Biomedical subjects
Publications and source records attributed to D Brunner.
A case is presented in which computed tomography of the abdomen was performed to search for possible peritoneal abscess. The incidental observation of an irregularly thickened wall of the colon led to the diagnosis of pseudomembranous colitis.
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Plasma levels of beta-thromboglobin (beta-TH) and of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1-alpha, the stable metabolites of thromboxane A2 and prostacyclin, were determined by radioimmunoassay methods in eight patients with noninsulin-dependent diabetes before and after dietary treatment and after administration of the sulfonylurea drug glibenclamide. Blood examinations were performed when hyperglycemia was detected for the first time, four weeks after a dietary regimen was started, and four and eight weeks after glibenclamide treatment was begun. Drug treatment was instituted because, despite a suitable diet, patients' postprandial blood sugar was higher than 8 mmol/L (145 mg/dl). At the initial examination, elevated TXB2 and beta-TH levels indicating platelet hyperactivity and hyperglycemia were found. TXB2 and beta-TH levels decreased significantly after glibenclamide treatment was started, as did the blood glucose level. There was no change in 6-keto-PGF1-alpha. We interpret these results to indicate that diabetes is associated with hyperactivity of platelet aggregation and that control of blood glucose is important because a lower blood glucose level attenuates platelet hyperactivity. Whether the decrease in platelet hyperactivity is a direct result of the lowered blood sugar or reflects the influence of the drug treatment requires clarification.
The aim of this study was to examine the duration of action of a single cutaneous application of a 10% isosorbide dinitrate ointment (ISDN-S) and also to ascertain the possible appearance of nitrate tolerance after 6--8 months' maintenance therapy with ISDN-S. After a single application of the ointment an effect lasting more than 7 hours was confirmed by bicycle ergometry. After longterm therapy an acute test with rapidly acting sublingual ISDN produced an undiminished response thus showing lack of nitrate tolerance.
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1. The effect of acute inhibition of angiotensin-converting enzyme by captopril (50 mg) on renal haemodynamics and function was assessed in nine patients with essential hypertension on unrestricted sodium intake (n = 8) or low sodium diet (n = 1). 2. Captopril induced a rapid and significant decrease in arterial pressure, which was maximal within 60 min. 3. Effective renal plasma flow (ERPF) increased, glomerular filtration rate (GFR) did not change and filtration fraction (FF) decreased after captopril. No change in sodium excretion and a decrease in urinary potassium occurred. 4. In the patient on low sodium diet, captopril induced striking increases in GFR and ERPF (64 and 106% respectively). 5. The logarithm of baseline plasma renin activity was positvely correlated with the change in ERPF and negatively correlated with changes in FF and renal resistance. 6. The results indicate that in patients with essential hypertension angiotensin participates actively in the maintenance of renal vascular tone at the efferent arteriolar level. A possible influence of kinins remains to be defined.
The effect of a gluttony diet in healthy subjects was studied over an observation period of 12 months. Twenty-six agricultural workers, all of them Yemenite Jews, received a high-caloric, high-fat diet, and the changes in serum cholesterol (CH), high-density-lipoprotein-cholesterol, triglycerides, and body weight were assessed. Yemenite Jews as a group are characterized by low serum CH levels and by a low incidence of coronary artery disease. For a period of 7 months the subjects received a diet of 4553 cal/day, more than double their original "Yemenite diet". After this time they resumed their customary low-caloric diet for 3 months, and thereafter for another 2 months they continued with the high-caloric food regimen. The high-caloric, high-fat diet resulted in the expected increase of serum CH. A similar increase of high-density lipoprotein-CH was found. Serum triglyceride levels changed inversely to those of CH. It is suggested that the altered relation of calories derived from carbohydrates to those derived from fats brought about the decrease of triglycerides, and this irrespective of the increased intake of carbohydrates and fats. The rather small gain of body weight over the trial period--despite the doubled caloric intake--is similar to other studies that showed that the ability of normal individuals to gain weight through overeating varies considerably.
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