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  • 1
    ISSN: 1432-1084
    Keywords: Kidney, transplantation ; Kidney, neoplasms ; Kidney, lymphoma ; Lymphoma ; Urinary bladder, lymphoma ; Drugs, toxicity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to study the clinical and radiological manifestations of post-transplantation malignant genito-urinary tumours in kidney recipients, we reviewed nine cases of genito-urinary neoplasms among 65 malignancies which developed in 61 of 620 kidney recipients. Ultrasound (US) and CT examinations were available in all the cases and MRI imaging in three. For each patient we reviewed the date of transplantation, immunosuppressive therapy, pathology and surgical reports and relevant radiographic studies. We determined tumour volume, the presence of necrosis and tumour extension. The malignant tumours included B-cell non-Hodgkin lymphomas of the native kidney (2) and urinary bladder (1), renal cell carcinoma (1), urotheliomas of the renal pelvis (1), ureter (1) and bladder (1), epidermoid carcinoma of the renal pelvis (1) and embryonal testicular carcinoma (1). Two of the three lymphomas developed in cyclosporine-treated recipients and regressed after reduction of the cyclosporine dose. The lymphomas presented as solid masses with necrosis visible on T2-weigthed MRI images. Other non-lymphomatous neoplasms were characterised by a large tumour volume and advanced local and regional extension. Five patients died within 2 years after diagnosis. It is concluded that the high incidence of malignancies (9.8 %), especially of the genito-urinary tract (1.4 %), and their advanced stage warrant radiographic follow-up studies.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 34 (1988), S. 601-604 
    ISSN: 1432-1041
    Keywords: cyclosporin A ; uveitis ; renal function ; creatinine clearance ; hypertension ; corticosteroids ; side-effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Renal function has been evaluated in 21 patients treated with cyclosporin A (CyA) for 9 months for idiopathic uveitis. Serum creatinine, which was 82 µmol·l−1 before treatment, was significantly elevated after 1 month (111 µmol·l−1). After 9 months of treatment, and despite a decrease in CyA dosage, the mean plasma creatinine remained elevated at 132 µmol·l−1. Hypertension developed in 6 patients, five of them being concomitantly treated with corticosteroids. In 8 patients serum creatinine 3 months after CyA had been stopped had decreased from 148 to 93 µmol·l−1. Two of those patients remained hypertensive 3 months after CyA treatment had ceased. In patients with idiopathic uveitis CyA induces a reversible increase in serum creatinine. However the reversibility of such a biochemical marker does not preclude a histopathological lesion. Chronic renal damage may be responsible for the persistance of hypertension after cessation of CyA treatment
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1041
    Keywords: atrial natriuretic peptide ; heart transplantations ; ANP release ; plasma ANP concentration ; Jarvic-7 artificial heart
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Plasma atrial natriuretic peptide (ANP) concentrations were measured by radioimmunoassay 1 to 12 days after operation in six patients with artificial hearts. The mean levels were significantly higher in artificial heart recipients (58.2 pg · ml−1) than in controls (12.6 pg · ml−1). The mechanism underlying the raised values is not clear, although it is suggested that elevated atrial pressure may have been the stimulus for higher ANP release. In 3 patients plasma ANP concentrations were also measured 1 to 5 days after orthotopic transplantation. In all of them ANP concentrations had increased by 20 to 74% despite lower right atrial pressure. An increase in atrial tissue mass may have contributed to the raised plasma ANP after orthotopic transplantation. It also suggests that the functioning sympathetic nervous system is not a necessary condition for ANP release.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1041
    Keywords: atrial natriuretic factor (ANF) ; acromegaly ; volume expansion ; plasma levels ; extracellular fluid volume ; saline load
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary In acromegaly the plasma volume is chronically elevated and it returns to normal when the disease is successfully treated. To define the role of ANF in such a chronic disorder of extracellular fluid volume homeostasis the plasma level was assayed in 37 acromegalic patients with active or inactive (successfully treated) disease. Five patients were studied before and after therapy. The effects of acute change in sodium-fluid status on plasma ANF levels was examined in 7 active and 4 inactive acromegalic patients and in 7 healthy subjects. As compared to 14 patients with inactive acromegaly, 23 patients with active acromegaly had an expanded plasma volume (n=12; 50.1 vs 37.6 ml · kg−1 BW) and an increased blood concentration of growth hormone (n=23; 22.5 vs 2.1 ng · ml−1). Plasma ANF concentrations in active and inactive acromegalic patients (33.2 and 26.6 pg · ml−1, respectively) did not differ significantly from one another or from the level in the controls (26.9 pg · ml−1). In those patients there was no correlation between plasma volume and ANF level. Infusion of 21 isotonic saline in 2 h led to a similar, significant increase in ANF levels in active (from 26.2 to 72.4 pg · ml−1) and in inactive acromegalic patients (from 33.6 to 96.7 pg · ml−1) as well as in healthy subjects (from 21 to 70.6 pg · ml−1). Successful treatment reduced the plasma volume (from 49.2 to 35.8 ml · kg−1 BW) and growth hormone level (from 10.1 to 2.6 pg · ml−1), while the ANF level remained unchanged (from 33.8 to 35.5 pg · ml−1). In the patients with active or inactive acromegaly and cardiac failure the plasma ANF level was markedly increased (89.9 and 66.1 pg · ml−1, respectively) as compared to all the other groups. It is concluded that ANF levels are not elevated in chronically volume expanded acromegalic patients. In the present patients ANF was released in response to acute volume expansion, therefore it may be important in the cardiovascular and renal response to acute changes in extracellular fluid volume.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1041
    Keywords: β-Adrenoceptor-blockade ; α1-Adrenoceptor blockade ; Atrial natriuretic peptide ; exercise ; atrial distension ; plasma catecholamines ; prazosin ; tertatolol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The role of atrial distension and/or adrenergic mechanisms in the regulation of atrial natriuretic peptide (ANP) secretion, plasma immunoreactive ANP, norepinephrine (NE), epinephrine (E) and left atrial diameter at rest, during and after graded bicycle exercise has been studies in 8 healthy male subjects after single doses of placebo, tertatolol 5 mg (a non-selective β-adrenoceptor blocker), prazosin 1 mg (an α1-adrenoceptor antagonist) and their combination. Systolic and diastolic left atrial diameters were measured before, during and just after exercise by bidimensional echocardiography. Exercise caused an increase in plasma ANP, which was greater after tertatolol alone, and tertatolol plus prazosin, than after placebo or prazosin alone; the mean area under the plasma ANP concentration curve was increased by 35% after tertatolol alone, by 45% after tertatolol and prazosin compared to placebo, and by 82% and 94%, respectively when compared to prazosin alone. The rise in plasma ANP was more marked during the post-exercise period: 80% after tertatolol alone, 67% after tertatolol and prazosin compared to placebo, and 133% and 115%, respectively, compared to prazosin alone. The rise in plasma ANP was accompanied by an increase in both the systolic and diastolic atrial diameter, which was also significantly greater after tertatolol alone and the combination than placebo, or after prazosin alone. β-Adrenoceptor blockade alone did not affect the plasma catecholamine concentrations, but the exercise-induced increase in plasma norepinephrine was significantly potentiated by prazosin and by prazosin plus tertatolol, and that of plasma epinephrine by the drug combination. We conclude that potentiation of the exercise-induced increase in plasma ANP by β-blockers may be due to atrial stretching consequent on the decreased myocardial contractility and relaxation, and not to alpha-1 adrenoceptor stimulation. Any increase in plasma catecholamines did not play an important role in ANP secretion.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 30 (1986), S. 499-501 
    ISSN: 1432-1041
    Keywords: clometacin ; prostaglandin ; renal excretion ; plasma renin activity ; pharmacokinetics ; non steroidal antiinflammatory agents ; cyclooxygenase inhibitor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary In 6 healthy subjects the effect of clometacin on renal function, sodium and water excretion, plasma renin activity and urinary excretion of prostaglandins has been studied. After four days of treatment with clometacin, the excretion of urinary prostaglandins E2, F2 α and 6 keto F1 α and thromboxane B2 were reduced by 61.2, 41.2, 59 and 42%, respectively. 62% reduction in plasma renin activity was also observed. There was no significant change in mean blood pressure, heart rate, body weight, creatinine clearance or urinary excretion of sodium. It is concluded that clometacin is an efficient cyclooxygenase inhibitor in healthy individuals with a normal sodium intake, and that caution is required when giving clometacin to patients at risk of developing renal failure during treatment with a cyclooxygenase inhibitor.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 37 (1989), S. 337-340 
    ISSN: 1432-1041
    Keywords: diltiazem ; methotrexate ; calcium antagonists ; nephrotoxicity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary We have tested the effects of calcium channel blockade with diltiazem on methotrexate-induced nephrotoxicity in patients with biopsy-proven malignant disease. The patients were randomized in a cross-over fashion to receive MTX (4 g · m−2 body surface area) with or without Diltiazem (360 mg per day orally) during two consecutive periods separated by a 3-week interval. Methotrexate caused reversible acute renal failure, with an increase in serum creatinine from 89 (7)µmol·1−1 on day 0 to 150 (6)µmol.·1−1 on Day 6. The patterns of β2-microglobulin and N-acetyl glucosaminidase urinary excretion were similar, with a sharp increase from Day 0 to Day 3. Urinary β2-microglobulin excretion increased from 161 (57) µg·1−1 on Day 0 to 1160 (840) µg·l−1 on Day 3 and fell to 918 (530) µg·l−1 on Day 10. Urinary Nacetyl glucosaminidase excretion increased from 250 (100) mmol·h−1 per mg of creatinine on Day 0 up to 655 (261) on Day 3 and fell to 285 (82) on Day 10. The evolution of renal function was not influenced by diltiazem. In patients receiving diltiazem, serum creatinine increased from 93 (0) µmol·l−1 on Day 0 to 151 (68) µmol·l−1 on Day 6 (p = NS when compared with control values). Urinary enzyme excretion also markedly increased from Day 0 to Day 3 to the same extent as in the group not receiving diltiazem. Our data indicate that acute deterioration in renal function caused by methotrexate is accompanied by tubular damage. Diltiazem was ineffective in preventing the acute renal failure induced by methotrexate. An inadequate dosage of diltiazem or multifactorial toxic effects of methotrexate may account for this negative result.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1041
    Keywords: Atrial natriuretic peptide ; Cardiac transplant recipients ; Intra cardiac pressures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Blood pressures and plasma atrial natriuretic peptide (ANP) concentrations have been measured in venous and intracardiac sites in 11 patients (10 men and 1 woman) given cardiac transplants. The mean plasma ANP level was 214.4 pg·ml−1 in the superior veina cava and 281 pg·ml−1 in the right atrium. This significantly higher level was maintained in the right ventricle (269) and in the pulmonary artery (295). The level in controls was 25 pg·ml−1. Intra cardiac and mean arterial pressures were in normal range in all patients, and there was no correlation between plasma ANP level and intracardiac pressure. The data suggest that in cardiac transplant patients right atrial pressure does not have a primary role in releasing ANP. The transplanted heart is denervated and remains so for many months after operation, thus suggesting that innervation is not obligatory for ANP secretion. Further studies are required to determine the relative contribution of donor and recipient atrial tissues to ANP secretion.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1041
    Keywords: Cicletanine ; (ANP) atrial natriuretic peptide ; plasma cyclic GMP ; antidiuretic hormone ; exercise
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The effect of 50 and 150 mg cicletanine, a new vasodilator antihypertensive, on plasma atrial natriuretic peptide (ANP), cyclic GMP and antidiuretic hormone has been investigated at rest and during standardized exercise, in a double blind cross over study in healthy subjects. Exercise significantly increased the plasma ANP, cyclic GMP and antidiuretic hormone concentrations, and cicletanine did not affect any of them either at rest or during exercise. Since the alpha-1 adrenoceptor blocker prazosine decreases, beta-adrenoceptor blockers increase and the vasodilator cicletanine does not alter the plasma ANP response to exercise, it is suggested that adrenergic receptors may be directly involved in the regulation of ANP secretion.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1041
    Keywords: atrial natriuretic peptide ; tertatolol ; atenolol ; beta-adrenoceptor blockade ; physical exercise ; aldosterone ; ADH ; cGMP ; PRA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The effect of a non selective and a cardio-selective beta-blocker on basal and exercise-stimulated plasma atrial natriuretic peptide concentrations in healthy volunteers has been studied. Nine healthy volunteers received single oral doses of 5 mg tertatolol, 100 mg atenolol or placebo, at one week intervals, in a double blind cross over trial. At rest plasma atrial natriuretic peptide, aldosterone, antidiuretic hormone and cyclic GMP concentrations and plasma renin activity were not modified by the treatments. During exercise plasma atrial natriuretic peptide concentrations were significantly increased by each treatment, the increment being significantly greater on beta-blockers than on placebo. The rise in atrial natriuretic peptide was 72% after placebo (from 24 to 42 pg/ml), 184% after atenolol (from 30 to 86 pg/ml), and 183% after tertatolol (from 34 to 95 pg/ml), respectively. Thus, the study has shown that in healthy subjects the plasma natriuretic peptide concentration is increased by exercise and that the increase is considerably and equally potentiated by selective and non selective beta-adrenoceptor blockade. The effect may be mainly due to a reduction in ventricular contractility with an increase in atrial pressure. The beta-blockers did not influence the resting plasma atrial natriuretic peptide levels, which suggests that in healthy subjects basal atrial natriuretic peptide secretion is not controlled via beta-receptors.
    Type of Medium: Electronic Resource
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