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Biomedical subjects

G Fuchs

Publications and source records attributed to G Fuchs.

At least 163 records · Page 9Linked to original sources
PubMed1986

Nomifensine and psychological dependence--a case report.

This case report indicates that nomifensine has not only a specific antidepressant profile but also a dose dependent addictive potential in patients with "addictive problems". Nomifensine supports not only norepinephrine transmission, but also acts on dopamine metabolism and this may be responsible for the stimulation of motor activity. This is in contrast to more frequently used tri- and tetracyclic antidepressants. This case report further supports other observations that several patients have psychological withdrawal difficulties after long term treatment with nomifensine in high doses (400-600 mg).

Adult↗
PubMed1986

Pathogenesis of Shigella diarrhea: rabbit intestinal cell microvillus membrane binding site for Shigella toxin.

This study examined the binding of purified 125I-labeled shigella toxin to rabbit jejunal microvillus membranes (MVMs). Toxin binding was concentration dependent, saturable, reversible, and specifically inhibited by unlabeled toxin. The calculated number of toxin molecules bound at 4 degrees C was 7.9 X 10(10) (3 X 10(10) to 2 X 10(11))/micrograms of MVM protein or 1.2 X 10(6) per enterocyte. Scatchard analysis showed the binding site to be of a single class with an equilibrium association constant, K, of 4.7 X 10(9) M-1 at 4 degrees C. Binding was inversely related to the temperature of incubation. A total of 80% of the labeled toxin binding at 4 degrees C dissociated from MVM when the temperature was raised to 37 degrees C, but reassociated when the temperature was again brought to 4 degrees C. There was no structural or functional change of MVM due to toxin as monitored by electron microscopy or assay of MVM sucrase activity. These studies demonstrate a specific binding site for shigella toxin on rabbit MVMs. The physiological relevance of this receptor remains to be determined.

Animals↗
PubMed1986

Experimental basis of angioinfarction for the treatment of renal hypertension.

Collateral circulation and recanalization represent the main problems of organ-ablating renal embolization. Different animal models were used to study the influence of central, peripheral, and capillary occlusion on organ necrosis. The first laboratory experiments were performed to optimize transcatheteral application of the embolization media tested (Gelfoam powder, Histoacryl, Ethibloc). Experiments with the model of a normal rat kidney (n = 400) showed that only capillary embolization homogeneously occluding the entire arterial system resulted in complete organ necrosis, while following central (renal artery ligation) or peripheral (Gelfoam powder) occlusion, areas of intact parenchyma remained. Ethibloc/glucose proved to be the embolization medium best suited for capillary embolization (radiopaque, inert, slow resorption). Studies with the model of unilateral renal hypertension of the rat (n = 146) demonstrated the equivalent therapeutic efficiency on blood pressure of Ethibloc embolization (57% cured, 21% improved) compared to surgical nephrectomy (50% cured, 29% improved), whereas renal artery ligation (85% failed) resulted in minor improvement only. In order to adapt capillary embolization with Ethibloc/glucose to clinical angiographic techniques, we performed angioinfarction of canine kidneys (n = 15): the use of a balloon catheter is mandatory. This guarantees blood stasis during the embolization procedure and avoids embolic reflux. Possible clinical indications of capillary embolization in renal hypertension as a less invasive method are, e.g.: malignant nephrosclerosis; renovascular or glomerulonephritic contracted kidneys, and renal dysplasia. Indications for super-selective vaso-occlusion are renal aneurysms, a-v malformations, and segmental hypoplasia.

Angioplasty, Balloon↗
PubMed1986

The proteinase inhibitor complexes (antithrombin III-thrombin, alpha 2antiplasmin-plasmin and alpha 1antitrypsin-elastase) in septicemia, fulminant hepatic failure and cardiac shock: value for diagnosis and therapy control in DIC/F syndrome.

Thrombin (Thr), plasmin (Pl) and elastase (ELP) are serine proteinases which are quickly inactivated by their specific inhibitors (AT III, alpha 2AP, alpha 1AT), if intravascular activation of coagulation and fibrinolytic system or if release from PMN granulocytes by different stimuli (F.I., endotoxin, activated factor XII, a.o.) occurs. The immunological determination of the developing proteinase inhibitor complexes (PIC) AT III-Thr, alpha 2AP-Pl and alpha 1AT-ELP gives information as to whether intravascular coagulation, hyperfibrinolysis or unspecific proteolysis induced by elastase have taken place. Despite the high antiprotease activity in the plasma the a.m. serine proteinases may exert their proteolytic activity towards their specific substrates in vivo. In infectious diseases, fulminant hepatic failure and cardiac shock a complex consumption of coagulation factors and inhibitors may cause severe coagulation defects, microcirculatory disturbances and bleeding tendency. The PICs behaviour was determined in more than 80 patients with infectious diseases, in 5 patients with fulminant hepatic failure (FHF) and 7 patients with cardiac shock. Only in infectious diseases, mainly in septic complications, and septic complications during FHF and cardiac shock, are alpha 1AT-ELP levels found to be highly elevated. After cardiac shock, in FHF and in infectious diseases coagulation and fibrinolysis may additionally be activated. In this case AT III-Thr and alpha 2AP-Pl complexes could be detected in the patients plasma. This indicates that intravascular coagulation and hyperfibrinolysis has additionally taken place. To prevent bleeding complications a replacement therapy with plasma derivatives (AT III, plasminogen concentrate, PPSB and FFP) has been successfully performed in several patients with septic complications and in the 5 patients with FHF and the 7 patients with cardiac shock. No bleeding complication occurred, and the haemostatic balance could be maintained in the treated patients. AT III replacement therapy is necessary to stop DIC, PPSB improves severe coagulation defects, only FFP may additionally provide alpha 1AT, alpha 2AP and factor V. In acute renal failure sometimes plasminogen replacement is necessary to maintain a normal activity of the fibrinolytic system. The complex consumption of coagulation proteins in infectious diseases, FHF and cardiac shock cannot successfully be treated with an anticoagulant such as heparin alone.

Aged↗
PubMed1986

[Extracorporeal lithotripsy in the treatment of renal lithiasis. 5 years' experience].

The historical background to extracorporeal lithotripsy using shock waves is described and indications for use of this treatment discussed in relation to other types of therapy for reno-ureteral lithiasis: percutaneous or trans-ureteral endoscopy. The reduction in invasive surgical procedures is emphasized. The first human use of extracorporeal lithotripsy by shock waves dates back to 1980. Since then, more than 30,000 calculi have been treated in this way, either exclusively or in combination with other therapy. For simple small calculi (less than 1 cm in diameter and situated in the pelvis or a calyx) the incidence of complications is minimal: renal colic (15%), fever (13%), need for complementary therapy (7%). With extension of use of extracorporeal lithotripsy to complex calculi (multiple calculi, staghorn calculi) these figures increased to 30, 5 and 12% respectively. Patients with obstructive and infected lithiasis were treated by percutaneous drainage nephrostomy with intensive antibiotic therapy prior to extracorporeal treatment. Extending indications also provided data on contraindications: coagulation disorders, major vascular problems, abnormal size or weight of patient, pregnancy and finally difficulty in localizing calculi. Of interest is the almost total lack of efficacy of shock waves for treating staghorn calculi. Treatment in these cases should be by an initial percutaneous approach to reduce size of calculus followed by extracorporeal lithotripsy under nephrostomy cover. Surgery for lithiasis should therefore be reserved for complex lithiasis cases with large caliceal calculi proximal to a long narrow infundibulum and to calculi proximal to a stenosis of pyelo-ureteral junction. Whenever possible, lumbar ureter calculi should be raised towards the pelvis by endoscopic manipulation before extracorporeal lithotripsy.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1985

Effects of nicotine and its major metabolites on blood pressure in anaesthetized rats.

Blood pressure and heart rate in anaesthetized rats has been determined after i.v. injection of increasing doses of nicotine (NI) and its major metabolites, i.e. continine (CO), nornicotine (NOR), metanicotine (MN) and dihydrometanicotine (DMN). NI and MN elicited similar dose response curves, increasing blood pressure according to the dose injected. However, the dose response curve of MN was shifted to the right. Furthermore DMN caused similar pressor effects than MN and the pressor effects of NOR was even weaker. Only after injection of CO was a dose-dependent depressor effect observed and this was reversed after very high doses. CO also reduced heart rate in a dose-dependent manner, whereas NI and its other metabolites did not significantly change heart rate.

Animals↗
PubMed1985

Formation of carbon monoxide from CO2 and H2 by Methanobacterium thermoautotrophicum.

Cell suspensions of Methanobacterium thermoautotrophicum were found to reduce CO2 with H2 to CO at a maximal rate of 100 nmol X min-1 X mg protein-1. Half-maximal rates were obtained at a H2 and a CO2 concentration in the gas phase of 10% and 30%, respectively. The CO concentration in the gas phase surpassed the equilibrium concentration by a factor of more than 15 which indicates that CO2 reduction with H2 to CO was energy-driven. This was substantiated by the observation that the cells only formed CO when they also generated methane and that CO formation was completely inhibited by uncouplers. CO formation by cell suspensions and by growing cells was inhibited by cyanide. Neither methane formation nor the electrochemical proton potential were affected by this inhibitor. Cyanide was shown to inactivate specifically the carbon monoxide dehydrogenase present in M. thermoautotrophicum. It is therefore concluded that reduction of CO2 to CO is catalyzed by this enzyme. CO production by growing cells was 5-10-times slower than by resting cells. This is explained by effective CO assimilation in growing cells; when CO assimilation was inhibited by propyl iodide the rate of CO production immediately increased more than tenfold.

Aldehyde Oxidoreductases↗
PubMed1985

Extracorporeal shock-wave lithotripsy: one-year experience with the Dornier lithotripter.

Extracorporeal shock-wave lithotripsy (ESWL) has now been in clinical use for more than 4 years. In October 1983, the second kidney lithotripter in the world was installed in our department and, from then until October 1984, 800 treatments were performed on 733 patients. Our results confirm the promising reports published by the Munich group. Furthermore, it was possible to extend the range of indications by combining ESWL with percutaneous procedures, such as percutaneous nephrolithotomy and ureteroscopy. As a result only 7% of all patients who were referred to our hospital with urinary stones (4% of renal stone patients and 15% of those with ureteral stones) had to undergo open surgery.

Combined Modality Therapy↗
PubMed1985

Antegrade ureteroscopy for stone removal.

Antegrade ureteroscopy, using the 11-French ureteroscope via a percutaneous transrenal access, provides safe and easy endoscopic exploration of the ureter above the level of the iliac vessels. The technique has proven to be reliable and effective for the removal of obstructing proximal ureteral calculi: all of the 22 patients who underwent antegrade ureteroscopy were stone-free after treatment. Since the introduction of this new technique in our department, no more open surgery has been required to manage ureteral calculi.

Endoscopy↗
PubMed1985

The clinical significance of alpha 1-antitrypsin-elastase (alpha 1AT-ELP) and alpha 2-antiplasmin-plasmin (alpha 2AP-PL) complexes for the differentiation of coagulation protein turnover: indications for plasma protein substitution in patients with septicaemia.

In inflammation, particularly in septicaemia, complex coagulation disorders may lead to a dangerous haemorrhagic diathesis. The conventional concept for this syndrome called DIC implicates the occurrence of active thrombin in the circulation, which may be followed by hyperfibrinolysis due to plasmin formation. In this study data are presented suggesting an important role for a third proteolytic system, granulocytic elastase. The complexes of plasmin and elastase with their specific inhibitors, alpha 2-antiplasmin-plasmin (alpha 2AP-PI) and alpha 1-antitrypsin-elastase (alpha 1AT-ELP) were determined immunologically. The alpha 1AT-ELP appears mainly in gram-negative septicaemia, particularly in meningococcal disease. The estimation of alpha 2AP-PI and alpha 1AT-ELP, together with a method for the detection of the antithrombin III--thrombin complex which remains to be established, is a suitable tool for for the differential diagnosis of the consumption of coagulation proteins. The assumption that at least three proteolytic systems participate in the development of the haemorrhagic diathesis during inflammation leads to the concept of a broad, comprehensive substitution therapy with e.g. concentrates of AT III, PPSB, or fresh frozen plasma. The aim of this treatment is to replace not only the consumed procoagulatory factors, but also the lacking inhibitors in order to control this "abnormal proteolysis syndrome".

Adult↗
PubMed1985

[Experience with extracorporeal shockwave lithotripsy based on 5 years' clinical use].

After 6 years of experimental research at the Departments of Urology and Surgical Research of the Ludwig-Maximilian University in Munich, extracorporeal shock-wave lithotripsy (ESWL) was introduced into clinical use in 1980. Uniquely successful and increasingly requested by stone patients, the method soon became widespread. Currently more than 70 lithotriptors are in operation worldwide and over 30,000 treatments have been carried out successfully. Clinical experience in all centers has proved the safety, reliability and reproducibility of the method. Currently, approximately 70% of nonselected stone patients are eligible to receive ESWL treatment and, when combined with endourological procedures, more than 95% of patients can benefit from this method and thus avoid open surgery.

Adolescent↗