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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Acta neuropathologica 69 (1986), S. 153-160 
    ISSN: 1432-0533
    Keywords: DNA ; Ependymomas ; Flow fluorescence ; Cytometry ; Tissue culture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The distribution of DNA is estimated from flow cytometric histograms in surgical specimens of ten ependymomas of different location and varying anaplasia. In three cerebral tumours grade I–II, including one ependymoma of the 4th ventricle, only limited elevation of the 4 C maxima was a prominent feature, corresponding to the microscopical frequency of typical mitoses. Four grade-III ependymomas showed aneuploid or polyploid histograms with stem lines. One frontal tumour was classified as “transitional” because of more numerous mitoses and abnormally elevated S and G2+M phases, which increased in tissue culture. A correlation between the degree of anaplasia with the DNA pattern was difficult to pursue in two spinal ependymomas obviously lacking microscopical mitoses: Both — one a so-called tanycytic variant of grade I–II, and the other probably a metastasis from a cerebellar tumour — had a clear polyploid DNA histogram with a strikingly increased proliferation index, similar to the more malignant tumours of grade III. Also flow DNA measurements probably allow the decoding of heterogenous mixtures of tumour cells which are not always benign in ependymomas of lower grades of anaplasia microscopically.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Bezafibrate ; Rhabdomyolysis ; Myoglobinuria ; Kidney failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A muscular syndrome has been described in patients on clofibrate and fenofibrate therapy. The present paper describes four patients with impaired renal function in whom symptoms and signs of skeletal muscle damage developed during treatment with another clofibrinic acid derivative, bezafibrate. The syndrome was characterized by variable degrees of muscular cramps and paresis, excessive elevation of muscle enzymes in serum, myoglobinemia and myoglobinuria. Transient deterioration of renal function was also common. All patients had been overdosed with bezafibrate with regard to their renal function. It is concluded that bezafibrate like other lipid lowering agents of the clofibrate type may induce muscle damage, at least if doses are not adjusted to renal function. Extreme caution is warranted when treating patients with renal impairment with bezafibrate and strict dose adjustment to kidney function is necessary to avoid muscle damage.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 67 (1989), S. 477-485 
    ISSN: 1432-1440
    Keywords: Enzymes ; HTK-solution ; Ischemia ; Kidney ; Organ Protection ; Urine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Following renal ischemia under protection, the perfusion of the tubular system increases concomitant to the rise of GFR. The transport into urine of enzymes entering the tubular lumen due to ischemic injury is dependent on tubular flow. Thus, we examined if in the early post-ischemic phase urinary enzyme determinations can contribute to the evaluation of a changing tubular washout. Canine kidneys were perfused with different protective solutions and subsequently rendered ischemic. From the beginning of reperfusion the endogenous creatinine clearance, the urine minute volume and the urinary LDH-concentration were determined. The urinary LDH-concentration allowed only a rough assessment of renal ischemic damage. The adjustment of the urinary LDH amounts to the GFR resulted in a better graduation according to the ischemic stress. With such a standardized LDH parameter the urinary LDH release was somewhat lower on the average when L-aspartate was added to the HTK solution in place of chloride. In conclusion, during the early postischemic recovery after renal protection the examination of the urinary enzyme release may be a useful diagnostic means for the assessment of the extent of the ischemic injury if an appropriate frame of reference is applied.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1434-0879
    Keywords: Euro-Collins-solution ; Glucose ; HTK-solution ; Intrarenal pH ; Lactate ; Renal ischemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Energy reserves (TAN) and anaerobic substrates (glucose, glycogen) are lower in renal than in myocardial tissue. Euro-Collins-solution contains nearly 200 mmol/l glucose, while the HTK-solution of Bretschneider contains none. Therefore the influence of glucose on kidney lactate production, on energy reserves (TAN), intrarenal pH and on morphology during the protection of ischemic kidneys was analysed using either Euro-Collins-solution, or modified “Euro-Collins-solution”, containing mannitol instead of glucose, or HTK-solution with and without the addition of 5, 10 and 20 mmol/l glucose. Glucose content changed during kidney perfusion with Euro-Collins-solution from about 60 to 800 μmol/gdw. While intrarenal pH decreased from 7.1 to 5.1 in Euro-Collins-kidneys during 420 min of ischemia at 25°C, pH decreased to 6.7 with the modified, mannitol containing “Euro-Collins-solution”. In HTK-protected kidneys intrarenal pH decreased with increasing glucose addition to the solution. Although Total Adenine Nucleotides are highest at the end of ischemia with Euro-Collins-solution, structural protection after the same ischemic stress was best in HTK-protected kidneys without glucose addition. We conclude that glucose stimulated lactate production, reduced interstitial pH in the kidney even in combination with a highly buffered solution and that it might cause greater membrane permeability leading to a structural detoriation. Mannitol seemed more appropriate than glucose in this respect, although other substances, which provide energy substrate and prevent structural damage, may exist.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1434-0879
    Keywords: Energy metabolism ; Euro-Collins-solution ; HTK-solution ; Kidney preservation ; Intrarenal pH ; Renal ischemia ; Structural preservation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 110 canine kidneys, we examined the time course of energy rich phosphates, lactate, intrarenal ph and renal morphology with Euro-Collins-or with HTK-protection of Bretschneider and compared these findings with unprotected kidneys during complete ischemia at 1 °C and at 25 °C. Both kidney protective solutions prolonged energyrich phosphate-decline by a factor of 3–4 compared with that of unprotected kidneys. The lactate increase was greater in Euro-Collins-protected kidneys than in HTK-protected and in unprotected kidneys, leading to pH values of 6.5 in Euro-Collins and to 6.4 in unprotected kidneys after 24 hours, in contrast to a pH-value of 7.3 with HTK-protection. This may be the reason for structural deterioration seen in unprotected and in Euro-Collins-protected kidneys after 12, and 48 h of ischemia at 1 °C, whereas in HTK-protected kidneys a sufficient preservation of structure can be seen. In one human kidney, protected with Euro-Collins-solution, we were able to show that at 1 °C intrarenal pH and lactate accumulation is similiar to the levels in canine kidneys. In Euro-Collins preserved kidneys lactate accumulation at 25 °C is even greater than at 1 °C, leading to inhibition of energy metabolism and to structural deterioration, whereas HTK-solution, because of its high buffer concentration, is able to maintain ischemic metabolism leading to sufficient protection of intrarenal pH and of adenine nucleotides as well as structural protection at 1 °C and at 25 °C.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1434-0879
    Keywords: HTK-solution ; Ischemia ; Kidney ; Metabolism ; Saccharides
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The addition of the dissaccharides maltose (10, 20, 30 mM) and sucrose (30, 60 mM) to Bretschneider's organ protective HTK solution was evaluated to improve renal protection by an enhanced glycolytic energy supply. Canine kidneys were perfused for 8 min with either HTK solution or HTK solution containing additional disaccharides. After nephrectomy the kidneys were incubated at 25°C and metabolic parameters were determined at regular intervals. Maltose and sucrose are slowly cleaved during renal ischemia but maltose distinctly faster than sucrose. Maltose increases intraischemic ATP supply. However, 30 mM maltose was no better than 10 mM. 60 mM sucrose was about as effective for glycolysis as 10 mM maltose. However, possibly due to fructose release there was an accelerated decrease of adenine nucleotides with sucrose. Although fructose enters glycolysis it seems to have negative side-effects. Hence, probably neither sucrose nor fructose are appropriate for renal substrate supply during ischemia.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1434-0879
    Keywords: Renal ischemia ; Renal protection and preservation ; Cardioplegic solution HTK
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The cardioplegic solution HTK of Bretschneider was used for canine kidney protection. The kidneys were perfused with this solution for 6–10 min prior to the induction of ischemia. The kidneys were left in-situ for 60, 90, 120 and 135 min ischemia time at a temperature of 25–34°C (n=13). As a control group we used unilateral nephrectomized dogs (n=9). After unilateral nephrectomy an elevated plasma creatinine in comparison to preoperative values was observed. After 60 and 90 min under HTK-protection the postoperative plasma creatinine was not elevated compared to the control group. After 120 min of ischemia creatinine level was slightly increased to an average of 2.1 mg% on the first and second postoperative day. These experiments indicate the protective effect of the cardioplegic solution for canine kidney preservation in situ.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1434-0879
    Keywords: Renal protection ; Perfusion catheter ; Perfusion pressure ; Equilibration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to improve dog kidney perfusion in situ with a protective solution, a perfusion catheter was constructed which allowed continuous pressure measurement in the center of the catheter tip during perfusion. Using this catheter, the equilibration of the extracellular space with a protective solution (HTK solution) was found to be pressure dependent. Continuous pressure and resistance control is therefore a prerequisite for reliable organ protection.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1434-0879
    Keywords: Kidney perfusion ; Equilibration ; HTK-solution ; Euro-Collins-solution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Kidneys were perfused either with Euro-Collinssolution or with HTK-solution of Bretschneider. The perfusion pressure as well as the perfusion flow were measured during a six-minute perfusion. The perfusion resistance was higher in Euro-Collins-kidneys than during HTK-perfusion. The venous outflow of the kidney as well as the ureteral outflow was measured during each minute of the perfusion and has analysed for osmolality, and for sodium and potassium concentrations. In Euro-Collins-kidneys a complete “equilibration” of the extracellular space was not achieved, while during HTK-perfusion concentrations in the venous as in the tubular outflow, similar to those in the HTK-solution itself, could be reached. At the end of the different perfusions, tissue was analysed for biochemical parameters such as ATP, ADP, AMP and lactate as well as for morphological features. Lactate had increased and ATP had decreased during perfusion with Euro-Collins-solution, while ATP had not changed and lactate had decreased during perfusion with HTK-solution. Normal glomerular, tubular and dilated vascular structures can be seen after HTK-perfusion, while a glomerular and vascular contraction takes place during Euro-Collins-perfusion.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1434-0879
    Keywords: HTK solution ; Kidney perfusion Electrolyte equilibration ; Kidney preservation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Twelve surgically removed human kidneys (mainly tumor kidneys) were investigated. The investigations comprised perfusion criteria (perfusion flow, perfusion pressure, perfusion resistance, electrolyte equilibration). During perfusion of the kidneys with HTK solution, the perfusion resistance was nearly three times as high in human kidneys as in canine kidneys perfused under the same conditions in previous studies. Beside possible species differences the raised perfusion resistance may be explained by the greater trauma to the human kidneys due to the surgery, the primary ischemic stress which cannot be avoided clinically and the often nonoptimal initial diuresis. Nevertheless definitive perfusion is possible under clinical conditions although pronounced increases of perfusion resistance may occur. As indicated by the raised perfusion resistance of human kidneys under clinical conditions as compared with canine kidneys in an experimental model, electrolyte equilibration of human kidneys was protracted. For this reason, a duration of perfusion of at least 10 min is necessary in clinical application of HTK solution, i.e., longer than in animal experiments.
    Type of Medium: Electronic Resource
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