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Biomedical subjects

H Köhler

Publications and source records attributed to H Köhler.

At least 379 records · Page 21Linked to original sources
PubMed1982

Subtypes of acute postinfectious glomerulonephritis. Synopsis of clinical and pathological features.

42 kidney biopsies from adults and children suffering from acute postinfectious glomerulonephritis were examined by light microscopy, immunofluorescence and electron microscopy. The biopsies were obtained within 9 weeks of the onset of the first clinical symptoms. The results show not only a range of variation in the histological picture (particularly in the accumulation of leukocytes in the capillary lumens, and in the degree of cell proliferation) but also different immunofluorescent patterns which we have called the "starry sky", "garland" and "mesangial" patterns. These patterns correspond to characteristic differences in the electron microscopic picture. The "starry sky" pattern (IgG, IgM and/or IgA, combined with C3) occurs mainly in the first weeks of the disease and is associated with an endocapillary-mesangial glomerulonephritis. This may turn into a "mesangial" pattern (mostly C3 alone) which is associated mainly with mesangial proliferation. Four types of immune deposits can be observed electron microscopically in all three patterns (subendothelial, subepithelial, mesangial and intramembranous), but their different quantitative distribution determines the characteristic picture. Subepithelial deposits (so called "humps") often considered characteristic of poststreptococcal glomerulonephritis play a dominant role in the "garland" pattern. The cases with a "garland" pattern often show strikingly high levels of proteinuria (greater than 5 g/24 hr). It is believed that in patients with postinfectious glomerulonephritis deposition of immune complexes of various composition is responsible for producing the described subtypes depending on their different distribution in the glomeruli. It seems possible that these subtypes have different clinical significance, something which could be confirmed by performing follow-up studies.

Acute Disease↗
PubMed1982

[Osteoarticular tuberculosis. Review - current status of diagnosis and therapy].

Osteo-articular tuberculosis has become now a relatively rare disease in civilized countries. This fact makes the recognition of this infectious disease more difficult. In comparison with the pre-chemotherapeutical era, the time of falling ill has shifted from childhood and youth to the adult age. In our own 804 cases (1970 to 1980) the mean age is now in the seventh decade. The localisation most common seen is the spine, followed by hip- and knee joint. As far as the best therapy is concerned, diagnostics is nowadays as important as formerly. The highly efficient tuberculostatic chemotherapy changed the therapeutic conception concerning osteo-articular tuberculosis. Lengthy immobilisation of the affected joints and bones, in former years the therapy of choice has now be replaced by functional treatment in combination with surgical procedures (radical cleaning of foci).

Adolescent↗
PubMed1982

The influence of renal function on plasma levels and urinary excretion of acebutolol and its main N-acetyl metabolite.

The pharmacokinetics of acebutolol and its major N-acetyl metabolite diacetolol were determined following acute intravenous and chronic oral administration to 22 subjects with glomerular filtration rate (GFR) between 3 and 127 ml/min. Following chronic oral administration the mean terminal elimination half-life of unchanged acebutolol was about 10 hours independent of renal function, whereas the hall-life of the N-acetyl metabolite increased from 12.8 hr in subjects with normal renal function (GFR greater than 90 ml/min) to 24.0 hr in preuremic patients (GFR less than 10 ml/min). The mean area of the plasma level-time curve (AUC) of the metabolite was 14.2 mg 1-1 hr in patients with normal renal function and rose to a value of 81.4 mg 1-1 hr in preuremic patients. The mean AUC of the parent drug was not influenced by changes in renal function. The considerable accumulation of the acetyl metabolite, which has about the same beta blocking activity as the unchanged drug, necessitates dose reduction of acebutolol in the presence of different degrees of renal impairment (reduction by half of the normal daily dose in patients with GFR between 30 and 10 ml/min and by three quarters when GFR less than 10 ml/min). In subjects with normal renal function, the ratio between the AUC of the parent drug and that of its major N-acetyl metabolite was 3:1 after intravenous injection of the drug, while it was 1:2.5 following chronic oral administration, indicating a marked first pass metabolism of acebutolol.

Acebutolol↗
PubMed1981

The aldolase-binding site of the human erythrocyte membrane is at the NH2 terminus of band 3.

Band 3 is the predominant membrane-spanning polypeptide and the mediator of anion transport in the human erythrocyte. In addition, it provides the sites of association for fructose 1,6-bisphosphate aldolase and other cytoplasmic proteins with the membrane. The aldolase-binding activity of water-soluble fragments of band 3 was measured by their inhibition of aldolase catalytic activity and by their displacement of aldolase from ghosts. At saturation, the binding of one band 3 or certain of its fragments per aldolase molecule partially inhibited the catalytic activity and band 3 binding of the unliganded subunits of the tetramer through an apparently cooperative mechanism. An NH2-terminal 23,000-dalton fragment generated by S-cyanylation of the cytoplasmic pole of band 3 was approximately 20% as avid in binding aldolase as was native band 3. Several fragments cleaved from the NH2-terminal portion of the 23,000-dalton peptide by trypsin, mild acid hydrolysis, and cyanogen bromide digestion all bound aldolase, while fragments from the rest of the polypeptide were essentially inactive. The first 31 residues of band 3 contained 16 Asp plus Glu, no basic residues, and a blocked alpha-amino terminus. The highly acidic composition of this region is consistent with the strongly electrostatic character of the interaction between band 3 and aldolase, presumably at the strongly basic catalytic center of the enzyme. We conclude that the NH2-terminal region of band 3 bears the membrane-binding site for aldolase.

Amino Acids↗
PubMed1981

[Ambulatory hemodilution therapy of peripheral arterial circulation disorders].

Ambulatory isovolaemic haemodilution in 10 patients with disturbances of the arterial blood supply of the stages II-IV after Fontaine resulted in an increase of the distance of claudication intermittens as well as in an occlusion-plethysmographically measurable increase of the reactive blood supply of the legs. The indications, contraindications and precautionary measures of the haemodilution therapy of advanced disturbances of the blood supply are discussed.

Adult↗
PubMed1981

Balb/c T cells have the potential to recognize the TEPC 15 prototype antibody and its somatic variants.

Immunization of BALB/c mice with phosphorylcholine-Limulus polyphemus hemocyanin (PC-Hy) induces a population of T cells that recognize the predominant PC-binding antibody, TEPC15 (T15). The splenic fragment culture system was used to examine the specificity of these T cells for a series of PC-binding myeloma and hybridoma antibodies representing the prototype variable region of the heavy chain (VH)T 15 sequence as well as somatic variants of the T15 germ line-encoded sequence. Included in this group of PC-binding proteins were both T15-positive and T15-negative antibodies, as defined by anti-idiotypic antibody. T cell help was identified by the ability to promote TNP-specific B cell responses to trinitrophenylated PC-binding proteins. It was found that T cells generated by immunization with PC-Hy recognize both antibodies with the T15 prototype sequence and the putative somatic variants of this sequence. A population of these T cells appear to recognize common determinants shared by these proteins because immunization with T15 itself also induces the recognition of the somatic variants. This suggests that idiotopes encoded in the T15 germ line gene expressed by the T15 prototype idiotype and the somatic variants can function as targets for T cell recognition and are thus regulatory idiotopes.

Amino Acid Sequence↗
PubMed1981

[Diagnostic possibilities using contrast echocardiography].

The contrast echocardiography is based on the occurrence of micro-bubbles in the blood which are stable for a short time and which are passed on the blood stream. These micro-bubbles reflected the ultrasound waves and are represented as contrast echos in the cavities of the heart and the large vessels. They are produced by a bolus injection of saline, glucose, dye (ujoviridin) or the patients' own blood into a peripheral vein or a cavity of the heart. This procedure enables intracardiac insufficiency to be recognized. While the peripheral venous injection is sufficient for differentiating a right-to-left shunt at atrial, ventricular or vascular level, the diagnosis of a left-to-right shunt or of a valvular insufficiency must be made by an injection within a cardiac catheterization. Our results with parasternal and suprasternal transducer position are demonstrated.

Adolescent↗
PubMed1981

Generation of idiotype-specific T cell help through network perturbation.

Different manipulations of BALB/c mice were used to generate idiotype-specific help: neonatally induced suppression of the T 15 idiotype and low-dose priming with anti-T15 antibody. The splenic foci culture system was used to study T15-idiotype-recognizing helper T cells under limiting-cell-dose conditions. These treatments induced T15 idiotype-specific help for B cells responding to TNP-T15. Normal or hemocyanin-primed BALB/c mice did not supply T15 idiotype-specific help. The helper cells were sensitive to anti-Thy-1.2 and complement treatment and can distinguish T15 from an idiotype-different, PC-binding myeloma protein, M167, and the TNP binding myeloma protein, M460. These data show that idiotype-specific T helper cells can be induced by at least two different manipulations of the idiotype network. These manipulations presumably do not act directly on the T15-recognizing T cells, but must involve complementary idiotypic circuits that stimulate anti-T15 specific T cells. Furthermore, this study demonstrates that the splenic-fragment culture technique provides a general method to investigate, at the single cell level, idiotypic T-B cell interactions induced by perturbations of the immune network.

Animals↗
PubMed1981

Pharmacokinetics of atenolol in relation to renal function.

The pharmacokinetics of atenolol were determined following acute intravenous and chronic oral administration to 20 subjects with a glomerular filtration rate (GFR) between 5 and 113 ml/min. Plasma levels in a further 5 patients on haemodialysis were measured after intravenous treatment. The mean half life of elimination increased from 5.9 h in patients with normal renal function to 42.1 h in preuraemic patients (GFR less than 10 ml/min) following a single i.v. dose. The half life of elimination following chronic oral administration was not significantly different. Mean peak plasma concentrations increased from 540 ng/ml in patients with normal renal function to 1493 ng/ml in preuraemic patients following chronic oral treatment with 100 mg/day. The mean half life of elimination during a single haemodialysis treatment was 4.3 h. In patients with a GFR greater than 10 ml/min the normal daily dose of atenolol should be employed, in patients with a GFR between 10 and 30 ml/min the dose should be reduced by half, and in patients with a GFR less than 30 ml/min a reduction by three quarters of the normal dose is recommended.

Administration, Oral↗
PubMed1981

Interaction of atenolol with furosemide and calcium and aluminum salts.

Six healthy subjects were treated with 100 mg atenolol. After a therapy-free interval of 4 wk the same subjects received the same dose of atenolol with furosemide, 40 mg, with calcium (as the lactate gluconate and carbonate), 500 mg, or with aluminum hydroxide, 5.6 gm. Atenolol alone and in combination was administered first as a single oral dose; a long-term 6-day treatment began 48 hr later. Addition of furosemide did not influence atenolol kinetics, but aluminum hydroxide led to an insignificant reduction (P greater than 0.05) of mean peak plasma levels of about 20% and of the area under the plasma concentration-time curve (AUC -infinity) from 5818 to 4353 ng ml-1 hr (P greater than 0.05). Calcium altered atenolol kinetics distinctly mean peak plasma levels of atenolol fell 51% (P less than 0.001), AUC0-infinity fell from 5818 to 3935 ng ml-1 hr (P less than 0.01) and elimination half-life (t1/2) increased to a mean of 11.0 hr (compared to 6.2 hr with atenolol alone). The prolongation of t1/2 induced by calcium coadministration led to atenolol cumulation during the long-term dosage. Twelve hours after atenolol, 100 mg, and calcium, 500 mg, exercise tachycardia was lower than with atenolol alone (P less than 0.001). During the 4-wk treatment in six hypertensive patients, blood pressure values of those on atenolol alone were not different from those on the combination therapies (P greater than 0.05).

Adult↗