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Biomedical subjects

E Wegmüller

Publications and source records attributed to E Wegmüller.

35 records · Page 2Linked to original sources
PubMed1980

Prediction of the histological type of glomerulonephritis. Multiple discriminant analysis of clinical and laboratory characteristics at time of diagnosis.

We performed a prospective study on 68 subjects with biopsy-proven clomerulonephritis using a discriminant analysis of 12 clinical and laboratory characteristics. Among these, the selectivity of proteinuria, the presence of hematuria and the plasma level of C3 proved to be the most useful. An equation based on these three variables discriminated without overlap between 17 patients with minimal change glomerulonephritis (MCGN) and 30 patients with either membranoproliferative or rapidly progressive glomerulonephritis. However, some overlap existed between MCGN and focal sclerosis or membranous glomerulonephritis. In addition, the formula seems to identify steroid-resistant patients with MCGN.

Adolescent↗
PubMed1979

[Acute combined alpha- and beta-adrenergic blockade in essential hypertension: effects on blood pressure, renal function, renin, and aldosterone].

In seven patients with uncomplicated essential hypertension the effects of an acute alpha-adrenergic blockade, alone and combined with a chronic beta-adrenergic blockade, on blood pressure, renal function as measured by standard clearance methods, plasma renin activity, and plasma aldosterone were evaluated. Acute alpha-adrenergic blockade with phentolamine (20 mg by intravenous infusion) significantly enhanced the antihypertensive effect of chronic beta-adrenergic blockade with slow-oxprenolol (160 mg/ day X 14 days) (- 14.5% verus - 7.4% for pulse pressure, - 12.4% versus - 6.0% for diastolic pressure, 2 alpha less than 0.05). Under combined adrenergic blockade renal plasma flow increased, glomerular filtration rate and filtration fraction decreased (2 alpha less than 0.05 each), whereas the fractional clearances of sodium, potassium, free water, and solute load remained unchanged. The activation of the renin-angiotensin-axis, elicited by alpha-adrenergic blockade alone, was suppressed by the preceding beta-adrenergic blockade. These findings demonstrate a favourable antihypertensive action of a combined blockade of alpha- und beta-adrenergic receptor sites without untoward side effects on renal function or the renin-angiotensin-axis.

Adult↗
PubMed1979

Paramyotonia congenita. A clinical, electrophysiological and histological study of 12 patients.

The present paper describes the clinical, electrophysiological and histological findings made in 12 patients belonging to 2 genealogical lineages in Switzerland, suffering from paramyotonia congenita. This is the first report of this disease in Switzerland. The myopathy, transmitted by autosomal dominant inheritance, is characterized by a typical past medical history and by the persistent contraction of the muscles of the face, arms and legs provoked by exposure to cold. Also of diagnostic importance are the myotonic reactions inducible at room temperature, such as percussion myotonia, active myotonia and paradoxical myotonia. During paramyotonic episodes provoked by exposure of the subjects in a refrigeration chamber, serum potassium concentrations remained within normal limits. Potassium loading producing serum levels above 6 mEq/1 in 2 patients gave rise to stiffness and weakness of the arms and legs, but no signs of paralysis. Induced hypokalemia in 3 cases caused no paramyotonic symptoms. Electromyographic recordings in 5 patients showed myotonic discharges, which disappeared upon cooling of the limb, giving way to progressive muscular stiffness. Histological, histochemical and electronmicroscopical examination of the muscle tissue revealed only diagnostically unspecific myopathological changes.

Cold Temperature↗
PubMed1978

[Certain and disputed indications of immunosuppressive therapy in kidney diseases].

The effect of immunosuppressive agents in different glomerulopathies is reviewed and some guidelines for their use in clinical practice are proposed. The immunological aspects of pyelonephritis and interstitial nephritis are studied to evaluate future possibilities of either therapeutic immunosuppression or immunization in these diseases.

Glomerulonephritis↗
PubMed1978

Complement components, degradation products and immune complexes after kidney transplantation.

Levels of complement components and the presence of immune complexes were determined in blood samples from 23 patients is a function of time after kidney transplantation. During the first three post-transplantation weeks a decrease in the concentration of plasma C3 with a simultaneous increase of one of its breakdown products (C3d) was generally observed. This pattern often accompanied acute rejection episodes beyond 4 weeks after transplantation, while in the absence of complications normal and stable levels prevailed. In contrast, the presence of circulating immune complexes appeared not to correlate with rejection reactions. All 7 cases with detectable immune complexes presented with various concomitant neoplastic (renal carcinoma, Kaposi sarcoma) or infectious diseases (pneumonia, septicaemia, Herpes zoster or Cytomegalovirus infection). Thus, monitoring of plasma C3 and C3d may represent a helpful additional criterion for the assessment of acute rejection in recipients of kidney allografts; the presence of circulating immune complexes, although not correlating with graft rejection, may be taken as a sign of complicating additional disease.

Antigen-Antibody Complex↗
PubMed1977

[Proteinuria and kidney transplantation. A quantitative immunochemical study of 7 protein clearances during the first 50 days following implantation of cadaver kidney].

During the initial 50 days following transplantation of a cadaver kidney into 8 patients, determinations of 7 individual protein clearances were performed twice a week. This, the first posttransplantation investigation of single protein clearances utilizing unconcentrated urine, was made possible by the highly sensitive electroimmunodiffusion method of LAURELL [24]. The following results were obtained: 1. Kidney implantation was immediately followed by glomerulo-tubular proteinuria. In patients exhibiting good transplant tolerance the tubular proteins disappeared from the urine by the 43rd day at the latest; on the other hand, excretion of the glomerular proteins transferrin and albumin continued. In patients without complications the proteinuria was already highly selective by the 7th day (70 degrees). 2. In 5 of 8 patients there was a change in the proteinuria pattern during the rejection crisis: glomerulo-tubular proteinuria occurred three times and glomerular proteinuria twice. In two of these cases there was a change in the selectivity. 3. Patients with good tolerance showed plasma prealbumin levels which increased as a function of the time lapse since transplantation. 4. The plasma concentration of retinol-binding protein did not vary following transplantation and remained at 16.8 +/- 2.8 mg% in patients with uneventful course and at 18.5 +/- 4.9 mg% in patients with transplant rejection reactions, both values being markedly above the norm (4.7 +/- 1.1 mg%, [1 SD]).

Adult↗
PubMed1977

[Activation of the complement system in different forms of glomerulonephritis].

The complement system may be activated by two pathways, the classical and the alternate. To evaluate their respective participation in different forms of glomerulonephritis, the plasma values of C3, C4, C3PA, C1q and properdin were determined in 70 patients. In systemic lupus erythematosus (LED), acute poststreptococcal glomerulonephritis (AGN) and septicemia the classical pathway appears to be mainly involved, whereas the amplification loop and the alternate pathway seem to be of secondary importance. By contrast, in membranoproliferative glomerulonephritis (MPGN) the alternate pathway plays a major role. However, the present data suggest that activation of the classical pathway may often be involved as well. In minimal change glomerulonephritis no signs indicating involvement of the complement system were apparent. Follow-up observation demonstrated a correlation between decreases in plasma complement concentrations and the clinical severity of the primary disease in LED, AGN and septicemia, but not in MPGN.

Antigen-Antibody Complex↗