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Biomedical subjects

W Fassbinder

Publications and source records attributed to W Fassbinder.

At least 91 records · Page 5Linked to original sources
PubMed1981

[Transluminal dilatation of renal artery stenoses for treatment of renovascular hypertension (author's transl)].

Transluminal angioplasty according to Grüntzig was performed for 10 stenoses in 7 patients with renovascular hypertension. Nine out of 10 renal artery stenoses were passable and could be dilated. Definite angiographic improvement could be shown in each case. The degree of stenosis could be decreased from 86% to 38% on average. At the narrowest point the diameter was enlarged by a factor of 3.1. The pressure gradient at the stenosis fell on average from 147 to 26 mm Hg. The maximal arterial blood pressure which was on average 254/124 mm Hg before drug treatment, and 169/97 mm Hg after high dosage antihypertensive treatment, fell to 140/84 mm Hg immediately after dilatation. Before dilatation there was a definite increase in peripheral plasma renin activity in every case which fell from 41 to 12 ng AI/ml . h. In one out of 5 patients restenosis occurred after 3 months which could again be successfully dilated. In the two younger patients blood pressure 3 to 9 months later was normal even without antihypertensives. In the older patients normal blood pressure could be maintained with mild antihypertensive treatment.

Adult↗
PubMed1981

Development of a radioimmunoassay for a high molecular mass tubular antigen in urine--its application for early detection of tubular damage.

In order to isolate urinary kidney antigens, the gammaglobulins fraction of an antiserum against human kidney cortex plasma membranes was coupled to Sepharose 4B. By immunospecific affinity chromatography an antigen fraction was obtained from the urine of a patient suffering from severe kidney disease. After gel filtration, the main fraction, eluted with the exclusion volume of a Sephadex G-200 column and enriched 16 000-fold, was labelled with 131I and used in a radioimmunoassay system. Soluble kidney antigens, presumably of proximal tubular origin, could be detected and quantified by the assay system in urine samples of patients with various diseases. The samples did not need to be treated, either concentrated or dialyzed, before application. The results of our experiments show a correlation between antigen excretion and kidney damage. Rejection episodes in patients with kidney transplants could be recognized early by enhanced antigen excretion. Potentially nephrotoxic drugs caused antigen excretion as well. In normal, healthy subjects output of the antigen was very low. The assay system might be of value for monitoring renal diseases.

Antigens↗
PubMed1980

[Autonomic circulatory regulation in uremia (author's transl)].

Uremic autonomic neuropathy leads to impaired function of the baroreflex. The main defect, according to literature, is located in the afferent limb of the reflex arc and in the efferent cardiac vagus nerve, whereas the sympathetic part of the efferent arc is still intact. Own results, obtained in hemodialysis patients during orthostasis and volume removal induced sympathetic stimulation, showed qualitatively and quantitatively adequate sympathetic response and also an adequate end organ receptor response. Autonomic nervous neuropathy predisposes to volume removal related symptomatic hypotension during hemodialysis treatment. In addition hemodialysis treatment per se induces a so far unexplained interference with sympathetic response to volume removal. The autonomic neuropathy also predisposes to development of hypertension in response to volume load.

Autonomic Nervous System↗
PubMed1980

[Increased success rate of renal transplantation by HLA-DR-typing: a retrospective analysis of the South-German co-operative study group for renal transplantation (author's transl)].

Retrospective HLA-DR-typing and the influence of HLA-DR antigen on transplantation prognosis was studied in 90 kidney donor-recipient pairs. It was clearly demonstrated that HLA-DR compatible donor kidney provides a significantly better transplant prognosis than if there is HLA-DR incompatibility. Donor kidneys with only one identical HLA-DR antigen gave a six-month survival rate of 80%. Only HLA-AB identical cadaver kidneys ("full house identity") give similar survival times. Because of relatively lower polymorphism of the HLA-DR alloantigen system, HLA-DR identical donor organs are discovered more frequently than when HLA-AB antigens are taken into consideration. HLA-DR identical donor kidneys (identical for both HLA-DR antigens) have an even better transplant prognosis than "full house identical" kidneys, since the survival rate in the former is 87% after six months.

HLA Antigens↗
PubMed1980

Transplantation of human fetal pancreas: experience in thymusaplastic mice and rats and in a diabetic patient.

The aim of the present study was to investigate if thymusaplastic nude mice and rats are favorable as recipients for transplantation of human fetal pancreas. Twenty human fetal pancreases were transplanted subcutaneously to 20 nude mice, and six human fetal pancreases were transplanted to six rats. The xenografts showed histotypical development of islets of Langerhans. Insulin, glucagon, somatostatin, and pancreatic polypeptide immunoreactivities were also seen in very early stages of the transplant development within the monolayered ducts. With the described "epigastric pouch technique" in rats, we co-ld demonstrate a new in vivo method for selective stimulations and simultaneous blood sampling from tissue-isolated xenografts. Transplantation of human fetal pancreas to the brachioradial muscle of an insulin-dependent patient in combination with a kidney transplant revealed that rejection crises of the kidney led to necrosis of the pancreas transplant, whereas rejection of the kidney was overcome by steroid pulse therapy.

Animals↗
PubMed1980

Differing haemodynamic stability due to differing sympathetic response: comparison of ultrafiltration, haemodialysis and haemofiltration.

In 12 RDT patients the volume removal related haemodynamic changes were correlated with concomitant changes in sympathetic activity during pure ultrafiltration (UF), post dilution haemofiltration (HF) and haemodialysis using either acetate (HDA) or bicarbonate (HDB) as buffer substitute. Total peripheral resistance (TPR) and plasma noradrenaline concentrations (PNA) increased during UF indicating a qualitatively adequate reaction of ESRD patients to volume removal. This physiological response is maintained during HF, resulting in intratreatment haemodynamic stability. In contrast no increase of PNA and insignificant changes of TPR were seen in HDA and HDB. As small molecule clearances were matched to those in HF, the behaviour of PNA indicates that not PNA removal but an impaired sympathetic response during HDA and HDB is responsible for the inadequate rise of TPR.

Adult↗
PubMed1979

Haemolysis due to formaldehyde-induced anti-N-like antibodies in haemodialysis patients.

During reuse of formaldehyde sterilized Kiil-dialysers, red cell survival, measured by means of 51Cr t/2, was significantly reduced (p less than 0.001) in 16 patients with anti-N-like positive sera, when compared with 19 antibody negative control patients (mean +/- SD: 16.5 +/- 2.7 versus 22.4 +/- 3.1 days.) In antibody negative patients (n = 10) replacement of formaldehyde sterilized dialysers by ethylene-oxide sterilized disposable dialysers resulted in a significant increase (p less than 0.002) of 51Cr t/2 (Mean +/- SD, days: Kiildialyser 16.3 +/- 1.9; disposable dialyser 20.3 +/- 3.5). This improvement took place, although antibody titres persisted during the 51Cr-measurements and declined thereafter only slowly. In antibody negative patients (n = 6) red cell survival did not increase, when formaldehyde as a sterilant was avoided. In antibody positive patients mean haematocrit rose significantly (p less than 0.05), whereas in none of the antibody negative patients a definite change of haematocrit occurred. The data demonstrate, that formaldehyde sterilisation of dialysers may cause antibody-mediated haemolysis contributing to the extent of renal anaemia. This immunohaemolysis may be corrected, in spite of continuing antibody persistance, when formaldehyde exposure is totally avoided, or possibly when minimized.

Antibody Formation↗
PubMed1978

[Haemodialysis in the treatment of biguanide-induced lactate acidosis (author's transl)].

Severe lactate acidosis developed in nine diabetics on biguanide. When lactate acidosis was diagnosed all patients had reduced renal function, six being oligoanuric. Pre-existing chronic renal failure as a factor in the development of lactic acidosis was excluded in five patients, normal renal function being restored later. All patients were dialysed, seven surviving. This mortality rate is lower than that reported by others for biguanide-induced lactate acidosis. Rapid biguanide elimination by dialysis was demonstrated both in vitro and in vivo. The in vivo clearance of buformin was 83 +/- 43 ml/min (mean +/- SD, n = 4), that of phenformin 68 +/- 33 ml/min (n = 7). The main advantages of haemodialysis in the treatment of biguanide-induced lactic acidosis are rapid removal of toxic biguanides and excess lactate and the ability to administer sodium bicarbonate adequately without risking hypernatraemia and fluid overload.

Acidosis↗
PubMed1978

Serum erythropoietin measurements using the fetal mouse liver cell culture: the importance of reduction of variation in the specific activity of radioiron--transferrin.

Because of varying iron--transferrin concentrations in different serum samples, and varying test serum portions within the culture, variations of the radioiron--transferrin/total iron--transferrin ratio are inevitable, when serum erythropoietin (Ep) concentrations are measured using the fetal mouse liver cell assay. It could be demonstrated that radioiron uptake is directly proportional to the specific activity of radioiron--transferrin, when the latter varies over the range which is inherent to the method. Variations of the ratio of radioiron--transferrin/total iron--transferrin were reduced by preincubating radioiron with human transferrin, and by minimizing the test serum portion of the culture. With this modified in vitro bioassay, serum Ep concentrations of 59 healthy subjects were measured. Mean serum Ep concentration was 136 +/- 66 (s.d.) mU/ml.

Animals↗
PubMed1978

Total parathyroidectomy with autograft of parathyroid tissue in treatment of secondary hyperparathyroidism.

In 16 patients with severe symptomatic hyperparathyroidism reduction of hyperplastic parathyroid mass was performed by total parathyroidectomy with autotransplantation of parathyroid tissue. In all patients except one serum parathormone (PTH) levels returned to normal and postoperative difficulties in calcium homeostasis were rarely observed. Fifteen patients had normal PTH levels after surgery. Graft function was proven in 10 cases, but in 5 cases graft function could not be definitely established with the methods applied. One graft failure was observed. Total parathyroidectomy with autotransplanation of parathyroid tissue is recommended as the treatment of choice when surgical correction of secondary hyperparathyroidism is necessary.

Adult↗
PubMed1977

The variable role of erythropoietin deficiency in the pathogenesis of dialysis anaemia.

To evaluate the role of reduced erythropoietin (Ep) production in the pathogenesis of dialysis anaemia, measurements of serum erythropoietin (SEp) concentration by means of a highly sensitive in vitro bioassay were performed in 88 non-nephrectomised non-transfused regular haemodialysis patients. In 50 patients (group 1) SEp levels were lower than 120 mU/ml. In the remaining 38 patients (group 2) SEp concentrations ranged from 120-369 mU/ml. Group 1 showed a highly significant positive correlation between SEp concentration and haematocrit as did 13 anephric patients investigated for comparison. In contrast, group 2 displayed a highly significant negative correlation between SEp concentration and haematocrit. The results demonstrate the existence of two distinctive groups of similar size in regular haemodialysis patients: those with an absolute (group 1) and those with a relative deficiency of Ep (group 2). In the case of the latter, lack of Ep is probably a secondary factor in the pathogenesis of anaemia, whereas uraemic toxicity and blood loss may play a primary role.

Anemia↗
PubMed1976

Occult blood loss and iron balance in chronic renal failure.

In 38 patients with chronic renal failure total daily blood loss and intestinal iron absorption were determined by means of a whole-body counter and radioiron. Bone marrow iron content was measured histochemically. Mean daily blood loss (corrected for laboratory blood sampling) and iron absorption were significantly higher than in normal controls. Bone marrow iron content was reduced in 46% of the patients. The results prove that gastrointestinal blood loss in patients with chronic renal failure is of such magnitude that negative iron balance results.

Absorption↗
PubMed1976

Factors predisposing to priapism in haemodialysis patients.

Clinical data and therapy of all male home dialysis patients of two centres were compared in order to establish predisposing factors to priapism. One centre (Frankfurt) had nine priapisms in 96 patients, whereas the other centre (Montpellier) had none in 59 patients. The only difference found were higher haematocrits in Frankfurt than in Montpellier. The highest haematocrits were found in the priapism patients. Further evaluation of the Frankfurt data showed that androgen therapy, high haematocrits and hypovolemia increase the risk of dialysis priapism. It is recommended to withdraw androgen therapy when the haematocrit is consistantly above 25%.

Adult↗