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Biomedical subjects

F D Goebel

Publications and source records attributed to F D Goebel.

At least 163 records · Page 9Linked to original sources
PubMed1989

Treatment of secretory diarrhea in AIDS with the somatostatin analogue SMS 201-995.

We have observed two patients with AIDS suffering from severe watery diarrhea refractory to conventional medical treatment. In the first patient the reason for the diarrhea could not be revealed in spite of extensive investigations; however, the clinical picture suggested cryptosporidia infection. In the second patient cytomegalovirus could be shown in colonic biopsy specimens. After failure of several attempts of symptomatic, antibiotic, and antiviral therapy, the long-acting somatostatin analogue SMS 201-995 was administered to the patients subcutaneously in a dose between 2 x 50 micrograms and 3 x 100 micrograms/day. This treatment resulted in a prompt reduction of stool volume and bowel motions. Somatostatin may be a useful addition to the symptomatic treatment of refractory diarrhea in AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Myelin basic protein in the cerebrospinal fluid of patients infected with HIV.

The major pathological abnormalities of HIV encephalopathy are infiltrates of macrophages, multinucleated giant cells, microglial nodules and demyelination. Elevated myelin basic protein (MBP) levels in the cerebrospinal fluid (CSF) provide a marker for central nervous system demyelination. The purpose of this study was to investigate the possible role of CSF MBP as a useful and early marker for HIV encephalopathy. The CSF of 40 consecutive patients with HIV infection of various clinical stages was investigated, including 13 patients with clinical signs of HIV encephalopathy. CSF MBP was elevated in 2 patients (5.0 and 5.3 ng/ml), both of whom had moderate to severe HIV encephalopathy. The course of the disease was rapid in both patients. In the remaining 38 patients, CSF MBP levels were marginally elevated (n = 12) or normal (n = 26). Our results suggest that CSF MBP is not a sensitive marker for the diagnosis and evaluation of HIV encephalopathy, but may be an indicator of prognosis for the course of the disease. There were only few findings of elevated CSF MBP levels in patients with HIV encephalopathy in the current study, and this may be because the disorder progressed slowly in most patients. It is possible that CSF MBP levels in HIV encephalopathy may only be elevated with acute clinical deterioration but are normal in slowly progressive forms of demyelination, as seen in multiple sclerosis.

AIDS-Related Complex↗
PubMed1989

Immunoreactive atrial natriuretic peptide (ANP) in endoscopic biopsies of the human gastrointestinal tract.

The human gastrointestinal tract, important for body salt and water balance, was investigated by endoscopic biopsy for the presence of atrial natriuretic peptide (ANP). Using immunohistochemistry, ANP-immunoreactive cells were identified in the lamina epithelialis mucosae of stomach, duodenum, jejunum, colon, and rectum. The findings indicate that ANP plays a role in intestinal salt and water regulation in man. ANP measurements in tissue specimens reached by endoscopic biopsy may be of major interest for future investigations on (patho-)physiological and pharmacological aspects of ANP.

Adult↗
PubMed1989

[AIDS disease and psychopathology--observations by the psychiatric consultation service of an internal medicine clinic].

The majority of HIV-infected inpatients are treated in departments of internal medicine. For the conditions of the west-german health service it was studied, if and how psychiatric symptoms of HIV-positive inpatients of a University Hospital for internal medicine require a psychiatrist. The evaluation of the suicide risk and psychopharmacological treatment of depressive syndromes were the most frequent reasons to ask for a psychiatrist. It became evident, that by means of a psychiatric consultation service, treatment of psychiatric complications in HIV-infection is feasible in a department of internal medicine.

AIDS Dementia Complex↗
PubMed1989

Leber's hereditary optic atrophy: further evidence for a defect of cyanide metabolism?

We studied one patient with Leber's optic atrophy (LOA) in the acute stage and 12 at the chronic stage of the disease, and measured the activity of rhodanese in white blood cells and the level of cyanide in whole blood. In the patient with acute disease the blood cyanide level was significantly increased at first. Treatment of this patient with cyanide antagonists reduced his cyanide level, but this was not accompanied by improvement in visual function. Rhodanese activity was normal in all patients, as were the blood cyanide levels in each of the 12 patients at the chronic stage of the disease. These findings suggest a temporary disturbance of cyanide metabolism during the acute phase of the disease in this family. The abnormal metabolic mechanism was not identified.

Acute Disease↗
PubMed1988

Serum neopterin levels as predictor of AIDS.

The reliability of laboratory parameters for the prediction of impending manifestation of AIDS in HIV-1 infected patients was investigated. Over a mean observation period of approximately 1 year (5 to 33 months) 56 patients were studied. Eleven patients progressed to AIDS (group 1) and 45 remained free of AIDS-defining disease (group 2). Eight candidate-predictor variables were measured on each patient at the beginning of the observation period: neopterin, hemoglobin, lymphocytes, CD4 counts, CD8 counts, platelets, gammaglobulins, and erythrocyte sedimentation rate. In a linear discrimination analysis, a stepwise entry of these parameters into the discriminant function was effected according to which variable added most to the separation into groups 1 and 2. Neopterin proved to be most discriminating with no improvement of separation when adding further variables. Thus, a final allocation rule was computed using neopterin alone. This rule assigns neopterin levels above 21.9 nmol/l to group 1 and levels below to group 2. We conclude, tentatively, that in HIV-infected patients neopterin levels of 22 nmol/l and over may indicate the manifestation of AIDS in the year to come.

AIDS-Related Complex↗
PubMed1988

[Diverticulosis of the duodenum].

A 62-year-old woman was admitted to hospital because of extremely severe colicky pain in the mesogastric region and vomiting. Six years earlier two duodenal diverticles had been found to be responsible for similar symptoms. Endoscopy and X-ray examination now revealed four extensive duodenal diverticles, the largest of which had an extension of 8 X 7 cm. There were no diverticular complications. The patient became free from complaints by conservative treatment, at first with "zero" diet, then with a regimen rich in dietary fibres and frequent small meals. She remained symptom-free during a follow-up period of six months so far.

Diverticulum↗
PubMed1988

Stimulation by hCRF of C-peptide release in type 2 diabetics during concomitant opioid receptor blockade.

Administration of synthetic human corticotropin-releasing factor (hCRF, 2 micrograms/kg body weight) during simultaneous application of the opioid antagonist naloxone (1.6 mg i.v. bolus, followed by an infusion at a rate of 1.2 mg/h) produced a significant increase in plasma C-peptide levels of six male Type 2 diabetic patients which even exceeded the postprandial values. This stimulatory effect of hCRF/naloxone on plasma C-peptide was less pronounced in six healthy men. hCRF alone did not provoke any reaction of plasma C-peptide in either group. The possibility of a paracrine, CRF-dependent mechanism in pancreatic islets which somehow involves inhibitory opioid receptors is preferentially discussed. Such a mechanism may underlie the stimulatory action of hCRF/naloxone on B cells and would explain the absent reaction of peripheral venous plasma C-peptide to hCRF alone as well as the amplifying effect of simultaneous opioid receptor blockade.

Blood Glucose↗
PubMed1988

[Cytomegalovirus infection as a cause of intestinal perforation].

Three male patients with the acquired immunodeficiency syndrome revealed perforations of the intestine (jejunum-ileum; colon ascendens; coecum). The cause was necrosis due to cytomegalovirus infection. The characteristic findings were cytomegalic inclusion bodies in endothelial cells of the capillaries. These lesions caused alterations of the microcirculation. Therefore it seems reasonable to conclude that in these cases necrosis and perforation were due to ischemia. Cytomegalovirus infection must be taken into consideration in any patient with the acquired immunodeficiency syndrome and gastrointestinal ulcerations.

Acquired Immunodeficiency Syndrome↗
PubMed1988

T4/T8 ratio and absolute T4 cell numbers in different clinical stages of Kaposi's sarcoma in AIDS.

Thirty-seven men (36 homosexual or bisexual and one heterosexual) with epidemic Kaposi's sarcoma and underlying HIV infection were followed up over a period of up to 32 months. Fourteen patients (38%) died, with a median survival time of 7.2 months after the diagnosis of AIDS. Seventeen patients (46%) presented with one or more opportunistic infections, mostly Pneumocystis carinii pneumonia. Eighteen patients (49%) had lymphadenopathy syndrome according to the definition of the CDC. Using the Laubenstein-classification of Kaposi's sarcoma, all patients either remained stable or deteriorated, improvement was never observed. Absolute T4 lymphocyte counts and the T4/T8 ratio were not related to the disease stage. With the onset of B symptoms (systemic symptoms), however, the absolute T4 numbers and the T4/T8 ratio markedly decreased. Delayed type hypersensitivity also showed no relationship to the clinical stages of Kaposi's sarcoma. Thus, the clinical progression of Kaposi's sarcoma lesions seems to be largely independent of the immunological parameters investigated. However, the onset of B symptoms was observed to be related to changes in immune status.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[The place of 67Ga scintigraphy in the primary diagnosis and follow-up evaluation of opportunistic pneumonia in patients with AIDS].

Opportunistic pneumonias are a life-threatening complication in patients with AIDS. Early diagnosis and therapy is necessary to improve prognosis. This study was designed to assess the value of 67Ga scintigraphy in the primary detection and follow-up of these special pneumonias. 67Ga scintigraphy was performed in 40 patients: 10 normal controls and 30 HIV-positive patients with AIDS or AIDS-related complex (ARC). 67Ga scan results were compared with current chest radiographs and the results of pathogen detection. The evaluation of positive scans was based on a quantification of the pulmonary uptake, expressed as a pulmonary/soft-tissue uptake ratio. Only 8/30 patients had a normal scan, 22/30 showed diffuse (13/22) or focal (9/22) increases of pulmonary uptake. In 7/8 patients with normal scans the chest radiograph was negative as well. The one patient with negative scan but positive chest radiograph had pulmonary Kaposi's sarcoma. In 11/22 patients the 67Ga scan and chest radiograph were positive simultaneously. In the other 11/22 patients with positive scans chest radiographs were initially negative but showed pathology in 5 cases within 1-2 weeks. The reason for positive scans in most cases was an opportunistic lung infection; other forms of pneumonia were only observed in two cases. The defined uptake ratio demonstrated to be a highly sensitive parameter for monitoring pneumonia and the effects of therapy in follow-up studies. In conclusion, quantitative 67Ga scintigraphy proved to be a reliable and highly sensitive method for primary detection and follow-up of opportunistic pneumonias in patients with AIDS.

Acquired Immunodeficiency Syndrome↗