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Biomedical subjects

P Bottermann

Publications and source records attributed to P Bottermann.

At least 19 recordsLinked to original sources
PubMed1991

[Diabetes mellitus and arterial hypertension. In search of the connecting link].

Late diabetic effects are the sequelae of for a long time super elevated blood sugar levels. The diabetic nephropathy is the cause of the secondary arterial hypertension. The investigation seeks for the connections between the diabetes mellitus and the essential, that is primary hypertension. The two diseases frequently appear and clearly increase in the second half of life. Moreover, they are above average frequently associated with each other. Among brothers and sisters of diabetic hypertensives in comparison to normal cohorts clearly increased high blood pressure prevalences were found. The insulin resistance which could be proved in a great number of hypertensive and which has been known since more than two decades might be the connecting link between hypertension and diabetes mellitus. Like the obesity the essential hypertension can be associated with all degrees of an insulin hyposensitiveness. The sodium-retaining effect of the insulin might explain the increased sodium content of the body in hypertensives. The differential diagnostics of the essential hypertension should therefore seek for conditions of an insulin resistance. The type II diabetic lacks a release of bradykinin during muscle work. Thus the glucose uptake into the cell is unfavourable influenced and demands an increased insulin excretion. This genetically (?) fixed defect is found also in essential hypertensives. It could be the connecting link between the two diseases. ACE-inhibitors have via a kininase II inhibition an effect also on the bradykinin decomposition and can favourable influence the glucose uptake into the muscle. An improved insulin effect among the ACE-inhibitors was described. Therefore, they should be preferred in the treatment of hypertensive diabetics.

Diabetes Mellitus, Type 2↗
PubMed1979

[Intravenous and oral TRH-stimulation test: comparison of the value of both tests concerning diagnosis and therapy of thyroid diseases (author's transl)].

15 euthyroid patients, 15 patients with a so-called non toxic goiter, 7 patients with hypothyroidism and 14 patients with hyperthyroidism (Grave's disease and autonomous adenoma) were submitted to intravenous (200 micrograms) and oral (40 mg) TRH-stimulation tests. After the oral application of TRH the patients with a normal thyroid function and the patients with a goiter showed an increase of the concentration of TSH which was about 1 1/2 fold higher than after the intravenous application of TRH. The patients who suffered from hypothyroidism showed a different reaction after intravenous and oral application of TRH. The patients with a hyperthyroidism had neither after the intravenous nor after the oral application of TRH an increase of the peripheral concentration of TSH. Therefore both intravenous and oral TRH-stimulation tests seem to be apt in the same way for the diagnosis of thyroid diseases and for the control of the therapy when thyroid hormones are applied.

Administration, Oral↗
PubMed1978

[Concentration of C-peptide and insulin in serum of patients with acute virus hepatitis (author's transl)].

Intravenous glucose tolerance tests were performed in 10 patients with acute virus hepatitis. The assimilation coefficient of glucose and the level of insulin and C-peptide in serum were determined before and in the course of the glucose tolerance tests. In comparison to healthy normal weight persons C-peptide concentration in patients with acute hepatitis increased twice as high whereas the pattern of insulin secretion did not differ significantly. The higher levels of C-peptide indicate an increase of the beta-cell secretion in acute hepatitis. One could suppose an increased hepatic destruction of insulin in acute hepatitis, because there is no significant difference among the insulin levels. More likely, there is a reactive increase of secretion of the beta-cell due to a reduction of insulin sensitivity and this is indicated much better by C-peptide- than insulin levels because of the longer half live of the the C-peptide molecule.

Acute Disease↗
PubMed1978

[Radioimmuno-assay of TSH before and after TRH in 350 patients with previous resection of euthyroid goiter (author's transl)].

Radioimmuno-Assay (RIA) of Thyroid-Stimulating-Hormone (TSH) was performed before and after i.v.-injection of Thyrotropin-Releasing-Hormone (TRH) in 350 patients subsequent to previous resection of euthyroid goiter to find out the optimal treatment schedule for preventing recurrent goiter. In patients without recurrent goiter the dosis of thyroid hormone was considered to be sufficient, if the difference in TSH-levels before and after TRH (delta-TSH) was equivalent to or less than 10 microunits/ml. In patients with recurrent goiter the optimal suppressive dosis of thyroid hormone was accepted for a delta-TSH less than or equal to 2,5 microunits/ml. 126 out of 135 patients, who were set on an immediate and continuous postoperative treatment were free of goiter, 58 presented a delta-TSH less than or equal to 10 microunits/ml (average interval of treatment = 2,5 years), 68 patients had elevated delta-TSH (average interval of treatment 2,1 years) as a sign of insufficient treatment. In 9 patients recurrent goiter was detected in spite of "adequate" treatment. 41 out of 57 patients, set on delayed and partly continuous, partly discontinuous treatment had recurrent goiter (in average after 10 years). delta-TSH was not indicative. 158 patients without any treatment had borderline or slightly increased delta-TSH (in average after 10 years). 122 of these 158 patients had recurrent goiter, 36 were free of goiter. The results favor the necessity of treatment with thyroid hormones starting immediately after operation and with continuous treatment. The combined use of TSH-RIA and TRH-test reliably informs about the individual thyroid hormone dosis necessary for prevention or treatment of recurrent goiters.

Goiter↗
PubMed1978

[Effects of the beta-adrenergic blocking agent propranolol on the carbohydrate- and lipometabolism (author's transl)].

Intravenous glucose tolerance tests were performed in 17 patients suffering from hyperthyreosis before and after a week of treatment with propranolol. The blood taken until the 125. minute after the glucose load was used for the determination of serum glucose, the free fatty acids (FFA), the free glycerol and the radioimmunologically measurable insulin (IRI). The following results were received: After the treatment with propranolol the glucose tolerance decreased significantly. The insulin secretion was diminished showing a significant difference for the fifth minute after glucose injection. The concentration of the FFA remained unchanged. The levels of the free glycerol were significantly lower after the propranolol treatment than before. Though an inhibition of lipolysis was possible by the propranolol treatment the glucose tolerance did not improve due to the inhibition of insulin secretion under propranolol. Beta-adrenergic blocking agents do not lead to an essential change in the carbohydrate- and lipometobolism. Therefore, their use in hyperthyroidism is mainly justified because of the cardial symptomatology.

Carbohydrate Metabolism↗
PubMed1977

[Concentration of C-peptide in correlation to kidney function (author's transl)].

Recently, the radioimmunological determination of C-peptide came into interest because of the jugdement of the remaining function of the islet apparatus in insulin-dependent diabetics. As the degradation of C-peptide preferably takes place in the kidney we performed an intravenous glucose load in 32 patients with kidney diseases. The following results were obtained: 1. In patients with a healthy carbohydrate metabolism a clear correlation exists between the concentration of creatinine on the one hand, the creatinine-clearance and the fasting C-peptide concentration respectively the measured amount of C-peptide on the other hand. 2. The more advanced the renal insufficiency the better is the correlation between the parameter of the kidney function and the C-peptide concentration. 3. In diabetic patients there shows to be no clear correlation between the C-peptide levels and the kidney function. --In insulin-dependent diabetics the amount of C-peptide is only of diagnostic use if the renal function is well known.

Adult↗
PubMed1977

[Studies on the question of a possible autoregulation of insulin secretion (author's transl)].

In eight normal weight healthy volunteers it was proved by C-peptide assay whether high concentrations of insulin in serum would suppress the secretion of insulin in an autoregulative manner. Insulin combined with glucose, therefore was given intravenously as a single bolus injection as well as an infusion over a period of two hours. Moreover it was proved whether high levels of insulin would suppress the reactivity of the B-cell to sulphonylurea administration. It was demonstrated that the secretion of the B-cell is regulated only by the concentration of the blood sugar, but not by the level of serum insulin. Likewise the stimulation of the B-cell by sulphonyl-urea administration is not suppressed by high concentrations of insulin.

Blood Glucose↗
PubMed1977

[TRH-test in hyperthyreoidism. Investigations of the TRH stimulated TSH-secretion in anti-thyroid drug treated primary hyperthyreoidism and in experimentally induced hyperthyreoidism (author's transl)].

Determinations in 11 patients with anti-thyroid drug therapy of hyperthyreoidism showed, that a pronounced lag period exist between normalisation of thyroid hormone level and TRH responsiveness. The lag period range between 5 and 27 weeks. During this time it is not necessary to give simultaneously thyroid hormones in antithyroid drug therapy to compensate hyperresponsiveness of TSH. - Investigations in 12 volunteers with experimental hyperthyreoidism induced by administration of thyroxine suggest a longterm suppression of the hypophysis to be the cause of the lag period of TSH-secretion. There are some similarities to the ACTH-suppression in therapy with corticosteroids and to the so-called "syndrome of oversuppression" in long lasting treatment with contraceptive drugs.

Adult↗
PubMed1977

[The effect of thyroxine on the 2,3-diphosphoglycerate content of erythrocytes in vivo and in vitro].

After ending a continous treatment with thyroxine the average dropping of the 2,3 DPG level was 0.4 mumol/ml. T4 decreased on the average by 7.6 microgram/ml. One time application of 1 mg thyroxine p.o. led within 24 hours to an increase of the 2,3 DPG level of -chi = 0.2 mumol/ml, the pH in the erythrocytes increased by 0.02 on the average. Blood incubation with thyroxine added in a concentration of -chi = 24 microgram/100 ml showed no increase of 2,3 DPG, pH and phosphate, while there was a significant acidosis and increase of phosphate in the control blood. The lactate production was significantly lower and glucose consumption was significantly higher in the blood with thyroxine.

Blood Glucose↗
PubMed1976

[Investigations of the mode action of buformin using a 3H-labelled glucose in people with a healthy metabolism (author's transl)].

In a total of 13 volunteers the changes in carbohydrate metabolism was investigated after administration of prednisolone, of buformin, and of a combination of prednisolone and buformin using 3H-labelled glucose. Under steady-state-conditions the glucose-turnover was estimated. Although, the changes of glucose assimilation of labelled and unlabelled glucose was observed to see the magnitude of glucose utilisation and of gluconeogenesis. It was concluded that biguanides enhance the glucose utilisation. Depending on the glucose level at the same time the gluconeogenesis is stimulated or inhibited.

Biguanides↗