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  • Artikel: DFG Deutsche Nationallizenzen  (8)
  • 2000-2004  (2)
  • 1995-1999  (6)
  • 1
    Digitale Medien
    Digitale Medien
    Antithrombin III (ATIII) replacement therapy in patients with sepsis and/or postsurgical complications: a controlled double-blind, randomized, multicenter study (1998)
    Springer
    Intensive care medicine 24 (1998), S. 336-342 
    Details
    ISSN: 1432-1238
    Schlagwort(e): Key words Acquired ATIII deficiency ; ATIII replacement therapy ; Septic shock
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: ATIII is decreased in sepsis and/or shock and its baseline value correlates with mortality. The efficacy of ATIII therapy on mortality was assessed in a selected group of patients admitted to the intensive care unit (ICU) in a double-blind, randomized, multicenter study. Methods: 120 patients admitted to the ICU with an ATIII concentration 〈 70 % were randomized to receive ATIII (total dose 24 000 units) or placebo treatment for 5 days; 56 patients had septic shock. Results: ATIII concentrations in the treated group remained constant throughout the treatment period (range 97–102 %). The Kaplan- Meier analysis showed no difference in overall survival between the two groups: 50 and 46 % for ATIII and placebo, respectively. Septic shock and hemodynamic support were unbalanced in the two groups at admission. Therefore the Cox analysis was carried out after adjusting for these two variables. Treatment with ATIII decreases the risk of death with an odds ratio (OR) of 0.56. Of the covariates analyzed, septic shock and the baseline multiple organ failure score were negatively associated with survival and plasma activity level was positively associated with survival with an OR of 0.97 for each 1 % increase in the ATIII plasma concentration at baseline. Conclusions: The results of ATIII treatment in this population of patients suggests that replacement therapy reduces mortality in the subgroup of septic shock patients only.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001340050576
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  • 2
    Digitale Medien
    Digitale Medien
    Cyclosporin-induced endothelial dysfunction and hypertension: are nitric oxide system abnormality and oxidative stress involved? (2000)
    Springer
    Transplant international 13 (2000), S. S413 
    Details
    ISSN: 1432-2277
    Schlagwort(e): Key words ecNOS ; Nitric oxide ; Cyclosporine ; Hypertension ; Superoxide anions
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Hypertension is a major side effect of cyclosporin (CsA). While the mechanism(s) responsible are unclear, CsA-induced endothelial dysfunction and CsA-induced hypertension have been attributed to the CsA effect on the endothelial-derived factors controlling vasomotor tone. Endothelial nitric oxide (NO) is crucial in the maintenance of a state of basal vasodilation, and recent studies have suggested an NO-mediated counterregulatory mechanism protective from CsA-induced vasoconstriction. Our study evaluates endothelial nitric oxide synthase (ecNOS) gene status (PCR analysis) and plasma levels of NO metabolites (ELISA) in kidney and heart transplant patients under chronic CsA treatment with CsA-induced hypertension. Since CsA increases superoxide production, which metabolises NO, plasma hydroperoxides from cholesterol esters and from triglycerides and peroxynitrite were also evaluated (HPLC) as an index of the presence of superoxides and of “oxidative stress”. Quantification of monocyte ecNOS mRNA and NO metabolites plasma levels from patients and controls (C) demonstrated NO system upregulation in patients notwithstanding the hypertension. The mean ecNOS to β-actin ratio was 1.80 ± 0.85 in patients vs 0.40 ± 0.09 in C (P 〈 0.04). NO metabolites were 34.03 ± 14.32 μM in patients vs 11.53 ± 5.64 μM in C (P 〈 0.001). Hydroperoxides from cholesterol esters and from triglycerides were also increased in patients, 3.4 ± 1.4 vs 1.3 ± 0.6 integrated area units (i. a. u.), P 〈 0.007 and 10.6 ± 6.4 vs 1.3 ± 0.8 i. a. u., P 〈 0.008, respectively, as well as the peroxynitrite plasma level, 0.32 ± 0.11 μM/l vs undetectable in C. This study confirms a CsA-induced NO system upregulation in transplanted patients. However, the NO-mediated counterregulatory system to CsA-induced vasoconstriction, present in normals, could be canceled in patients by CsA-induced superoxide (O2 –) and free radical production which, by increasing NO metabolism, could contribute to CsA-induced vasoconstriction and hypertension and predispose to atherosclerosis.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001470050374
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  • 3
    Digitale Medien
    Digitale Medien
    Utility of transesophageal echocardiography and pulmonary artery catheterization during laparoscopic assisted abdominal aortic aneurysm repair (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 1099-1101 
    Details
    ISSN: 1432-2218
    Schlagwort(e): Key words: Laparoscopy — Vascular — Abdominal aortic aneurysm
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Advanced laparoscopic procedures are more commonly performed in elderly patients with cardiac disease. There has been limited data on the use of pulmonary artery catheters (PAC) and transesophageal echocardiography (TEE) to monitor hemodynamic changes. Methods: We prospectively studied eight patients undergoing laparoscopic assisted abdominal aortic aneurysm repair. All patients had a PAC and all but one had an intraoperative TEE. Data included heart rate (HR), temperature (temp), pulmonary artery systolic (PAS) and diastolic (PAD) pressures, mean arterial pressure (MAP), central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP), cardiac index (CI), mixed venous oxygen saturation (MVO2), and oxygen extraction ratio (O2Ex) and was obtained prior to induction, during insufflation, after desufflation, during aortic cross-clamp, and at the end of the procedure. End diastolic area (EDA), a reflection of volume status, was measured on TEE. ANOVA was used for data analysis. Results: No changes were noted in HR, temp, PAS, PCWP, CI, MVO2, and O2Ex. PAD and CVP were greater during insufflation compared with baseline and aortic cross-clamp without associated changes in EDA. MAP was higher at baseline compared with all other times during the procedure. Conclusions: Insufflation increased PAD and CVP. However, volume status as suggested by EDA and PCWP did not change. These data question the reliability of hemodynamic measurements obtained from the PAC during pneumoperitoneum and suggest that TEE may be sufficient for evaluation of volume status along with the added benefit of timely detection of ventricular wall motion abnormalities.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s004649900539
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  • 4
    Digitale Medien
    Digitale Medien
    Laparoscopically assisted abdominal aortic aneurysm repair (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1136-1139 
    Details
    ISSN: 1432-2218
    Schlagwort(e): Key words: Laparoscopy — Vascular — Abdominal aortic aneurysm
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Laparoscopic surgery decreases postoperative pain and length of hospital stay. Whether laparoscopically assisted abdominal aortic aneurysm (AAA) repair can be safely and reliably performed is unknown. This prospective study was designed to establish the feasibility of laparoscopically assisted AAA repair and its effects on intraoperative and postoperative variables. Methods: With IRB approval, 10 patients with infrarenal AAA requiring a tube graft underwent laparoscopically assisted AAA repair. The procedure consisted of laparoscopic dissection of the aneurysm neck and iliac vessels. Then, through an 8–11-cm minilaparotomy, a standard endoaneurysmorrhaphy was performed. Data included laparoscopic and total operative times, blood loss, fluid requirements, duration of nasogastric suction (NGT), and lengths of intensive care unit (ICU) and postoperative hospital stays. Results: Laparoscopically assisted AAA was completed in nine of 10 patients. The first patient was converted to a standard incision because the aneurysm neck could not be adequately dissected. Laparoscopic and total operative times were 1.8 ± 0.4 and 4.5 ± 0.7 h, respectively. Mean blood loss was 1 ± 0.6 l. Intraoperative fluid requirement was 6.6 ± 1.3 l. The duration of NGT suction was 1.8 ± 1.0 days. The ICU stay was 2.1 ± 0.8 days and hospital stay was 6.7 ± 2.5 days. There were two minor complications and no deaths. Conclusions: Laparoscopically assisted AAA repair is technically feasible with acceptable blood loss, operative time, morbidity, and mortality. Potential advantages may be early removal of the NGT and shorter ICU and hospital stays. Prospective randomized trials are needed to determine if laparoscopically assisted AAA repair is advantageous.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s004649900265
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  • 5
    Digitale Medien
    Digitale Medien
    Effect of doxazosin in mild to moderate hypertensive patients with insulin-dependent diabetes mellitus (1998)
    Springer
    Acta diabetologica 35 (1998), S. 96-100 
    Details
    ISSN: 1432-5233
    Schlagwort(e): Key words Insulin-dependent diabetes mellitus ; Hypertension ; Doxazosin
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Diabetic patients often develop hypertension, and the presence of both hypertension and diabetes doubles the risk of death from coronary heart disease (CHD). Moreover, the presence and importance of abnormalities such as high low-density lipoprotein (LDL) cholesterol and triglycerides levels as CHD risk factors in insulin-dependent diabetes mellitus type 1 have been downplayed, while increasing evidence suggests that the management of type 1 patients should include control of dyslipidemia and hyperglycemia and an effective antihypertensive treatment able also to reduce risk factors for coronary artery events. In this study we assessed the antihypertensive and metabolic effects of doxazosin in hypertensive patients with type 1 diabetes. We show that the drug normalizes blood pressure, and while no improvement in glucose control was observed, it reduced total cholesterol and increased HDL cholesterol as well as the HDL to total cholesterol ratio. The changes of the various parameters studied, including the calculated CHD risk score based on the Framingham equation, suggest that doxazosine can reduce the CHD risk for hypertensive type 1 patients.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s005920050111
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  • 6
    Digitale Medien
    Digitale Medien
    Effect of In Vivo Administration of Naloxone on ATP-ase's Enzyme Systems of Synaptic Plasma Membranes from Rat Cerebral Cortex (2000)
    Springer
    Neurochemical research 25 (2000), S. 867-873 
    Details
    ISSN: 1573-6903
    Schlagwort(e): Cerebral cortex ; ATP-ases ; synaptic plasma membranes ; naloxone
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Naloxone is a specific competitive antagonist of morphine, acting on opiate receptors, located on neuronal membranes. The effects of in vivo administration of naloxone on energy-consuming non-mitochondrial ATP-ases were studied in two different types of synaptic plasma membranes from rat cerebral cortex, known to contain a high density of opiate receptors. The enzyme activities of Na+, K+-ATP-ase, Ca2+, Mg2+-ATP-ase and Mg2+-ATP-ase and of acetylcholinesterase (AChE) were evaluated on synaptic plasma membranes obtained from control and treated animals with effective dose of naloxone (12μg · kg−1 i.m. 30 minutes). In control (vehicle-treated) animals specific enzyme activities assayed on these two types of synaptic plasma membranes are different, being higher on synaptic plasma membranes of II type than of I type, because the first fraction is more enriched in synaptic plasma membranes. The acute treatment with naloxone produced a significant decrease in Ca2+,Mg2+-ATP-ase activity and an increase in AChE activity, only in synaptic plasma membranes of II type. The decrease of Ca2+,Mg2+-ATP-ase enzymatic activity and the increased AChE activity are related to the interference of the drug on Ca2+ homeostasis in synaptosoplasm, that leads to the activation of calcium-dependent processes, i.e. the extrusion of neurotransmitter. These findings give further evidence that pharmacodynamic characteristics of naloxone are also related to increase [Ca2+] i , interfering with enzyme systems (Ca2+,Mg2+-ATP-ase) and that this drug increases acetylcholine catabolism in synaptic plasma membranes of cerebral cortex.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1007529826905
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  • 7
    Digitale Medien
    Digitale Medien
    Energy Metabolism of Synaptosomal Subpopulations from Different Neuronal Systems of Rat Hippocampus: Effect of L-Acetylcarnitine Administration In Vivo (1999)
    Springer
    Neurochemical research 24 (1999), S. 617-624 
    Details
    ISSN: 1573-6903
    Schlagwort(e): Synaptosomal subpopulations ; “large” and “small” synaptosomes ; energy metabolism ; enzymes ; L-acetylcarnitine treatment
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The maximum rate (Vmax) of some enzyme activities related to glycolysis, Krebs' cycle, acetylcholine catabolism and amino acid metabolism were evaluated in different types of synaptosomes obtained from rat hippocampus. The enzyme characterization was performed on two synaptosomal populations defined as “large” and “small” synaptosomes, supposed to originate mainly from the granule cell glutamatergic mossy fiber endings and small cholinergic nerve endings mainly arising from septohippocampal fiber synapses, involved with cognitive processes. Thus, this is an unique model of pharmacological significance to study the selective action of drugs on energy metabolism of hippocampus and the sub-chronic i.p. treatement with L-acetylcarnitine at two different dose levels (30 and 60 mg · kg−1, 5 day a week, for 4 weeks) was performed. In control animals, the results indicate that these two hippocampal synaptosomal populations differ for the potential catalytic activities of enzymes of the main metabolic pathways related to energy metabolism. This energetic micro-heterogeneity may cause their different behaviour during both physiopathological events and pharmacological treatment, because of different sensitivity of neurons. Therefore, the micro-heterogeneity of brain synaptosomes must be considered when the effect of a pharmacological treatment is to be evaluated. In fact, the in vivo administration of L-acetylcarnitine affects some specific enzyme activities, suggesting a specific molecular trigger mode of action on citrate synthase (Krebs' cycle) and glutamate-pyruvate-transaminase (glutamate metabolism), but mainly of “small” synaptosomal populations, suggesting a specific synaptic trigger site of action. These observations on various types of hippocampal synaptosomes confirm their different metabolic machinery and their different sensitivity to pharmacological treatment.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1021008306414
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  • 8
    Digitale Medien
    Digitale Medien
    Action of L-Acetylcarnitine on Different Cerebral Mitochondrial Populations from Cerebral Cortex (1998)
    Springer
    Neurochemical research 23 (1998), S. 1485-1491 
    Details
    ISSN: 1573-6903
    Schlagwort(e): Cerebral cortex ; energy metabolism ; enzymes ; L-acetylcarnitine
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The maximum rate (Vmax) of some mitochondrial enzymatic activities related to the energy transduction (citrate synthase, α-ketoglutarate dehydrogenase, succinate dehydrogenase, malate dehydrogenase, cytochrome oxidase) and amino acid metabolism (glutamate dehydrogenase, glutamate-pyruvate-transaminase, glutamate-oxaloacetate-transaminase) was evaluated in non-synaptic (free) and intra-synaptic mitochondria from rat brain cerebral cortex. Three types of mitochondria were isolated from rats subjected to i.p. treatment with L-acetylcarnitine at two different doses (30 and 60 mg·kg−1, 28 days, 5 days/week). In control (vehicle-treated) animals, enzyme activities are differently expressed in non-synaptic mitochondria respect to intra-synaptic “light” and “heavy” ones. In fact, α-ketoglutarate dehydrogenase, succinate dehydrogenase, malate dehydrogenase, glutamate-pyruvate-transaminase and glutamate-oxaloacetate-transaminase are lower, while citrate synthase, cytochrome oxidase and glutamate dehydrogenase are higher in intra-synaptic mitochondria than in non-synaptic ones. This confirms that in various types of brain mitochondria a different metabolic machinery exists, due to their location in vivo. Treatment with L-acetylcarnitine decreased citrate synthase and glutamate dehydrogenase activities, while increased cytochrome oxidase and α-ketoglutarate dehydrogenase activities only in intra-synaptic mitochondria. Therefore in vivo administration of L-acetylcarnitine mainly affects some specific enzyme activities, suggesting a specific molecular trigger mode of action and only of the intra-synaptic mitochondria, suggesting a specific subcellular trigger site of action.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1020907400905
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