PubMed Health⌕ Search

Biomedical subjects

R Möricke

Publications and source records attributed to R Möricke.

At least 19 recordsLinked to original sources
PubMed1989

[Computer-assisted perioperative blood glucose control in metabolically stable diabetic patients and diabetic patients with coronary disease--a contribution to computer-assisted optimal therapy of diabetes].

Issuing from the metabolic changes under perioperative conditions the problems and the significance of a subtile perioperative management of the metabolism in diabetics with labile metabolism and coronary disease are described. The device-technical components and the function of a computer-assisted regulation and advisory system (Glucon) for the support of the perioperative management of blood glucose and for the parenteral glucose supply in diabetics during large operative interventions. When the system was applied for several days under submaximal metabolization of glucose nearly normoglycaemia conditions could be achieved. The system is proposed as alternative to the conventional perioperative blood glucose management for diabetics with labile metabolism and coronary diseases in large operations.

Blood Glucose↗
PubMed1988

Interaction between glucose utilization and left ventricular heart function in type I-diabetics.

The aim of the present study was to check whether equal, therapeutically relevant, positively inotropic doses of different adrenergic agents elicit equal inotropic and metabolic effects in 6 type I-diabetics as in 6 matched nondiabetic subjects. The effects of increasing doses of norepinephrine (NE)- and orciprenaline (0.12, 0.20, 0.33 microgram/kg min) on heart function (systolic time interval, heart rate, blood pressure) and on serum fatty acid (NEFA), glucose, lactate, pyruvate and insulin concentrations were recorded. In the therapeutic dose range, NE, and orciprenaline elicited in diabetics without clinical signs of any cardiovascular disease a diminished myocardial inotropic response (20-40%), less marked vascular effects (vasoconstriction, vasodilatation), but greater metabolic changes in right atrial blood (NEFA, pyruvate, lactate) compared to matched controls (p less than 0.05). The smaller increase of cardiac performance in diabetics to exogenous catecholamines cannot be explained by sympathetic cardiac denervation, since chronotropic beta 1-beta 2-stimulation with orciprenaline provoked nearly equal dose-dependent changes in diabetics and controls. It is suggested that the smaller positive inotropic effect during NE and orciprenaline infusion in type I-diabetics is a result first of all of alterations in myocardial energy turnover in diabetes due to reduced myocardial glucose utilization. It seems necessary to secure continuous myocardial glucose utilization and subnormal NEFA concentrations in the serum during the therapeutic application of inotropic adrenergic agents in severe cardiac failure and cardiogenic shock in diabetics.

Adult↗
PubMed1987

Effects of computer controlled submaximal glucose utilization on myocardial energy potential and on survival time during acute strophantin intoxication in dogs.

We checked the effect of a 4 hourly computer controlled submaximal glucose utilization (CCSGU) of 12.01 +/- 1.19 mg/kg min under normoglycaemic conditions and of a simultaneous diminishing of myocardial NEFA supply on trigger mechanism of ventricular fibrillation during acute strophantin intoxication (4 micrograms/kg min) in 17 mongrel dogs. Dogs treated with CCSGU (protective group, n = 8) showed a nearly 30% (p less than 0.01) major survival time (47.6 +/- 3.6 min) before ventricular fibrillation occurred in comparison to a control group (33.1 +/- 3.7 min, n = 9). CCSGU induced a 90% higher left ventricular hydraulic work (5.18 +/- 0.57 Nm/g heart weight) during strophantin infusion compared to controls (2.75 +/- 0.47). No significant myocardial NEFA extraction was evident in the protective group. During CCSGU myocardial oxygen extraction was on a lower level in rest (15.8 +/- 1.0%, p less than 0.01) as well as during strophantin infusion (11.3 +/- 2.6%, p less than 0.01) compared to controls. In dogs treated with CCSGU nearly equal myocardial levels of HEP and lactate were found compared to controls in spite of a major survival time and higher left ventricular hydraulic work. A higher myocardial glycogen content was observed in the protective group (45.1 +/- 6.7 mumol/g w.w.) in comparison to controls (28.1 +/- 2.9, p less than 0.05). Our results prove that CCSGU using the device system GLUCON induces a shift in substrate utilization from NEFA to glucose, decreases myocardial oxygen extraction, increases myocardial glycogen content, enlarges heart work and protects against strophantin induced ventricular fibrillation.

Animals↗
PubMed1981

[Effect of the beta-receptor blockers propranolol and talinolol on glucose-orciprenaline induced insulin secretion, glucose tolerance and the behavior of nonesterified free fatty acids in metabolically normal probands].

With the help of a special clinico-pharmacological test arrangement on 5 test persons with healthy metabolism was proved that the oral treatment with the selective beta 1-blocker Cordanum (Talinolol, 0.3 g/die) and with the non-selective beta 1-beta 2-blocker Obsidan (Propranolol, 0.12 g/die) leads to a complete suppression of the insulin secretion which can be additionally mobilised via beta 2-adrenoreceptors in test persons with healthy metabolism. In contrast to Talinolol under the treatment ith the unspecific beta-blocker Propranolol a clear blocking of the beta 2-mediated glycogenolysis which can be evoked with the help of Orciprenalin and of the lipolysis evocable via beta 1-receptors was observed. Due to the more insignificant metabolic side-effects, with regard to an intact energy supply and the maintainance of the physical functional capacity, the selective beta 1-blocker Talinolol is preferred in the long-term therapy of cardiovascular diseases.

Adrenergic beta-Antagonists↗
PubMed1980

[Effect of noradrenergic stimulation on the peripheral venous concentrations of thyroxine and triiodothyronine in young test subjects with normal metabolism].

The influence of intravenous noradrenalin infusions in increasing dosages lasting 60 minutes on the peripheral venous total T3- and total T4-concentrations of blood, blood pressure and heart rate was established on 5 test persons during a period of 110 minutes. Immediately after the addition of 0.12 micrograms NA/kg Kgw./min an increasing tendency of the T4-concentration in the venous blood occurred, respectively. Under influence of higher NA-doses (0.20 and 0.33 micrograms/kg Kgw./min) the noradrenergically induced T4-increase (p < 0.05) with average increases of the T4-level by 28.7 and 22.3%, respectively, in comparison to the initial values was statistically secured. The total T3-concentration did not show any statistically secure changes under NA-infusion. The fundamental possibilities of an influence of the intravenously applied NA on the production of the hormone of the thyroid gland, the secretion of the thyroid hormone and the peripheral conversion are discussed. Using findings of animal experiments the supposition of the immediate influence of the NA on the follicle cells of the thyroid gland and the secretory process gains importance. The clinical importance of the adrenergic modulation of the thyroxin secretion for the clinician is discussed.

Adult↗
PubMed1980

[Criticism of the K value-utility and evidence of the glucose assimilation coefficient].

Theoretical statements concerning the calculation of the K-value and explanations of the practical approach in the estimation of the K-value are the initial position. It is proved that it is not possible after a standardized glucose supply to establish by means of the K-value a true gradation of the glucose assimilation, which is independent on the population and lies on an absolute proportion scale, of any test persons on various conditions. Up to now this fact is not taken into consideration when the K-value is used and judged for the characterization of the glucose assimilation and leads to weighty errors in the kinetic evaluation of the measuring data. Since both the height of the fasting blood glucose and the speed of the glucose elimination are included as diagnostic separation criteria in the K-value, it is, on the other hand, well suited for the delimitation of latent, asymptomatic and manifest diabetics from persons with healthy metabolism.

Blood Glucose↗
PubMed1977

[Behavior of the body weight in 2261 maturity-onset diabetics under conditions of ambulatory care].

Of 2,261 maturity-onset-diabetics (970 males, 1,691 females) body weight, size and Broca-index were established at the beginning of the treatment, one year after the beginning of the treatment and at the date of analysis (x=5.7 years after the manifestation of diabetes). 72% of the females and 49% of the males had a Broca-index of more than 10 at the beginning of the treatment. The average loss of weight of the diabetics of adult type with overweight with a Broca-index of more than 5 was in the first year 7.6 kg in males and 5.2 kg in females. In the first year after beginning of the disease in the diet group and in the buformin group was achieved an average reduction of weight in males of about 7 kg and in females of about 6 kg. After the first year of treatment in the groups mentioned the body weight remained or rose to one kg. The patients treated with sulfonylureas--compared with the diet-biguanide group--showed in the first year of treatment, indeed, a loss of weight which was about 50% smaller, however, also in the following years (x=4.7) a further continuous reduction of weight could be recognized. The initial results and the late results in the treatment of elderly diabetics with overweight show that, compared with former years, partial success is to be achieved with reduction cures performed in outpatient departments. The importance of the reduction of weight in elderly diabetics for the improvement of the carbohydrate tolerance and the fat metabolism is emphasized.

Adult↗
PubMed1977

[Type distribution of hyperlipoproteinemias in 645 diabetics].

On 645 diabetics of the treatment-groups diet (n = 180), sulfonylurea therapy (n = 250), biguanide therapy (n = 50), and insulin therapy (n = 165) the concentrations of cholesterol and triglyceride were determined and the lipoprotein electrophoresis was carried out. 29% of the diabetics showed hyperliproteinaemias, males and females in the same frequency. In about 54% the type IV was observed most frequently, then followed the types IIb with 25% and the type IIa with about 13%. The dependence of triglycerides on the metabolic situation and the body weight was proved in diabetics. The cholesterol values were independent on form of therapy, body weight and metabolic situation. In the group with sulfonylurea in about 49%, in the group with insulin in about 37% and in the group with diet and buformin only in about 32% a hyperlipoproteinaemia was proved. The opinion is represented that the high percentage of hyperlipoproteinaemia in diabetics and the connected with this additionally increased risk for vascular complications should lead to the introduction of diagnostics and therapy of hyperlipoproteinaemia into the programme of the diabetes dispensaries of the GDR. For the treatment of diabetes the principle should be taken into consideration that a diabetes is optimally regulated only then, when apart from the blood sugar values also the blood fats are within the normal.

Biguanides↗
PubMed1976

[Vital microscopic investigation of terminal blood vessels in patients with diabetes mellitus].

It is reported on findings of vital-microscopic investigations at the terminal vascular system of the conjunctiva bulbi and the mucous membrane of the lips carried out on 50 juvenile diabetics and 50 test persons of the same age. By quantitative establishment of the morphological and functional changes of the vessels and the aggregation of the erythrocytes in the different regions of the terminal vascular system we succeeded in delimitating all 50 diabetes as individuum or as collective (x equals 10.7 +/- 1.5) from the test persons (x equals 3.4 +/- 0.9) by means of a point system (p less than 0.001). In 4 figures typical vascular findings are demonstrated. No pathognomonic significance was ascribed to the individual vascular findings. The morphological and functional changes of the vascular wall are regarded as an expression of fundamental reactive possibilities of the vessels of the terminal vascular system after influence of different factors of risk. As criteria of the findings were used: venular sacculations, meander-like forms, convolutions, haemorrhages, aneurysms, reticular structures, varieties of calibres, changed arteriolarvenular relations of the inner diameter of the vessels, constant proof of aggregates of erythrocytes with temporary standstill of the flow in the different parts of the terminal vascular system. The author is of the opinion that with simultanuous establishment of the morphological and functional changes of wall of the vessel and content of the vessel degenerative changes in diabetes mellitus are provable earlier than at the eye-ground by means of ophthalmocoscopy when only morphological findings are established. The reciprocities between the vascular changes and the rheological properties of the blood are described.

Adult↗
PubMed1975

[Misplaced implantation of a pacemaker electrode in a coronary vein].

The wrong implantation of pacemaker electrodes into a coronary vein is in most cases accidentally diagnosed when thoracic X-ray pictures are made in two planes. It is to be excluded not with certainly in the sagittal ray-path of the thoracic X-ray picture and in the ECG of the extremities. The diagnostic criteria for the recognition of a false position are the end of the electrode which is in the frontal ray-path directed dorsally to the spine and a right bundle branch block in the ECG existing since implantation. Pacemaker-synchronous contractions of the diaphragm as well as an increased already at the time of implantation stimulus threshold may be references. Description of an own observation with an up to now long-term stimulation through a coronary vein without complications lasting 15 months, in which a correction of the position is not regarded as necessary due to the regular function of the pacemaker.

Aged↗
PubMed1975

[Complications of cardiac pacemakers].

Since the number of patients with pacemakers increases and the further decentralisation of the care of these patients is planned the survey has the purpose to inform as many physicians as possible about the complications of the pacemaker therapy. In the several paragraphs the problems of the regular and anticipated exhaustion of the battery, defects of the electronic constituents of the pacemaker, fracture of the cable, dislocation of the electrodes, disturbances of the transmission between endocardium and myocardium, disturbances of rhythm under pacemaker-therapy, disturbing influences by intra- and extracorporal causes, surgical complications and implantations in the false place are reported on. Knowledge and early recognition of the complications in the pacemaker-therapy will furthermore favourably influence the long-term prognosis of this group of patients.

Cardiac Surgical Procedures↗
PubMed1975

[Fundamental problems on the care of patients with permanent artificial pacemaker therapy].

In the GDR the number of patients with pacemakers increases with about 900 new implantations each year. The further decentralisation of the care of patients with pacemakers proposed by the team pacemaker therapy demands the inclusion of more physicians into the care of these patients. The pacemaker systems used at present in the GDR are described as well as the practical approach in the control of the function of the pacemakers is discussed. In the figures typical electrocardiographic pictures of various models of pacemakers are demonstrated.

Germany, East↗