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  • 11
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 50 (1972), S. 548-551 
    ISSN: 1432-1440
    Keywords: Hyperamylasemia ; Macroamylase ; Gel filtration ; Ultracentrifugation ; Hyperamylasämie ; Makroamylase ; Gelfiltration ; Ultrazentrifugation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei einer 60jährigen Patientin wurde eine ausgeprägte Hyperamylasämie festgestellt, für die klinisch keine Ursache gefunden werden konnte. Auffallend waren normale Urinamylasewerte trotz ungestörter Nierenfunktion. Die Amylaseclearance war erheblich eingeschränkt. Durch Gelfiltration wurde nachgewiesen, daß der größte Teil der Amylase im Patientenserum als makromolekularer Komplex vorliegt. Bei Ultrazentrifugation im Sucrosegradienten sedimentierte der Enzymkomplex im 7-S-Bereich. Gelfiltration des Patientenserums bei saurem pH führte zur Dissoziation des Makromoleküls und Elution ausschließlich normal großer Amylase. Inkubation der dissoziierten und isolierten Globuline des Patientenserums mit Normalserum bei neutralem pH führte erneut zur Bildung eines Makroamylasemoleküls. Der Makroamylasekomplex konnte durch spezifische Immunseren nicht präzipitiert werden.
    Notes: Summary A 60 year old female patient with normal kidney function showed high amylase activity in the serum and normal activity in the urine. Macroamylase complexes were identified by gel filtration as cause of the serum abnormality. Only small amounts of normal size amylase were present. After sucrose density-gradient ultracentrifugation the macromolecular amylase was recovered with 7-S globulins. The amylase complex was split by gel filtration at pH 3.4 and normal size amylase could be detected. Macromolecular compounds formed again after incubation with normal serum at pH 7. Treatment of the patient's serum with specific antisera in order to precipitate the macromolecular complex was not successful.
    Type of Medium: Electronic Resource
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  • 12
    ISSN: 1432-1440
    Keywords: Hyperparathyreoidismus ; Immunoheterogenität ; Parathormon ; Pseudohypoparathyreoidismus ; Vitamin D ; hyperparathyroidism ; immunoheterogeneity ; parathyroid hormone ; pseudohypoparathyroidism ; vitamin D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A review of the chemistry, the biosynthesis, the regulation of the secretion and the metabolism of parathyroid hormone (PTH) provides a background to problems related to the determination of immunoreactive PTH levels in the blood of normal subjects and of patients suffering from disorders of mineral metabolism. Immunoreactive PTH measurements have to be interpreted in the light of the immunoheterogeneity encountered and the occurrence of several circulating PTH species with different molecular weights and immunological properties.
    Notes: Zusammenfassung Eine Übersicht über die Chemie, die Biosynthese, die Regulation der Sekretion und den Stoffwechsel von Parathormon (PTH) erleichert das Verständnis der radioimmunologischen Messungen von PTH im Blut von Normalpersonen und von Patienten mit Störungen des Calciumstoffwechsels. Die wichtigsten Probleme, die zu unterschiedlichen Interpretationen Anlaß geben können, liegen in der Immunoheterogenität des zirkulierenden PTH und beim Nachweis von PTH Formen mit verschiedenartigem Molekulargewicht und immunologischen Eigenschaften.
    Type of Medium: Electronic Resource
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 67 (1989), S. 627-631 
    ISSN: 1432-1440
    Keywords: Kidney transplantation ; Urinary tract infection ; Bacterial colonisation and infection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Among 124 recipients of a renal allotransplant (22 men, 52 women), 60 patients (27 men, 33 women) showed more than 106 colony-forming units/ml midstream urine on one or several occasions. 26 patients (10 men, 16 women) did not present with leucocyturia whereas 23 (10 men, 13 women) did so. Urine samples were examined 1/2 to 5 1/2 years after transplantation. The comparison of the 2 groups of patients with and without leucocyturia revealed the following: there was no age difference; during the first year after grafting, bacteriuria with leucocyturia was more common; recurrent and de novo infections, dysuria, pyelonephritis and demonstration of E. coli were more frequent. Therapy was more effective in cases of bacteriuria without leucocyturia; the serum creatinine was more seldom elevated above the normal range and complications with ureters, bladder emptying or stenoses of the urethra were more seldomly observed.
    Type of Medium: Electronic Resource
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 25 (1983), S. 523-527 
    ISSN: 1432-1041
    Keywords: diazoxide ; labetalol ; acute hypertension ; haemodialysis ; renal failure ; blood pressure control
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The antihypertensive effect of the peripheral vasodilator diazoxide in 13 patients and the alpha-beta adrenoceptor blocking agent labetalol in 12 patients were compared in 46 severe acute hypertensive episodes during haemodialysis. A single dose of diazoxide 150 mg or labetalol 50 mg was effective in 74% and 70% of the hypertensive episodes, respectively. In the diazoxide-treated patients blood pressure fell from 192±3/115±4 mmHg to 141±8/85±4 mmHg 2 h after injection. In 7 hypertensive episodes a second dose of diazoxide 150 mg was given 60±11 min after the first injection. The reduction in mean arterial blood pressure at the end of haemodialysis was 21.5±2.6% in patients treated with a single dose and 24.8±3.5% in patients treated with the repeated dose of diazoxide. In the labetalol-treated patients blood pressure in 17 instances fell from 198±5/104±4 mmHg to 143±7/89±5 mmHg 180 min following injection of labetalol 50 mg. In 6 episodes a second dose labetalol 50 mg was given 41±9 min after the first injection. At the end of haemodialysis the decrease in mean arterial blood pressure was 17.2% in patients treated with a single dose and 18±5% in patients given the repeated dose of labetalol. The reduction in blood pressure caused by diazoxide was slightly greater than that due to labetalol. At the end of haemodialysis the percentage reduction in mean arterial blood pressure was 23±2% in the diazoxide-treated group and 17±2% after labetalol. Side-effects of diazoxide and labetalol treatment occurred rarely and were generally mild.
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  • 15
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Transplant recipients have an increased propensity to develop multiple actinic keratoses, which demonstrate an increased transformation rate into invasive squamous cell carcinoma.Objective  To evaluate the efficacy and tolerability of topical photodynamic therapy with the new highly tumour-selective photosensitizer methyl aminolaevulinate vs. placebo in the treatment of actinic keratoses in transplant recipients.Methods  Seventeen transplant recipients with a total number of 129 mild to moderate actinic keratoses were enrolled in a prospective, randomized, double-blind, placebo-controlled study. Two lesional areas within a patient were randomized for two consecutive treatments of topical photodynamic therapy 1 week apart using either methyl aminolaevulinate or placebo cream. Sites were illuminated with 75 J cm−2 of visible light delivered at 80 mW cm−2 by a noncoherent light source. Complete resolution and reduction in the number or size of actinic keratoses within the lesional area relative to the initial findings were evaluated at weeks 4, 8 and 16 after treatment.Results  The lesional areas treated with methyl aminolaevulinate were clinically cleared in 13 of 17 patients at 16 weeks. A partial response was recorded in a further three. No reduction in the size or number of actinic keratoses was observed in one area treated with methyl aminolaevulinate and in all placebo-treated areas. Adverse events, such as erythema, oedema and crust formation, were mild to moderate, and treatment was well tolerated by all patients.Conclusion  Photodynamic therapy using methyl aminolaevulinate is a safe and effective treatment for actinic keratoses in transplant recipients. It may also reduce the risk of transformation of actinic keratoses to invasive, potentially fatal, squamous cell carcinoma.
    Type of Medium: Electronic Resource
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  • 16
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 357 (1982), S. 141-150 
    ISSN: 1435-2451
    Keywords: Renal transplantation ; Immunosuppression ; Colitis ; Ischemic colitis ; Cytomegalovirus infection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Vom Dezember 1964 bis Ende Juni 1980 wurden im Universitätsspital Zürich bei 524 Patienten total 596 Nierenallotransplantationen durchgeführt unter ausschließlicher Verwendung von Nieren Frischverstorbener. Bei einer Nachkontrollzeit von minimum 1 $${\raise0.5ex\hbox{$\scriptstyle 1$}\kern-0.1em/\kern-0.15em\lower0.25ex\hbox{$\scriptstyle 2$}}$$ Jahren wurden bei 12 Patienten schwere Colonkomplikationen festgestellt. Sie umfassen 4 Perforationen (eine Sigmadiverticulitis, 1 Cytomegalieulcus des Coecums, 2 ischämische Colitiden), 5 Fälle von ischämischer Colitis ohne Perforation und 3 Patienten mit „erosiver Colitis”, die aber ebenfalls ischämisch gedeutet werden muß. Bei 9 der 12 Patienten war der Colonkomplikation eine hypotone Phase von 4–17 Tage vorausgegangen. Die Häufigkeit der Komplikation von 2 % in unserem Krankengut ist mit der mittleren Komplikationsrate der Literatur von 2,4 % vergleichbar. Auch die Letalität von 75 % entspricht derjenigen anderer Berichte. Der wichtigste ursächliche Faktor der Colonkomplikationen ist die Ischämie; die Verhütung von hypotonen Phasen nach Nierentransplantation ist daher wichtig.
    Notes: Summary From December 1964 to June 1980, 569 kidney allotransplants were performed in 524 patients at the University Hospital in Zurich. Necrokidneys were used exclusively. Twelve of these patients exhibited severe colonic complications: four perforations (1 perforated diverticulitis of the sigmoid, 1 perforation of the cecum during cytomegalovirus infection, 2 cases of ischemic colitis), 5 cases of ischemic colitis without perforation, and 3 patients with erosive colitis. In 9 of the 12 patients, hypotonic episodes were noted 4–17 days previously. The 2 % complication rate in our patients is comparable with the mean rate of complications mentioned in the literature (2.4 %). The lethality of 75 % also corresponds with the results of other authors. The most important pathogenetic factor for colonic complications is ischemia; prevention of hypotonic episodes after renal transplantation is therefore mandatory.
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  • 17
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 343 (1976), S. 11-21 
    ISSN: 1435-2451
    Keywords: Kidney transplantation ; Renal artery stenosis ; Renal hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Nach 268 Nierentransplantationen trat in 7 Fällen eine Transplantatarterienstenose auf. Drei weitere Patienten wurden von einem anderen Zentrum überwiesen. Das Hauptsymptom der Nierenarterienstenose war bei allen 10 Patienten eine innerhalb von 10 Monaten aufgetretene, medikamentös nicht beherrschbare Hypertonie. In 9 Fällen fand sich ein Stenosegeräusch über dem Transplantat. In 6 Fällen war die Hypertonie von einer leichten, auf Abstoßungstherapie nicht ansprechenden Funktionsverschlechterung begleitet. Bestätigt wurde die klinische Verdachtsdiagnose durch eine selektive Transplantatarteriographie. Es ließen sich 2 Haupttypen von Stenosen feststellen: Segmentstenosen, die immer 0,5-2 cm distal der Anastomose auftreten und durch Intimaläsionen anläßlich der Entnahme und Perfusion verursacht werden, und Knickstenosen infolge technisch fehlerhafter Arterienimplantation. Mit einer Ausnahme ließ sich die Hypertonie durch die Gefäßrekonstruktion unter Kontrolle bringen. Jede medikamentös nicht beherrschbare Hypertonie nach Nierentransplantation muß durch eine selektive Transplantatarteriographie abgeklärt werden. Angiographisch nachgewiesene, klinisch manifeste Stenosen sollten operiert werden.
    Notes: Summary After 268 kidney allotransplants, 7 cases of renal artery stenosis were observed. An additional 3 patients were referred to us from another center. The outstanding symptom of all 10 patients was hypertension refractory to medical treatment, beginning not later then 10 months after transplantation. In 9 cases there was a murmur over the transplant. In 6 patients hypertension was accompanied by a deterioration of renal function which was resistant to antirejection therapy. The tentative diagnosis was confirmed by selective renal arteriography of the transplant. Two main types of stenoses could be diagnosed: Segmental stenoses, 0.5–2 cm distal to the anastomosis, which were due to intimal lesions caused during removal of the kidney or by the perfusion canula; and kinking stenoses due to a technically inadequate implantation. Hypertension was controlled in all but 1 patient with reconstruction of the artery. Therefore, hypertension after kidney transplantation refractory to medical treatment should be further investigated with selective renal arteriography of the transplant. Stenoses with clinical symptoms which are confirmed by arteriography should be surgically corrected.
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  • 18
    Electronic Resource
    Electronic Resource
    Springer
    International orthopaedics 18 (1994), S. 368-371 
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Cinquante six transplantés rénaux (TR) ont été traités par arthroplastie totale de hanche (ATH) pour nécrose aseptique de la tête fémorale (NA), de 1972 à 1992 (recul moyen 6.9 ans). Huit hanches (10.1%) chez 6 patients (11.3%) ont dû être réopérées pour descellement aseptique après un délai moyen de 11.2 ans. Trois patients ont présenté une arthrite septique à Salmonella enteritidis, 6.2 ans en moyenne après l'intervention. Un des trois patients a été traité par révision de l'arthroplastie, le deuxième par une dèsarticulation de hanche en raison d'un risque vital et le troisième par antibiothérapie. Deux fois sur les trois, l'examen bactériologique des urines a révélé la présence de salmonelles. L'analyse des courbes de survie en cas d'ATH et de TR montre un risque de réintervention sur la hanche de 9.9% à dix ans et de 54.6% à quinze ans et un risque de mortalité de 32.2% à dix ans et de 42.2% à quinze ans. Donc les patients qui survivent quinze ans ont plus de risque de voir leur prothèse se desceller que de mourir. L'espérance de vie pour TR n'ayant cessé d'augmenter grâce à l'amélioration des traitements immuno-suppresseurs, les prothèses non-cimentées peuvent représenter une alternative intéressante pour ces jeunes patients, même s'ils souffrent d'une ostéopathie rénale et d'une ostéoporose par corticothérapie.
    Notes: Summary Seventy nine hips in 53 recipients of renal allografts were treated by cemented total hip replacement for avascular necrosis of the femoral head between 1972 and 1992. Eight hips in 6 patients required revision for aseptic loosening after a mean of 11.2 years. Three replacements in 3 patients became infected with salmonella enteritidis after a mean of 6.2 years. One was revised, one had a disarticulation of the hip, and the third was treated with long term antibiotics. Survivorship analysis for total hip replacement and the renal allografts showed a hip reoperation rate of 9.9% at 10 years and 54.6% at 15 years with mortality rates of 32.2% and 42.2% respectively. Thus patients surviving 15 years are at a higher risk of failure of the prostheses than of dying.
    Type of Medium: Electronic Resource
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 68 (1990), S. 874-879 
    ISSN: 1432-1440
    Keywords: Acute uric acid nephropathy ; Hyperuricemia and gout ; Renal tubular defects in gout
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Acute uric acid nephropathy has been described almost uniformly in patients with massive uric acid overload (malignancies with rapid cell destruction, epileptic seizures). Severe hyperuricosuria and intratubular uric acid precipitation result. Here we present two patients with gout, normal uric acid production, and moderate hyperuricemia, both of whom developed acute uric acid nephropathy. Because of pronounced urine acidity (pH values of 4.6 and 5.0 in morning fasting urines), supersaturation with respect to undissociated uric acid exceeded solubility (0.54 mmol/l), despite basal urate secretions of less than 2.2 mmol/24 hours. Additional predisposing factors, such as uricosuric treatment, heavy beer-drinking, over-consumption of purine-rich foods, and hot environment, were superimposed in both cases.
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  • 20
    ISSN: 1432-1440
    Keywords: Renal transplantation ; Immunosuppression ; Cyclosporine A ; Immunologic monitoring ; T lymphocytes ; Cell surface antigens ; Monoclonal antibodies ; Flow cytometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The lymphocyte subsets in the peripheral blood were examined 3 times a week in 17 patients receiving a cadaveric renal allograft using 2-color flow cytometry and several combinations of monoclonal antibodies. Patients who experienced a rejection crisis (n=12) had a significantly higher CD4/CD8-ratio (2.72±1.26 mean±SD) than patients with stable graft function (1.76±1.33, p〈0.05). 9/12 patients showed 0–3 days prior to the rejection episode an increase of the CD4/CD8-ratio (≥0.5) and/or a high ratio (≥2.5) with a decrease following antirejection therapy. The activation markers HLA-DR and IL-2 receptor on T cells were increased only during 3/12 rejection episodes. Patients with rejections resistant to prednisone pulse therapy (n=6) had significantly more lymphocytes/mm3 in the peripheral blood (1111.7±597.5) than successfully treated patients (n=6, 336.7±196.0, p〈0.02). Antirejection therapy with prednisone pulses and/or antithymocyte globuline resulted in a significant decrease of T lymphocytes (CD3+) with a selective reduction of T helper/inducer cells (CD4+). 6 months after renal transplantation the patients had a higher percentage of suppressor/cytotoxic cells (CD8+) compared to the pretransplant values (26.3±10.9% vs 17.7±6.2%, p〈0.02) and blood donors (16.3±6.2%, p〈0.01). Furthermore the percentage of T helper cells (CD4+/CD28−) was significantly higher and the T suppressor-inducer cells (CD4+/CD28+) were significantly lower compared to the controls. Serial flow cytometric determinations of lymphocyte subsets in renal allograft recipients may be helpful in some cases although rejection episodes could not be predicted in the individual patient.
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