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Biomedical subjects

M Brandis

Publications and source records attributed to M Brandis.

At least 127 records · Page 7Linked to original sources
PubMed1988

[Exact description of non-glomerular and glomerular erythrocyte forms in pediatric hematuria].

We examined 70 urinary sediments of 35 children with non-glomerular hematuria (NGH) and 65 urinary sediments of 17 children with glomerular hematuria (GH) by phase-contrast microscopy at 1,000 X magnification. In each urinary sediment 200 erythrocytes were classified into 18 types of "non-glomerular erythrocytes" and 15 types of "glomerular erythrocytes". According to the percentage of greatly altered erythrocytes the urinary finding was termed isomorphic, mixed or dysmorphic. In 91% of the urinary sediments of patients with NGH the erythrocyte pattern was isomorphic, and in 91% of the urinary sediments of children with GH it was dysmorphic. 9 types of non-glomerular erythrocytes and 10 types of glomerular erythrocytes constituted 94.5% of all 26,809 erythrocytes examined. Torocytes (doughnut-like cells) can be considered characteristic for GH. This study demonstrates a high specificity of this method in discriminating NGH from GH. The exact morphological description of urinary erythrocytes allows the method to be reproducible. For future use examiners can concentrate on the 19 commonest erythrocyte types.

Adolescent↗
PubMed1987

Microproteins in amniotic fluid as an index of changes in fetal renal function during development.

Protein content and protein composition were studied in amniotic fluid obtained from 171 healthy pregnant women between the 16th and 38th week of gestation, using microgradient gel electrophoresis to separate proteins according to their molecular size into albumin (68 KD), proteins of low molecular weight (LMW proteins, less than 68 KD), and proteins of high molecular weight (HMW proteins, greater than 68 KD). Additionally alpha-1-microglobulin (alpha-1-MG, 33 KD) and beta-2-microglobulin (beta-2-MG, 11,8 KD) were analysed as micromolecular marker proteins. Concentrations of LMW proteins were 0.15-0.22 g/l, of alpha-1-MG 28.4-34.5 mg/l, and of beta-2-MG 7.2-11.6 mg/l during the second trimester of gestation, and thereafter decreased progressively to 0.03 g/l, 14.1 mg/l and 2.4 mg/l respectively near term. The same developmental trends were confirmed by calculating the protein/creatinine ratios in amniotic fluid. The concentrations of LMW proteins found in the first postnatal urine of 73 healthy infants born prematurely or at term were similar to those in amniotic fluid of corresponding fetal age. Concentrations of albumin and HMW proteins in postnatal urine were about 5% and 15% respectively when compared with amniotic fluid concentrations. No strong correlation existed between gestational age and either of the analysed proteins which would allow accurate assessment of fetal maturation by protein analysis in amniotic fluid. It is concluded that fetal urinary excretion is the major determinant of the microprotein content of amniotic fluid. Microproteins seem to reflect an increasing tubular reabsorption capacity, which accelerates rapidly after the second trimester of gestation.

Adult↗
PubMed1987

Effect of a modified fluid therapy on renal function during indomethacin therapy for persistent ductus arteriosus.

A rehydration with 7 ml/kg/h for six hours prior to indomethacin administration prevented the adverse effects of this drug on renal function in prematures with persistent ductus arteriosus. During the 36 hour observation period after indomethacin administration, no significant changes in serum creatinine, sodium, and potassium concentrations, or urinary flow, creatinine clearance, or filtered sodium could be detected. The only significant finding was a reduction in fractional sodium excretion. One can assume that this beneficial effect of the fluid load is due to a suppression of some parts of the vasoconstrictor mechanisms, which are responsible for the deterioration of renal function in newborns during indomethacin therapy. Using this modified fluid regimen, no cardiovascular side effects were noticed, a closure of the duct was achieved in 7 of 10 treatment courses.

Creatinine↗
PubMed1987

Phosphate transport in brush-border membranes from control and rachitic pig kidney and small intestine.

1. Na-Pi co-transport was analysed using renal cortical and small intestinal brush-border membrane vesicles which were isolated from control (normal, heterozygotes) and rachitic piglets (homozygotes). 2. A kinetic analysis of Na-dependent initial linear uptake of Pi was performed using vesicles obtained from control animals. The results suggest similar kinetic properties for the renal and small intestinal co-transport system. (i) A sigmoidal dependence on Na concentration of Pi uptake suggests the involvement of more than one Na ion in the co-transport. (ii) Increasing Na concentration leads to an increase in the apparent affinity of the transport system for Pi and has minimal effect on the apparent Vmax (maximum velocity of uptake). (iii) Increasing pH leads to an increase in Pi transport rate. 3. The kinetic characteristics of the Na-Pi co-transport system in vesicles obtained from rachitic animals were similar to those in controls. The apparent Vmax, but not the apparent Km (Michaelis constant) for Na and Pi, is reduced in intestinal and renal brush-border membranes isolated from rachitic animals as compared to control animals. Injection of vitamin D3, three days prior to killing of rachitic litter-mates, increased the Na-Pi uptake rate in the brush-border membrane vesicles isolated from these piglets. 4. It is concluded that intestinal and renal brush-border membranes from piglets contain a similar Na-Pi co-transport system and that in vitamin-D-dependent rickets the number of operating transport units is reduced in both membranes.

Animals↗
PubMed1987

[Developmental physiologic aspects of volume and sodium regulation in premature and mature newborn infants].

Concentrations of sodium and creatinine were measured in serum and time collected urine samples of 72 newborn infants in the first ten days of life. Creatinine clearances, fractional and absolute sodium excretions were calculated. For analysis the group of newborns was divided into three according to gestational age: group A: less than 33 weeks; group B: 33-37 weeks; group C: greater than 37 weeks. The GFR was correlated to the conceptional age. Renal sodium losses exceeded alimentary supplementation in premature infants during the observation period. An additional supplementation of sodium seems therefore to be indicated early in life, as sodium balance is negative from the first day on. Individual investigations are necessary to evaluate the amount of sodium needed. 3-5 mMol/kg/day seem to be well tolerated and preventive for hyponatriaemia. Fluid administration during the first days should be calculated so that a weight loss of about 10% of body weight is achieved in premature infants in order to prevent cardiovascular and gastrointestinal complications. Because of a higher insensible water loss the amount of fluids administered per body weight should be higher in prematures than in matures.

Aldosterone↗
PubMed1987

[Disorders of kidney function and acute kidney failure in newborn infants].

Compromised kidney function in the perinatal period has been increasingly recognized during recent years, and acute renal failure is a frequent clinical situation in neonatal intensive care units. Renal underperfusion due to various prerenal conditions is assumed to be the most common cause of renal failure in neonates. With rapid restoration of renal blood flow, prerenal failure is completely reversible in the early course of the disease. If adequate treatment is delayed, however, structural damage to the kidneys by prolonged ischemia will ensue leading to a poor prognostic outcome. This review, therefore, mainly focuses on early diagnosis of disturbed neonatal kidney function and prophylactic therapeutical aspects which may be of particular benefit for critically ill newborns at high risk for developing acute renal failure.

Acid-Base Equilibrium↗
PubMed1986

[Pre- and postnatal diagnostic imaging of congenital urinary tract disorders].

The prenatal diagnosis of urinary tract obstruction was made in 10 neonates. These findings were confirmed postnatally by sonography, urography, voiding cystourethrography, and scintigraphy. There were 8 neonates with unilateral obstruction of the ureter, and 2 with urethral valves and reflux. Nephrectomy because of hydronephrosis was necessary in 2 instances. The prenatal diagnosis of a urinary tract obstruction is of great importance, because the neonate may be operated upon without delay. Thus the diseased kidney can be saved. Diuretic radionuclide urography is helpful in differentiating between dilated obstructed and dilated nonobstructed kidneys.

Constriction, Pathologic↗
PubMed1984

Acute interstitial nephritis in childhood.

Three children aged 11 to 14 years with acute interstitial nephritis (AIN) are presented. In one patient AIN developed following antibiotic treatment with trimethoprim/sulfamethoxazole (TMP/SMX). In two patients no infection, drug, or toxin could be implicated. Severe polyuric renal failure without elevation of blood pressure was the predominant clinical feature. Uveitis occurred either simultaneously with the nephritic symptoms or several weeks after complete recovery of renal function. Renal functions were characteristically altered and led to suspicion of AIN even prior to renal biopsy. Renal plasma flow was relatively more reduced than glomerular filtration rate (GFR) with an accordingly increased filtration fraction. Quantitative evaluation of selective tubular functions revealed significant transport deficiencies for glucose, amino acids, inorganic phosphate and low molecular weight proteins. In two patients GFR increased rapidly following initiation of steroid treatment and tubular symptoms simultaneously disappeared. In one patient spontaneous remission occurred. We conclude that--in contrast to adults--the prognosis of AIN in childhood is favorable. Although general clinical features are rather nonspecific, symptoms of decreased tubular reabsorption ability provide a good indication of the diagnosis and may contribute to enhanced recognition of this disease.

Acute Kidney Injury↗
PubMed1984

Severe digoxin intoxication in a child treated by infusion of digoxin-specific Fab-antibody-fragments.

Accidental digitalis ingestion in children is a rare, but potentially life-threatening emergency. We report the case of a 2 10/12-year-old boy with accidental ingestion of 6 mg beta-Acetyl-digoxin. Soon after admission, the boy developed sinus bradycardia, SA and AV-block, of increasing severity without circulatory impairment. As the serum digoxin level reached 21.7 ng/ml digoxin-specific Fab-antibody-fragments were used to bind free serum digoxin. Immediately after infusion, serum free digoxin was below the detection limit, whereas total digoxin peaked at 219 ng/ml 5 h thereafter. The arrhythmias did not subside totally, so that in addition, a transvenous pacemaker was placed, but never used. The antibody-infusion was well tolerated and the boy was discharged in good health.

Acetyldigoxins↗
PubMed1983

[Treatment of hypertension in children].

The treatment of hypertension should be a stepwise approach to the problem. The mild forms can be handled by diuretics. More severe forms are successfully treated by a combination of beta-blocker, vasodilator and diuretics. In resistent cases the Angiotensin II - inhibitor (Captopril) can be tried. In emergency situations with malignant hypertension more powerful vasodilators like diazoxid or Nitroprussid Sodium are necessary. For the discontinuation treatment interruption a slow reduction of drugs is recommended as rebound-phenomena can be expected.

Adrenergic beta-Antagonists↗
PubMed1983

Survival time in cystinosis. A collaborative study.

In a retrospective study the overall survival time of 205 cystinotic patients of six countries was determined. The median survival time was 8.5 years. The median time for 'renal death' (age at death due to uraemia or age at starting renal replacement therapy) was 9.2 years. The youngest patient dying of renal death was 5.2 years. No sex difference in survival time was noticed. Furthermore no difference in survival time was noted between the different countries. The analysis of the overall survival curve indicates no clear differences between the infantile and adolescent types of cystinosis.

Adolescent↗
PubMed1981

Acute leukemia after cytotoxic treatment for nonmalignant disease in childhood. A case report and review of the literature.

The case history of an 11-year-old boy is reported. The child developed the nephrotic syndrome at the age of 17 months. He was treated with prednisolone, cyclophosphamide, cytosine-arabinoside and chlorambucil for the following three and a half years. Three and a half years after cessation of any medical treatment he developed anemia, thrombocytopenia and a diagnosis of acute lymphocytic leukemia (ALL) was made. Subsequently he responded to the West Berlin Protocol. Reviewing the literature, another eight cases of acute leukemia after cytotoxic treatment for nonmalignant disease in childhood have been reported. Most often the myeloblastic form of acute leukemia was diagnosed. Even though the pathogenic mechanism of acute leukemia after cytotoxic treatment is not known, the possibility must be considered that the incidence of this malignant disease is increased after cytotoxic treatment for nonmalignant diseases.

Antineoplastic Agents↗
PubMed1981

Glomerular podocyte cell junctions in nephrotic syndrome. II. Freeze-fracture studies in human nephrotic syndrome.

In six patients with nephrotic syndrome and in two control subjects freeze-fracture studies of isolated glomeruli obtained by needle biopsies were performed. In the nephrotic patients replicas of freeze-fractured podocytes showed an increased number of cell junctions. These were represented by incomplete occluding junctions and communicating junctions (gap junctions). There was morphologically a similarity between the glomerular podocyte cell junctions in human and experimental nephrotic syndrome (Kühn et al., 1981).

Adolescent↗