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  • 1
    Electronic Resource
    Electronic Resource
    SPECIFIC, NONGENOMIC ACTIONS OF STEROID HORMONES (1997)
    Palo Alto, Calif. : Annual Reviews
    Annual Review of Physiology 59 (1997), S. 365-393 
    Details
    ISSN: 0066-4278
    Source: Annual Reviews Electronic Back Volume Collection 1932-2001ff
    Topics: Medicine , Biology
    Notes: Abstract Traditionally, steroid hormone action has been described as the modulation of nuclear transcription, thus triggering genomic events that are responsible for physiological effects. Despite early observations of rapid steroid effects that were incompatible with this theory, nongenomic steroid action has been widely recognized only recently. Evidence for these rapid effects is available for steroids of all clones and for a multitude of species and tissues. Examples of nongenomic steroid action include rapid aldosterone effects in lymphocytes and vascular smooth muscle cells, vitamin D3 effects in epithelial cells, progesterone action in human sperm, neurosteroid effects on neuronal function, and vascular effects of estrogens. Mechanisms of action are being studied with regard to signal perception and transduction, and researchers have developed a patchy sketch of a membrane receptor-second messenger cascade similar to those involved in catecholamine and peptide hormone action. Many of these effects appear to involve phospholipase C, phosphoinositide turnover, intracellular pH and calcium, protein kinase C, and tyrosine kinases. The physiological and pathophysiological relevance of these effects is unclear, but rapid steroid effects on cardiovascular, central nervous, and reproductive functions may occur in vivo. The cloning of the cDNA for the first membrane receptor for steroids should be achieved in the near future, and the physiological and clinical relevance of these rapid steroid effects can then be established.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1146/annurev.physiol.59.1.365
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  • 2
    Electronic Resource
    Electronic Resource
    Aneurysms of coronary arteries in a patient with adult polycystic kidney disease: arteriosclerosis or involvement by the primary disease? (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 150-152 
    Details
    ISSN: 1432-1440
    Keywords: Adult polycystic kidney disease ; Coronary vascular abnormalities ; Coronary artery aneurysms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Adult polycystic kidney disease is frequently associated with gastrointestinal and cardiovascular abnormalities. These include hypertension, mitral valve prolapse, mild dilation of the aortic root, abdominal aneurysms, and predisposition to aortic, mitral, and tricuspidal valve regurgitation reminiscent of Marfan's syndrome. Although tho exact molecular mechanisms of adult polycystic kidney disease are not well established, a generalized defect of collagen structure is hypothesized. The most severe vascular problems, however, are typical intracranial aneurysms with a high incidence of subarachnoid hemorrhage and a high mortality rate. We report a case of dilated coronary arteries found incidentally in a patient with adult polycystic kidney disease and stress-induced angina pectoris. The typical angina pectoris of the patient is explained by left ventricular hypertrophy and coronary heart disease. Multiple liver cysts, mitral valve prolapse, and the coronary aneurysms in this patient with adult polycystic kidney disease appear to reflect the manifestation of a generalized connective tissue disorder in this syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00179997
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  • 3
    Electronic Resource
    Electronic Resource
    Effects of aldosterone on intralymphocytic sodium and potassium in patients with essential hypertension (1990)
    Springer
    Journal of molecular medicine 68 (1990), S. 71-76 
    Details
    ISSN: 1432-1440
    Keywords: Essential hypertension ; Lymphocytes ; Sodium ; Potassium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In vitro binding of aldosterone to mineralocorticoid receptors on human mononuclear leukocytes (HML) and its effects on the intracellular sodium and potassium concentrations of HML have already been described. In the present paper this easily accessible human cell model was investigated in 13 patients with essential hypertension. In only four patients sodium in HML without incubation was elevated compared with the range for normal persons. A decrease of intracellular sodium or potassium occurred during incubation without aldosterone (P〈0.02). The addition of 1.4 nM aldosterone did not prevent this loss of electrolytes as observed in normal persons. Plasma renin activity and aldosterone were not correlated with the electrolyte response and were within the normal limits. The number of mineralocorticoid receptors/cell were within or close to the normal range (n=9). The independence of intracellular electrolytes from aldosterone despite a normal number of mineralocorticoid receptors may reflect an impairment of the mineralocorticoid effector mechanism in the HML of patients with essential hypertension.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01646846
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  • 4
    Electronic Resource
    Electronic Resource
    Volumes and Na+/H+ antiporter activity of lymphocytes in patients with congestive heart failure (1994)
    Springer
    Journal of molecular medicine 72 (1994), S. 985-991 
    Details
    ISSN: 1432-1440
    Keywords: Cell volume ; Na+/H+ antiporter activity ; Human mononuclear leukocytes ; Angiotensin-converting enzyme inhibitor ; Diuretic therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous studies in patients with congestive heart failure (CHF) treated with diuretics and/or digoxin have shown abnormalities of cellular volume and electrolytes in biopsies of skeletal muscle. These abnormalities seem to play an important role with regard to the dysregulation of peripheral vascular resistance and characteristic clinical features of CHF, for example, muscular weakness. This study assessed the effect of angiotension-converting enzyme (ACE) inhibitor therapy on cell volume and cell volume regulation in patients with CHF. Cell diameters of human mononuclear leukocytes (HML) were determined electronically by a Coulter Counter. Cell diameters for 19 patients with decreased left ventricular ejection fraction (determined via levocardiography) on therapy with ACE inhibitors (group 1) were compared to those of HML from patients on diuretics alone (group 2,n = 16). The activity of the Na+/H+ antiporter was determined by cell swelling in isotonic propionate. The control group consisted of 20 normal, age- and sex-matched volunteers. HML diameters were significantly increased from 7.16 ± 0.07 in normals to 7.24 ± 0.08 μm (group 1;P 〈 0.01) and 7.23 ± 0.11 μm (group 2;P 〈 0.05), indicating an abnormal regulation of cell volume. There were no statistically significant correlations between the individual ejection fraction or digoxin therapy and average cell diameters. In both patient groups ethylisopropylamiloride-sensitive swelling rates were normal compared to the control group indicating a normal activity of the Na+/H+ antiporter. In conclusion, increased cell sizes reflect a structural change in HML rather than a rapidly reversible functional abnormality which was not affected different by ACE inhibition and diuretic therapy. The pathomechanisms underlying abnormal cell sizes in CHF patients remain to be determined but could be similar to those responsible for muscular changes in CHF. Further studies should show whether HML, being easily accessible, are a valid cell model to reflect these muscular abnormalities in CHF, and whether a normal cell size can be achieved therapeutically by normalized neurohumoral activities.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00577741
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  • 5
    Electronic Resource
    Electronic Resource
    Looking beyond the dogma of genomic steroid action: insights and facts of the 1990s (1995)
    Springer
    Journal of molecular medicine 73 (1995), S. 439-447 
    Details
    ISSN: 1432-1440
    Keywords: Steroids ; Membrane receptors ; Nongenomic action ; Cellular signaling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The genomic theory of steroid action has been the unquestioned dogma for the explanation of steroid effects over the past four decades. Despite early observations on rapid steroid effects being clearly incompatible with this theory, only recently has nongenomic steroid action been more widely recognized and led to a critical reappraisal of unsolved questions about this dogma. Evidence for nongenomic steroid effects is now coming from all fields of steroid research, and mechanisms of agonist action are being studied with regard to the membrane receptors and second messengers involved. A prominent example of a receptor/effector cascade for nongenomic steroid effects has been described for rapid aldosterone effects in various cell types, including lymphocytes and vascular smooth muscle cells. Rapid in vitro effects of aldosterone on the sodium proton antiport have been found in human lymphocytes, cultured vascular smooth muscle, and endothelial cells involving nonclassical membrane receptors with a high affinity for aldosterone, but not for cortisol, and phosphoinositide turnover. Another important second messenger, [Ca2+]i, is consistently increased by aldosterone within 1–2 min. In vascular smooth muscle cells, calcium is released from perinuclear stores while in endothelial cells a predominant increase of subplasmalemmal calcium is seen. Effects are half-maximal at physiological concentrations of free aldosterone (0.1 nM), while cortisol is inactive up to 0.1 μM; the classical mineralocorticoid antagonist canrenone is ineffective in blocking the action of aldosterone. The data show that intracellular signaling for nongenomic aldosterone effects also involves calcium, but pathways of cell activation may vary between different cell types. Further evidence for nongenomic steroid effects is encountered presently for various groups of steroids such as neurosteroids, mineralocorticoids, vitamin D3, and sex hormones. Future research will have to target the cloning of the first membrane receptor for steroids and evaluate the clinical relevance of these rapid steroid effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00202262
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  • 6
    Electronic Resource
    Electronic Resource
    Pharmacotherapy for hypertonia in pregnancy (1999)
    Springer
    Der Gynäkologe 32 (1999), S. 443-449 
    Details
    ISSN: 1433-0393
    Keywords: Key words Pregnancy • Hypertonia • Antihypertension therapy ; Schlüsselwörter Schwangerschaft • Hypertonie • ; Antihypertensive Therapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Für die Therapie des arteriellen Bluthochdruckes ist eine Unterscheidung in chronische Hypertonie, Gestationshypertonie und Präeklampsie wesentlich. Die Prognose für Mutter und Kind ist gut, sofern es sich um eine chronische oder Gestationshypertonie handelt. Während die Gestationshypertonie meist ohne medikamentöse Therapie auskommt, müssen bei der chronischen Hypertonie nur die schweren Formen behandelt werden. Die Pharmakotherapie mit Antihypertensiva besonders im Hinblick auf die chronische Hypertonie erlaubt es der Frau, die Schwangerschaft auszutragen. Die Präeklampsie stellt eine potentielle Gefahr für Mutter und Feten dar, die sich nur unbefriedigend mit Antihypertensiva beeinflussen läßt. Nur eine engmaschige medizinische Überwachung und eine frühzeitige Entbindung als einzige kausale Therapie stellen adäquate Maßnahmen dar. Als Antihypertensivum der Wahl für die Langzeittherapie gilt das alteingeführte Medikament Methyldopa, das hinsichtlich seines Nebenwirkungsprofil bei der Mutter gegenüber modernen Antihypertensiva im Nachteil ist; es bietet aber einen höheren Schutz für den Feten. Bei Unverträglichkeit und Ineffektivität von Methyldopa kann auf den β-Blocker Metoprolol ausgewichen werden. Für die Akutsituation ist besonders Dihydralazin geeignet. Als Mittel der 2. Wahl gilt Clonidin.
    Notes: Summary The distinction between chronic hypertension, gestational hypertension, and preeclampsia is essential for the choice of the adequate pharmacotherapy. In chronic and gestional hypertension there is a positive prognosis for mother and child. Mostly, there is no need for pharmacotherapy in gestational hypertension and in chronic hypertension pharmacotherapy is only necessary in serious cases. Particularly in chronic hypertension the application of antihypertension drugs allows the woman to carry the child to full term. In contrast, preeclampsia represents potential danger for mother and fetus. In this case pharmacotherapy rarely shows satisfactory results. Only frequent clinical control and a premature delivery are considered adequate measures. Methyldopa is a well known antihypertensive drug for long-term therapy. Concerning adverse events in the mother modern antihypertensive drugs have disadvantages in relation to but there are advantages in terms of protection for the fetus. Of methyldopa ineffective is or cannot be tolerated of the β-blocker metoprolol can be alternatively applied. In case of emergency dihydralazine or – as as second choice – clonidine is appropiate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00003252
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  • 7
    Electronic Resource
    Electronic Resource
    β-Blocker Stellenwert bei kardiovaskulären Erkrankungen (1999)
    Springer
    Der Internist 40 (1999), S. 680-685 
    Details
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Substanzklasse der β-Blocker hat eine besondere Bedeutung in der Pharmakotherapie von kardiovaskulären Erkrankung wie der arteriellen Hypertonie, der koronaren Herzerkrankung, Herzrhythmusstörungen oder der Herzinsuffizienz gewonnen. Die Erkenntnis, daß die Effekte der Katecholamine durch die Aktivierung verschiedener α- und β-Rezeptoren vermittelt sind, setzte die Entwicklung zahlreicher β-Rezeptor-blockierender Substanzen in Gang, die bis heute anhält. Ziel des folgenden Artikels ist es, die Einsatzmöglichkeiten der Substanzklasse der β-Blocker besonders unter dem Aspekt kardiovaskulärer Erkrankungen darzustellen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050389
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  • 8
    Electronic Resource
    Electronic Resource
    Wichtige Unterschiede im Metabolismus von CSE-Hemmern (1999)
    Springer
    Der Internist 40 (1999), S. 235-236 
    Details
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Diese Unterschiede im Metabolismus der CSE-Hemmer darzustellen, ist die Aufgabe des vorliegenden Beitrags.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050328
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  • 9
    Electronic Resource
    Electronic Resource
    Assuming the worst may not be bad at all Carvedilol in heart failure treatment (1998)
    Springer
    European journal of clinical pharmacology 54 (1998), S. 281-285 
    Details
    ISSN: 1432-1041
    Keywords: Key words Chronic heart failure ; Mortality ; Carvedilol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: Carvedilol, a β-adrenoceptor blocking agent with additional α1-adrenoceptor blocking properties, has been shown to improve left ventricular function in chronic heart failure (CHF). However, its effect on mortality has recently been the subject of controversial discussion. The aim of this meta-analysis is to review the data on mortality from two large study programs (the US Carvedilol Heart Failure Study and the study by the Australia/New Zealand Heart Failure Research Collaborative Group) on additional carvedilol treatment in CHF standard therapy and to analyse the design and limitations of the individual studies. Methods and Results: For determination of overall, mortality, all patients who died and all patients who were withdrawn for other reasons during the open run-in phase of the studies were assigned to the carvedilol group to create a “worst-case analysis.” Meta-analysis of mortality data using the random effects model shows a significantly reduced relative risk of 0.55 × 95%-confidence interval 0.325–0.924; p 〈 0.05 of death in patients treated with carvedilol compared with patient on standard treatment only. Conclusion: Treatment of CHF using carvedilol significantly reduces mortality in patients with CHF, even if the “worst case” is assumed by assigning all deaths in the open run-in phase to carvedilol.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002280050460
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  • 10
    Electronic Resource
    Electronic Resource
    Der Einsatz von Thrombozytenaggregationshemmern in der Kardiologie (1997)
    Springer
    Der Internist 38 (1997), S. 1242-1246 
    Details
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050135
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