early diabetic nephropathy is necessary to postpone or even prevent progression of irreversible kidney damage by therapeutic measures. Beta 2-microglobulin (beta 2-MG) as a parameter of the glomerular filtration rate has been measured by immunoassay in the serum of 100 diabetic subjects, 50 insulin-dependent (IDD), and 50 noninsulin-dependent (NIDD) patients. The results are compared with endogeneous creatinine-clearance, serum creatinine concentration, and proteinuria and are related to different stages of diabetic retinopathy (RD). Normal values were obtained from 50 healthy age- and sex-matched subjects. A close correlation was found between beta 2-MG levels and endogeneous creatinine clearance. Thirty-nine diabetics revealed an elevated beta 2-MG (2.5 mg/l or higher), only 16 of whom had increased serum creatinine levels (1.4 mg/dl or higher). Significant differences of beta 2-MG were obtained between each group of patients with different stages of RD. A relevant difference of serum creatinine was found only between patients with normal eye fundus and advanced proliferative retinopathy, respectively. Without RD 26% of the patients revealed elevated beta 2-MG but normal creatinine values demonstrating a "latent nephropathy", just 8% showed an increase of both parameters. Of the diabetics with proliferative retinopathy 40% suffered from impaired kidney function proven by reduced creatinine clearance and by elevation of beta 2-MG and creatinine as well, 15% just revealed an increase of beta 2-MG with normal creatinine levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Mönckeberg's sclerosis after sympathetic denervation in diabetic and non-diabetic subjects.

Medial arterial calcification is frequently seen in diabetic patients with severe diabetic neuropathy. Sixty patients (19 diabetic and 41 non-diabetic) were examined radiologically for typical Mönckeberg's sclerosis of feet arteries 6-8 years after uni- or bilateral lumbar sympathectomy. Fifty-five out of 60 patients (92%) revealed medial calcification. This calcification was observed in both feet of 93% of patients, who had undergone bilateral operation. After unilateral sympathectomy the incidence of calcified arteries on the side of operation was significantly higher than that on the contralateral side (88% versus 18%, p less than 0.01). Although diabetic patients showed longer stretches of calcification than non-diabetic subjects, the difference was not significant in terms of incidence and length. Of 20 patients who had no evidence of calcinosis pre-operatively, 11 developed medial calcification after unilateral operation exclusively on the side of sympathectomy. In seven patients calcinosis was detected in both feet after bilateral operation. In conclusion, sympathetic denervation is one of the causes of Mönckeberg's sclerosis regardless of diabetes mellitus.

Aged↗
PubMed1982

[Diagnosis of heterozygous beta-thalassemia].

In the past three years 42 patients with heterozygous beta-thalassemia have been observed in our clinic. This group included 39 foreign and three German patients. A ratio of the MCV and the number of erythrocytes below 14 and normal serum iron level distinguish between the hereditary anemia and iron deficiency anemia. The diagnosis is confirmed by haemoglobin electrophoresis. For recognition of the most frequent type in Europe - the heterozygous beta-thalassemia - the demonstration of an elevated HbA2 level by simple microcolumn technique is sufficient. Ten out of 42 patients have been operated because of cholelithiasis. Five additional persons revealed gall bladder stones by ultrasonography. The high incidence of 36% in relatively young patients probably is due to longstanding hemolysis, which produces usually radiolucent pigment stones. Therefore attempts to dissolve gall bladder stones in patients with thalassemia do not seem to be rewarding.

Anemia, Hypochromic↗
PubMed1981

[Rheology, metabolism and oxygen transport in old and young erythrocytes in arterial occlusive disease].

Red blood cell (RBC) rheological and metabolic functions were studied in 10 diabetics with peripheral vascular disease (PAD) following separation of RBC according to cell age by density layer centrifugation. Decreased levels of ADP, ATP, 2,3-DPG and GSH were observed in dense layers of RBC containing older cell fractions. Further, raised lactate/pyruvate ratios were obtained from the same RBC fractions. O2-function was markedly impaired in all patients with PAD. Thus, metabolic disorder of RBC associated with reduced red cell deformity by retarding blood flow through the microcirculation may be important factors in states of peripheral vascular insufficiency in diabetics.

Arterial Occlusive Diseases↗