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  • 1
    ISSN: 1432-1440
    Keywords: Hemodialysis ; Left ventricular performance ; Left ventricular hypertrophy ; Ionized calcium to potassium ratio ; Uremic cardiomyopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Hemodialysis is associated with alterations in myocardial contractility, but duration and precise determinants responsible for these changes are unknown. We investigated the effect of several variables, established to influence left ventricular (LV) contractility, which normally changed during dialysis: the plasma concentrations of ionizied calcium, potassium, bicarbonate, and magnesium and the removal of uremic toxins. The influence of three different isovolemic bicarbonatedialysis procedures in 16 patients with normal (group 1) and hypertrophied myocardium (group 2) was assessed by echocardiography prior to and up to 44 h following each dialysis. During the first procedure, ionized calcium and potassium concentration decreased, but LV performance remained unchanged in both groups. The second procedure with increased ionized calcium and decreased potassium concentration resulted in an improvement of mean circumferential fiber shortening (VCF from 1.15 to 1.56 circ/s (P〈0.001) in group 1 and from 1.05 to 1.16 circ/s (P〈0.05) in group 2. The positive inotropic effect declined gradually up to 12 h (group 1) and 2.5 h (group 2) respectively. In the third procedure when ionized calcium was increased and potassium concentration remained unchanged contractility did not improve. Removal of uremic toxins, decrease in magnesium, and increase in bicarbonate concentrations were comparable during each procedure. These results suggest that the ionized calcium to potassium ratio is the important determinant of dialysis-related augmentation in LV contractility. In LV hypertrophy the expected contractile response is diminished indicating a depressed inotropic state.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Biochimica et Biophysica Acta (BBA)/Biomembranes 307 (1973), S. 366-371 
    ISSN: 0005-2736
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Medicine , Physics
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Intensivmedizin und Notfallmedizin 34 (1997), S. 810-816 
    ISSN: 1435-1420
    Keywords: Key words Anuria ; dialysis ; volemia ; Schlüsselwörter Anurie ; Dialyse ; Hydratationszustand
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Therapieziele und Behandlungsart des Hydratationsgrades unterscheiden sich wesentlich zwischen stabilen chronischen Dialysepatienten und anurischen Intensivpatienten. Das Konzept des „Trockengewichts“ ist für chronische Dialysepatienten entwickelt worden und beschreibt ein am Ende einer Dialyse zu erreichendes Gewicht, das mit einem möglichst normalen Extrazellulärvolumen vergesellschaftet ist. Klinische, sonographische und bioelektrische Methoden können bei der Monitorisierung eines „normalen“ Hydratationsgrades hilfreich sein. Bei anurischen Intensivpatienten sind diese Methoden nur beschränkt interpretierbar. Ein normaler Volumenstatus ist nicht immer Therapieziel, sondern die gezielte Veränderung des Flüssigkeitsstatus wird als Hilfsmittel zur Stabilisierung der Makro- und Mikrozirkulation einerseits oder der Beatmungsparameter bei ARDS andererseits eingesetzt.
    Notes: Summary Handling and monitoring of volume state in chronic dialysis patients and anuric intensive care patients are different. The concept of “dialysis dry weight” has been developed for maintenance dialysis patients and it describes the ultrafiltration goal of reaching a normal hydration state at the end of dialysis. Non-invasive methods such as sonography of vena-cava inferior of bioimpedance are helpful in monitoring volemia. In anuric ICU patients – however – these methods are of restricted diagnostic value. Normovolemia is not more the ultimate goal of dialysis therapy and in order to stabilize macro- and microperfusion of critical organs or ventilation the hydration state has to be manipulated in both directions.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 72 (1994), S. 720-721 
    ISSN: 1432-1440
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Pflügers Archiv 339 (1973), S. 317-338 
    ISSN: 1432-2013
    Keywords: Pancreas ; Active Transport ; Ionophores ; Membrane Enzymes ; Secretion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The isolated cat pancreas was perfused with a Krebs-Henseleit-solution containing different concentrations of Amphotericin, Amiloride, Gramicidin, Dinitrophenol, Valinomycin, and Nigericin. In order to separate functionally the effects of these substances on the mitochondrial and the plasma membrane, we tested their influence on the secretory flow rate under aerobic and anaerobic conditions. A Na+−K+- and a HCO3 −-ATPase have been found in membrane fractions of pancreatic homogenates. Since there is a possibility that these enzymes are involved in active ion transport, we tested the effect of all substances on the level of activity of both Na+K+-ATPase and HCO3 −-ATPase. The following were found: 1. The secretory flow rate under anaerobic conditions was about 10% of that observed under aerobic conditions. Omission of glucose from the perfusate decreased flow rate to nearly zero. α-ketoglutarate and fumarate did not increase secretion in the absence of glucose which indicates that secretion was maintained by energy from anaerobic glycolysis. 2. Amphotericin which increases the permeability of other membranes unspecifically, yielded an inhibition of pancreatic secretion under both aerobic and anaerobic conditions, presumably by an increase of the permeability of the luminal cell border. Amphotericin induced no effect on the Na+−K+-nor on the HCO3 −-ATPase. 3. Amiloride (2–4×10−3M) which inhibits sodium influx into epithelial cells, decreased pancreatic secretion by up to 50% in both aerobic and anaerobic conditions. Amiloride also inhibited the Na+−K+-ATPase activity in vitro but was without effect on the HCO3 −-ATPase. In small concentrations however Amiloride stimulated the Na+−K+-ATPase activity. 4. Gramicidin which creates rather unspecific channels for ions through membranes did not affect pancreatic secreatic secretion or ATPase activities. 5. Dinitrophenol decreased secretion by about 30–60% under aerobic conditions, which might be due to the known uncoupling effect on oxidative phosphorylation. DNP stimulated in vitro Na+−K+-ATPase activity, which, however, was not reflected in an increase of secretory flow rate under anaerobic conditions. 6. The ionophores Valinomycin and Nigericin, which increase membrane permeability to K+ and H+ ions in a variety of tissues, increased secretion up to 70% under anaerobic conditions but caused a decrease of 30%–90% under aerobic conditions. These findings suggest that both the plasma- and mitochondrial membrane must have been affected. Both ionophores stimulated the HCO3 −-ATPase activity in vitro. All tested substances except Gramicidin had an effect on pancreatic electrolyte secretion. Concerning the aerobic experiments, the inhibitory effect of Dinitrophenol and the ionophores might be due to uncoupling of oxidative phosphorylation. The results of the anaerobic experiments are interpreted as being due to changes of cell membrane permeability. As the effects of Nigericin, Valinomycin and Amiloride in the anaerobic experiments correspond to the effects of these substances on the ATPase activity, we suggest that these enzymes might be involved in the active transport processes of NaHCO3 −-secretion.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-2013
    Keywords: Pancreas ; Acini ; Ducts ; Membrane Enzymes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Enzymes activities of the Na+K+-and the HCO3 −-ATPases, alkaline phosphatase, amino peptidase and 5′ nucleotidase have been measured in 4 different preparations from the cat pancreas a) in the ducts including all sizes b) in ducts of three different diameters c) in that tissue, which had been dissected off from the ducts, called “acini”, and d) in the whole homogenate of the pancreas. The distribution of the measured enzymes shows, that the Na+K+-activity is highest in the acinar structures (mean value 0.532 μM/mg Protein x h), while the ducts show nearly no Na+K+-ATPase activity. The HCO3 −-ATPase, the alkaline phosphatase and the 5′ nucleotidase are in the ducts between 2.4 and 3.6 times higher than in the whole organ whereas the amino peptidase does not appear to have a selective distribution. As the HCO3 −-ATPase activity distribution pattern is identical with that of the secretory capacity of HCO3 − as evidenced by earlier micropuncture studies, the data suggest that the HCO3 −-ATPase is the main enzyme involved in the secretion of the bicarbonate buffer. Concerning the Na+K+-ATPase activity in the acinar structures we cannot contribute to its function in the enzyme secreting process.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1435-2451
    Keywords: Isolated liver perfusion ; Portocaval hemofiltration ; Portosystemic encephalopathy ; Ammonia ; Colorectal carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Während der isolierten Leberperfusion zur Chemotherapie von Lebermetastasen wird ein temporärer portocavaler Shunt angelegt und durch die Zwischenschaltung eines Hämofilters eine Senkung toxischer Metaboliten aus dem Pfortaderblut erreicht. Messungen bei Tierexperimenten und zwei Leberperfusionen bei Patienten mit Lebermetastasen nach colorectalem Carcinom ergaben, daß die systemischen Ammoniakspiegel nicht in toxische Bereiche anstiegen.
    Notes: Summary A temporary porto-caval shunt is constructed during isolated liver perfusion for chemotherapy of metastatic cancer to the liver and a portocaval hemofiltration is performed for reduction of toxic metabolites produced in the gut. When systemic ammonia concentration was measured during experimental perfusions in dogs as well as during isolated perfusions in two patients with liver metastases from colorectal primary cancer, the concentration level did not rise to a toxic level.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1435-702X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An 29 chronisch niereninsuffizienten Patienten wurde das intraoculare Druckverhalten während verschiedener Behandlungsverfahren gemessen. Bei 15 Patienten stieg der IOD eine Stunde nach Beginn der konventionellen Hämodialyse an. Das Diffusionsprinzip der Dialyse führte bei Patienten mit einer Kopfschmerzsymptomatik während der Behandlung zu einem deutlichen IOD-Anstieg, was als Dysäquilibriumsyndrom gedeutet wurde. Die bei 6 Patienten durchgeführte Hämofiltration (Prinzip: Konventioneller Massentransport) hatte einen geringen IOD-Anstieg nach zweistündiger Behandlung zur Folge. Bei simultaner Hämofiltration/Hämodialyse änderte sich der IOD nicht. Bei den beiden letzten Verfahren wurde kein Dysäquilibriumsyndrom beobachtet. Änderungen der Serumosmolarität, des arteriellen Mitteldrucks und das Ausmaß des Flüssigkeitsentzuges korrelierten nicht mit dem IOD-Verhalten.
    Notes: Abstract In 29 patients suffering from chronic renal failure intraocular pressure was measured during different therapeutic regimens. Conventional hemodialysis (principle of transport diffusion,n=15) led to an increase in IOP after one hours treatment. In individuals complaining of headaches during dialysis a marked increase in IOP was observed indicating a disequilibrium syndrome. Hemofiltration is characterized by mass transfer and exchange of plasma water. When this treatment was applied to 6 patients IOP was elevated during the second hour. Simultaneous hemofiltration/hemodialysis (n=8) had no influence on IOP behaviour. Statistically there was no correlation between the behaviour of serumosmolarity, arterial blood pressure, loss of body weight and IOP.
    Type of Medium: Electronic Resource
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