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Biomedical subjects

M Rothkopf

Publications and source records attributed to M Rothkopf.

At least 19 recordsLinked to original sources
PubMed1997

Home parenteral lipids in AIDS: a three-month study.

Parenteral nutrition is a part of the nutritional support regimen of patients with AIDS-associated wasting syndrome and gastrointestinal dysfunction. The cholesterol (CHOL) level in human immunodeficiency virus (HIV) membrane is very high, and recent lipid formulations with high phospholipid (PL) content have demonstrated the ability to trap CHOL from endogenous sources, modifying the composition of cell membranes. We administered lipid-based home parenteral nutrition for 3 mo to malnourished AIDS patients. The patients were randomly divided into two groups: 23 received the regular 20% fat emulsion formulation, and 27 received a 2% formulation enriched 10-fold with PLs but containing the same amount of triglycerides. All patients gained weight and improved their activity level. Those receiving the high-PL composition showed increased serum CHOL concentrations (from 147 to 241 mg/dL; P < 0.01), but no increase was seen in the number of CD4 cells or improvement in immune function. HIV infectivity was not modified. Patients receiving regular PLs had significantly decreased (P < 0.02) IgA concentrations (from 776 to 300 mg/dL) and improved mitogen response to phytohemagglutinin and to concanavalin A. This formula, too, had no effect on HIV infectivity. We conclude that standard parenteral nutritional influences the nutritional and immune status of malnourished AIDS patients. A PL-enriched parenteral formulation can trap CHOL, but it does not affect the immune profile or HIV infectivity in patients with advanced disease.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Metabolic and ventilatory responses during very low level exercise.

1. Nine male and six female healthy subjects were studied during supine bicycle exercise at workloads of 12 and 37 W; pedalling rates varied between 30 and 50 cycles/min at each workload. Measurements were made of oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE), tidal volume (VT), respiratory frequency (fR), inspiratory and expiratory time (TI, TE) and mean inspiratory flow (VT/TI) using a non-invasive canopy-computer-spirometer system. 2. At rest, males had greater values of VE, VT, TI, inspiratory duty cycle (TI/TTOT), VCO2 and VO2, and a lower fR, than females. 3. At the lower workload, VO2, VCO2, VE, VT and VT/TI increased linearly with increasing pedalling rate, whereas at the higher workload there was a decrease in VO2 and little or no change in ventilatory parameters from 30 to 50 cycles/min except for an increase in fR in females. 4. While performing supine exercise, there was an effect of pedalling rate on ventilatory and metabolic parameters at the low workload (12 W) which diminished at the higher workload (37 W). An increase in pedalling rate appears to enhance efficiency at these low workloads. 5. Differences between the sexes during exercise generally include: (a) a higher breathing frequency, (b) a greater mechanical efficiency, and (c) lower ventilatory equivalents of O2 and CO2 (VE/VO2 and VE/VCO2) during the higher workload in females than males.

Adult↗
PubMed1987

[Tuberculous prostatitis within the scope of urogenital tuberculosis--pathogenetic and diagnostic aspects].

208 males with tuberculosis of the urogenital system showed a participation of prostate in 110 cases (53%), however, in 52 transrectal punch biopsies of the prostate only 25 times a tuberculosis could histologically be proved. An isolated tuberculosis of the prostate was found only in 6 males (5.4%), in most cases accidentally in biopsies of the prostate, after adenomectomy of the prostate or TURP. The way of the infection of the tuberculosis of the male genitals and the question of the primary focus on the genitals remained unclarified.

Biopsy↗
PubMed1986

Patterns of fuel utilization during parenteral nutrition.

Utilization of fuel in clinical conditions has become an important area of interest to the clinician. Injury and sepsis cause predictable changes in the metabolism of fuel, favoring a shift toward the oxidation of fat. Similar considerations apply to the tumor-bearing host.

Blood Glucose↗
PubMed1986

[Detection of mycobacteria in tissue in urogenital tuberculosis].

121 tissue specimens of the urogenital systems (66 from the kidney, 39 from the epididymis and testis, 8 from the prostate, 4 from the bladder and 4 from the female genital tract) were examined by microscopy, culture and animal experiment on the presence of mycobacteria. In 37 of these specimens (30.6%) mycobacteria were demonstrated, 10 of that only by microscopy and in 27 cases by culture and/or animal experiment. Up to 20 weeks after onset of treatment mycobacteria were demonstrated from the kidney tissue of treated patients by the diagnostic methods mentioned above. After this time mycobacteria never could be demonstrated. There was no correlation between the histological findings and the mycobacteriological investigations. The investigation of tissue specimens on the presence of mycobacteria also from other organs of the urogenital tract is suitable method of the bacteriological proof of tuberculosis, especially in the absence or positive bacteriological findings from the urine or accessory gland secretion for the estimation of species and resistance of these bacteria.

Animals↗
PubMed1986

[Nonspecific pyelonephritis and the formation of urinary calculi in urogenital tuberculosis].

The course of urogenital tuberculosis is complicated by unspecific bacterial infections of the urinary tract and nephrolithiasis. Among 605 patients with bacteriological or histological verified urogenital tuberculosis, 122 patients (20%) developed unspecific bacterial urinary infection--commonly caused by E. coli, proteus and pseudomonas--and 57 patients (9.4%) showed nephrolithiasis. In 42% of the lithiasis patients an urinary tract infection simultaneously occurred. 22 calculi are analyzed by the combined crystal-optical and x-ray-diffraction method with following results: 9 X struvite/carbonate apatite, 6 X calcium phosphate, 7 X calcium oxalate. The texture of 12 calculi was investigated on thin sections by polarization microscopy and a high concentration of organic material was found in both calcium oxalate and struvite/carbonate apatite calculi.

Bacteria↗
PubMed1985

Lethal atherosclerosis associated with abnormal plasma and tissue sterol composition in sitosterolemia with xanthomatosis.

Tissue sterol composition was determined in an 18-year-old male with sitosterolemia with xanthomatosis who died suddenly and whose coronary and aortic vessels showed extensive atherosclerosis and, for comparison, in an 18-year-old male with minimal atherosclerosis who died accidently. Sterols in the control tissues (plasma, erythrocytes, cardiac muscle, lung, liver, aorta, and brain) contained cholesterol with only trace amounts of cholestanol. In contrast, sterols in corresponding tissues of the sitosterolemic subject (except brain) were composed of cholesterol, increased amounts of plant sterols, campesterol and sitosterol, and 5 alpha-saturated stanols, cholestanol, 5 alpha-campestanol, and 5 alpha-sitostanol, that were deposited in approximately the same ratio as present in plasma. However, sitosterolemic brain sterol composition resembled that of the control brain with cholesterol and only trace amounts (less than 1%) of cholestanol and phytosterols. The sitosterolemic aorta was extensively atherosclerotic and contained more than twice the quantity of sterols as the control aorta (5.6 mg/g versus 2.6 mg/g) with increased amounts of cholesterol, plant sterols, and 5 alpha-saturated stanols. These results indicate that cholesterol, plant sterols, and 5 alpha-stanols are deposited prematurely and are associated with accelerated atherosclerosis in subjects with sitosterolemia with xanthomatosis.

Adolescent↗
PubMed1984

[Priorities in the treatment and nursing of patients with urogenital tuberculosis].

With the regression of tuberculosis of the respiratory tract a marked reduction of urogenital tuberculosis caused by the known late manifestations resulted, too. In 1981 152 new cases of urogenital tuberculosis were registered in GDR being an incidence rate of 0.91 per 100,000 inhabitants. The total duration of antibiotic therapy could be reduced from previously two years to 9 months. Inspite of using highly effective aggressive antituberculotic drugs the portion of persons with nephrectomy in our hospital amounted to 27%. Superinfection with nonspecific germs and by formation of stones in the urinary tract complicated the later course of disease. 18% among 567 patients showed a nonspecific mixed infection and additional 8% had stones in the urinary tract. Complications occurred in 50% of the cases with residual kidneys. Cases of delayed diagnosis have become more frequent in the last 8 years. The prognosis of the illness is decisively determined by early diagnosis, by adequate therapy and intensive urological-nephrological dispensairic care.

Adolescent↗
PubMed1983

[Therapy of bladder cancer. Value of transurethral resection--treatment results].

The significance of carcinomas of the bladder is shown on the basis of epidemiological data. A survey is given of the numbers of operations using various methods over the last 24 years; in our institution TuTuR is mainly used. A report is given on the indications, procedure and possibilities of complications, showing the limits of the method. Problems of radical operations, which make supravesical derivation of the urine necessary, are discussed. Our therapeutic results are presented in the form of mortality curves. The unfavourable therapeutic results cause us to pose the question once again whether, in the light of modern intensive medicine, greater radicality might not be recommendable.

Carcinoma, Papillary↗
PubMed1982

[20 years' treatment of urogenital tuberculosis with reference to the epidemiology and the general tuberculosis situation].

After introductory remarks on the historical development of the treatment of patients with UGT, the general tuberculosis situation in the GDR is referred to. With the steady decline in tuberculosis of the respiratory system, a clear reduction in the rate of new cases of UGT was registered from 1972 on, due to the well-known late manifestation of the disease. In 1980, 164 new cases of urological tuberculosis were registered, which represent a rate of less than 1 (0.97) new case per 100,000 head of population for the first time. It has been possible to reduce the total duration of medicinal treatment to 9 months from an original figure of 2 years. Despite the use of highly effective aggressive anti-tuberculosis agents the rate of nephrectomy in our patients is 27%, whereby in the last 6 years as many as 31% of all patients with UGT have undergone nephrectomy in the course of treatment. In 20 of these 54 patients the nephrectomy had already been performed elsewhere and UGT was diagnosed from histological examination of the surgical specimen. Neglected cases have become more common in the last 6 years. UGT has been diagnosed very late, whereby it has been observed that patients with pronounced tubercular changes have been little affected in their general state of health. In one case urotuberculosis appeared after a kidney allotransplantation from a dead donor.

Adolescent↗
PubMed1980

[Quantitative kidney function scintigraphy (FSG) on separate sides in urogenital tuberculosis].

Depending on degree and size of the changes the function of the tuberculous kidney is disturbed with different strength. With the help of the quantitative function scintigraphy by means of 131 J hippuran (sequence scintigraphy, ROI nephrography and side-separated clearance) 33 patients with urotuberculosis were examined and their course of the disease was observed. The greatest value has the function scintigraphy in progressed renal tuberculosis in the differential therapy (nephrectomy, organ-maintaining operation or conservative therapy) and control of the course.

Creatinine↗
PubMed1979

Hemodynamic evaluation of the Carpentier-Edwards bioprosthesis in the aortic position.

The Carpentier-Edwards bioprosthesis is a glutaraldehyde-fixed porcine xenograft with a fully flexible thin-walled stent. Cardiac catheterization studies were performed in 17 patients to evaluate use of this valve in the aortic position. Hemodynamic studies established a mean peak gradient across the prosthesis of 19 mm Hg (range 5 to 65). The mean effective orifice area was calculated to be 1.6 cm2 (range 0.8 to 3.3). All patients demonstrated an improvement in functional class after operation. Mean left ventricular ejection fraction increased from 51 +/- 16 to 68 +/- 9 percent (P less than 0.004) in eight patients operated on for aortic stenosis, but was not significantly changed in patients operated on for aortic insufficiency. Hemodynamic comparison of the Carpentier-Edwards bioprosthesis with the standard Hancock xenograft showed similar effective orifice areas for the 23 and 25 mm diameter valves. In two patients studied the 21 mm Carpentier valve demonstrated a greater effective orifice area than that previously reported for the standard Hancock xenograft. The Carpentier-Edwards bioprosthesis affords both clinical and hemodynamic improvement when used in the aortic position and may allow improved effective orifice area when used in the smaller aortic root.

Adult↗
PubMed1979

Detection of myocardial infarct extension by CK-B radioimmunoassay.

Myocardial infarct extension after the acute event was defined as a second reise in the myocardial isoenzyme of serum creatine kinase (CK-B) after the initial return of CK-B to normal values. In 43 patients with acute myocardial infarcts, CK-B was measured by radioimmunoassay every 12 hours for 14 days. Nineteen patients had anterior transmural myocardial infarcts AMI, 14 had inferior transmural myocardial infarcts (IMI) and 10 had subendocardial myocardial infarcts (SEMI). Infarct extension as detectd by a second rise in serum CK-B occurred in six patients (32%) with AMI, two (14%) with IMI and two (20%) with SEMI; these differences are not statistically significant. Infarct extension for all patients combined was 23%. Four patients with AMI also had infarct extension as determined by recurrent chest pain. ECG alterations and other enzyme changes. In the other six, the infarct extension was undetected clinically. Four patients with AMI and infarct extension died within 3 weeks after hospitalization. We did not note any additional morbidity or mortality in patients with infarct extension who had IMI or SEMI. There was no significant difference in the frequency of previous myocardial infarction, history of hypertension, diabetes mellitus or smoking history in patients with and without infarct extension shown by serum CK-B isoenzyme elevations. The measurement of serum CK-B values with a quantitative and sensitive assay suggests that myocardial infarct extension occurs more commonly than clinically recognized, but the frequency of extension may be less than that reported in patients in whom precordial mapping and total serum CK values were measured to identify this phenomenon.

Adult↗
PubMed1978

[Modern therapy and after-care in urogenital tuberculosis].

The present therapy of the urogenital tuberculosis is based on the effective medicaments (rifampizin, isonicotinic acid hydrazid, streptomycin, and ethambutol). It rests on an optimum dosage in connection with a best suited combination, taking into consideration the relations of sensitiveness and side effects as well as consequent long-term treatment. It is referred to the possibility of additional administrations of corticosteroid preparations and it is taken notice to the necessity also to treat unspecific mixed infections. Under the modern chemotherapy with bactericidal effect a stable negativation practically always develops within 3 months. Actual recidivations were not seen during the last 12 years. Apart from a compilation of the indications to nephrectomy references to possibilities of plastic surgical corrections of the urinary system are given. Two tables give information about the patients who were operatively treated during the last 15 years. A close collaboration of the various therapeutic institutions with a consulting urologist -- particularly in problematic and advanced cases of the disease -- nearly always saves the patient with urogenital tuberculosis from invalidism.

Adrenal Cortex Hormones↗