[Significance of kidney biopsies for nephrology. Re: the article from DMW 36/2005].
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Biomedical subjects
Publications and source records attributed to R Liebl.
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The seco-acid of the natural macrolactone, tuckolide (decarestrictin D) and the C-7 epimer have been prepared in enantiomerically pure form from D-gluconolactone and poly(3-hydroxy butyric acid). The key steps are Horner Emmons olefination and stereoselective reduction of the resulting enone to provide both epimers at C-7. None of the seco-acids inhibit microsomal HMGCoA reductase of pea or rat liver. It may be concluded that the cholesterol biosynthesis inhibiting effect of tuckolide is unlikely to proceed via HMGCoA reductase inhibition.
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A 52 year old patient was admitted to the hospital for further clarification of a cystic structure in the region of the spleen hilus noticed in the upper abdominal sonogram. The investigations revealed a spontaneous splenorenal shunt in hepatic cirrhosis.
The interpretation of the dexamethasone suppression test in endocrinology and psychiatry depends on several variables. False-positive results can be caused by stress, weight loss, alcohol withdrawal, treatment with diphenylhydantoin, phenobarbital, rifampicin, carbamazepine and lithium. Therapy with spironolactone, naloxone, alpha 1-mimetic agents and estrogen can be responsible for an increase in plasma-cortisol concentration. False-negative results are seen in patients with liver disease and can also result from therapy with benzodiazepines at high dosages, indomethacin and possibly methadone and ketoconazole.
Serial plasma cortisol concentrations were recorded under controlled conditions after an overnight dexamethasone suppression (DST) in 20 depressed patients with initially abnormal test results. The cortisol levels were related to clinical course. All 20 patients showed normalisation of hypothalamic-pituitary-adrenal (HPA) hyperactivity, a mean of 3.4 +/- 1.8 weeks before clinical recovery was achieved. In 4 clinically remitted patients the endocrine disturbance as evidenced by abnormal DST results preceded a depressive relapse. DST results did not appear to be affected by psychotropic drugs including benzodiazepines.
Temporomandibular joint alterations were reported which were determined on the basis of reproducible preoperative and postoperative roentgenograms. The films were produced with the help of the Hanel. C arch in the transcranial, lateral oblique projection. Displacements were demonstrated particularly in the anterior and the caudal directions. This method however does not allow a definite statement to be made concerning the postoperative position of the condyles.
This peper describes the rare cryptophthalmus syndrome combined with several other malformations of the urogenital tract and of the nose, in addition to dyscephalia and cutaneous syndactilism of fingers and toes. Because of a high incidence of parental consanguinity autosomal recessive heredity is discussed.