[Therapy of hyperuricemia and gout. Effect of a combination therapy of allopurinol with benzbromarone].
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Biomedical subjects
Publications and source records attributed to F Matzkies.
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A procedure for the quantitative determination of O-hydroxyethylated rutosides by high-performance liquid chromatography is described, which can be used for the detection of these modified flavonoids in human serum. Serum samples are processed by the addition of acetone, which removes most of the proteins. After passing the supernatant through a microcolumn of Amberlite XAD-2 and washing with water, the hydroxyethylated rutosides are eluted with methanol. The eluate is concentrated in vacuo. The methanolic solution of the residue is chromatographed on RP-8 columns using UV and fluorescence detectors. The mono- to tetrahydroxyethylated constituents and their corresponding aglycones could be separated with a step gradient, starting with a solvent system of water-methanol-acetic acid (70:30:6) followed by a mixture of water-ethanol-acetic acid (70:30:6). Alternatively, the rutosides can be separated by a linear gradient of water-acetonitrile. An almost linear calibration curve and about 80% recovery are obtained. A detection limit of 1 mg/l is achieved. Pharmacokinetic studies in human volunteers are described.
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8 patients with relative weights averaging 31% above normal values as defined by Broca followed a formula diet for 2 weeks. The diet consisted of 50.7 g protein, 13.6 g fat, 91.3 g carbohydrates and also contained 14.3 g wheat bran and 3 g apple pectin as sources of roughage. The group had a mean weight loss of 5.9 kg (421 g/day). Blood biochemistry estimations showed a decrease in cholesterol from 197 +/- 13 to 166 +/- 13 mg/day (p less than 0.01). There were no disorders of water and electrolyte balance. Transaminases remained within the normal range. No increase in leucocytes and erythrocyte sedimentation rate was observed. Physical efficiency of the patients was tested intermittently on days 7 and 13 by means of muscular training lasting 180 minutes. This did not lead to additional disorders of water and electrolyte metabolism except for a transient increase in magnesium excretion during muscular activity. In the second week the mean weight of the stools was 79 +/- 11 g/day. Because of the adequate supply of dietary fibre no constipation was noted.
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Eight healthy men received a formula diet over a period of 12 days. The acceptance of the diet was good. Gastroenterological side-effects were rarely noticed. Stool frequency was 0.5/day. To keep weight constant a caloric need of 24 +/- 3 cal/kg/BW was necessary. The nitrogen balance was regulated by feeding 59 g protein, 53 g fat and 216 g carbohydrate. The average intake of nitrogen amounted to 8.9 +/- 1.7 g/day. A daily nitrogen loss of 6.96 +/- 1.87 g/day was noticed.
For weight reduction nine healthy subjects received a formula diet rich in protein and dietary fibers. The weight loss was 335 g/day. Cholesterol concentrations dropped about 30% in the course of 14 days. With a daily dose of 75 g protein-mixture the nitrogen-balance was slightly positive. Due to the high fiber content of the formula diet the stool weight was 78 +/- 45 g/day. No changes in blood chemistry and mineral content of urine were observed.
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Linoleic acid, gamma-linoleic acid and arachidonic acid are essential substrates for human nutrition. The daily requirement of linoleic acid or linoleic acid equivalent are 6.5 g/die. The recommended dietary allowance (RDA) for safety intake has been fixed to 10 g/die. During deficiency of essential fatty acids (EFA) linoleic acid concentration in tissue is diminished and the prostaglandin synthesis is lowered, too. Prostaglandins are formed exclusively from linoleic acid equivalent, mostly arachidonic acid. Augmented application of EFA lowers cholesterol and triglicerides concentration in blood. An antihypertensive effect of EFA has recently been described. Unsaturated fatty acids can be used in therapy of hypercoagulability. In the dietary treatment of diabetes mellitus EFA improve the effect of insulin. EFA stop the development of atheromatosis. Therefore one should not hesitate to practice an EFA-rich diet.
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The effect of a 60 g protein diet was compared to a 120 g protein diet. Under nutrition with 60 g protein/day the uric acid clearance dropped from 6.3 +/- 2.2 ml/min to 4.9 +/- 1.6 ml/min. During application of 120 g protein/day uric acid clearance was not reduced. Therefore serum uric acid concentration dropped from 7.7 +/- 0.5 mg/dl to 6.4 +/- 0.5 mg/dl. The supply of 120 g protein/day has such a strong uricosuric action that the otherwise occurring inhibition of uric acid clearance during weight reduction can be balanced.
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