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  • Articles: DFG German National Licenses  (11)
  • Bone density  (4)
  • Tubuloglomerular feedback  (3)
  • Intratubular Pressure  (2)
  • Risk factors  (2)
  • Slow wave sleep  (2)
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  • Articles: DFG German National Licenses  (11)
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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 60 (1982), S. 1245-1248 
    ISSN: 1432-1440
    Keywords: Chronic salt loading ; Volume expansion ; Glomerular filtration rate ; Tubuloglomerular feedback ; Humoral substances in tubular fluid ; Chronische Salzbelastung ; Volumenexpansion ; Glomeruläre Filtrationsrate ; Tubuloglomeruläre Rückkoppelung ; Humorale Substanzen in tubulärer Flüssigkeit
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei normalem Extrazellulärvolumen reduziert der Harnfluß durch das macula densa Segment der Henle'schen Schleife die glomeruläre Filtrationsrate durch ein Signal aus dem juxtaglomerulären Apparat (tubuloglomerulärer Rückkopplungsmechanismus, TGF). Bei Vergrößerung des Extrazellulärvolumens wird dieser Mechanismus gehemmt, so daß die glomeruläre Filtrationsrate ansteigt. Um festzustellen, ob diese Hemmung durch Veränderungen im juxtaglomerulären Apparat oder in der Tubulusflüssigkeit verursacht wird, wurden an zwei Gruppen von Ratten, deren Extrazellulärvolumen entweder normal war oder durch kochsalzreiche Ernährung expandiert wurde, Austauschversuche mit spätproximaler Tubulusflüssigkeit durchgeführt. Die Tubulusflüssigkeit wurde mit Mikrosaug/Perfusionspumpen gesammelt. Ihre Wirkung auf den TGF wurde geschätzt, indem Henle'sche Schleifen einzelner Tubuli mit 40, 10, und 0 nl/min perfundiert wurden, während gleichzeitig der Harnfluß (EPF) in einem glomerulusnahen Segment des jeweiligen proximalen Tubulus gemessen wurde. Insalzreich ernährten Tieren war die EPF von der Schleifenperfusionsrate unabhängig, wenn die Henle'schen Schleifen mithomologer Tubulusflüssigkeit perfundiert wurden. Mit Tubulusflüssigkeit aussalzarm ernährten Tieren und einer Schleifenperfusionsrate von 40 nl/min fiel die EPF jedoch um etwa 50% gegenüber dem Kontrollwert bei nichtperfundierter Schleife ab. Insalzarm ernährten Tieren, deren Henle'sche Schleifen mithomologer Tubulusflüssigkeit und einer Rate von 40 nl/min perfundiert wurden, fiel die EPF um etwa 50% gegenüber dem Kontrollwert bei nicht perfundierter Schleife ab. Mit Tubulusflüssigkeit aussalzreich ernährten Tieren war die EPF von der Schleifenperfusionsrate unabhängig. Es wird gefolgert, daß der TGF in volumenexpandierten Tieren durch eine Substanz in der Tubulusflüssigkeit gehemmt wird.
    Notes: Summary Experiments were carried out in Wistar rats to determine whether the loss of sensitivity of the tubuloglomerular feedback mechanism (TGF) which is known to occur in volume expansion is due to a change in the functional characteristics of the juxtaglomerular apparatus or to a change in some property of the tubular fluid which influences the feedback signal at the macula densa. Proximal tubular fluid was collected by means of a microperfusion/suction pump from Wistar rats maintained for a minimum of 10 days on a high salt diet and also from rats fed a control low salt diet. Both fluids were then used to perfuse loops of Henle in rats from both groups and the feedback response assessed from the change in early proximal tubular flow rate (EPF). In high salt rats, perfusion of the loop of Henle with homologous tubular fluid confirmed the loss of sensitivity of the TGF mechanism in volume expansion, the response of EPF was practically absent. In contrast, the low salt rat responded with a 50% decrease in EPF to loop perfusion at 40 nl/min with its homologous fluid. On the other hand, when the loop of Henle in high salt rats was perfused at 40 nl/min with heterologous (low salt) tubular fluid, EPF again decreased by some 50% whereas EPF in low salt rats failed to respond to loop perfusion with high salt fluid. From these results it is concluded that in rats chronically volume expanded by a high salt diet an unknown inhibitory principle occurs in the proximal tubular fluid which reduces the sensitivity of the tubuloglomerular feedback mechanism.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-2965
    Keywords: Bone density ; Prospective studies ; Risk factors ; Vertebral fracture incidence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the ability of bone density and vertebral fractures at baseline to predict vertebral fracture incidence in a cohort of postmenopausal women with osteoporosis. The study population was 380 postmenopausal women (mean age 65 years) treated for osteoporosis in a randomized, placebo-controlled, clinical trial of the bisphosphonate etidronate at seven geographic centers in the United States. Baseline measurements of bone mineral density were obtained in 1986 by quantitative computed tomography at the spine and dual-photon absorptiometry at the lumbar spine and hip. Vertebral fractures were documented on serial spine radiographs. Proportional hazards models were used to evaluate the ability to predict the risk of subsequent fractures during an average of 2.9 years of follow-up. Presence of one or two fractures increased the rate of new vertebral fractures 7.4-fold (95% confidence interval = 1.0 to 55.9). Additional fractures at baseline further increased the fracture rate. A decrease of 2 standard deviations in spinal bone density by absorptiometry was associated with a 5.8-fold increase in fracture rate (95% confidence interval = 2.9 to 11.6). The lowest and highest quintiles of bone density had absolute fracture rates of 120 and 6 cases per 1000 patient-years, respectively. In general, the simultaneous use of two predictors (bone density and prevalent fractures or two bone density measurements) improved fracture prediction, compared with the use of a single predictor. We conclude that both bone density and prevalent vertebral fractures are strong, complementary predictors of vertebral fracture risk. The results suggest that physicians can use bone density and prevalent vertebral fractures, individually or in combination, as risk factors to identify patients at greatest risk of new fractures.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Osteoporosis international 4 (1994), S. 1-5 
    ISSN: 1433-2965
    Keywords: Bone mass ; Bone density ; Fracture incidence ; Fracture prevalence ; Longitudinal studies ; Risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A prospective cohort study of 1098 postmenopausal Japanese-American women evaluated the relationship between baseline non-spine fractures and new (incident) spine fractures. At the baseline examination in 1981, prevalent non-spine fractures were ascertained by interview, and prevalent spine fractures by radiograph. Bone mass measurements of the distal radius, proximal radius, calcaneus (1981), the lumbar spine (1984) were obtained and repeated at 1- to 2-year intervals. Women with existing non-spine fractures have a threefold greater risk of subsequent spine fractures, independent of bone mass, and independent of the known association between prevalent spine fractures and subsequent spine fractures. Women with both a prevalent non-spine fracture and low bone mass (50th percentile or lower) have an eightfold greater risk of new spine fractures compared with women above the 50th percentile of bone mass and no prevalent fractures. In addition to low bone mass, both prevalent spine fractures and prevalent non-spine fractures are strong risk factors for subsequent spine fracture. These data suggest that not all osteoporotic risk factors are expressed via bone mass, and that other, unmeasured risk factors, such as bone quality defects, may explain these results. In clinical terms, women with both prevalent fractures and low bone mass should be recognized as being at extremely high risk, and treatment potency should be commensurate with this level of risk.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Calcified tissue international 57 (1995), S. 115-119 
    ISSN: 1432-0827
    Keywords: Glucocorticoid ; Bone density ; Bone loss rates ; Longitudinal study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract Although high doses of glucocorticoids are believed to cause bone loss, the effects of low glucocorticoid doses are still controversial. Our study examined the effects of low-dose glucocorticoids on the rate of bone loss at three appendicular bone sites. The study population was a cohort of elderly Japanese-Americans, 1094 women and 1378 men. The women were all postmenopausal. At the baseline examination the mean age of the women was 64 years (range 45–81), and the mean age of the men was 68 years (range 61–82). Glucocorticoid users (19 women and 21 men) had used oral systemic or inhaled glucocorticoids on a regular schedule for more than 1 month (mean use was 2.1 years for the women and 1.9 years for the men). The most common dose was equivalent to 5 mg/day of prednisone; fewer than 15% of users had taken doses equivalent to 10 mg/day or more. Changes in bone mass at the calcaneus, distal radius, and proximal radius were documented using bone densitometry at 1 to 2-year intervals over an 8-year period. The initial bone mass of the glucocorticoid users and controls was similar at the baseline examination. The subsequent loss rates among females during glucocorticoid use, however, were approximately double that of the controls. Among males, bone loss rates during glucocorticoid use were 2–3 times that of controls for the calcaneus and radius sites. The differences between glucocorticoid users and controls persisted after adjusting for confounding variables such as age and use of thiazides and estrogens. We conclude that users of low-dose glucocorticoids have increased rates of bone loss at appendicular sites among both elderly women and men.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Calcified tissue international 55 (1994), S. 243-248 
    ISSN: 1432-0827
    Keywords: Osteoporosis ; Bone density ; Longitudinal studies ; Statistical models ; Decision models
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract We calculated how long to wait before repeating bone mineral density (BMD) measurements to reassess fracture risk. Correlation results from serial measurements of 495 postmenopausal Japanese-American women were used to estimate 95% confidence intervals (CI) for future BMD. After 7 years of follow-up, BMD correlations with the initial measurement ranged between 0.81 and 0.94, depending on age group and measurement site. In this analysis, the period between measurements was defined as the time required for the lower 95% CI to fall below the BMD value corresponding to doubling of fracture risk. Progressive bone loss causes fracture risk to double after 10 years, on average. However, the 95% CIs indicate that a second BMD measurement will detect risk doubling after only 2 or 3 years for some women. For untreated, early postmenopausal women, the period between measurements was approximately 2–5 years for the radius and 4–6 years for the calcaneus, depending on the initial BMD level. The period was approximately 1 year longer for women age 60 and older. Treatments that halve the bone loss rate would increase the period by 1–3 years. In the absence of a second measurement of BMD, the CI will continue to expand with time, corresponding to a wider range in risk between individuals, and a greater proportion of women will be at increased fracture risk. Obtaining a second BMD measurement pinpoints the patient's status within the precision of the measurement. We conclude that repeated BMD measurements will provide a more accurate estimate of fracture risk than a single, baseline measurement.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-2072
    Keywords: Anxiety ; Slow wave sleep ; Ritanserin ; 5-HT2 receptor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Eight patients with generalised anxiety disorder (GAD) and eight matched healthy controls had their polysomnogram measured on two occasions separated by 1 week. On one occasion they received the 5-HT2 receptor antagonist, ritanserin (5 mg orally) and on the other matching placebo. The increase in slow wave sleep produced by ritanserin was the same in GAD patients as in healthy controls. These findings do not support the hypothesis that GAD is associated with a generalised hypersensitivity of brain 5-HT2 receptors; however, the present data cannot exclude the presence of a regionally specific change in this receptor subtype in anxiety disorders.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Pflügers Archiv 411 (1988), S. 322-327 
    ISSN: 1432-2013
    Keywords: Tubuloglomerular feedback ; Juxtaglomerular apparatus ; Glomerular filtration rate ; Acute volume expansion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Loss of sensitivity or “resetting” of tubuloglomerular feedback has been reported after both acute and chronic volume expansion in rats. In chronic volume expansion due to dietary salt loading, resetting was found to result from the appearance of an inhibitory factor in tubular fluid. The aim of the present study was to test the possibility that resetting after acute isooncotic volume expansion may also be due to such an inhibitor. Rats were acutely volume expanded (4.5% of body weight) by infusion of a solution of fresh plasma and Ringer's solution. Tubuloglomerular feedback activity was assessed in expanded and control animals by measuring early proximal flow (EPF) rate during perfusion of the loop of Henle at varying rates with proximal tubular fluid harvested from the control (control TF) and expanded animals (AVE TF). When loops of Henle in control animals were perfused with control TF at 10, 20 or 40 nl min−1, EPF fell from (mean ±SD) 29.8±5.6 at zero loop flow to 27.5±7.5, 21.1±4.2 and 15.5±4.5 nl min−1 gKW−1 respectively. Perfusion at the same rates with control TF in expanded animals reduced EPF from 39.5±9.6 (at zero loop flow) to 35.9±11.3, 31.6±4.3 and 22.9±6.8 nl min−1 gKW−1 respectively. When loops of Henle in control animals were perfused with AVE TF, EPF fell from 28.6±9.5 (zero loop flow) to 23.5±8.6, 19.9±8.2 and 15.6±6.5 nl min−1 gKW−1 respectively. Perfusion at these rates with AVE TF in the expanded animals depressed EPF from 36.7±7.8 (at zero loop flow) to 33.6±7.3, 28.6±7.6 and 22.7±8.0 nl min−1 gKW−1 respectively. Since the responses to the two perfusion fluids were the same in each group, it is concluded that there is no inhibitory factor present in AVE TF. Although EPF at each perfusion rate was significantly higher in the expanded animals than in control, the change in EPF per unit change in loop perfusion rate was the same in both groups from which it is concluded that no resetting of tubuloglomerular feedback occurred in the present study.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-2013
    Keywords: Autoregulation ; Tubuloglomerular feedback ; Renal blood flow ; Glomerular filtration rate ; Plasma renin activity ; Deoxycorticosterone acetate ; Plasma volume ; rats
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tubuloglomerular feedback (TGF) function and autoregulation (renal blood flow RBF; glomerular filtration rate, GFR; single-nephron glomerular filtration rate, SNGFR) were examined in rats chronically treated with deoxycorticosterone acetate (DOCA) and given isotonic saline to drink. DOCA treatment depressed arterial plasma renin activity, expanded plasma volume by 25% and increased arterial blood pressure. Autoregulation of RBF and GFR was maintained in the DOCA animals above 90 mm Hg and 110 mm Hg respectively, whereby both GFR and RBF were lower than in controls. Micropuncture experiments demonstrated the absence of TGF in the DOCA animals. There was no difference between SNGFR values measured in the distal and proximal tubules, nor was there a significant response of SNGFR when loops of Henle were perfused with Ringer's solution at 20 nl/min. Loop perfusion in control rats with tubular fluid collected in DOCA rats elicited a normal TGF response, showing that TGF inhibition in the DOCA animals is due to changes in the function of the juxtaglomerular apparatus. In contrast to control rats, proximal SNGFR was perfectly autoregulated. These results suggest that TGF is not primarily responsible for autoregulation and that the vasodilatation normally resulting from acute TGF interruption is therefore compensated by some other mechanism such that RBF and GFR are lower than in controls.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Pflügers Archiv 333 (1972), S. 271-280 
    ISSN: 1432-2013
    Keywords: Nephron Filtration Rate ; Tubulo-Glomerular Feedback ; Intratubular Pressure ; Polyfructosan
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two possible artifacts may explain the phenomenon that nephron GFR (N-GFR) measured by distal tubular puncture is smaller than that measured by proximal tubular puncture: a loss of the inulin-like substance used in this laboratory (polyfructosan) from the tubular lumen or unreliable distal punctures. To test these possibilities (a) known amounts of polyfructosan were injected into the proximal tubule and the percentage recovery from the distal tubule measured, (b) N-GFR was measured by distal puncture, subsequently by recollection from the same site and finally by a proximal puncture. On the average, 98.5±7.5% of the proximally injected polyfructosan was recovered from the distal tubule. This is not significantly different from 100% (p〉0.1) and demonstrates that proximal tubule and loop of Henle are impermeable to polyfructosan. The ratio between the N-GFR measured by a distal puncture and that measured by subsequent recollection was 1.016±0.096 and not significantly different from 1.000 (p〈0.20), demonstrating the reliability of distal tubular puncture. The mean distal N-GFR of 27.9±5.3 nl/min was significantly smaller (p〈0.001) than the proximal N-GFR of 35.1±8.0 nl/min. The existence of the proximal-distal N-GFR difference thus is confirmed and two possible artifacts eliminated. The best explanation remains the operation of a tubulo-glomerular feedback mechanism. A current point of dispute is the effect of alterations in intratubular pressure (ITP) on N-GFR. Collection of tubular fluid at ITPs below the previously measured free flow pressure (FFP) resulted in a change of N-GFR of 0.45 nl/min· cm H2O. In contrast, fluid collection at ITPs greater than the FFP resulted in a change of N-GFR of 1.48 nl/min· cm H2O. We conclude that although N-GFR is sensitive to ITP changes in both directions, pressure decreases are of little practical importance for the determination of N-GFR whereas intratubular pressure increases are to be avoided.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-2013
    Keywords: Nephron Filtration Rate ; Saline Diuresis ; Intratubular Pressure ; Retrograde Contamination ; Sampling Pipettes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The theory of a functional coupling between distal tubular fluid composition and glomerular filtration rate implies that the blockade of flow at a proximal site should lead to a marked increase of GFR. This potential alteration of steady state GFR was studied by comparing the influence of sampling from distal or proximal sites on the filtration rate of identical nephrons. During antidiuresis an average GFR of 25.2 nl/min±7.5 S.D. was found in distal collections, while proximally collected samples gave an average GFR of 34.5 nl/min±8.4 S.D. This difference of 9.3 nl/min is highly significant (p〈0.001). During saline diuresis a mean nephron GFR of 41.6 nl/min±5.0 was found by distal sampling and of 45.3 nl/min±5.4 by proximal sampling (p〉0.05). The proximal-distal difference in nephron GFR is interpreted to indicate the operation of a tubulo-glomerular feedback control system. Thus, a true steady-state GFR probably cannot be obtained by proximal fluid collection. Even in the presence of high intratubular pressures and unusually short oil blocks no evidence of sample contamination by retrograde fluid flow past an injected oil block was obtained. The application of a counter-pressure to the sampling pipette which has been recommended by Gertzet al. [5] as a means to standardize fluid collections, was found to lead to abnormally high intratubular pressures. The reason for this finding appears to be an unexpectedly high and inconstant tip resistance to flow during fluid flow into the pipette.
    Type of Medium: Electronic Resource
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