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Summary Aims Limited data are available on determinants of diabetic neuropathy as its pathogenesis is multifactorial. Since homocysteine exhibits toxic effects on vascular endothelial cells, the association between homocysteine and the prevalence of neuropathy in Type 2 diabetes mellitus was investigated. Methods A total of 65 Type 2 diabetic patients were consecutively enrolled into the study. Neuropathy was diagnosed according to clinical symptoms, clinical examination, electrophysiological sensory testing and autonomic function testing. With regard to homocysteine-related parameters, plasma homocysteine, folate, vitamin B12, vitamin B6 and renal function (creatinine, ceratinine clearance, cystatin C) were measured, and the C677T polymorphism of the methylenetetrahydrofolate reductase gene was determined. Results Forty-three of the Type 2 diabetic patients were classified as suffering from neuropathy. Both patient groups were comparable with regard to demographic data, blood pressure, glucose metabolism, renal function and homocysteine-related vitamins. In contrast, homocysteine levels (P = 0.04) and the frequency of hyperhomocysteinemia (≥ 15 μmol/l) (P = 0.01) were significantly increased in neuropathic patients. In a logistic regression model with neuropathy as dependent variable, homocysteine (adjusted for creatinine, homocysteine-related vitamins, HbA1c and duration of diabetes) was the only significant variable associated with the prevalence of neuropathy (odds ratio for homocysteine per 5 μmol/l increase: 2.60 (95% confidence interval 1.07–6.33)). Conclusion The data indicate that homocysteine is independently associated with the prevalence of diabetic neuropathy in a collective of Type 2 diabetic patients. A larger, prospective study would be desirable to clarify the role of homocysteine in the pathogenesis of diabetic neuropathy.

The Framing Camera (FC) is the German contribution to the Dawn mission. The camera will map 4 Vesta and 1 Ceres through a clear filter and 7 band-pass filters covering the wavelengths from the visible to the near-IR. The camera will allow the determination of the physical parameters of the asteroids, the reconstruction of their global shape as well as local topography and surface geomorphology, and provide information on composition via surface reflectance characteristics. The camera will also serve for orbit navigation. The resolution of the Framing Camera will be up to 12 m per pixel in low altitude mapping orbit at Vesta (62 m per pixel at Ceres), at an angular resolution of 93.7 μrad px−1.

A German family with 21 members affected by Alzheimer disease (AD) was studied clinically and genetically. The diagnosis was histologically verified in three affected family members. Ancestors were traced through seven generations to a couple residing in East-Westfalia during the middle of the 19th century. Dementia was often accompanied by extrapyramidal features and myoclonus. No cases of Down syndrome or hematologic malignancy occurred in this family. Clinical manifestations, temporal progression, neurological testing, and neuropathological features do not differ from the more common sporadic form of AD. The inheritance pattern is most consistent with autosomal-dominant transmission.

A randomized, double-blind trial compared treatment with the immune modulator WF10 (ten patients) and placebo (nine patients) administered in cycles over 3 months among individuals with advanced AIDS. There were no notable clinical adverse events; changes in hematologic and chemistry values were comparable in the two groups. In both groups, median HIV-RNA PCR values remained stable. Immunologic variables showed a consistent tendency to increase in the WF10 group and to decrease in the control group, with significant differences between groups for median WBC, lymphocyte, CD19, and CD35 values. Ten infections occurred in the control group, four of which were Pneumocystis carinii pneumonia (PCP), and three in the WF10 group none of which was PCP. Five patients in the control group were hospitalized during the trial for a total of 53 days; no patients in the WF10 group were hospitalized. Over a subsequent 9-months follow-up, six patients from the control group and one from the WF10 group died. These results indicate that WF10 administration appears safe, may enhance immunologic function, and unlike other macrophage-activating cytokines does not increase HIV expression in this patient population. Further studies of WF10 in larger patient populations are warranted.

Fifteen mini-pigs were bled to a mean aortic blood pressure of 40 mm Hg and maintained at that level for three hours. The control group consisted of eight animals with shock for three hours, while the test group was comprised of seven animals with a similar shock period but which had undergone splanchnicectomy 14 days earlier. In all animals a stimulated gastric secretion test was performed three days before and eight days after splanchnicectomy. All animals in the control group showed severe gastric mucosal lesions after shock. Conversely, the piglets with splanchnicectomy developed no changes (five animals) or only minor changes (two animals). The efficacy of splanchnicectomy was confirmed by a stimulated gastric secretion test in which basal acid output did not change after operation, but peak acid output increased significantly. This study suggests that gastric splanchnicectomy prevents gastric ulceration following experimental shock.

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The development of experimental atherosclerosis was studied in subtotally nephrectomized rats which were subjected to preimmunisation with horseradish peroxidase and subsequent feeding with atherogenic diet. Both in sham operated pairfed control animals and in uremic animals, the atherogenic diet caused hyperlipemia which was more pronounced in uremic than in control animals (control animals: triglycerides 1.11 ± 0.04 mmol/1; cholesterol 5.82 ± 0.21 mmol/1; uremia: triglycerides 1.33 ± 0.06; cholesterol l0.9 ± 0.31). An increase of cholesterol was seen both in the VLDL and in the LDL fractions. Despite more pronounced hyperlipemia, lipid concentration in the aortic wall was not increased nor were more marked histological abnormalities encountered in the aorta of uremic animals.The results suggest that despite hyperlipemia short term experimental renal insufficiency does not promote atherogenesis.

Summary Violent ruptures of the spleen caused by accidents are regarded as an indication for necessary splenectomy. Experiences of modern ultrasonic surgery, e.g. in ultrasonic welding of bone fractures prompted us to experimentally investigate ultrasonic welding of spleen ruptures in dogs. We immediately obtained a safe closing of the ruptures with a durable scar and thus the method may give an alternative to splenectomy with saving of the organ.

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TCDO (Tetrachlordecaoxid) ist ein neuartiger anorganischer Sauerstofftrager, der durch Enzyme intracellular in aktiven Sauerstoff und Chlorid-Ionen gespalten wird. Er wurde zur Behandlung von Problemwunden bei 148 Patienten angewendet. Der Wirkstoff bewirkt eine rasche Wundsauberung, fordert die Granulation und die Reepithelisierung. Bei uber 90% der behandelten Falle hatten wir sehr gute und gute Ergebnisse. Nur 4,7 % der Patienten klagten uber Nebenwirkungen. Diese Ergebnisse lassen erwarten, das sich der Wirkstoff zur lokalen Behandlung von Problemwunden durchsetzen wird.