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  • 1
    Electronic Resource
    Electronic Resource
    Haemolysis due to formaldehyde-induced anti-N-like antibodies in haemodialysis patients (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 673-679 
    Details
    ISSN: 1432-1440
    Keywords: Formaldehyd ; Anti-N-artige Antikörper ; Immunhämolyse ; Hämodialyse ; renale Anämie ; Formaldehyde ; Anti-N-like antibodies ; Immunohaemolysis ; Haemodialysis ; Renal anaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary During reuse of formaldehyde sterilized Kiil-dialysers, red cell survival, measured by means of51Cr t/2, was significantly reduced (p〈0.001) in 16 patients with anti-N-like positive sera, when compared with 19 antibody negative control patients (Mean±SD: 16.5±2.7 versus 22.4±3.1 days.) In antibody negative patients (n=10) replacement of form-aldehyde sterilized dialysers by ethylene-oxide sterilized disposable dialysers resulted in a significant increase (p〈0.002) of51Cr t/2 (Mean±SD, days: Kiil-dialyser 16.3±1.9; disposable dialyser 20.3±3.5). This improvement took place, although antibody titres persisted during the51Cr-measurements and declined thereafter only slowly. In antibody negative patients (n=6) red cell survival did not increase, when formaldehyde as a sterilant was avoided. In antibody positive patients mean haematocrit rose significantly (p〈0.05), whereas in none of the antibody negative patients a definite change of haematocrit occurred. The data demonstrate, that formaldehyde sterilisation of dialysers may cause antibody-mediated haemolysis contributing to the extent of renal anaemia. This immunohaemolysis may be corrected, in spite of continuing antibody persistance, when formaldehyde exposure is totally avoided, or possibly when minimized.
    Notes: Zusammenfassung Während der Wiederverwendung Formaldehyd-sterilisierter Kiil-Dialysatoren war die mit51Cr bestimmte Erythrocytenüberlebenszeit bei 16 Patienten mit Anti-N-artigen Antikörpern significant (p〈0,001) kürzer als bei 19 Antikörper-negativen Kontrollpatienten (MW±SD: 16,5±2,7 bzw. 22,4±3,1 Tage). Bei Antikörper-positiven Patienten (n=10) führte das Umsetzen von Formaldehyd-sterilisierten Kiil-Dialysatoren auf Ethylenoxid-sterilisierte Einmaldialysatoren vergleichbarer Effektivität zu einem sofortigen, signifikanten (p〈0,002) Anstieg der Erythrocytenüberlebenszeit (MW±SD: 16,3±1,9 Tage, Kiil-Dialysator; 20,3±3,5 Tage Einmaldialysator). Die Antikörper-Titer blieben während der Messung der Erythrocytenüberlebenszeit unverändert, danach fielen sie im Verlauf von Monaten langsam ab. Bei Antikörper-negativen Kontrollpatienten (n=6) führte das Umsetzen von Formaldehyd-sterilisierten Kiil-Dialysatoren auf die Ethylenoxid-sterilisierten Einmaldialysatoren nicht zum Anstieg der Erythrocytenüberlebenszeit. Bei den Antikörper-positiven Patienten stieg der mittlere Hämatokritwert nach dem Umsetzen signifikant (p〈0,05) an, dagegen kam es nach dem Umsetzen bei keinem der Antikörper-negativen Patienten zu einer gerichteten Veränderung der Hämatokritwerte. Die Untersuchungen belegen, daß die Formaldehyd-Sterilisation von Dialysatoren zu einer Antikörper-vermittelten Hämolyse führen kann, die zum Ausmaß der renalen Anämie dieser Patienten beiträgt. Diese Immunhämolyse kann, auch bei Persistenz der Anti-N-artigen Antikörper, zumindest teilweise verhindert werden, wenn eine weitere Formaldehyd-Exposition des Patienten vermieden wird.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01477668
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  • 2
    Electronic Resource
    Electronic Resource
    HLA-DR-MT matching improves graft survival rate in cadaver kidney transplantation (1983)
    Springer
    Journal of molecular medicine 61 (1983), S. 17-23 
    Details
    ISSN: 1432-1440
    Keywords: MHC ; Cadaver kidney transplantation ; Graft survival rate ; Blood transfusions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The influence of prospective HLA-DR matching on the graft survival rate was investigated in a multicenter analysis of 85 transplants. Simultaneously in a retrospective analysis of graft outcome the importance of matching for MT-antigens MT1, MT2 and MT3 as a newly defined B-cell alloantigen system was evaluated. HLA-DR antigens and MT-specificities were determined on B-cells enriched by nylon-wool filtration using locally well characterised HLA-DR antisera and the antiserum set of the 8th International Histocompatibility Workshop (“discase set”) which allowed the definition of the HLA-DR specificities HLA-DR 1–9 and of the MT-antigens MT 1–3. HLA-DR matching showed a significantly improved graft outcome only in HLA-DR identical donor-recipient combinations. In 11 of 60 patients with one HLA-DR compatibility additional matching for two MT-antigens, however, improved the two year graft survival rate from 60% to 91%. Altogether 17 patients were matched for two MT-specificities with their kidney donor and showed a superior prognosis of 94% at two years compared to 53% or 17% of recipients with one or zero MT compatibility. Graft outcome in this patient group was also superior to that of HLA-DR identical or HLA-AB identical grafts. These data suggested that the MT-system rather than the HLA-DR antigens may be of critical importance in cadaver kidney transplantation. In addition a favorable influence of pretransplant blood transfusions on less HLA-DR matched grafts was confirmed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01484435
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  • 3
    Electronic Resource
    Electronic Resource
    Impaired renal responsiveness to human atrial natriuretic peptide (hANP) in normotensive patients with type 1 diabetes mellitus (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 527-532 
    Details
    ISSN: 1432-1440
    Keywords: Diabetes mellitus ; Hypertension ; Sodium homeostasis ; Human atrial natriuretic peptide ; Kidney function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Potential impairment of the efficacy of human atrial natiuretic peptide (human ANF-(99-126), hANP), the most potent endogenous natriuretic agent in healthy subjects, was examined in eight male normotensive patients with uncomplicated type 1 diabetes mellitus (aged 22–37 years). After giving informed consent, patients and eight male control subjects (aged 22–28 years) received in a random double-blind study design i.v. bolus injections of 100 µg hANP (Bissendorf peptide) or placebo. At base-line, patients differed from controls in elevated creatinine clearance (P〈0.05) and in mild postprandial hyperglycemia. Whereas the responses of urinary cyclic guanosine monophosphate, the second messenger of hANP, were found to be normal in patients, the diuretic and natriuretic effects of hANP were grossly impaired when compared to controls (P〈0.01); hANP resulted in increased plasma protein concentrations only in controls (P〈0.05 vs patients). In both groups, creatinine clearance remained uninfluenced by hANP. There were similar decreases in plasma renin activity, aldosterone, levels, and blood pressure (systolic more than diastolic) in both groups (P〈0.05 vs placebo). Heart rate and blood glucose remained unchanged. Thus, there is evidence for a decreased responsiveness to hANP exclusively of renal fluid, sodium, and chloride excretion in uncomplicated type 1 diabetes mellitus. The mechanisms responsible for this phenomenon remain obscure, neither a down regulation at the hANP receptor sites nor an hANP-induced shift from intra- to extravascular fluid volume are likely to be involved in its probably diabetes-specific pathogenesis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01736521
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  • 4
    Electronic Resource
    Electronic Resource
    Autonome Kreislaufregulation in der Urämie (1980)
    Springer
    Journal of molecular medicine 58 (1980), S. 1037-1042 
    Details
    ISSN: 1432-1440
    Keywords: Uremic autonomic neuropathy ; Baroreflex ; Efferent sympathetic limb ; Circulatory regulation ; Urämische autonome Neuropathie ; Baroreflex ; Sympathicus ; Kreislaufregulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die urämische autonome Neuropathie führt zu Störungen der Funktion des Baroreflexes. Aus der Literatur geht hervor, daß die wesentlichen Defekte den afferenten Reflexbogen sowie den efferenten cardialen Vagus betreffen, während die sympathische Funktion des efferenten Schenkels intakt bleibt. Eigene Befunde, an chronischen Hämodialysepatienten während Orthostase und Volumenentzug erhoben, belegen ebenfalls eine qualitativ und quantitativ adäquate Antwort des efferenten Sympathicus sowie eine erhaltene Ansprechbarkeit der Rezeptoren des Endorgans. Die autonome Neuropathie disponiert zur symptomatischen Hypotension bei Volumenentzug während der Dialysebehandlung. Zusätzlich führt die Hämodialysebehandlung selbst zu einer noch ungeklärten Hemmung der sympathischen Reaktion auf Volumenentzug. Die autonome Neuropathie disponiert bei Volumenbelastung zur arteriellen Hypertonie.
    Notes: Summary Uremic autonomic neuropathy leads to impaired function of the baroreflex. The main defect, according to literature, is located in the afferent limb of the reflex arc and in the efferent cardiac vagus nerve, whereas the sympathetic part of the efferent arc is still intact. Own results, obtained in hemodialysis patients during orthostasis and volume removal induced sympathetic stimulation, showed a qualitatively and quantitatively adequate sympathetic response and also an adequate end organ receptor response. Autonomic nervous neuropathy predisposes to volume removal related symptomatic hypotension during hemodialysis treatment. In addition hemodialysis treatment per se induces a so far unexplained interference with sympathetic response to volume removal. The autonomic neuropathy also predisposes to development of hypertension in response to volume load.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01476874
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  • 5
    Electronic Resource
    Electronic Resource
    Osteocalcin serum levels in patients following renal transplantation (1989)
    Springer
    Journal of molecular medicine 67 (1989), S. 297-303 
    Details
    ISSN: 1432-1440
    Keywords: Osteocalcin ; Renal transplantation ; Secondary hyperparathyroidism ; Steroid induced bone disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Osteocalcin serum levels reflect bone turnover. In renal insufficiency secondary hyperparathyroidism and reduced renal clearance might be responsible for elevated serum levels of osteocalcin. Renal transplantation might improve renal osteodystrophy and therefore could influence osteocalcin serum levels. We determined the influence of renal transplantation on osteocalcin levels in 37 consecutive patients (25m/12f) by RIA. Blood samples were collected prior to, 3 days, 28 days, 6 months and 12 months after renal transplantation. Prior to renal transplantation osteocalcin levels were significantly elevated (x±s: 23.4±12.8 ng/ml) compared to healthy volunteers (4.1±1.4 ng/ml). Following renal transplantation osteocalcin decreased significantly (9.4±8.9 ng/ml) 3 days and (7.1±7.8 ng/ml) 28 days. However, 6 and 12 months following renal transplantation the mean osteocalcin level increased again (8.3±5.7 ng/ml, 12.1±15.4 ng/ml). At 6 months 11 and at 12 months only 6 of 37 patients had osteocalcin levels in the normal range. 12 months following renal transplantation 21 out of 37 patients with elevated osteocalcin levels had parathyroid hormone levels above the normal range. Additionally to increased osteocalcin levels patients prior to renal transplantation had elevated alkaline phosphatase. Alkaline phosphatase had following renal transplantation a similar pattern as osteocalcin with initial decrease and secondary increase 6 and 12 months after renal transplantation. Parathyroid hormone was elevated in all patients before renal transplantation. Following renal transplantation mean parathyroid hormone levels fell significantly, however remained above normal range in 57% of these 37 patients. Osteocalcin serum levels correlated positively with alkaline phosphatase (rs=0.43−0.62;p〈0.011) and parathyroid hormone (0.3−0.66p〈0.07). This correlation of osteocalcin with alkaline phosphatase and parathyroid hormone prior to and after renal transplantation suggests that osteocalcin may be a confirmative parameter in renal osteodystrophy in patients on chronic intermittent hemodialysis and following renal transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01892898
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  • 6
    Electronic Resource
    Electronic Resource
    Aldosterone and prolactin responsiveness after prolonged treatment of congestive heart failure with captopril (1985)
    Springer
    European journal of clinical pharmacology 28 (1985), S. 1-4 
    Details
    ISSN: 1432-1041
    Keywords: captopril ; congestive heart failure ; plasma aldosterone ; plasma prolactin ; metoclopramide ; dexamethasone suppression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary After long-term captopril treatment, an inappropriate increase in aldosterone levels has been observed in hypertensive patients. It is not known, whether a similar change would occur in patients with severe congestive heart failure, and whether it is due to a decrease in endogenous dopaminergic inhibition of aldosterone secretion or to aldosterone stimulation by ACTH or an ACTH-related peptide. Therefore, the aldosterone and prolactin responses to metoclopramide have been studied in 10 patients with severe congestive heart failure (NYHA Class III or IV) after 6 months of captopril treatment, before and 11 h after pretreatment with dexamethasone. 7 placebo-treated patients served as double-blind controls. In captopril-treated patients, the supine aldosterone levels exceeded the normal range and were as high as in placebo-treated patients. The responsiveness of aldosterone and prolactin to metoclopramide was not influenced by captopril. Only in the placebo group were the aldosterone levels decreased by dexamethasone. Captopril increased plasma renin activity and serum potassium, and decreased supine epinephrine and norepinephrine and serum sodium. Thus, previous reports of inappropriately high aldosterone levels after long-term captopril treatment were confirmed in patients with severe congestive heart failure. It is concluded that increased aldosterone is due neither to a decrease in endogenous dopaminergic inhibition nor to dexamethasone-suppressible stimulation of aldosterone secretion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00635699
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  • 7
    Electronic Resource
    Electronic Resource
    Effect of human atrial natriuretic peptide on blood glucose concentrations and hormone stimulation during insulin-induced hypoglycaemia in healthy man (1989)
    Springer
    European journal of clinical pharmacology 36 (1989), S. 593-597 
    Details
    ISSN: 1432-1041
    Keywords: atrial natriuretic peptide (hANP) ; hypoglycaemia ; metabolic stress ; plasma renin activity ; cortisol ; aldosterone ; catecholamines ; pituitary function ; growth hormone ; ACTH ; adrenaline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary A double-blind placebo-controlled study using the double-dummy technique has been done to examine whether the responses of pituitary and adrenal hormones to insulin-induced hypoglycaemia were impaired by a pharmacological dose of human atrial natriuretic peptide (human ANF-(99-126), hANP). After an overnight fast eight male healthy volunteers (aged 23–40 years) received in random order i.v. bolus injections of insulin 0.125 U·kg−1 + placebo, hANP 100 µg + placebo, insulin + hANP, or both placebo preparations. In the insulin-only experiment, human growth hormone, adrenocorticotrophic hormone, cortisol, aldosterone, plasma renin activity, adrenaline, and noradrenaline were all stimulated by hypoglycaemia. In the hANP-only experiment there were no hormonal changes other than decreases in plasma renin activity and aldosterone concentration. In the insulin + hANP experiment the nadir of blood glucose was decreased to 1.3 from the 2.0 mmol·1−1 found in the insulin-only experiment. The exaggerated hypoglycaemia resulted in increased stimulation of human growth hormone, adrenocorticotrophic hormone and adrenaline when compared to the insulin-only experiment. The rise in the cortisol and aldosterone concentrations was only slightly increased, and the stimulation of plasma renin activity was blunted. Unexpectedly, hANP was found to enhance the hypoglycaemic action of insulin, most probably by inhibiting insulin degradation within the liver. There was no evidence of an inhibitory effect of hANP on the stimulation of pituitary or adrenal hormones during insulin-induced hypoglycaemia. The reduction in renin may indicate an inhibitory action of hANP on catecholaminergic effects within the kidney.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00637742
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  • 8
    Electronic Resource
    Electronic Resource
    Development of a radioimmunoassay for a high molecular mass tubular antigen in urine - Its application for early detection of tubular damage
    Amsterdam : Elsevier
    Clinica Chimica Acta 110 (1981), S. 91-104 
    Details
    ISSN: 0009-8981
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0009-8981(81)90305-3
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  • 9
    Electronic Resource
    Electronic Resource
    Qualitätssicherung durch Fortbildung (2000)
    Springer
    Der Internist 41 (2000), S. M047 
    Details
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Tagungen der Hessischen Internisten sind inzwischen zu einer Institution geworden. Sie heben sich in vielfacher Weise von anderen Fortbildungsveranstaltungen ab, besonders durch die hohe Qualifikation der Referenten, aber auch durch das besondere Ambiente. Mehr als 2.500 Teilnehmer aus allen Teilen der Bundesrepublik, die die letztjährige Tagung Hessischer Internisten besucht hatten, sind ein deutliches Votum für unser Konzept der freiwilligen ärztlichen Fortbildung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080070069
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  • 10
    Electronic Resource
    Electronic Resource
    Über Ernährung und motorische Aktivität (1948)
    Springer
    Pflügers Archiv 250 (1948), S. 474-491 
    Details
    ISSN: 1432-2013
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Es wurde gezeigt, daß Reduktion der Eiweißzufuhr bei Mäusen zu einer vorübergehenden Aktivitätssteigerung führt. Diese tritt gewöhnlich erst einen oder mehrere Tage nach Beginn der verringerten Eiweißzufuhr ein, erreicht in etwa 1 Woche ein Maximum, das sich ebenso lange hält, um mit langsamem Absinken der Aktivität in die bereits früher beschriebene Aktivitätssenkung bei langfristiger Ernährung mit wenig Eiweiß überzugehen. Die Aktivitätssteigerung findet sich jedoch in der Regel nicht bei Zufuhren, die nur unterhalb des motorisch-bestimmten Eiweißminimum liegen, sondern erst bei Unterschreitung des sog. physiologischen Minimums bis herunter zu praktisch eiweißfreier Nahrung. Der Effekt wurde direkt im Aktogramm und indirekt im Umsatzversuch nachgewiesen, wobei es absolut zur Erhöhung des Gesamtumsatzes um 50% und je Gewichtseinheit zur Verdoppelung kommen kann. Die methodische Sicherung des Effektes und die näheren Bedingungen für sein Eintreten werden beschrieben. Die gezeigte Aktivitätssteigerung wird mit den Erfolgen von Eiweißentziehungskuren beim vorher vollernährten Menschen in Zusammenhang gebracht.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00369953
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