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Biomedical subjects

U Cordes

Publications and source records attributed to U Cordes.

At least 55 records · Page 3Linked to original sources
PubMed1980

[Surgery of the adrenals: result of 154 operations (author's transl)].

Biochemical and radiological results, surgical technique and its results were critically analysed in a retrospective study of 154 operations on the adrenals in 127 patients, operated on between 1957 and 1980. There were no complications in 95 patients. In the remaining 32, both intra- and postoperative complication rate was greater after extraperitoneal than transabdominal approach to the adrenals. Postoperative mortality was 6%, but since 1967 only two patients have died in the postoperative period. Thromboembolic phenomena were the main cause of death, patients with Cushing's disease most commonly having this complication.

Adrenal Gland Neoplasms↗
PubMed1980

Glucagon secretion in four duodenopancreatectomized patients after arginine and glucose load.

It is well established that in sera of totally duodenopancreatectomized dogs after complete insulin deprivation an immunoreactive glucagon can be found, which is indistinguishable from the pancreatic glucagon, and which can be stimulated by oral glucose and i.v. arginine as well. In four duodenopancreatectomized patients we found, after 26 h insulin deprivation, normal and elevated basal levels of IRG which were not stimulated by intravenous arginine but by oral glucose. Dilution tests of the sera before glucose stimulation showed immunological properties different from pancreatic standard glucagon, whereas in sera after stimulation immunoidentity with pancreatic standard glucagon could be demonstrated. Gel chromatography of the sera after stimulation yielded at least three immunoreactive peaks, the first over 30 000 daltons, a second eluting in the region of insulin, and a third of about 2000 daltons. True glucagon (3500 MW) could not be clearly demonstrated.

Adult↗
PubMed1980

Treatment of delayed puberty by intranasal application of gonadotropin-releasing hormone (GnRH).

Seven male patients between 15(5)/12 and 19(6)/12 years of age with delayed puberty, two of them anosmic, received 200 microgram GnRH nasally (N) six to eight times daily for a period of 3 months, or in one case for 6 months. Changes in basal secretion and responsiveness of the gonadotropins were recorded by serial GnRH tests. Serial measurements of serum testosterone (T) were also done. While serum T, before treatment, was low it prepubertal levels in all patients, basal serum gonadotropins and gonadotropin responsiveness in the GnRH tests were found to be within the adult range in most of the patients. In the two anosmic patients, after 2 to 4 weeks of treatment decreasing gonadotropin responsiveness of GnRH was observed, and no, or only transitory, increases of serum T were found. In another patient, in spite of sustained gonadotropin responsiveness of GnRH throughout the treatment, no increase of serum T was seen which is probably due to additional primary Leydig cell deficiency. In the other four patients increases of serum T were observed which, however, did not reach the middle of the normal adult range. If stimulation of T secretion was achieved a further increase of serum T was observed after termination of the treatment. Thereafter, serum T returned to pretreatment values in one patient or stayed within the normal adult range in two other patients. No significant effects on clinical parameters were found with the GnRH therapy. This is probably due to the short duration of therapy in these patients as well as to the changes in serum T observed during the treatment, which are small in comparison to gonadotropin therapy.

Administration, Intranasal↗
PubMed1980

Plasma catecholamines in long-term diabetes.

To investigate a possible defect in sympathetic innervation of the blood vessels in diabetics, 18 normals, 13 normotensive juvenile diabetics without complications and 13 normotensive juvenile diabetics with complications were first treated with an increasing infusion of norepinephrine (NE) and subsequently given a two minutes' exercise with a 150 Watt load. Plasma catecholamines were measured under both conditions. In the infusion experiments diabetics were found to have higher NE levels than normals. In normals NE fells to starting levels 5 min. after completion of the work load. In diabetics this fall-back rate was slower. The reduction in the fall-back rate was correlated with the duration of the diabetes.

Adult↗
PubMed1980

[Experience with CT and adrenal venography in the diagnosis of adrenal disease with endocrine activity (author's transl)].

Report of the result of CT and venography in 12 patients with suspected adrenal disease, venography being combined with selective blood sampling for hormone analysis. In one patient CT showed a 1.6 cm big pheochromocytome in the left adrenal gland, not demonstrated by venography, but proven by analysis of the blood sample. Both methods showed hyperplasia of both adrenals in one patient with Cushing Syndrome with elevated Cortisol levels found in the analysis of the blood smples. Of 3 patients with hyperaldosteronism, venography was able to demonstrate 2 Conn adenomas, not seen on CT; whereas CT showed the third 2 X 1.5 cm big Conn adenoma hidden in an enlarged adrenal gland. Hormone analysis was helpful in 2 of these cases, while in the third it was misleading. The authors believe that both methods should be employed to localise over adrenal disease with endocrine activity.

Adrenal Gland Diseases↗
PubMed1979

[Modern methods in localization of pheochromocytomas (author's transl)].

In six patients with adrenal pheochromocytoma the tumors were localized by ultrasonography, phlebography of the adrenal glands and by estimation of plasma catecholamines selectively obtained from the vena cava and the adrenal gland veins. All tumors were localized by selective catecholamine estimation, five by ultrasonography, and four by phlebography. The smallest pheochromocytoma of 1.5 g weight was only localized by selective catecholamine estimation but not by ultrasonography or phlebography. This tumor, however, had been visualized by computed tomography. To avoid diagnostic errors by selective catecholamine estimation, it is important to withdraw blood from the adrenal gland veins prior to the injection of any radiographic contrast media, since this may result in an extremely enhanced secretion of catecholamines from the adrenal medulla.

Adrenal Gland Neoplasms↗
PubMed1979

[The effect of premedication with thalamonal on the plasma catecholamine levels (author's transl)].

The sympathetic suppressant properties of Thalamonal as a premedication is reported in both normotensive and hypertensive patients. The investigations were carried out in 27 patients altogether, of whom 7 were previously treated hypertensives. The plasma catecholamines noradrenaline and adrenaline, the blood pressure and heart rate were monitored before and after premedication.

Blood Pressure↗
PubMed1979

[The diagnosis of phaeochromocytoma: sensitivity of vanillylmandelic acid and urinary catecholamine determination and the Katecult test (author's transl)].

Tumour weight was compared with maximal vanillylmandelic acid and catecholamine excretion in 24-hour urine in 21 patients with phaeochromocytoma. The tumour weight correlated both with vanillylmandelic acid (r = 0.805, P less than 0.001) as well as urinary catecholamine levels (r = 0.725, P less than 0.001). Normal vanillylmandelic acid excretion was found in seven patients; urinary catecholamine levels were abnormal in all patients. The Katecult test was additionally performed in ten patients, with nine positive results.

Adrenal Gland Neoplasms↗
PubMed1979

[Adrenal and extra-adrenal phaeochromocytoma: diagnostic features and localisation by determining plasma catecholamines (author's transl)].

Urinary catecholamines and urinary excretion of vanillylmandelic acid confirmed the diagnosis of phaeochromocytoma in ten patients. In two of seven a modified glucagon test significantly aided confirmation of the diagnosis. In all patients the tumour was localised both by catecholamine determination in blood from the vein draining into the inferior vena cava (IVC) and by adrenal phlebography. Site of the adrenal tumour was definitively determined by the high catecholamine level in the adrenal veins and by phlebography. Three extra-adrenal tumours, a thoracic and two abdominal ones, were localised by high catecholamine levels in blood from other veins draining into the IVC. Vanillylmandelic acid determinaion was unreliable in the diagnosis of small phaeochromocytomas.

Abdominal Neoplasms↗
PubMed1979

Secretory B-cell activity in insulin dependent maturity-onset diabetic.

In 10 insulin dependent maturity onset diabetics we found elevated basal C-Peptide levels (4.78 +/- 0.5 ng/ml. Normal range 1.1--3.6 ng/ml), which could be suppressed by insulin injection to the same extent as in sulfonylurea treated diabetics could be demonstrated. C-Peptide immunoreactivity in these patients therefore seems to be newly secreted rather than accumulated material. Since adrenalectomized patients could be suppressed in the same way, it is likely, that catecholamines are not the major factor in the mechanism of suppression. Therefore only decrease of bloodsugar levels seems to be accountable for the decrease of C-Petide levels. High C-Petide levels in insulin dependent maturity onset diabetics which cannot be stimulated but suppressed may be explained by a loss of glucoreceptor molecules.

Adrenalectomy↗
PubMed1979

[Plasma-catecholamines under electrostimulation and neurolept anaesthesia for retina and vitreous body operations (author's transl)].

We determined in two groups of patients with normal circulation and metabolism during operations on the retina and vitreous body the concentration of plasma catecholamines. The intensity of stress was compared between electrostimulation anaesthesia and neuroleptanaesthesia. Venous blood was sampled 1) before premedication, 2) 30' after premedication, 3) at the start of surgery, 4) 45' after the start of surgery, 5) 30' after extubation. Plasma catecholamines (adrenaline and noradrenaline) were determined using a modified trihydroxyindol-spectrofluoremetric method (combined "Batch-technique"). There was no relevant difference between the two techniques of anaesthesia when using the concentrations of plasmacatecholamines as an indicator of stress resulting from operation and anaesthesia.

Acid-Base Equilibrium↗
PubMed1979

The artificial beta cell (Biostator) in the adjustment of instable diabetics--results after 20 months.

In 55 poorly controlled insulin-dependent diabetics, we tried to discover criteria for an improvement of metabolism by means of the "artificial beta-cell" (Biostator). To this end, during the first 24 h of hospitalization, blood glucose was monitored continuously under conventional insulin therapy (monitoring period). Insulin requirement was determined during the next 24 h by the artificial beta-cell (feedback period). Corrections of diabetes regimen were made with reference to the insulin consumption during the feedback period and to the extent of the postprandial blood sugar increases and decreases during the monitoring period. The resulting new diabetes regimen led to a significant improvement of the daily blood sugar profiles.

Artificial Organs↗
PubMed1978

Sympathetic nervous system and blood-pressure control in essential hypertension.

In normotensive subjects an inverse correlation was observed between an index of sympathetic nervous activity (the plasma-noradrenaline concentration during physical exercise) and reactivity to exogenous noradrenaline. This relationship was invariably disturbed in age-matched patients with essential hypertension. Multiple-regression analysis revealed a highly significant correlation between the combination of both factors and the height of mean arterial blood-pressure (r=0.91). The findings suggest that sympathetic nervous activity and pressor response to noradrenaline together form an important determinant of the arterial blood-pressure level. An inverse relationship could be demonstrated between plasma-renin concentration and pressor response to angiotensin II in normotensives, and this relationship was unchanged in hypertensive patients. Therefore angiotensin II does not appear to contribute directly to high blood-pressure.

Adult↗
PubMed1978

Sympathetic responsiveness and antihypertensive effect of beta-receptor blockade in essential hypertension.

The relationship between sympathetic responsiveness and the blood pressure reduction induced by long-term beta-blockade was assessed in patients with essential hypertension. The increase in plasma noradrenaline concentration during physical exercise was used as an index of sympathetic responsiveness. The cardioselective beta-blocker, atenolol, was given to 16 patients with sustained benign essential hypertension for five weeks at a dose of 200 mg/day. Atenolol induced a marked decrease in blood pressure and pulse rate during recumbency, orthostasis and exercise concomitant with a marked increase in plasma noradrenaline concentration (p less than 0.0125) and a pronounced decrease in plasma renin concentration (p less than 0.01). The ratio of plasma noradrenaline during exercise to the base line concentration correlated significantly with the subsequent decrease in mean arterial blood pressure induced by beta-blockade (r = 0.840; p less than 0.001). A less significant correlation was observed between the plasma renin concentration and the subsequent decrease in mean arterial pressure (r = 0.542; p less than 0.05). The results obtained indicate that sympathetic responsiveness is an important determinant of blood pressure response to beta-blockade induced by atenolol.

Adrenergic beta-Antagonists↗
PubMed1978

Gonadotropin and testosterone secretion in normal human males after stimulation with gonadotropin-releasing hormone (GnRH) or potent GnRH analogs using different modes of application.

Gonadotropin-releasing hormone (GnRH) and some potent long-acting GnRH analogs, applied by different routes of administration, were tested in six healthy human males. The effects on gonadotropin secretion were compared with the one after intravenous (i.v.) bolus injection of 25 microgram of GnRH. The net increase of luteinizing hormone (deltaLH) in serum produced by 25 microgram of GnRH i.v. was matched by subcutaneous (s.c.) injection of 100 microgram of GnRH, dissolved in 20% gelatin or without gelatin; 5 microgram of D-Ser (TBU)6-des-Gly10-GnRH-ethylamide i.v.; 5 microgram of D-Leu6-des-Gly10-GnRH-ethylamide i.v.; and 50 microgram of D-Trp6-des Gly10-GnRH-ethylamide given pernasally (p.n.). D-Leu6-des-Gly10-GnRH-ethylamide, 50 microgram p.n., produced one-half such increase as did also multiple p.n. administrations of 200 microgram of GnRH every 2 hours. With 100 microgram of GnRH and all analogs, elevation of serum LH lasted for about 7 to 9 hours. The longest elevation was observed with GnRH dissolved in gelatin and with D-Ser (TBU)6-des-Gly10-GnRH-ethylamide, as reflected by the greatest areas under the curves of net increase. The longer the duration of the action of LH secretion, the higher was the observed increase in follicle-stimulating hormone (FSH). Correlation between effect on LH secretion and testosterone secretion was not found. By infusion of 1 microgram/kg/hour od D-Leu6-des-Gly10-GnRH-Ethylamide in two men over a period of 15 hours, a plateau of gonadotropin levels was reached within 7 to 9 hours. These plateau levels, especially of FSH, were higher than after bolus injection or p.n. application.

Administration, Intranasal↗
PubMed1978

Plasma noradrenaline and the pressor action of exogenous noradrenaline in normotensive subjects and patients with essential hypertension.

1. An inverse relationship was found between plasma noradrenaline and reactivity to exogenous noradrenaline in normotensive subjects. 2. The relationship between plasma noradrenaline and reactivity was distrubed in age-matched patients with essential hypertension. 3. A multiple-regression analysis showed a highly significant correlation between adrenergic activity and reactivity to noradrenaline and the mean arterial blood pressure level (r = 0.91). The results suggest that adrenergic activity and pressor response to noradrenaline combined are important determinants of arterial blood pressure. 4. An inverse relationship could also be demonstrated between plasma renin activity and reactivity to exogenous angiotensin II. No difference was observed between normotensive and hypertensive subjects.

Adult↗
PubMed1978

The phlebographic diagnosis of phaeochromocytomas.

The diagnosis of phaeochromocytomas is based on the clinical features and on the hormone findings in the peripheral blood. Localisation, however, depends on radiological methods. Pneumoperitoneum was abandoned, because of its low accuracy, in favour of arteriography; lately, suprarenal phlebography has been available for the localisation of phaeochromocytomas. Our experience in nine patients with operatively confirmed phaeochromocytomas is described. Together with venous sampling from the caval system and the suprarenal veins for catecholamine estimations, it was possible to localise all tumours correctly. One tumour lying in the sympathetic chain in the thorax was correctly localised by hormone estimation. Our experience suggests that suprarenal phlebography represents a reliable method for localising phaeochromocytomas which carries a low risk and is to be preferred to arteriography.

Adrenal Gland Neoplasms↗