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Biomedical subjects

I Lang

Publications and source records attributed to I Lang.

At least 19 recordsLinked to original sources
PubMed1992

A decrease in plasminogen activator inhibitor-1 activity after successful percutaneous transluminal coronary angioplasty is associated with a significantly reduced risk for coronary restenosis.

To determine a possible relation of changes in plasma levels of plasminogen activator inhibitor 1 (PAI-1) and tissue plasminogen activator (t-PA) to the development of coronary restenosis after successful coronary angioplasty (PTCA), we followed 104 patients with a low grade residual stenosis after PTCA (less than 30%) for a period of 12 months. PAI-1 plasma levels (functional activity) and t-PA antigen were determined 1 day before PTCA and 3 days, 3 months and 6 months thereafter. Thirty-four patients (32.69%) developed angiographically proven coronary restenosis (group A) within a time range of 4-48 weeks (median 12.5 weeks) after PTCA while the remaining patients (group B) had neither clinical signs nor angiographic evidence of restenosis after 6 months. No significant differences could be demonstrated in t-PA antigen or PAI-1 activity (plasma levels between the two groups of patients the day before PTCA). During the whole observation period t-PA plasma levels were not significantly different between the two groups; however, PAI-1 plasma levels were significantly higher at 3 months and 6 months after PTCA in patients of group A (p less than 0.005). When the pattern of PAI-1 plasma levels over time (increase or decrease between two consecutive time points of blood collection) was used to discriminate between the two study groups only 3.5-18% of patients with a decrease in PAI-1 developed coronary restenosis within the following observation period in contrast to 25-58% of patients with an increase in PAI-1 plasma levels (p less than 0.05 to p less than 0.0005).

Aged↗
PubMed1991

Enhanced growth hormone responses to growth hormone releasing hormone in male type I diabetic patients.

In a previous paper we have demonstrated that growth hormone (GH) responses to growth hormone releasing hormone (GHRH) are higher in premenopausal normal women than in age matched healthy men. As in type I diabetes mellitus various disturbances of GH secretion have been reported, the aim of our study was to assess the effect of sex on basal and GHRH stimulated GH secretion in type I diabetes mellitus. In 21 female and 23 male type I diabetic patients and 28 female and 30 male control subjects GH levels were measured before and after stimulation with GHRH (1 microgram/kg body weight i.v.) by radioimmunoassay. GH responses to GHRH were significantly higher in female than in male control subjects (p less than 0.02), whereas the GH levels following GHRH stimulation were similar in female and male type I diabetic patients. GH responses to GHRH were significantly higher in the male type I diabetic patients than in the male control subjects (p less than 0.001); in the female type I diabetic patients and the female control subjects, however, GH responses to GHRH were not statistically different. The absence of an effect of sex on GHRH stimulated GH responses in type I diabetes mellitus provides further evidence of an abnormal GH secretion in this disorder.

Adult↗
PubMed1990

Medroxyprogesterone acetate lowers plasma corticotropin and cortisol but does not suppress anterior pituitary responsiveness to human corticotropin releasing factor.

The endocrine action of medroxyprogesterone acetate (MPA) has been claimed to be of a glucocorticoid-like nature. Upon clinical observation, MPA has been shown to improve life quality and overall well-being in patients with advanced breast cancer, renal carcinoma, prostatic carcinoma, and uterine adenocarcinoma. The authors have evaluated MPA endocrine action by the administration of human corticotropin releasing factor (hCRF) in a 90-minute assay in 15 patients with advanced breast cancer or renal cell carcinoma both, before the initiation of oral high-dose MPA treatment (1000 mg MPA) as well as after at least 10 days of therapy. The curves for corticotropin, beta-endorphin, and cortisol responses to hCRF of tumor patients who were tested before the initiation of MPA treatment were parallel to the curves of a healthy control group of probands tested under equal conditions, although at significantly higher respective hormone levels. In patients with malignant disorders assayed after MPA administration, both basal and peak hormone levels were found to be comparable with values obtained in healthy controls. In conclusion, MPA appeared to act at a suprapituitary level since pituitary responsiveness to hCRF was preserved under MPA treatment. Moreover, it appeared that MPA brought the hormonal stress state found in patients with malignant tumors back to normal.

Administration, Oral↗
PubMed1990

Plasminogen activator inhibitor-1 levels in patients with chronic angina pectoris with or without angiographic evidence of coronary sclerosis.

Increased plasma levels of plasminogen activator inhibitor-1 (PAI-1) have been shown to exist in 40 to 60% of patients with stable coronary artery disease and have been suggested to be responsible for the development of coronary thrombotic complications. However, it is also discussed whether PAI-1 elevation might mainly be due to variables like increased age or to reactive mechanisms caused e.g. by the chest pain itself. To exclude age dependent or pain related influences, age-matched patients with stable angina pectoris (NHYA II) and angiographically proven coronary artery disease (CAD, n = 16) or without evidence for coronary sclerosis (variant angina, n = 10; angina-like syndrome with normal coronary angiogram, n = 5; non-CAD, n = 15) have been investigated for their plasma PAI-1 activity and t-PA antigen levels. The mean PAI activity in CAD patients (17.5 U/ml) was significantly higher than in non-CAD patients (9.6 U/ml) (p less than 0.0001). In the CAD patients no significant variation in plasma PAI-1 values could be demonstrated when related to the extent of the disease or to a history of previous myocardial infarction. t-PA antigen was also elevated in CAD patients as compared to the non-CAD group (p less than 0.02). The results suggest therefore a strong correlation between coronary artery disease itself and elevated levels of components of the plasma fibrinolytic system.

Angina Pectoris↗
PubMed1990

[Long-term follow-up of pulmonary hypertension of unknown etiology].

Since 1967, 166 patients with primary pulmonary hypertension of unknown etiology have been followed-up at the Department of Cardiology at the University of Vienna. Although an exact etiopathogenetic differentiation was not possible, three groups of patients were identified clinically: patients with so-called primary pulmonary hypertension (PPH)--group 1; patients with pulmonary hypertension induced by anorexipens (aminorex fumarate)--group 2; and patients with pulmonary hypertension due to emboli in the large pulmonary vessels--group 3. In addition to non-invasive echocardiographic assessment of pulmonary pressures, regular cardiac catheterizations were carried out, which revealed right atrial mean pressure, cardiac output, and mixed venous saturation to be prognostic predictive factors. Patients with anorexigen-induced pulmonary hypertension have a clearly better life expectancy than those with PPH. Owing to the temporally limited effect of the pulmonary hypertension-inducing agent, aminorex fumarate (Menocil), patients with anorexigen-induced pulmonary hypertension may be considered a model group for drug-induced vascular pathology.

Aminorex↗
PubMed1988

[Penicillin-induced acute renal failure as a rare severe complication of erysipelas treatment].

Penicillins are the most commonly used antibiotics in dermatology owing to their bacteriocidal effect and the high responsiveness of most bacterial dermatoses to penicillin treatment. Although there is a wide range of adverse reactions to penicillins, severe complications are seen very rarely. We report on two cases of penicillin-induced acute interstitial nephritis and summarize the characteristic features of this serious adverse reaction to penicillin administration.

Acute Kidney Injury↗
PubMed1988

The influence of age on human pancreatic growth hormone releasing hormone stimulated growth hormone secretion.

63 non-obese healthy subjects aged 18 to 95 years were investigated for age-dependence of GHRH-stimulated GH-secretion. In addition, priming of GH-secretion with three oral doses of propranolol (3 x 80 mg, the last dose 2 hours prior to the second GHRH-bolus) was carried out in 15 subjects below 40 years and 13 subjects older than 70 years. We found that mean maximal incremental GH-levels were inversely correlated with chronological age (r = -0.44, P = 0.001) of the probands. Propranolol premedication caused a significant rise of both basal and peak GHRH-induced relative increases in all subjects tested, whereas GHRH-induced relative increases of GH remained unchanged. In a well selected group of non-obese healthy subjects stimulated GH-secretion is found to undergo an aging process that is supposed to be of pituitary and suprapituitary origin. Priming GH-secretion with a beta-Blocker is possible both in young and very old healthy subjects and is likely to affect the basal GH secretory tone and not GHRH-stimulated GH-secretion.

Adult↗
PubMed1988

Recurrent paradoxical embolism complicating severe thromboembolic pulmonary hypertension.

A patient with a three-year history of recurrent pulmonary embolism is presented. Thromboembolic pulmonary hypertension was proven in the final stage of disease in the presence of repeated episodes of systemic embolic events. Paradoxical embolism was assumed to be present on the basis of blood-gas analysis and contrast echocardiography that demonstrated a right-to-left shunt at atrial level. Autopsy revealed a patent foramen ovale and provided strong evidence for the accuracy of the clinical diagnosis.

Adult↗
PubMed1988

Pulmonary veno-occlusive disease in a patient with unilateral absence of right pulmonary artery.

A 25-year-old patient had unilateral absence of the right pulmonary artery (UARPA) and severe left pulmonary artery hypertension. After death from congestive right heart failure, autopsy revealed histologic signs of pulmonary veno-occlusive disease (PVOD) and pulmonary hypertension (PH). An accessory arterial vessel that was thrombotically occluded was found connecting the ascending aorta and the right pulmonary hilum. There was also histologic evidence of arterial thrombi within the right lung arterial vascular bed. The PH in UARPA usually occurs very early during the course of disease. From histologic findings and medical history, it is likely that in this case, late-onset elevation of pulmonary pressures was triggered by the occurrence of PVOD. This is the first case of UARPA and PVOD--a congenital unilateral arterial malformation in the presence of bilateral involvement in a possibly acquired venous obliterative disease.

Adult↗
PubMed1987

Abnormalities in the hypothalamic-pituitary-adrenocortical axis in patients with chronic renal failure.

The recently described human corticotropin-releasing factor was administered to eight patients with chronic renal failure in order to assess hypothalamic-pituitary-adrenocortical (HPA) function. Acute administration of corticotropin-releasing factor lead to a diminished increase of the basally elevated levels of ACTH and beta-endorphin immunoreactivity in patients on chronic hemodialysis. Basal plasma cortisol concentration was normal in end-stage renal disease; however, considering the corresponding elevated ACTH concentrations, cortisol levels were inadequately low. Thus, the hypothalamus as well as the adrenal gland seems to contribute to the alterations in HPA function observed in patients with chronic renal failure; involvement of the pituitary gland and effects of metabolic alterations cannot be ruled out.

Adrenocorticotropic Hormone↗
PubMed1987

Effects of sex and age on growth hormone response to growth hormone-releasing hormone in healthy individuals.

The influence of age and sex on human GH secretion is controversial. In previous studies, serum GH responses to arginine and insulin-induced hypoglycemia were significantly higher in pre- and postovulatory women than in men. In contrast, recent studies suggest that GH responsiveness to GHRH is higher in normal young men than in age-matched women. To clarify the question of sex and age influence on GHRH-(1-44)-stimulated GH secretion, we studied 116 normal women and men (with body mass indexes of 18-25 and 19-26, respectively) between the ages of 18 and 95 yr. The peak serum GH increments after GHRH administration were significantly higher in premenopausal women than in age-matched men (P less than 0.003 for the age group 18-30 yr and P less than 0.03 for the age group 30-50 yr, as assessed by analysis of variance). The responses were not different in postmenopausal women and age-matched men. Multiple regression analysis revealed a significant negative correlation between GHRH-induced GH responses (integrated area under the curve) and age in both women (P less than 0.002) and men (P less than 0.001). In addition, we determined basal serum testosterone, estradiol, cortisol, and PRL levels in all subjects. Multivariate regression analysis of the GH responses to GHRH administration revealed a significant positive correlation (P less than 0.01) between serum estradiol and both GH increase and the area under the GH response curve. No correlation was found between GHRH-stimulated GH secretion and basal serum cortisol, testosterone, or PRL concentrations. Our data clearly demonstrate a marked influence of both sex and age on GHRH-stimulated GH secretion. We found a higher GH increase in premenopausal women compared with age matched-men and an age-dependent decrease in GHRH-stimulated GH secretion in both sexes. Furthermore, in women a significant influence of estradiol on GH secretion after GHRH administration could be demonstrated.

Adolescent↗
PubMed1987

[Successful treatment of antimony-resistant cutaneous leishmaniasis].

We report the case of a patient who acquired cutaneous leishmaniasis in Israel, with multiple lesions on the face and wrists. The diagnosis was made several months after the onset of disease. We observed large multiple ulcers, which at first responded to sodium stibogluconate (600 mg daily for 2 weeks). After initially decreasing in size, the lesions remained unchanged. Several weeks later clinical exacerbation of the cutaneous leishmaniasis was observed. Fearing late complications on the upper eyelid, we administered two 2-week courses of ketoconazole, 800 mg daily. The early and rapid improvement achieved indicates that ketoconazole was successful in this case of cutaneous leishmaniasis.

Aged↗