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  • 1
    ISSN: 1432-0428
    Keywords: Microalbuminuria ; lipoproteins ; linoleic acid ; polyunsaturated fatty acids ; diet ; Type 1 (insulin-dependent) diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We conducted a 2-year prospective randomised study to investigate the effects of a linoleic-acid-enriched diet on albuminuria and lipid levels in Type 1 (insulin-dependent) diabetic patients with elevated urinary albumin excretion (overnight urinary albumin excretion rate between 10 and 200 μg/min). Thirty-eight patients were randomly assigned to increase dietary polyunsaturated: saturated fatty acids ratio to 1.0 by replacement of saturated fat with linoleic-acid-rich products (n=18, two dropouts, analysis was performed in n=16) or to continue their usual diet (n=20). The total fat and protein content of the diet was unaltered. Clinical characteristics, albuminuria, blood pressure, glomerular filtration rate, metabolic control and dietary composition were similar in the two groups at baseline. In the high linoleic acid diet group, linoleic intake rose from 7±4 to 11±2 energy % and polyunsaturated: saturated fatty acids ratio rose from 0.60±0.28 to 0.96±0.16 (p〈0.001 compared to usual diet group). The median increase albuminuria was 58% (95% confidence interval, 13 to 109) during the first year (p〈0.02) and 55% (95% confidence interval, 11 to 127) (p〈0.01) during the second year. Glomerular filtration rate remained unaltered and filtration fraction tended to rise (p〈0.05 compared to usual diet group). In the usual diet group, albuminuria did not significantly increase by 16% (95% confidence interval, -17 to 38) and glomerular filtration rate declined during the second year. Blood pressure tended to rise similarly in both groups. Multiple regression analysis showed an independent effect of the high linoleic acid diet on the progression of albuminuria as well as the lack of decrease in glomerular filtration rate. Low density lipoprotein cholesterol and apolipoprotein B levels decreased in the high linoleic acid diet group (p〈0.05). High density lipoprotein cholesterol declined in both groups (p〈0.05). It is concluded that a linoleic-acid-enriched diet reduces atherogenic lipoproteins but does not have a beneficial effect on and might even promote renal functional abnormalities in Type 1 diabetic patients with elevated urinary albumin excretion.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1041
    Keywords: dopamine ; sulpirides ; prazosin ; phentolamine ; natriuresis ; renal haemodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The effect of sulpiride on dopamine-induced changes in renal function in man has been investigated. Dopamine dose-response studies were performed in 7 healthy volunteers before and after sulpiride 200 mg i. v. The same investigations were performed in 15 healthy volunteers after pretreatment with the selective alpha-1-adrenoceptor antagonist prazosin (n=7) and the non-selective alpha-adrenoceptor-blocker phentolamine (n=8). Infusion of dopamine 0.25 to 8 μg·kg−1·min−1 resulted in a dose-dependent increase in effective renal plasma flow (ERPF) and glomerular filtration rate (GFR), and a fall in filtration fraction (FF) in 7 normal volunteers. Sulpiride had no effect on base-line ERPF or GFR and did not influence the dopamine-induced renal vasodilatation in those volunteers. It did cause a fall in the fractional sodium excretion (FENa+%) from 1.7 to 1.38, and shifted the dose-response curve of the natriuretic response to a subsequent infusion of dopamine. Sulpiride enhanced the fall in diastolic blood pressure during infusion of dopamine. In 7 other volunteers pretreated with prazosin, sulpiride did not influence base-line ERPF, GFR or FF or their response to dopamine, but the sodium excretion fell markedly (FENa+% changed from 1.13 to 0.63). Administration of sulpiride to 8 volunteers after phentolamine pretreatment 20 mg·h−1 i.v. in the first hour followed by 10 mg·h−1 i.v. resulted in a fall in sodium excretion (FENa+% from 1.09 to 0.53) without affecting ERPF or FF, and it did not affect the dose-response curve in the subsequent DA infusion. Both after prazosin pretreatment and during phentolamine infusion the usual natriuretic response to dopamine was completely absent, while phentolamine alone did not influence base-line values of sodium excretion or of ERPF, GFR and FF. Overall, in normal men sulpiride did not antagonise the dopamine-induced renal vasodilatation. This was not due to a presumed additional alpha-antagonist activity of sulpiride. Its effect on base-line sodium excretion and dopamine-induced natriuresis did not appear to be dependent on renal haemodynamics and may be the consequence of inhibition of a direct proximal tubular effect of dopamine.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1017
    Keywords: Key words Action potential model ; Inward rectifier ; Sodium-potassium pump ; Tubular potassium concentration ; Muscle fatigue
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Physics
    Notes: Abstract During prolonged activity the action potentials of skeletal muscle fibres change their shape. A model study was made as to whether potassium accumulation and removal in the tubular space is important with respect to those variations. Classical Hodgkin-Huxley type sodium and (potassium) delayed rectifier currents were used to determine the sarcolemmal and tubular action potentials. The resting membrane potential was described with a chloride conductance, a potassium conductance (inward rather than outward rectifier) and a sodium conductance (minor influence) in both sarcolemmal and tubular membranes. The two potassium conductances, the Na-K pump and the potassium diffusion between tubular compartments and to the external medium contributed to the settlement of the potassium concentration in the tubular space. This space was divided into 20 coupled concentric compartments. In the longitudinal direction the fibre was a cable series of 56 short segments. All the results are concerned with one of the middle segments. During action potentials, potassium accumulates in the tubular space by outward current through both the delayed and inward rectifier potassium conductances. In between the action potentials the potassium concentration decreases in all compartments owing to potassium removal processes. In the outer tubular compartment the diffusion-driven potassium export to the bathing solution is the main process. In the inner tubular compartment, potassium removal is mainly effected by re-uptake into the sarcoplasm by means of the inward rectifier and the Na-K pump. This inward transport of potassium strongly reduces the positive shift of the tubular resting membrane potential and the consequent decrease of the action potential amplitude caused by inactivation of the sodium channels. Therefore, both potassium removal processes maintain excitability of the tubular membrane in the centre of the fibre, promote excitation-contraction coupling and contribute to the prevention of fatigue.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The sentinel lymph node procedure enables selective targeting of the first draining lymph node, where the initial metastases will form. A negative sentinel node (SN) predicts the absence of tumour metastases in the other regional lymph nodes with high accuracy. This means that in the case of a negative SN, regional lymph node dissection is no longer necessary. Besides saving costs, this will prevent many side-effects of lymph node dissection. The aim of this study was to evaluate the reliability of intraoperative cytological and frozen section investigation of the SN to detect metastases. This would allow the axillary lymph node dissection to be performed in the same session as the SN procedure and the excision of the primary tumour in case of a positive SN.〈section xml:id="abs1-2"〉〈title type="main"〉Methods and resultsSeventy-four SNs were detected by gamma probe detection of nanocolloid and visual localization of Patent Blue accumulations in 54 women with stage T1–2N0M0 invasive breast cancer. The identified SN were immediately investigated by frozen section and imprint cytological investigation. Diagnoses were confirmed on the paraffin material, and in case of negative frozen section and paraffin haematoxylin and eosin sections, skip sections and immunohistochemistry were performed. Thirty-one SNs (42%) contained metastases, of which 27 were detected by the frozen section procedure (sensitivity 87%). There were no false positives (specificity 100%). The sensitivity of the imprints was 62% with a specificity of 100%. When evaluating the data per patient, for the frozen section procedure the sensitivity was 91% and the specificity 100%, and for the imprints, the sensitivity was 63% and the specificity 100%. There were no SNs in which the imprints showed metastases and the frozen section did not.〈section xml:id="abs1-3"〉〈title type="main"〉ConclusionsIntraoperative frozen section analysis is a reliable procedure by which a high percentage of sentinel lymph node metastases can be detected in breast cancer patients without false positive results. This allows the surgeon to perform an immediate axillary lymph node dissection in case of positive SNs. In up to 10% of cases, the final paraffin sections will reveal micrometastases that were not detected by the frozen section, and in these patients axillary lymph node dissection will have to be performed in a second session. The imprint method is significantly less sensitive than the frozen section but may be used as an alternative when frozen section is not possible.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1365-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Macrophages play a role in the host defence against cancer. Little is known about changes in macrophage populations during early metastatic growth. To evaluate the distribution, number and phenotype of macrophages in the development of hepatic metastases in a rat model (Wag/Rij rats and syngeneic CC531 colon carcinoma cell line), an immunohistochemical study was performed with the monoclonal antibodies ED1 (monocytes, and all macrophages), ED2 (resident tissue macrophages, like Kupffer cells) and ED3 (a subpopulation of macrophages which may play a role in the recruitment of lymphocytes). OX19 and Hisl4 were used to identify lymphocytes. In this study a new monoclonal antibody CC52 is described, which recognizes the CC531 tumour cell line. Liver metastases were induced by injection of CC53I colon carcinoma cells into a mesenteric vein. Rats were killed at various intervals. Results show three major macrophage populations during hepatic tumour growth: (1) on day 3, infiltrates are observed around the micrometastases, which contain mainly newly recruited macrophages (ED1+ and ED2−); (2) after 7 days, ED3-positive (ED3 +) macrophages together with T lymphocytes are found in the infiltrates; (3) an increase in the number of ED2-positive (ED2+) Kupffer cells is observed in the liver parenchyma after 14 days. In conclusion, the present results suggest that various populations of macrophages, newly recruited (ED1+) as well as resident Kupffer cells (ED2+), are involved in the immune response against tumour cell deposits in the liver.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 377 (1978), S. 339-349 
    ISSN: 1432-2307
    Keywords: Riedel's thyroiditis ; Occlusive phlebitis ; Multifocal fibrosclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Five cases of Riedel's invasive fibrous thyroiditis are presented.-Clinically and histopathologically all cases fulfilled the criteria for this lesion. In both small and large veins there were inflammatory changes and obliteration of the lumen, followed by sclerosis. These changes were found in each operative specimen, and seemed to be a diagnostic feature of invasive fibrous thyroiditis. We consider this change to be an occlusive phlebitis, and have noted that it occurs in association with multifocal fibrosclerosis. Three stages can be recognised: infiltrative, occlusive and sclerotic. In other thyroid lesions such as Hashimoto's thyroiditis, granulomatous thyroiditis of the Quervain type and adenomatous goitre these peculiar changes in the veins were not found.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied renal function in nine patients with disseminated testicular carcinoma before and after remission-induction and maintenance therapy with a drug combination containing cis-platinum. The median glomerular filtration rate (GFR) decreased during remission-induction therapy from 146 to 118 ml/min. No effect of cumulative toxicity on the median GFR was found during maintenance therapy, nor did the median GFR improve. The median effective renal plasma flow (ERPF) decreased during the total period from 705 to 514 ml/min. No significant changes in median filtration fraction (FF) and serum creatinine were observed. It is suggested that intrarenal hemodynamic effects are important in the nephrotoxicity of cis-diamminedichloride platinum (CDDP).
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Cancer chemotherapy and pharmacology 45 (2000), S. 89-92 
    ISSN: 1432-0843
    Keywords: Key words Nephrotoxicity ; JM216
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: The purpose of this study was to assess renal function in patients treated with the oral platinum drug JM216 [bisacetato-ammine-dichloro-cyclohexylamine-platinum(IV)], since the effects of JM216 on renal function have only partly been investigated using serum parameters or 51Cr-EDTA clearance. We used a sensitive method that assessed glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and indicators of tubular and glomerular damage. Methods: A group of 24 patients with either non-small-cell lung cancer (NSCLC) stage IIIb/IV or small-cell lung cancer (SCLC), limited disease (LD) or extensive disease (ED), treated with JM216 were studied. All patients had no prior chemotherapy, a performance score 〈2, a life expectancy of more than 3 months and normal liver, renal and bone marrow functions before treatment. All patients received oral JM216 120 mg/m2 per day for 5 consecutive days, repeated every 21 days with a maximum of six cycles. In six SCLC patients the dose was escalated to 140 mg/m2 per day after the first cycle. Prior to treatment, after the first cycle and after the end of treatment renal function was assessed by 125I-sodium thalamate and 131I-hippurate clearances to determine acute and cumulative changes in GFR and ERPF, respectively. Furthermore, tubular and glomerular damage were assessed by urinary excretion of β2-microglobulin, lactic dehydrogenase (LDH), alkaline phosphatase (ALP), gamma-glutamyltransferase (GT) and albumin. Results: In 20 evaluable patients no significant acute impairment of renal function was observed. Median (range) GFR, ERPF and filtration fraction (FF) before treatment were 101 ml/min (53–164 ml/min), 417 ml/min (227–719 ml/min), and 0.25 (0.19–0.33), respectively. After the first cycle values were 117 ml/min (71–189 ml/min), 418 ml/min (228–709 ml/min) and 0.28 (0.21–0.33), respectively. Also, no indications of tubular or glomerular damage were found. In four patients renal function was evaluated at the end of treatment (one after three cycles, one after five cycles and two after six cycles). Median (range) GFR, ERPF and FF were 99 ml/min (74–139 ml/min), 401 ml/min (277–496 ml/min) and 0.26 (0.23–0.30), respectively, revealing no delayed nephrotoxicity. Conclusion: We conclude that oral JM216 shows no nephrotoxicity.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 14 (1988), S. 238-240 
    ISSN: 1432-1238
    Keywords: Petroleum distillates ; Multiple organ failure ; Renal tubular necrosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract After oral ingestion of 600 ml of refined petrol a 23-year-old male developed multiple organ failure. Acute renal insufficiency due to nephrotoxic tubular necrosis requiring hemodialysis was a major manifestation. Moreover, respiratory failure, seizures, hemolysis, disseminated intravascular coagulation, liver damage and erosions of mucous membranes occurred. The patient subsequently recovered completely. In spite of the poor absorption from the gastrointestinal tract and the high first-pass effect in the liver, massive petrol intoxication may lead to reversible multisystemic lesions.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    International journal of colorectal disease 14 (1999), S. 177-180 
    ISSN: 1432-1262
    Keywords: Key words Cryosurgery ; Rectal cancer ; Palliation index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Cryosurgery is one of the palliative treatment options to decrease local symptoms due to rectal carcinoma. A total of 106 patients (aged 45–92 years) underwent palliative cryosurgery for primary rectal cancer. Inclusion criteria were prohibitive surgical risk, unresectability, distant metastases, patient refusal of surgical intervention, and old age. The palliative effect of cryosurgery on local symptoms was classified as good, moderate, or none. The duration of palliation was calculated in relation to survival as a palliative index: the number of months of (moderate or good) palliation divided by the number of months of survival from the start of the treatment, multiplied by 100. In 66 patients (62%) there was complete relief of local symptoms, with a palliative index of 88%. In 17 patients (16%) palliation was moderate, and in 23 patients (22%) no palliation was achieved. The 50% survival duration in the 66 patients was 33 months. Especially symptoms of blood and/or mucous discharge were easily alleviated. Good alleviation of local symptoms was associated with the extent of the primary tumor process. Palliative effect was be assessed after a few treatments. Patients with circular rectal tumors seldom had long-term palliative effects of cryosurgery. Our findings show that Cryosurgery is a simple and safe treatment for rectal cancer. It should be considered for alleviation of local symptoms in patients with rectal cancer who are unsuitable for radical surgery.
    Type of Medium: Electronic Resource
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