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Biomedical subjects

T Ring

Publications and source records attributed to T Ring.

At least 19 recordsLinked to original sources
PubMed2000

Relationship between methylmalonic acid and cobalamin in uremia.

UNLABELLED: Relationship between methylmalonic acid and cobalamin in uremia. BACKGROUND: To evaluate the requirement for routine supplementation with vitamin B12 and to study the effect of a change from injection to oral B12 supplementation, we examined the relationship between cobalamin and methylmalonic acid in plasma from 67 patients on chronic hemodialysis, all in regular therapy with intramuscular cobalamin injections (1 mg) every third month. METHODS: Starting just before one cobalamin injection, blood samples were collected once a month during a nine-month withdrawal from regular cobalamin substitution to a final three-month period with cyanocobalamin tablets (1 mg) administered once daily. RESULTS: Plasma cobalamin was above the lower reference limit in all subjects, and from a peak value one month after the regular injection, the cobalamin concentration during the withdrawal period decreased to a level below the point of origin, followed by a significant rise after cyanocobalamin tablets. The methylmalonic acid concentrations were above the reference interval. In the withdrawal period, the concentrations significantly increased further, followed by a significant decrease after oral cyanocobalamin substitution. CONCLUSION: We demonstrated a within-patient inverse relationship between the concentrations of methylmalonic acid and cobalamin in plasma from these uremic patients. Despite the fact that only two of the patients developed subnormal plasma cobalamin values, we demonstrated a B12 depletion during the withdrawal period. Treatment with cyanocobalamin tablets once daily was found efficient, but the oral doses should possibly be increased.

Adult↗
PubMed1999

[Primary hyperoxaluria type 1 detected by liver biopsy].

PH1 is caused by deficiency of the liver-specific peroxisomal enzyme alanine: glycoxylate aminotransferase (AGT). Early onset with progressive renal failure and systemic oxalosis is typical. We report a case of a 42 year-old man with PH1 in whom liver biopsy and DNA-analysis showed reduced AGT-activity and homozygosity for the polymorphism C154T and the point mutation G630A. The patient seems to respond to pyridoxine treatment. We suggest that clinical suspicion of PH1 be pursued with a diagnostic liver biopsy.

Adult↗
PubMed1998

[Changes in subjective cyclodeviation and objective cycloposition after modified Harada-Ito operation in acquired trochlear paralysis].

BACKGROUND: After recently published own investigations on subjective and objective cyclorotatory changes following inferior oblique recession for inferior oblique overaction, it was our aim to determine and to compare subjective and objective cyclorotatory changes following a modified Harada-Ito procedure for acquired trochlear palsy. PATIENTS AND METHODS: Eight patients suffering from acquired uni-(n = 3) or bilateral (n = 5) trochlear palsy were investigated before surgery and 1 day, 3 days and 4 months after surgery. Subjective cyclodeviation was assessed by Harms' tangent scale. Objective cycloposition was measured by means of fundus cyclometry using an infrared Scanning Laser Ophthalmoscope. RESULTS: The immediate postoperative incyclorotatory effect was 12 degrees in the unilateral group and 18 degrees in the bilateral group. Subjective and objective changes were nearly equal in both groups, with a subjective over-effect of 1 degree. After two days of binocular stimulation a marked regression of the surgical effect was found which still increased after four months. The long term incyclorotatory effect was subjectively and objectively nearly equal in the unilateral group which showed a relaps of subjective excyclodeviation of 5 degrees: in the bilateral group, the subjective effect was more pronounced than the objective effect, the immediate postoperative over-effect being disappeared. CONCLUSIONS: In contrast to our results concerning inferior oblique muscle recession for strabismus sursoadductorius, subjective and objective cyclorotatory changes did not differ grossly following a modified Harada-Ito procedure. Subjective and objective short and long term regression was confirmed which objectively exceeded the amount of over-correction. As the underlying cause mechanical and sensory mechanisms are discussed.

Adult↗
PubMed1998

[Occasional alcohol drinkers and chronic alcoholics. Comparison of two patient groups from the viewpoint of accident surgery].

Patients who suffer an accident after alcohol consumption can be differentiated into 2 groups: patients which drink alcohol occasionally and chronic alcoholics. We examined prospectively in-patients treated after suffering a trauma in an alcoholised state. The diagnosis acute alcohol intoxication was made by a breath-alcohol-analysis, the diagnosis chronic alcoholism by a shortened MAST-test. In the average chronic alcoholics were 12 years older than acute intoxicated. Family background of chronic alcoholics was more often disrupted and social status lower than in acute alcoholics. For the acute alcoholics a car crash, for the chronic alcoholics a fall was the main trauma cause. In over 50% both patient groups suffered a minor head injury. Chronic alcoholics had a twice as long hospital stay (16.1 +/- 3.2 vs. 8.5 +/- 1.1 days), needed more specialist consultations (84% vs. 60%) and developed more complications (40% vs 16%) than the acute alcohol intoxicated. The ISS (Injury Severity Score) was the same for both patient groups (6.7 +/- 0.7 vs. 7.1 +/- 0.8) and had no prognostic value for the group of the chronic alcoholics. On the basis of the present findings it is advisable to check the diagnosis alcohol intoxication and to look whether chronic alcoholism is present whenever a drunken patient is admitted.

Accidents↗
PubMed1995

Calcium in patients on hemodialysis.

Analyzing 415 measurements from 33 patients on chronic maintenance hemodialysis we confirm that 50% of total calcium in the range 1.59 to 3.33 mmol/l gives a valuable approximation to ionized calcium in the range 0.79 to 1.62 mmol/l. However, a small but significant effect of albumin and phosphate on ionized calcium can also be demonstrated. Conventional albumin correction of total calcium using the formula: total calcium + (43 g/l-Albumin g/l).0.017 mmol/g is of poor value in these patients on maintenance hemodialysis.

Calcium↗
PubMed1995

Ultradian variation in serum phosphate concentration in patients on haemodialysis.

To study how much the serum phosphate concentration could vary on the day before scheduled dialysis we obtained 24-37 timed measurements during 24 h in nine patients on maintenance haemodialysis. During the observation there was an increase in serum phosphate concentration of 0.239 +/- 0.022, P < 0.01). Surprisingly six of the nine patients exhibited nine statistically and clinically significant nadirs with decrements of 0.21 +/- 0.04 mmol/l against an intra-assay standard deviation of about 0.05 mmol/l. Five of the nadirs occurred at 11.40-14.50, mean 12.59, and three at 19.00-21.30, mean 20.00. We found no coinciding changes in the serum calcium concentration. These findings indicate that serum phosphate concentrations do not always reflect phosphorus balance or intake.

Activity Cycles↗
PubMed1995

Mineralization defect but no effect on hypercalcemia during clodronate treatment in secondary hyperparathyroidism.

In four patients with severe secondary hyperparathyroidism, treatment with clodronate caused no decrease in serum calcium. In one of the patients treatment for seven months was associated with a severe mineralization defect which was not caused by aluminium. This lesion was reversible upon termination of clodronate treatment. In a single patient without hyperparathyroidism, a precipitous decrease in serum calcium was observed due to clodronate. However, long-term treatment with clodronate did not ameliorate ectopic calcification in this patient. It is concluded that in severe secondary hyperparathyroidism, clodronate does not always decrease serum calcium. Our experience suggest that clodronate like other bisphosphonates may inhibit bone mineralization.

Adult↗
PubMed1994

[Acute and chronic alcohol abuse--effect on inpatient treatment of trauma surgery patients].

The effect of alcoholism on the length of stay and costs of hospital treatment is not well documented. The posttraumatic course of treatment of 75 alcohol intoxicated patients was prospectively followed. A shortened MAST-test served to identify chronic alcoholised patients. The obtained data were compared with a control group according to the matched-pair method. The course of treatment of 44 drunken patients without signs of chronic alcoholism was not different from the control group. However 31 chronic alcohol intoxicated patients showed a clearly different course from the control group. The hospital stay was nearly doubled (13.5 days) compared to the control group (7.5 days). There were explicitly more consultations of specialists (26 vs. 9) necessary and the complication rate (9 vs. 1) during the hospital stay was significantly increased. Chronic alcoholism of traumatised patients yields to a cost increase of the hospital treatment. The high complication rate forces an intensive supervision of the affected patients. These results have to be taken into account by calculations of reimbursement rates for the field of trauma surgery.

Adolescent↗
PubMed1993

[Neurootologically detectable brain stem damage in mild to moderate pediatric craniocerebral trauma].

Children with mild to moderate brain injury often show by conventional neurological and radiological primary examination no pathologic findings. But follow-up controls demonstrated, that the initial neurologic damage is not always sufficiently registered. With the additional neurootological examination is an accepted method available, which permits objective statements about lesions in the peripheral and central sensory system. With this examination we were able to demonstrate in a definite collective of children with mild brain injury neurological deficits in a high percentage; 40% had in impairment of the auditory system. In the course nearly all children showed a spontaneous recovery of the sensory system. Kind and localisation of the posttraumatic lesions pointed out, that mild to moderate traumatic brain injuries in childhood predominantly yield to an indirect damage of the brainstem.

Adolescent↗
PubMed1993

Calcium acetate versus calcium carbonate as phosphorus binders in patients on chronic haemodialysis: a controlled study.

The first reported double-blind cross-over comparison between the phosphorus binders calcium carbonate and calcium acetate was undertaken in 15 stable patients on chronic maintenance haemodialysis. Detailed registration of diet and analysis of the protein catabolic rate suggested an unchanged phosphorus intake during the study. It was found that predialytic serum phosphate concentration was significantly decreased by 0.11 mmol/l (0.34 mg/dl) (P = 0.021, 95% confidence limits 0.02-0.21 mmol/l; 0.06-0.65 mg/dl) during calcium acetate treatment. The calcium phosphate product was insignificantly decreased during treatment with calcium acetate whereas we could not exclude the possibility that calcium concentration had increased.

Acetates↗