PubMed Health⌕ Search

Biomedical subjects

K Engel

Publications and source records attributed to K Engel.

At least 55 records · Page 3Linked to original sources
PubMed1987

Methionine-induced acidosis in the weanling rat.

Whole body balances of non-metabolizable base (NB) were studied in weanling rats fed a cereal-based diet with or without added L-methionine. In response to L-methionine loading (2.5 mmol day-1) the rats exhibited a significant reduction in rates of food intake (109 vs. 160 g per 8 days) and body growth (3 vs. 52 g per 8 days); fractional oxidation of absorbed dietary amino acid sulphur increased from 0.28 to 0.64; and mean urinary sulphate excretion increased from 2.3 to 14.8 mmol per 8 days. Mean rates of renal excretion of NB and filtered titratable organic acid decreased from 20 to -11 mmol per 8 days and from 22 to 8 mmol per 8 days. Balances of calcium and NB remained at reference values despite a decrease in whole blood 'base excess' from -1.0 to -6.4 mmol l-1. The concentration of NB in plasma rose but slightly. It is concluded that L-methionine loading in the weanling rat leads to extracellular non-carbonic acidosis subject to renal compensation. This acidosis is due not to retention of H+ released by ionization of endogenous sulphuric acid but possibly to accumulation of (acid) organic metabolites of methionine which are efficiently conserved by the kidneys. The rise in sulphuric acid production leads to an adaptive decrease in fractional reabsorption of filtered sulphate. Even during inhibited growth, absorbed dietary NB is retained and deposited in the skeleton, probably as calcium carbonate.

Acid-Base Equilibrium↗
PubMed1987

[Prognostic factors of anorexia nervosa--an empirical study for constructing a hierarchical order of important factors].

Reports on prognostic factors of anorexia nervosa differentiate positive, negative and irrelevant data. However, these fields stand in parallel without quantification and thus without aspiring a hierarchical order. Establishing such an order by relative importance is the aim of this study in which we report on n = 113 patients. Among these prognostic factors from the time before, during and after hospitalization are investigated empirically. The patients' present state acts as a criterion (follow-up after 6.4 years). The relevant factors are set up hierarchically and investigated by multivariate analysis with special respect to relative importance of somatic, psychological or social variables. Finally we give therapeutic recommendations.

Adult↗
PubMed1986

Interests and specialty choice in medicine.

The study deals with the origin of occupational satisfaction in the medical profession. It examines the relationship between the specialty choice within the medical profession on the one hand, and satisfaction with the occupational choice on the other. Following an intensive analysis of the medical profession and interviews with senior physicians, three dimensions along which the medical specialties differ were defined: contact with people (contact), usage of instruments and equipment (instruments), and occurrence of dramatic events in the physician's daily work (sensation). Eighty-one medical practitioners answered the IIP (interest inventory for physicians) which was constructed to measure their vocational interests. Results show: reliability coefficients of 0.85, 0.92 and 0.83 for the contact, instruments and sensation components of the IIP, respectively; and correlations of 0.31, 0.27 and 0.53 between interest-specialty congruence in contact, instruments and sensation, respectively, on the one hand, and satisfaction with the medical specialty choice on the other. Several implications and applications are discussed.

Career Choice↗
PubMed1986

Amenorrhea and predictors for remenorrhea in anorexia nervosa: a psychoendocrinological study in inpatients.

34 consecutively admitted anorexia nervosa inpatients were studied for variables relevant for 'early' vs. 'late' amenorrhea and for probable remenorrhea after therapy. The subsample reporting 'early' amenorrhea, i.e. preceding weight loss (n = 11), was characterized by less 'anorexia-specific' psychological traits and more weight loss before admission and a more marked (= pathological) FSH responsiveness to GnRH stimulation. Hence--contrary to our expectation--'early' amenorrhea seems to be a 'nonpsychogenic' phenomenon. Analysis according to FSH hyperresponsiveness yielded no additional information. Studying LH changes during therapy we found that a nonrise in basal LH secretion is associated with a type of anorexia characterized by early onset and a less severe but protracted course before admission, which then proves also more recalcitrant to therapy. The subsample which attained LH fluctuation before discharge showed a clear reduction of 'weight phobia' and a higher weight both on admission and before discharge.

Adult↗
PubMed1986

Psychoendocrinology of remenorrhea in the late outcome of anorexia nervosa.

Within a late follow-up of our former anorectic patients 38 consented to an endocrine checkup in addition to clinical and sociopsychologic assessments. Univariate comparisons of still or again amenorrheic patients (n = 22) versus remenorrheic patients (n = 16) showed many significances. However, some of these variables intercorrelated substantially. Therefore, we performed a stepwise discriminant analysis which yielded as the most differentiating variables 'subjective well-being' (24%), follow-up interval (16%), Frisch's 'fat percentage within body weight' (12%) and 'sexual behavior' (5%). As the mean follow-up intervals were 10 versus 6 years, anorectic patients seem to need considerable time for remenorrhea, or rather for the psychosocial-sexual adaptation necessary for it. The equally necessary weight gain does not correlate with the follow-up interval. Then there is a factor which seems to be 'constitutional': Early onset of amenorrhea predicts late nonremenorrhea (3%).

Adolescent↗
PubMed1986

Therapy motivation in anorexia nervosa: theory and first empirical results.

Anorexia nervosa patients are considered to be unmotivated for psychotherapy of eating disorders, because they present a lack of understanding and feeling for their disease. In order to objectify this lack of therapy motivation we formulated two questionnaires for patients and therapists. The items were obtained from 15 theoretically determined fields of both intra- and interpersonal subsets of motivation, and a 'motivation profile' was gained. In a first clinical application these profiles are obtained from an anorexia sample at the beginning and at the end of an inpatient treatment and combined with the corresponding therapist ratings. The results are compared with two control groups (preattended psychosomatics and somatic patients). Results collected hereby are used for the improvement of our questionnaires and for suggestions concerning further studies.

Adult↗
PubMed1985

Acid-base balance in ruminating calves given sodium hydroxide-treated straw.

1. Studies of whole-body balances of non-metabolizable base (NB) and several minerals, and of relevant acid-base quantities in blood and urine, were carried out in two 6-month-old ruminating Holstein X Friesian bull calves fed on fixed rations containing 500 g barley straw/kg diet (group A) to examine the quantitatively important components of the balance of NB and determine the rates of mineral and NB retention associated with normal body growth. 2. Parallel balance studies were conducted in six other bull calves given fixed rations containing 500 g alkali-treated barley straw/kg diet to evaluate the effects of long-term alkali-straw feeding on the rates of body growth and skeletal mineral and NB deposition and the renal control of extracellular electrolyte and acid-base status. The straw component was treated either with 50 g sodium hydroxide/kg dry matter (DM) (group B; two calves), or with 50 g or 100 g NaOH/kg DM and subsequently neutralized with hydrochloric acid (groups C and D, two calves per group). In all groups the animals were given free access to tap water. 3. Throughout the total 105 d experiment, all animals remained healthy and gained weight. Normal body growth group A) was associated with a positive balance of NB (1-2 mmol/kg live weight (LW) per d) due to continuing deposition of dietary NB in 'new tissue', largely in the developing skeleton. 4. During 105 d alkali-straw feeding, the animals showed a remarkable ability to cope with dietary loads of NAOH or sodium chloride, up to about 30 mmol/kg LW per d, without any significant disturbance of extracellular acid-base and electrolyte status or body growth rate. The surplus mineral and NB loads were absorbed and subsequently excreted in an increased volume of urine. Rates of mineral and NB retention were not significantly different from the reference values of group A and remained within the range of values reported from similar studies. In all groups, maintenance of normal whole blood and plasma acid-base and electrolyte status was accounted for by efficient renal control of the composition of the extracellular fluid compartment.

Acid-Base Equilibrium↗
PubMed1984

[Advantages and hazards of preventing infection following cesarean section--clinical and bacteriologic results of a high-dosage treatment with mezlocillin and oxacillin short-term preventive following clamping of the umbilical cord].

Between August 1980 and August 1981 a prospective randomised study was conducted at the Krankenhaus Nordwest , Dept. of OBGYN , Frankfurt, to investigate the efficacy of a short term prophylaxis using mezlocillin and oxacillin ( Optocillin ) in reducing infections after Caesarean section (6 gs Optocillin after clamping the umbilical cord and after 8 and 16 hours, respectively). Both the study group (sg) and the control group (cg) consisted of 50 patients each. Both groups were statistically homogeneous . Infections were significantly reduced by the prophylaxis: sg 26%/cg 64% - p less than 0,001, febrile morbidity: sg 10%/cg 38% - p less than 0,001, endometritis: sg 6%/cg 20% - p less than 0,08, UTI: sg 18%/cg 36% - p less than 0,05, wound infections: sg 2%/cg 18% - p less than 0,02. Severe infections, however, were seen in neither group. The duration of infections was shorter in the sg. The various postoperative infections were associated with different risk factors (rf) - endometritis: green amniotic fluid, operating time greater than 75 min; cervical dilatation less than 2 cm, UTI: PROM (greater than 6 hs), operating time less than 75 min, internal monitoring, cervical dilatation greater than 2 cm, wound infections: green amniotic fluid, internal monitoring, frequent vaginal examinations (greater than 6), cervical dilatation greater than 2 cm and operating time greater than 75 min. The prophylaxis was especially effective in the presence of the following rfs: green amniotic fluid, internal monitoring, frequent vaginal examinations (6), operating time greater than 75 min and when associated with combined rfs. The reduction of wound infections following the prophylaxis can be ascribed to the elimination of organisms (Staph. spec., enterococci,) at the site of operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Cesarean Section↗
PubMed1983

Corticotropin-induced alkalosis in the weanling rat and its relation to the balance of non-metabolizable base.

Studies of whole body balances of non-metabolizable base (NB) and several electrolytes and of the acid-base status of blood and urine during development of corticotropin-induced alkalosis in the weanling rat were carried out in order to identify the primary source of base and factors instrumental in maintenance of the alkalotic state. The data were compared to baseline and running control values and to the results of whole carcass analysers. Primary accumulation of NB was accounted for by ongoing gastrointestinal NB absorption in the weight-losing animal, distributed to extracellular and non-extracellular compartments of the body. An increase in the rate of renal excretion of non-metabolizable acid (NA), from negative values to zero, corresponded to an increased load of endogenous sulphuric acid and a reduced rate of gastrointestinal NB absorption. Accordingly, the renal response did not per se contribute to the induction of extracellular alkalosis. Maintenance of alkalosis occurred in spite of ample chloride in the renal tubular lumen and a moderate increase in relative extracellular volume. In the absence of evidence of overloading (with base) or malfunction of the kidney, corticotropin-induced alkalosis is classifiable as a 'set-point disturbance' of acid-base metabolism in which fluctuations in the (non-renal) load of NA lead to commensurate changes in renal NA excretion at an elevated extracellular pH. Withdrawal of corticotropin injections was followed by prompt restoration of a normal extracellular acid-base status and a return to reference values for renal NA excretion despite a marked fall in the balance of NB. This observation supports a concept of the extracellular compartment as the immediate reference system of the kidney.

Acid-Base Imbalance↗
PubMed1981

[Sonographic diagnosis of a placental tumour with high-grade intrauterine foetal development deficiency, increasing anhydramnia and subsequent foetal death (author's transl)].

The article reports on prenatal diagnosis of a large tumour of the placenta (chorioangioma) and, for the first time, on sonographic observation of the course of the disease with intrauterine deficient development of the foetus, increasing oligohydramnia and subsequent intrauterine foetal death. The complications associated with large chorioangiomas, which are well known, with an intrauterine and perinatal mortality of up to 30%, underline the need for timely sonographic diagnosis. Chances of sufficiently early intervention have been created via closely meshed checkup controls.

Adult↗
PubMed1981

[Computer tomography for tumours of the oesophagus and stomach (author's transl)].

The diagnostic scope of CT has been demonstrated for malignant tumours of the oesophagus (41 patients) and tumours of the stomach (18 patients). Of importance is the demonstration of circumferential spread of tumours of the oesophagus, the early demonstration of mediastinal lymph node metastases and the demonstration of infradiaphragmatic lymph node involvement from tumours of the middle and lower thirds of the oesophagus. In the presence of tumours of the stomach, it is possible to demonstrate infiltration of neighbouring organs (pancreas, spleen, hilum of liver) and haematogenous or lymphatic spread.

Adenocarcinoma↗
PubMed1979

Balance of net base in the rat: adaptation to and recovery from sustained hypercapnia.

Net base and mineral balances were evaluated in a group of male 350 g Wistar rats exposed to 10% carbon dioxide in air for 10 days with a view to identifying the source of net base subject to retention during renal compensation of sustained respiratory acidosis. In response to hypercapnia, the rate of renal net acid excretion rose but insignificantly. However, a rise in whole body net base concentration from about 215 mmol/kg to about 250 mmol/kg came about by ongoing gastrointestinal absorption in the weight-losing animal, absorbed net base being distributed to extracellular and non-extracellular compartments of the body, presumably including bone. During an 8-day recovery period, a small decrement in whole body net base concentration was observed.

Acid-Base Equilibrium↗
PubMed1979

Balance of net base in the rat. V. Effects of oral ammonium chloride loading.

The physiology of oral ammonium chloride loading was studied in four groups of male weanling rats weighing about 100 g and fed either standard ground Rostock rat food (containing 317 mmol net base/kg) or ground barley (containing only 20 mmol net base/kg). One group of animals on the Rostock diet received oral supplements of ammonium chloride (approximately 32 mmol . kg-1 . day-1) sufficient to provide a net zero rate of oral net base intake. In this group, ongoing fecal net base excretion caused net acid to be absorbed at an average rate of 15 mmol . kg-1 . day-1. The mean rate of renal net acid excretion rose markedly (by 29.4 mmol . kg-1 . day-1); and over an 8-day balance period the animals were able to maintain near-normal balances of net base. During a subsequent 8-day recovery the pattern of mineral turnover returned to normal. Even in the barley-fed rats, gastrointestinal net acid absorption was observed. These animals suffered a 61% reduction in the rate of body growth, but the overall rate of net base retention, per kilogram of mass gain, was close to the reference value. Finally, the combination of barley and ammonium chloride led to weight loss, positive net acid balances (8.5 mmol . kg-1 . day-1), and a maximal rate of renal net acid excretion (50.8 mmol . kg-1 . day-1). Some implications for the metabolism of organic acids are discussed.

Acid-Base Equilibrium↗
PubMed1979

[Parents of children dialysed at home. Psychological assessment (author's transl)].

Ten married couples with children undergoing home dialysis were examined by means of different tests used in family interaction diagnosis (Joint Rorschach, SIMFAM, Giessen Test, Bales Scale, Expert Rating). The couples showed a similar cooperation as found in a group of psychologically "ordinary" couples, but emotional problems between the parents of home dialysis children were at least as frequent as in a group of psychologically, disturbed couples needing family therapy. The role of the psychologist for the stability testing in parents of children destined for regular dialysis and for psychotherapeutic preparation to home dialysis is described.

Adolescent↗
PubMed1978

Balance of net base in the rat. III. Effects of oral sodium bicarbonate and sodium citrate loading.

The balance of net base in groups of male weanling Wistar rats exposed to sustained oral loads of net base were studied. In response to dietary loads of sodium bicarbonate (approx. 50 mmol.kg-1.day-1) an average increment in the mean rate of retention of net base of 21.8 mmol.kg-1.day-1 was observed in the absence of significant changes in the blood 'base excess'. Following withdrawal of sodium bicarbonate, mean rates of gastrointestinal absorption, renal excretion, and retention of net base promptly returned to control values, accumulated net base being retained in the body, presumably as skeletal sodium carbonate. In response to equimolar loads of net base in the form of trisodium citrate, a similar, albeit less pronounced, rise in the rate of retention of net base occurred.

Acid-Base Equilibrium↗