Recombinant eglin c is a potent reversible inhibitor of human pancreatic elastase. At pH 7.4 and 25 degrees C, kass. = 7.3 x 10(5) M-1.s-1, kdiss. = 2.7 x 10(-4) s-1 and Ki = 3.7 x 10(-10) M. Stopped-flow kinetic indicate that the formation of the stable enzyme-inhibitor complex is not preceded by a fast pre-equilibrium complex or that the latter has a dissociation constant greater than 0.3 microM. The elastase-eglin c complex is much less stable at pH 5.0 and 25 degrees C, where kdiss. = 1.1 x 10(-2) s-1 and Ki = 7.3 x 10(-8) M. At pH 7.4 the activation energy for kass. is 43.9 kJ.mol-1 (10.5 kcal.mol-1). The kass. increases between pH 5.0 and 8.0 and remains essentially constant up to pH 9.0. This pH-dependence could not be described by a simple ionization curve. Both alpha 2-macroglobulin and alpha 1-proteinase inhibitor are able to dissociate the elastase-eglin c complex, as evidenced by measurement of the enzymic activity of alpha 2-macroglobulin-bound elastase or by polyacrylamide-gel electrophoresis of mixtures of alpha 1-proteinase inhibitor and elastase-eglin c complex. The rough estimate of kdiss. obtained with the alpha 2-macroglobulin dissociation experiment (1.6 x 10(-4) s-1) was of the same order of magnitude as the constant measured with the progress curve method. Eglin c strongly inhibits the solubilization of human aorta elastin by human pancreatic elastase. The extent of inhibition is the same whether elastase is added to a suspension of elastin and eglin c or whether elastase is preincubated with elastin for 3 min before addition of eglin c. However, the efficiency of the inhibitor sharply decreases if elastase is reacted with elastin for more prolonged periods.

Elastin↗

PubMed1990

Staphylococcus aureus nasal carriage and infection in patients on continuous ambulatory peritoneal dialysis.

We studied 140 consecutive patients beginning continuous ambulatory peritoneal dialysis (CAPD) at one of seven hospitals to assess the relation of the nasal carriage of Staphylococcus aureus to subsequent catheter-exit-site infection or peritonitis. Shortly before the implantation of the catheters, the patients' anterior nares were cultured for the presence of S. aureus. Antibiotics were not prescribed for the S. aureus carriers, but all the patients were monitored for signs of catheter infection (median follow-up, 10.4 months). At the initiation of CAPD, 63 patients (45 percent) carried S. aureus in the nares. Nasal carriage was more frequent among the 30 patients with diabetes (77 percent) than among the 110 without the disease (36 percent). The carriers of S. aureus had a significantly higher rate of exit-site infection than the noncarriers (0.40 vs. 0.10 episode per year; P = 0.012). Of these episodes, 24 of 34 were caused by S. aureus. The rates of peritonitis of all bacterial types did not differ significantly between the groups, but all 11 episodes of peritonitis caused by S. aureus occurred among the carriers. In 85 percent of the patients with clinical S. aureus infections, the strain from the nares and the strain causing the infection were similar in phage type and antibiotic profile. We conclude that in patients beginning ambulatory peritoneal dialysis, the nasal carriage of S. aureus is associated with an increased risk of catheter-exit-site infection and that the performance of nasal cultures before the implantation of the catheter can identify patients at high risk of subsequent morbidity.

Adult↗

PubMed1990

[Continuous ambulatory peritoneal dialysis in patients over 75 years].

In a clinical retrospective study, the authors report their chronic ambulatory peritoneal dialysis (CAPD) experience in 31 patients, aged more than 75 years. All present 3.7 diseases associated with continuous renal failure. CAPD lasted 24 months/patient and was adapted to the patient's clinical situation and residual kidney function. Twenty patients require help to perform CAPD. The clinical and biological results are good. The nutritional status is acceptable, so is the peritonitis rate: 1 ep/17 patients months. Because the patients stay in hospital 19 days/year, there is a need of backup facilities.

Aged↗

PubMed1990

Continuous ambulatory peritoneal dialysis (CAPD) or center hemodialysis? Retrospective evaluation of the success of both methods.

In a retrospective study, the authors analysed the dialysis-technique success rate in 276 chronic renal patients. Of these, 137 patients have been treated with in center hemodialysis (CHD) from 1972 to 1989 and 139 with continuous ambulatory peritoneal dialysis (CAPD) from 1978 to 1989. The six-year technique success rate was 28% in CAPD and 31% in CHD (statistically not significantly different). Various risk factors influence the technique-success rate of both methods in the same way. The results suggest that in our center CAPD is as effective as CHD in the treatment of patients with end-stage renal failure.

Adolescent↗

PubMed1990

[Daily hemodialysis of ultra-short duration with non-traumatic vascular access. Two cases].

The authors report their experience on treating two patients, suffering end-stage renal disease, by daily hemodialysis of ultra-short duration with a non-traumatic vascular access. 90 minutes dialysis are realized 6 days a week. Clinical tolerance is excellent and patients' adhesion is satisfactory. However, despite reutilization of the dialyzer, the method remains costly.

Aged↗

PubMed1990

[Influence of experience on the success of the treatment of chronic kidney failure by continuous ambulatory peritoneal dialysis compared with hemodialysis at a center].

Experience influence on treatment success of renal chronic failure by continuous ambulatory peritoneal dialysis comparatively to hemodialysis in center is estimated by the probability variation of still being in dialysis techniques. The retrospective study was realized in 276 dialysed patients who were taken over from 1972 to April 1989. In this population, there isn't any significant difference between the probability to stay in ambulatory peritoneal dialysis or in hemodialysis in center. But, if the study is realizing from the 4 years which followed the technique introduction in the center, the success probability at 30 months, remains the same for hemodialysis in center whether the technique has began in 1972 or 1976, whereas for continuous ambulatory peritoneal dialysis, this probability raises from 52% to 72% if it begins after 1982. Ambulatory peritoneal dialysis treated patients would be maintained more longer in their system than hemodialysis patients. Those results are explaining by prevention of the peritonitis thanks to technological progress and the early prevention of possible complications.

Adolescent↗

PubMed1989

Rheumatic syndromes and beta 2-microglobulin amyloidosis in patients receiving long-term peritoneal dialysis.

We studied 56 patients who had been receiving peritoneal dialysis for greater than 3 years, to investigate the prevalence of rheumatic diseases suggestive of beta 2-microglobulin (beta 2m) amyloid deposition. Eight patients were found to have carpal tunnel syndrome, 16 had chronic shoulder pain, 8 had subchondral bone cysts, and 13 had destructive arthropathies. Amyloid reacting with anti-beta 2m was demonstrated in the hip synovium of 1 patient. Serum beta 2m levels were elevated in all patients. These data suggest that peritoneal dialysis, like hemodialysis, may lead to the development of an arthropathy associated with beta 2m accumulation and beta 2m amyloid deposition.

Adult↗

PubMed1989

[Local immunologic reactions induced by CAPD].

During CAPD, the peritoneal cavity is submitted to situations such as the accidental bacterial contaminations and the continuous presence of dialysate, which stimulate immunological factors. The antibacterial defenses include opsonins and cells. Only IgG and fibronectin are present in the peritoneal effluent but they are diluted by the dialysate. Macrophages represent 70 to 80% of the peritoneal cells. Beside good phagocytic capacity, some may have a defective bactericidal activity. The continuous presence of dialysate leads to a chronic local inflammation. Macrophages and lymphocytes will synthesize IL-1, PGE2 and IFN-Y. These substances generate movement, attachment and proliferation of fibroblasts in the peritoneal submesothelial tissue, resulting in progressive fibrosis. This fibrosis, generally asymptomatic, may be responsible for loss of Ultrafiltration (UF) and Sclerosing Encapsulating Peritonitis (SEP).

Bacterial Infections↗

PubMed1988

[Joint diseases in hemodialysed patients. The extrarenal epuration method is not involved].

Explore the source record for details and available documents.

Female↗

PubMed1988

[Experience of decentralized informatics at a nephrology unit of a general hospital].

The computerized medical specialized records covering the follow-up of hypertension (ARTEMIS), diabetes (MELLITEE), chronic renal failure and the minimum medical record of Nephrology (THESEE) using the temporal database management system LIED, have been developed in several units of University Hospitals. The authors show that these computerized records are usable in a Nephrology Unit in a General Hospital.

Diabetes Mellitus↗

PubMed1987

[Evaluation of the control quality of arterial hypertension over a 10-year period at a hemodialysis center].

Using the "Diaphane" computed medical record system enables multicentric statistical studies to be conducted. With this system, the quality of arterial hypertension control (supine systolic and diastolic arterial pressure before and after dialysis) was evaluated over a 10-year period in chronic haemodialysis patients in comparison with a multicentric population. A continuous statistical study of the results showed a regular voluntary decrease in arterial pressure. The evaluation of the quality of medical care represented by this comparison contributes to a therapeutic improvement.

Adult↗

PubMed1987

Progressive calcifying peritonitis: a new complication of CAPD? Report of two cases.

The authors report the history of two patients treated with CAPD who developed a progressive calcifying peritonitis (PCP). The symptoms include abdominal pain, impairment of bowel movements, sterile effluent dialysate and progressive development of peritoneal calcifications. The etiology of the PCP remains elusive, but dialysate with acetate, high peritonitis incidence and continuous lavage as treatment for peritonitis are suspected to play a role in its evolution.

Acetates↗

PubMed1987

[Decentralization of the ARTEMIS system in a nephrology service in a general hospital].

"ARTEMIS" is a standardized and computerized medical file which is intended for improving the follow-up of hypertensive patients, the efficacy of treatment and for realising national-wide surveys. The software "LIED" of data base for "ARTEMIS" is nowadays transposable on mini-computer. In Nephrology Unit of General Hospital from Colmar, the system has been working since September 1985 with MICRO-MEGA E 32 (Thomson). The administrative and medical data are directly acquired by the doctors and secretaries of the Unit on a conversational mode from six terminals. There is no writing collecting of data. An evaluation of the system was realized with the 113 first hypertensive patients. The results were compared to those obtained from patients of Paris area.

Follow-Up Studies↗

PubMed1987

[Continuous ambulatory peritoneal dialysis: results after more than 3 years].

The authors report the result obtained with CAPD in 20 chronic renal patients treated during 4.6 years in average. The dialysis possibilities have maintained at middle term. Nevertheless, the awaited advantages concerning anemia, calcium and phosphorus disorders, neuropathy, are transient and incomplete. The water and sodium intakes need strongly to be controlled in order to achieve normal blood pressure. Finally the use of "Y" disconnect systems dramatically reduces the peritonitis rate.

Adult↗