Skip to main content
Erschienen in: Diabetologia 5/2008

01.05.2008 | Article

Reduced EDHF responses and connexin activity in mesenteric arteries from the insulin-resistant obese Zucker rat

verfasst von: E. J. Young, M. A. Hill, W. B. Wiehler, C. R. Triggle, J. J. Reid

Erschienen in: Diabetologia | Ausgabe 5/2008

Einloggen, um Zugang zu erhalten

Abstract

Aims/hypothesis

The objective of this study was to examine the effect of insulin resistance on endothelium-derived hyperpolarising factor (EDHF) and small mesenteric artery endothelial function using 25-week-old insulin-resistant obese Zucker rats (OZRs) and lean littermate control rats (LZRs). The involvement of gap junctions and their connexin subunits in the EDHF relaxation response was also assessed.

Methods

Mesenteric arteries were evaluated using the following assays: (1) endothelial function by pressure myography, with internal diameter recorded using video microscopy; (2) connexin protein levels by western blotting; and (3) Cx mRNA expression by real-time PCR.

Results

Relaxations in response to acetylcholine were significantly smaller in mesenteric arteries from the OZRs than the LZRs, whereas there was no difference in relaxations in response to levcromakalim. Responses to acetylcholine were not altered by nitric oxide inhibitors, but were abolished by charybdotoxin in combination with apamin, which blocked the EDHF component of the response. 40Gap27 significantly attenuated the response to acetylcholine in the LZRs, but had no effect in the OZRs. Connexin 40 protein and Cx40 mRNA levels in mesenteric vascular homogenates were significantly smaller in the OZRs than in the LZRs, with no difference in connexin 43 or Cx43 mRNA levels.

Conclusions/interpretation

These findings demonstrate that endothelial dysfunction in mesenteric arteries from the insulin-resistant OZRs can be attributed to a defect in EDHF. The results also suggest that the defective EDHF is at least partly related to an impairment of connexin 40-associated gap junctions, through a decrease in connexin 40 protein and Cx40 mRNA expression in the OZRs.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat De Vriese AS, Verbeuren TJ, Van de Voorde J, Lameire NH, Vanhoutte PM (2000) Endothelial dysfunction in diabetes. Br J Pharmacol 130:963–974PubMedCrossRef De Vriese AS, Verbeuren TJ, Van de Voorde J, Lameire NH, Vanhoutte PM (2000) Endothelial dysfunction in diabetes. Br J Pharmacol 130:963–974PubMedCrossRef
2.
Zurück zum Zitat Doughty JM, Plane F, Langton PD (1999) Charybdotoxin and apamin block EDHF in rat mesenteric artery if selectively applied to the endothelium. Am J Physiol 276:H1107–H1112PubMed Doughty JM, Plane F, Langton PD (1999) Charybdotoxin and apamin block EDHF in rat mesenteric artery if selectively applied to the endothelium. Am J Physiol 276:H1107–H1112PubMed
3.
Zurück zum Zitat Garland CJ, Plane F (1996) Relative importance of endothelium-derived hyperpolarising factor for the relaxation of vascular smooth muscle in different arterial beds. In: Vanhoutte PM (ed) Endothelium-derived hyperpolarising factor. Harwood Academic Publishers, Amsterdam, pp 173–179 Garland CJ, Plane F (1996) Relative importance of endothelium-derived hyperpolarising factor for the relaxation of vascular smooth muscle in different arterial beds. In: Vanhoutte PM (ed) Endothelium-derived hyperpolarising factor. Harwood Academic Publishers, Amsterdam, pp 173–179
4.
Zurück zum Zitat Feletou M, Vanhoutte PM (1996) Endothelium-derived hyperpolarizing factor. Clin Exp Pharmacol Physiol 23:1082–1090PubMedCrossRef Feletou M, Vanhoutte PM (1996) Endothelium-derived hyperpolarizing factor. Clin Exp Pharmacol Physiol 23:1082–1090PubMedCrossRef
5.
Zurück zum Zitat Eichler I, Wibawa J, Grgic I et al (2003) Selective blockade of endothelial Ca2+-activated small- and intermediate-conductance K+-channels suppresses EDHF-mediated vasodilation. Br J Pharmacol 138:594–601PubMedCrossRef Eichler I, Wibawa J, Grgic I et al (2003) Selective blockade of endothelial Ca2+-activated small- and intermediate-conductance K+-channels suppresses EDHF-mediated vasodilation. Br J Pharmacol 138:594–601PubMedCrossRef
6.
Zurück zum Zitat Sandow SL, Goto K, Rummery NM, Hill CE (2004) Developmental changes in myoendothelial gap junction mediated vasodilator activity in the rat saphenous artery. J Physiol 556:875–886PubMedCrossRef Sandow SL, Goto K, Rummery NM, Hill CE (2004) Developmental changes in myoendothelial gap junction mediated vasodilator activity in the rat saphenous artery. J Physiol 556:875–886PubMedCrossRef
7.
Zurück zum Zitat McNeish AJ, Garland CJ (2007) Thromboxane A2 inhibition of SKCa after NO synthase block in rat middle cerebral artery. Br J Pharmacol 151:441–449PubMedCrossRef McNeish AJ, Garland CJ (2007) Thromboxane A2 inhibition of SKCa after NO synthase block in rat middle cerebral artery. Br J Pharmacol 151:441–449PubMedCrossRef
8.
Zurück zum Zitat Crane GJ, Gallagher N, Dora KA, Garland CJ (2003) Small- and intermediate-conductance calcium-activated K+ channels provide different facets of endothelium-dependent hyperpolarization in rat mesenteric artery. J Physiol 553:183–189PubMedCrossRef Crane GJ, Gallagher N, Dora KA, Garland CJ (2003) Small- and intermediate-conductance calcium-activated K+ channels provide different facets of endothelium-dependent hyperpolarization in rat mesenteric artery. J Physiol 553:183–189PubMedCrossRef
9.
Zurück zum Zitat Gluais P, Edwards G, Weston AH, Falck JR, Vanhoutte PM, Feletou M (2005) Role of SKCa and IKCa in endothelium-dependent hyperpolarizations of the guinea-pig isolated carotid artery. Br J Pharmacol 144:477–485PubMedCrossRef Gluais P, Edwards G, Weston AH, Falck JR, Vanhoutte PM, Feletou M (2005) Role of SKCa and IKCa in endothelium-dependent hyperpolarizations of the guinea-pig isolated carotid artery. Br J Pharmacol 144:477–485PubMedCrossRef
10.
Zurück zum Zitat Chaytor AT, Martin PE, Edwards DH, Griffith TM (2001) Gap junctional communication underpins EDHF-type relaxations evoked by ACh in the rat hepatic artery. Am J Physiol Heart Circ Physiol 280:H2441–H2450PubMed Chaytor AT, Martin PE, Edwards DH, Griffith TM (2001) Gap junctional communication underpins EDHF-type relaxations evoked by ACh in the rat hepatic artery. Am J Physiol Heart Circ Physiol 280:H2441–H2450PubMed
11.
Zurück zum Zitat Edwards G, Feletou M, Gardener MJ, Thollon C, Vanhoutte PM, Weston AH (1999) Role of gap junctions in the responses to EDHF in rat and guinea-pig small arteries. Br J Pharmacol 128:1788–1794PubMedCrossRef Edwards G, Feletou M, Gardener MJ, Thollon C, Vanhoutte PM, Weston AH (1999) Role of gap junctions in the responses to EDHF in rat and guinea-pig small arteries. Br J Pharmacol 128:1788–1794PubMedCrossRef
12.
Zurück zum Zitat Sokoya EM, Burns AR, Setiawan CT, Coleman HA, Parkington HC, Tare M (2006) Evidence for the involvement of myoendothelial gap junctions in EDHF-mediated relaxation in the rat middle cerebral artery. Am J Physiol Heart Circ Physiol 291:H385–H393PubMedCrossRef Sokoya EM, Burns AR, Setiawan CT, Coleman HA, Parkington HC, Tare M (2006) Evidence for the involvement of myoendothelial gap junctions in EDHF-mediated relaxation in the rat middle cerebral artery. Am J Physiol Heart Circ Physiol 291:H385–H393PubMedCrossRef
13.
Zurück zum Zitat Yeager M, Unger VM, Falk MM (1998) Synthesis, assembly and structure of gap junction intercellular channels. Curr Opin Struct Biol 8:517–524PubMedCrossRef Yeager M, Unger VM, Falk MM (1998) Synthesis, assembly and structure of gap junction intercellular channels. Curr Opin Struct Biol 8:517–524PubMedCrossRef
14.
Zurück zum Zitat Emerson GG, Segal SS (2000) Electrical coupling between endothelial cells and smooth muscle cells in hamster feed arteries: role in vasomotor control. Circ Res 87:474–479PubMed Emerson GG, Segal SS (2000) Electrical coupling between endothelial cells and smooth muscle cells in hamster feed arteries: role in vasomotor control. Circ Res 87:474–479PubMed
15.
Zurück zum Zitat de Wit C, Wolfle SE (2007) EDHF and gap junctions: important regulators of vascular tone within the microcirculation. Curr Pharm Biotechnol 8:11–25PubMedCrossRef de Wit C, Wolfle SE (2007) EDHF and gap junctions: important regulators of vascular tone within the microcirculation. Curr Pharm Biotechnol 8:11–25PubMedCrossRef
16.
Zurück zum Zitat Chaytor AT, Bakker LM, Edwards DH, Griffith TM (2005) Connexin-mimetic peptides dissociate electrotonic EDHF-type signalling via myoendothelial and smooth muscle gap junctions in the rabbit iliac artery. Br J Pharmacol 144:108–114PubMedCrossRef Chaytor AT, Bakker LM, Edwards DH, Griffith TM (2005) Connexin-mimetic peptides dissociate electrotonic EDHF-type signalling via myoendothelial and smooth muscle gap junctions in the rabbit iliac artery. Br J Pharmacol 144:108–114PubMedCrossRef
17.
Zurück zum Zitat Miller AW, Katakam PV, Ujhelyi MR (1999) Impaired endothelium-mediated relaxation in coronary arteries from insulin-resistant rats. J Vasc Res 36:385–392PubMedCrossRef Miller AW, Katakam PV, Ujhelyi MR (1999) Impaired endothelium-mediated relaxation in coronary arteries from insulin-resistant rats. J Vasc Res 36:385–392PubMedCrossRef
18.
Zurück zum Zitat Miller AW, Hoenig ME, Ujhelyi MR (1998) Mechanisms of impaired endothelial function associated with insulin resistance. J Cardiovasc Pharmacol Ther 3:125–134PubMedCrossRef Miller AW, Hoenig ME, Ujhelyi MR (1998) Mechanisms of impaired endothelial function associated with insulin resistance. J Cardiovasc Pharmacol Ther 3:125–134PubMedCrossRef
19.
Zurück zum Zitat Coppey LJ, Gellett JS, Yorek MA (2003) Mediation of vascular relaxation in epineurial arterioles of the sciatic nerve: effect of diabetes in type 1 and type 2 diabetic rat models. Endothelium 10:89–94PubMedCrossRef Coppey LJ, Gellett JS, Yorek MA (2003) Mediation of vascular relaxation in epineurial arterioles of the sciatic nerve: effect of diabetes in type 1 and type 2 diabetic rat models. Endothelium 10:89–94PubMedCrossRef
20.
Zurück zum Zitat Burnham MP, Johnson IT, Weston AH (2006) Impaired small-conductance Ca2+-activated K+ channel-dependent EDHF responses in type II diabetic ZDF rats. Br J Pharmacol 148:434–441PubMedCrossRef Burnham MP, Johnson IT, Weston AH (2006) Impaired small-conductance Ca2+-activated K+ channel-dependent EDHF responses in type II diabetic ZDF rats. Br J Pharmacol 148:434–441PubMedCrossRef
21.
Zurück zum Zitat Matsumoto T, Kakami M, Noguchi E, Kobayashi T, Kamata K (2007) Imbalance between endothelium-derived relaxing and contracting factors in mesenteric arteries from aged OLETF rats, a model of type 2 diabetes. Am J Physiol Heart Circ Physiol 293:H1480–H1490PubMedCrossRef Matsumoto T, Kakami M, Noguchi E, Kobayashi T, Kamata K (2007) Imbalance between endothelium-derived relaxing and contracting factors in mesenteric arteries from aged OLETF rats, a model of type 2 diabetes. Am J Physiol Heart Circ Physiol 293:H1480–H1490PubMedCrossRef
22.
Zurück zum Zitat Kuroki T, Inoguchi T, Umeda F, Ueda F, Nawata H (1998) High glucose induces alteration of gap junction permeability and phosphorylation of connexin-43 in cultured aortic smooth muscle cells. Diabetes 47:931–936PubMedCrossRef Kuroki T, Inoguchi T, Umeda F, Ueda F, Nawata H (1998) High glucose induces alteration of gap junction permeability and phosphorylation of connexin-43 in cultured aortic smooth muscle cells. Diabetes 47:931–936PubMedCrossRef
23.
Zurück zum Zitat Inoguchi T, Yu HY, Imamura M et al (2001) Altered gap junction activity in cardiovascular tissues of diabetes. Med Electron Microsc 34:86–91PubMedCrossRef Inoguchi T, Yu HY, Imamura M et al (2001) Altered gap junction activity in cardiovascular tissues of diabetes. Med Electron Microsc 34:86–91PubMedCrossRef
24.
Zurück zum Zitat Wigg SJ, Tare M, Tonta MA, O’Brien RC, Meredith IT, Parkington HC (2001) Comparison of effects of diabetes mellitus on an EDHF-dependent and an EDHF-independent artery. Am J Physiol Heart Circ Physiol 281:H232–H240PubMed Wigg SJ, Tare M, Tonta MA, O’Brien RC, Meredith IT, Parkington HC (2001) Comparison of effects of diabetes mellitus on an EDHF-dependent and an EDHF-independent artery. Am J Physiol Heart Circ Physiol 281:H232–H240PubMed
25.
Zurück zum Zitat Matsumoto T, Kobayashi T, Kamata K (2003) Alterations in EDHF-type relaxation and phosphodiesterase activity in mesenteric arteries from diabetic rats. Am J Physiol Heart Circ Physiol 285:H283–H291PubMed Matsumoto T, Kobayashi T, Kamata K (2003) Alterations in EDHF-type relaxation and phosphodiesterase activity in mesenteric arteries from diabetic rats. Am J Physiol Heart Circ Physiol 285:H283–H291PubMed
26.
Zurück zum Zitat Kasiske BL, O’Donnell MP, Keane WF (1992) The Zucker rat model of obesity, insulin resistance, hyperlipidemia, and renal injury. Hypertension 19:I110–I115PubMed Kasiske BL, O’Donnell MP, Keane WF (1992) The Zucker rat model of obesity, insulin resistance, hyperlipidemia, and renal injury. Hypertension 19:I110–I115PubMed
27.
Zurück zum Zitat Kuo L, Davis MJ, Chilian WM (1988) Myogenic activity in isolated subepicardial and subendocardial coronary arterioles. Am J Physiol 255:H1558–H1562PubMed Kuo L, Davis MJ, Chilian WM (1988) Myogenic activity in isolated subepicardial and subendocardial coronary arterioles. Am J Physiol 255:H1558–H1562PubMed
28.
Zurück zum Zitat Hill MA, Ege EA (1994) Active and passive mechanical properties of isolated arterioles from STZ-induced diabetic rats. Effect of aminoguanidine treatment. Diabetes 43:1450–1456PubMedCrossRef Hill MA, Ege EA (1994) Active and passive mechanical properties of isolated arterioles from STZ-induced diabetic rats. Effect of aminoguanidine treatment. Diabetes 43:1450–1456PubMedCrossRef
29.
Zurück zum Zitat Duling BR, Gore RW, Dacey RG Jr, Damon DN (1981) Methods for isolation, cannulation, and in vitro study of single microvessels. Am J Physiol 241:H108–H116PubMed Duling BR, Gore RW, Dacey RG Jr, Damon DN (1981) Methods for isolation, cannulation, and in vitro study of single microvessels. Am J Physiol 241:H108–H116PubMed
30.
Zurück zum Zitat Potocnik SJ, Murphy TV, Kotecha N, Hill MA (2000) Effects of mibefradil and nifedipine on arteriolar myogenic responsiveness and intracellular Ca2+. Br J Pharmacol 131:1065–1072PubMedCrossRef Potocnik SJ, Murphy TV, Kotecha N, Hill MA (2000) Effects of mibefradil and nifedipine on arteriolar myogenic responsiveness and intracellular Ca2+. Br J Pharmacol 131:1065–1072PubMedCrossRef
31.
Zurück zum Zitat McCulloch AI, Randall MD (1996) Modulation of vasorelaxant responses to potassium channel openers by basal nitric oxide in the rat isolated superior mesenteric arterial bed. Br J Pharmacol 117:859–866PubMed McCulloch AI, Randall MD (1996) Modulation of vasorelaxant responses to potassium channel openers by basal nitric oxide in the rat isolated superior mesenteric arterial bed. Br J Pharmacol 117:859–866PubMed
32.
Zurück zum Zitat Katakam PV, Ujhelyi MR, Miller AW (1999) EDHF-mediated relaxation is impaired in fructose-fed rats. J Cardiovasc Pharmacol 34:461–467PubMedCrossRef Katakam PV, Ujhelyi MR, Miller AW (1999) EDHF-mediated relaxation is impaired in fructose-fed rats. J Cardiovasc Pharmacol 34:461–467PubMedCrossRef
33.
Zurück zum Zitat Nelson MT, Brayden JE (1993) Regulation of arterial tone by calcium-dependent K+ channels and ATP-sensitive K+ channels. Cardiovasc Drugs Ther 7(Suppl 3):605–610PubMedCrossRef Nelson MT, Brayden JE (1993) Regulation of arterial tone by calcium-dependent K+ channels and ATP-sensitive K+ channels. Cardiovasc Drugs Ther 7(Suppl 3):605–610PubMedCrossRef
34.
Zurück zum Zitat Wulff H, Miller MJ, Hansel W, Grissmer S, Cahalan MD, Chandy KG (2000) Design of a potent and selective inhibitor of the intermediate-conductance Ca2+-activated K+ channel, IKCa1: a potential immunosuppressant. Proc Natl Acad Sci USA 97:8151–8156PubMedCrossRef Wulff H, Miller MJ, Hansel W, Grissmer S, Cahalan MD, Chandy KG (2000) Design of a potent and selective inhibitor of the intermediate-conductance Ca2+-activated K+ channel, IKCa1: a potential immunosuppressant. Proc Natl Acad Sci USA 97:8151–8156PubMedCrossRef
35.
Zurück zum Zitat Richards GR, Weston AH, Burnham MP, Feletou M, Vanhoutte PM, Edwards G (2001) Suppression of K+-induced hyperpolarization by phenylephrine in rat mesenteric artery: relevance to studies of endothelium-derived hyperpolarizing factor. Br J Pharmacol 134:1–5PubMedCrossRef Richards GR, Weston AH, Burnham MP, Feletou M, Vanhoutte PM, Edwards G (2001) Suppression of K+-induced hyperpolarization by phenylephrine in rat mesenteric artery: relevance to studies of endothelium-derived hyperpolarizing factor. Br J Pharmacol 134:1–5PubMedCrossRef
36.
Zurück zum Zitat Edwards G, Feletou M, Gardener MJ et al (2001) Further investigations into the endothelium-dependent hyperpolarizing effects of bradykinin and substance P in porcine coronary artery. Br J Pharmacol 133:1145–1153PubMedCrossRef Edwards G, Feletou M, Gardener MJ et al (2001) Further investigations into the endothelium-dependent hyperpolarizing effects of bradykinin and substance P in porcine coronary artery. Br J Pharmacol 133:1145–1153PubMedCrossRef
37.
Zurück zum Zitat Chaytor AT, Marsh WL, Hutcheson IR, Griffith TM (2000) Comparison of glycyrrhetinic acid isoforms and carbenoxolone as inhibitors of EDHF-type relaxations mediated via gap junctions. Endothelium 7:265–278PubMed Chaytor AT, Marsh WL, Hutcheson IR, Griffith TM (2000) Comparison of glycyrrhetinic acid isoforms and carbenoxolone as inhibitors of EDHF-type relaxations mediated via gap junctions. Endothelium 7:265–278PubMed
38.
Zurück zum Zitat Chaytor AT, Evans WH, Griffith TM (1997) Peptides homologous to extracellular loop motifs of connexin 43 reversibly abolish rhythmic contractile activity in rabbit arteries. J Physiol 503:99–110PubMedCrossRef Chaytor AT, Evans WH, Griffith TM (1997) Peptides homologous to extracellular loop motifs of connexin 43 reversibly abolish rhythmic contractile activity in rabbit arteries. J Physiol 503:99–110PubMedCrossRef
39.
Zurück zum Zitat Sandow SL, Tare M, Coleman HA, Hill CE, Parkington HC (2002) Involvement of myoendothelial gap junctions in the actions of endothelium-derived hyperpolarizing factor. Circ Res 90:1108–1113PubMedCrossRef Sandow SL, Tare M, Coleman HA, Hill CE, Parkington HC (2002) Involvement of myoendothelial gap junctions in the actions of endothelium-derived hyperpolarizing factor. Circ Res 90:1108–1113PubMedCrossRef
40.
Zurück zum Zitat Berman RS, Martin PE, Evans WH, Griffith TM (2002) Relative contributions of NO and gap junctional communication to endothelium-dependent relaxations of rabbit resistance arteries vary with vessel size. Microvasc Res 63:115–128PubMedCrossRef Berman RS, Martin PE, Evans WH, Griffith TM (2002) Relative contributions of NO and gap junctional communication to endothelium-dependent relaxations of rabbit resistance arteries vary with vessel size. Microvasc Res 63:115–128PubMedCrossRef
41.
Zurück zum Zitat Haddock RE, Grayson TH, Brackenbury TD et al (2006) Endothelial coordination of cerebral vasomotion via myoendothelial gap junctions containing connexins 37 and 40. Am J Physiol Heart Circ Physiol 291:H2047–H2056PubMedCrossRef Haddock RE, Grayson TH, Brackenbury TD et al (2006) Endothelial coordination of cerebral vasomotion via myoendothelial gap junctions containing connexins 37 and 40. Am J Physiol Heart Circ Physiol 291:H2047–H2056PubMedCrossRef
42.
Zurück zum Zitat de Wit C, Roos F, Bolz SS, Pohl U (2003) Lack of vascular connexin 40 is associated with hypertension and irregular arteriolar vasomotion. Physiol Genomics 13:169–177PubMed de Wit C, Roos F, Bolz SS, Pohl U (2003) Lack of vascular connexin 40 is associated with hypertension and irregular arteriolar vasomotion. Physiol Genomics 13:169–177PubMed
43.
Zurück zum Zitat De Vriese AS, Van de Voorde J, Lameire NH (2002) Effects of connexin-mimetic peptides on nitric oxide synthase- and cyclooxygenase-independent renal vasodilation. Kidney Int 61:177–185PubMedCrossRef De Vriese AS, Van de Voorde J, Lameire NH (2002) Effects of connexin-mimetic peptides on nitric oxide synthase- and cyclooxygenase-independent renal vasodilation. Kidney Int 61:177–185PubMedCrossRef
44.
Zurück zum Zitat de Wit C, Roos F, Bolz SS et al (2000) Impaired conduction of vasodilation along arterioles in connexin40-deficient mice. Circ Res 86:649–655PubMed de Wit C, Roos F, Bolz SS et al (2000) Impaired conduction of vasodilation along arterioles in connexin40-deficient mice. Circ Res 86:649–655PubMed
45.
Zurück zum Zitat Oku H, Kodama T, Sakagami K, Puro DG (2001) Diabetes-induced disruption of gap junction pathways within the retinal microvasculature. Invest Ophthalmol Vis Sci 42:1915–1920PubMed Oku H, Kodama T, Sakagami K, Puro DG (2001) Diabetes-induced disruption of gap junction pathways within the retinal microvasculature. Invest Ophthalmol Vis Sci 42:1915–1920PubMed
46.
Zurück zum Zitat Ding H, Hashem M, Wiehler WB et al (2005) Endothelial dysfunction in the streptozotocin-induced diabetic apoE-deficient mouse. Br J Pharmacol 146:1110–1118PubMedCrossRef Ding H, Hashem M, Wiehler WB et al (2005) Endothelial dysfunction in the streptozotocin-induced diabetic apoE-deficient mouse. Br J Pharmacol 146:1110–1118PubMedCrossRef
Metadaten
Titel
Reduced EDHF responses and connexin activity in mesenteric arteries from the insulin-resistant obese Zucker rat
verfasst von
E. J. Young
M. A. Hill
W. B. Wiehler
C. R. Triggle
J. J. Reid
Publikationsdatum
01.05.2008
Verlag
Springer-Verlag
Erschienen in
Diabetologia / Ausgabe 5/2008
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-008-0934-y

Weitere Artikel der Ausgabe 5/2008

Diabetologia 5/2008 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.