Zeitschrift für die gesamte innere Medizin und ihre Grenzgebiete
-
Pulmonary histiocytosis X is a histiocytic granulomatosis of yet unknown etiology and of partial immunopathogenesis. The incidence ist about 5% compared to sarcoidosis. Almost all patients are smokers, the age peak lies between 20 and 40 years. ⋯ The characteristic ring figures may be detected only by tomography. Until recently diagnosis was made exclusively by lung biopsy, but now bronchoalveolar lavage may be already diagnostic. Early corticosteroid therapy seems to prevent the progression to the fibrotic-bullous end-stage in almost all cases.
-
In 4 different forms of cardiomyopathy which had been diagnosed echocardiographically we performed stethoacoustic investigations. Hereby each of these 4 different forms of cardiomyopathy developed a specific noise. ⋯ In the obstructive cardiomyopathy (hypertrophic obstructive cardiomyopathy) we found a mesotelesystolic murmur in 4 L 3 and called it obstruction murmur. In the dilatative cardiomyopathy (COCM) existed an immediate systolic murmur above the apex and we called it dilatation murmur.
-
The appearance of myocardial infarctions in fertile women is to agree upon the concept of cardiovascular risk factors. Women without diabetes showed in 3 age groups up to 49 years 2.5-3.1 factors and with diabetes 4.4-4.8 factors, such as smoking, hyperlipoproteinaemia, hypertension, obesity, oral contraceptives, hyperuricaemia and diabetes mellitus, respectively. ⋯ A critical indication for oral contraceptives is recommended, if already one of the factors, such as smoking, hyperlipoproteinaemia, hypertension, obesity or diabetes mellitus is present, or, if possible, its removal before ordination. Also low-dose oral contraceptives must be regarded as a potential risk factor up to further clarification.
-
The causal connection of aluminium accumulation in the organism and of toxic aluminium effects on the bone metabolism is at present regarded as extensively ascertained. On the other hand, there is no final consent about the fact which exact pathomechanisms are the basis of the aluminium effects. Apart from the direct interaction of aluminium with osseous transformation processes influences of the aluminium load of the body on significant, modulating the bone turnover extraosseous factors could be proved. Discussions about the complex pathogenetic principles of aluminium-induced bone changes concentrate themselves upon inhibitory effects of aluminium in the process of mineralisation, upon immediate toxicity of aluminium on the bone cells, potential interactions between aluminium and changed NSD-function as well as the influence of the aluminium accumulation on the vitamin-D-balance.
-
Issuing from the accomplishments of Köhler for the development of the intensive medicine in internal medicine-in 1964 he performed the first long-term respiration at the then Medical Clinic of the Karl Marx University, in 1969 he institutionalized the young subdiscipline at the clinic, in 1978 he founded the department for intensive medicine and is at work by his decisions concerning the development of young scientists, by the handbook "Intensive Medicine. Internal Medicine and Adjacent Subjects" as well as a member of the presidium of the GDR Society for Internal Medicine for the development of the internal intensive medicine-a description of the development of the department, its achievements and problems is given. The promotion of the intensive medicine by Köhler results, as we think, also from the comprehension that it has the duty to perform a function integrating the subdisciplines, which the modern internal medicine oriented to organs and systems threatens to lose, which, however, makes its self-apprehension, which the patient wishes and the teaching is demanding. From this and from the charge for a highly specialized care of patients who life-threateningly fell ill with internal diseases as well as from the duty to create a scientific forerunning results the stringent necessity of the development of the non-operative, in reality internal intensive medicine in the clinics for internal medicine of the county hospitals and university institutions as well as the greater identification of the internist with the subdiscipline in the district hospitals dealing with multidisciplinary intensive medicine.