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Biomedical subjects

F Scheler

Publications and source records attributed to F Scheler.

At least 145 records · Page 8Linked to original sources
PubMed1977

[Hyperreninism without hyperaldosteronism in diuretic abuse: a report of a case with identification of mefruside and ethacrynic acid in urine (author's transl)].

A 46-year-old nurse had been hospitalized 16 times during the preceding five years because of episodes of excessive hypokalaemia. On admission to hospital there was hypokalaemia, polyuria, excessive plasma renin activity but no increased aldosterone secretion rate. Diuretic abuse was confirmed by gas-chromatography and mass spectrometry of mefruside and ethacrynic acid in the patient's urine. Apart from other interesting aspects of this case there was the demonstration of hyperreninism without hyperaldo-steronism. The stimulating effect of renin on aldosterone secretion was obviously lower than the inhibiting effect of hypokalaemia. The general term "renin-angiotensin-aldosterone system" is, therefore, misleading because it mentions only one pathway of aldosterone regulation. The combination of hypokalaemia, polyuria, hyperreninism without hyperaldosteronism is apparently the principal but not widely recognised feature of diuretic abuse.

Aldosterone↗
PubMed1977

[Surgical aspects of secondary hyperparathyroidism (author's transl)].

During long-term dialysis of patients in chronic renal failure disorders of mineral metabolism in the sense of renal osteodystrophy occur increasingly with time. Quite separate from these patients with renal osteopathy (osteomalacia and osteopenia) as a result of dialysis there is a group of patients in whom, despite appropriate dialysate composition, a full-blown picture of renal osteodystrophy due to secondary hyperparathyroidism develops. Subtotal parathyroidectomy will significantly improve them. Experience in 12 patients has demonstrated that, in addition to the clinical signs, biochemical findings and radiological changes, the quantitative evaluation of iliac crest biopsy and determination of parathormone and ionised serum-calcium fraction are decisive as indications for surgery. In these patients subtotal parathyroidectomy gave satisfactory results, but the treatment of renal osteopathy in the sense of osteopenia is often unsatisfactory and the full clinical picture can often be improved only by early renal transplantation.

Adult↗
PubMed1977

[Treatment of glomerulonephritis with heparin (author's transl)].

32 patients with different histologically proven forms of glomerulonephritis were treated with heparin for an average of 31 days. A dosage of heparin was chosen, which allowed an increase in thrombin time to 20-40 seconds. Histological findings alone do not allow any prediction concerning the therapeutic success of heparin treatment in glomerulonephritis. According to our results and comparable information given in the literature, the following therapeutic scheme can be recommended: Best results are seen in patients with a slow decrease of GFR (i.e. less than 30 ml/min) during the year preceding the beginning of the treatment. In rapid progredient glomerulonephritis, however, as in patients without any changes of GFR during this time, predictions as to the course of illness cannot be made. A high level of fibrin split products in serum may be expected to be the most valuable sign of therapeutic effect, as could be documented in 7 out of 8 successfully treated patients. Hypertension and proteinuria were not influenced by the treatment. Because of severe side effects the heparin treatment of glomerulonephritis should not be initiated in patients with severe hypertension.

Blood Coagulation Tests↗
PubMed1977

[Clinical aspects of diabetic nephroangiopathy (author's transl)].

Diabetic nephropathy is a dangerous and insidious complication of diabetes mellitus. The course is variable and from the statistical point of view usually unfavorable. The pathogenesis of the complaint is not fully known. Of the numerous hypotheses, the one most favored is a defective glucose metabolism with uncontrolled inundation of the kidney cells with glucose. The predominant symptom is proteinuria. Early recognition and optimal correction of the metabolic disorder may possibly delay the manifestation of diabetic nephropathy for a time. The use of Somatostatin is attracting great attention today. With such a preparation, the stabilization of diabetes could be facilitated.

Adolescent↗
PubMed1977

[The pathogenesis of oral contraceptive hypertension (author's transl)].

Simultaneous administration of estrogen and progestogen accelerates Goldblatt-type hypertension in rats. Neither estrogen nor progestogen alone alters arterial blood pressure. In the hormonal combination the hypertensive effect of estrogen can be replaced by epsilon-amino-capronic acid and the hypertensive effect of progestogen by desoxycorticosterone acetate. Estrogen is the only substance increasing plasma renin activity. There exists no correlation between the increase of the blood pressure and the plasma renin activity in the various groups of experimental animals receiving the different hypertensive preparations. Because of this, oral contraceptive hypertension may be supposed not to result from a stimulation of the renin-angiotensin system but may easily be seen in a combination of endothelial lesions and sodium retention, the former being caused by the estrogen's effect on blood coagulation, the latter produced by the synthetic progestogen.

Animals↗
PubMed1977

[The influence of the beta-blocking agent pindolol on blood pressure and heart weight of rats with Goldblatt-type hypertension (author's transl)].

Preexisting increase of plasma renin activity in hypertension seems to indicate an effective hypotensive action of adrenergic beta-receptor antagonists. In spite of marked elevation of plasma renin activity in Goldblatt-rats, the beta-blocker Pindolol failed to lower the blood pressure. On the contrary, high doses of this substance led to an acceleration of the Goldblatt-type hypertension, perhaps because of the intrinsic sympathomimetic activity of Pindolol. These findings support the conception that beta-blockers are effective in lowering the blood pressure only in hypertension with stimulated renin secretion, which is caused by an increased activity of the sympathetic nervous system. Plasma renin activity was not altered by Pindolol. There existed a linear relationship between blood pressure and left-ventricular weight in all groups of rats, which was not impaired by Pindolol in all used doses.

Animals↗
PubMed1977

Plasma digoxin levels in anuric patients and normal subjects taking digitoxin.

Plasma digoxin suspected to be elevated in anuric patients taking digitoxin was determined by radioimmunoassay in 15 anuric patients and 15 normal persons subjected to 0.1 mg digitoxin therapy per day. All plasma digoxin values from the anuric patients and the normal subjects were far below the lower limit of the therapeutic range of plasma digoxin. There existed no difference between the digoxin values determined in anuric patients and subjects with normal renal function; in both groups there was a scatter of digoxin values about the cross reaction line between digitoxin and digoxin antibody. It is concluded from the results that digoxin retention in anuric patients taking digitoxin plays an insignificant role; thus, the pharmacological effect is mediated by digitoxin itself.

Anuria↗
PubMed1977

Effect of dialysate calcium concentration on plasma parathyroid hormone during hemodialysis.

The effect of changes in the dialysate calcium concentration on calcium fractions and parathyroid hormone species in plasma during hemodialysis has been examined. C-terminal immunoreactive parathyroid hormone was suppressed when plasma calcium increased by greater than 25% whereas N-terminal fragments demonstrated an increase. The significance of this is discussed in light of present knowledge of parathyroid hormone metabolism.

Adult↗
PubMed1977

Parathyroid hormone, calcium and phosphate balance in hemofiltration.

The acute changes in calcium, phosphate and parathyroid hormone have been examined in chronic renal failure patients under-going hemofiltration therapy and the results compared to a similar group treated by hemodialysis. In both groups there was a significant increase in Catot (0.32 mEq/1 for hemodialysis; 0.56 m Eq/1 for hemofiltration) with Ca++ remaining constant. Plasma phosphate and parathyroid hormone decreased during hemofiltration. Calcium balances were slightly positive and phosphate balances distinctly negative in all cases. To date there is no indication of induced osteodystrophy during hemofiltration therapy, although long-term studies are needed. However, the present results indicate, that hemofiltration more closely approaches the physiological situation than conventional hemodialysis.

Calcium↗
PubMed1977

Elimination of hormones through hemofiltration.

The concentrations of testosterone, cortisone, gastrin, GIP, somatomedin B, insulin, HGH, and TSH have been determined in the plasma and the ultrafiltrate of five uremic patients undergoing intermittent hemofiltration treatment. There was a considerable loss of gastrin, GIP, somatomedin B, and insulin by hemofiltration treatment; the plasma concentrations, however, did not decrease. Cortisone, HGH, and TSH were not detectable in the ultrafiltrate. Our results therefore indicate that hemofiltration does not cause a hormone deficiency syndrome. On the contrary, the loss of degradation products of hormones with disturbing biological activity may be a favourable effect of the hemofiltration treatment.

Cortisone↗
PubMed1977

Drug elimination by hemofiltration.

Elimination by hemofiltration of gentamicin, doxycylin, ampicillin, sulfamethoxazole and clofibrate was measured in patients with chronic renal insufficiency. Clearance values of ampicillin and clofibrate were roughly in the range that might be expected according to the reported protein binding values of these drugs, whereas doxycyclin and sulfamethoxazole were eliminated to a much higher degree. Gentamicin clearances during a 6-hour hemofiltration treatment were lower than should be expected from reported protein binding values. For gentamicin and doxycyclin the filtered fraction linearly increased with time, a phenomenon which may be explained by membrane polarization.

Ampicillin↗
PubMed1977

Elimination of cardiac glycosides through hemofiltration.

Elimination of three different cardiac glycosides by hemofiltration was investigated using the flat bed RP-6 (Rhône-Poulenc, Paris). At a filtration rate of 59 +/- 9 ml/min the mean clearance of 3-H-g-strophanthin was 54.9 +/- 10.4, that of a 3-H-digoxin and unlabelled digoxin 36.7 +/- 6.6 and that of digitoxin 4.6 +/- 2.8 ml/min. It is concluded from these results that hemofiltration is able to eliminate more than 50% of the amount excreted during the same period of time by normal kidneys. Elimination of cardiac glycosides by continuous hemofiltration is high enough to justify its use in digitalis intoxication, particularly because of the excellent control of electrolyte balance with this new method of detoxification.

Cardiac Glycosides↗