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Biomedical subjects

W Kaufmann

Publications and source records attributed to W Kaufmann.

At least 19 recordsLinked to original sources

[Hemodynamic and humoral changes during administration of a sympathomimetic and a sympatholytic drug with special notes on the regulation of renin release (author's transl)].

Studies in normal volunteers documented the positive inotropic effects of Etilefrin-HCL, a direct sympathomimetic drug, with increases of systolic blood pressure, renal blood flow and glomerular filtration rate. Sodium and potassium excretion as well as serum potassium decreased. After an additional injection of Metoprolol, a beta 1-sympatholytic drug, blood pressure, renal blood flow and glomerular filtration rate normalized, whereas electrolyte excretion decreased further. Renin release was decreased during administration of Etilefrin as well as during combined Etilefrin and Metoprolol application. Reziprocal to changes of blood pressure, plasma norepinephrine concentration decreased during Etilefrin and increased during combined administration of Etilefrin and Metoprolol. The results lead to the following interpretation: Changes of blood pressure and renal hemodynamics are mediated by beta 1-adrenergic effects of Etilefrin, whereas the electrolyte excretion is influenced by beta 2-adrenergic effects. Renin release seems to be influenced by beta 1 as well as beta 2-adrenergic receptors.

Adult

[The saralasin test in the diagnosis of hypertension (author's transl)].

The saralasin test was performed in 68 hypertensives. A clear-cut dependence of the test results on initial plasma-renin concentration and particular sodium balance was demonstrated. Because of this dependence the saralasin test should be performed only under constant conditions. A mild stimulation of the renin-angiotension system by salt restriction to a mean sodium excretion of 50 mmol daily and 80 mg furosemide by mouth 12 hours before the test seems best. In this way essential and renovascular hypertension could be distinguished with considerable reliability (P less than 0.001). Among patients with essential hypertension one could clearly separate those with high plasma-renin concentration from those with a normal or low one. Among patients with renovascular hypertension those with haemodynamically significant renal artery stenosis could with high probability be distinguished from those with non-effective stenosis. A positive saralasin test without testing the function of the normal contralateral kidney does not provide an indication for operation.

Adult

[Improved interpretation of renal-vein-renin-ratio by simultaneous determination of renal 131I-hippuric-acid-clearance-ratio in patients with renovascular hypertension (author's transl)].

In patients with unilateral vascular kidney disease and hypertension, ratio of renal-vein-renin was compared with 131I-Hippuric-acid clearance and change in blood pressure during Saralasininfusion. The ratio of renal-vein-renin was positively correlated with the ratio in renal plasma flow between the kidneys in all patients studied. The ratio of renins therefore is a result of two factors: The difference in renin secretion and the difference in blood flow in the two kidneys. In patients with angiotensin independent hypertension renin-ratios up to 2.0 were found without relevance to elevated blood pressure. When the difference in renal blood flow between both kidneys was small, even a slight difference in renal vein renin indicated hypertension related to increased renin secretion. Renin-ratios in the critical range between 1.5 and 2.5 should only be interpreted in respect to a similar ratio in renal blood flow.

Adult

Sympathetic activity and transcendental meditation.

Ten male advanced meditators and ten male long-term meditators subjected themselves four times to slight physical exercise following a period of rest, meditation or reading. Daily urine excretions of catecholamines and VMA were determined in both groups. On the experimental days 4-hour urine specimens, one before and one after the experiments, were again collected for analysis. During the experiments blood pressure and heart rate were measured continuously and blood samples were taken for plasma catecholamine levels immediately before and after the physical exercise. Daily catecholamine and VMA excretions showed to be higher in advanced meditators. During the experiments the pattern of noradrenaline, adrenaline and VMA excretions were different in both groups, long-term meditators showing a higher adrenaline excretion after exercise. After the resting period there was in both groups a similar increase of plasma catecholamine levels during exercise. However, after meditation the advanced meditators showed a significant increase in plasma noradrenaline and no further increase in plasma noradrenaline level during the following physical exercise. Also after the reading period differences between both groups in plasma catecholamine levels during exercise could be observed. In advanced meditators heart rate reduction after meditation was about 9% and diastolic blood pressure was slightly raised. The preceding conditions of rest, meditation or reading had a significant different influence on the behaviour of heart rate and blood pressure during the following physical exercise and this pattern was different for both groups.

Adult

Interaction of synthetic progestagens with renal mineralocorticoid receptors.

Progesterone increases urinary sodium excretion at least in part by competition for renal mineralocorticoid receptors. In contrast, synthetic progestagens do not increase sodium excretion or even cause a slight sodium retention. We therefore compared the ability of progesterone and 12 progesterone like compounds to displace [3H]aldosterone from binding at cytoplasmic mineralocorticoid receptors in rat kidney. All synthetic progesteronelike steroids were less active than progesterone in competing with [3H]aldosterone for the receptor binding: progesterone 100%, 11 beta-OH progesterone 50%, 17 alpha OH-progesterone 24% and 16 alpha-methyl-progesterone 3%. Derivates of 17 alpha OH-progesterone (medrogestone 5%, dydrogestone 4%, medroxy progesterone-acetate 2% and chlormadinone-acetate 0.5%) were more potent than 19-nor-testosterone derivates: ethisterone 1%, norethisterone less than 1%, norethindrone less than 1%, norethyl-nodrel less than 1%, and ethynodiol-diacetate less than 1%. The decreased affinity of synthetic progestins for mineralocorticoid receptors explains in part the lack of natriuretic activity of these compounds.

Aldosterone

[The importance of changes in whole-body balance of sodium and noradrenaline in essential hypertension (author's transl)].

In 22 patients with essential hypertension plasma levels and urine excretions of sodium and noradrenaline were studied before, during and after long-term beta-blockade with pindolol. The relation between mean blood pressure and the quotient of sodium-/noradrenaline-excretion changed during treatment (placebo r=-0.34; pindolol r=+0.31). During placebo there existed a significant (p is less than 0.03) correlation between blood pressure and sodium-excretion which disappeared during beta-blockade. No correlation between blood pressure and noradrenaline was seen during placebo, whereas during beta-blockade a significant (p is less than 0.003) correlation was observed. In contrast to the placebo period there was a significant positive correlation between sodium- and noradrenaline-excretion during long-term treatment with pindolol. It is concluded that whole-body balance of sodium and noradrenaline is an important factor in essential hypertension.

Adrenergic beta-Antagonists

[Neoplasms of the small intestine].

Tumors of the small bowel comprise only 3--6% of all tumors of the intestine. The symptoms associated with tumors of the small bowel are not characteristic at the beginning. To establish an early diagnosis one must be "small bowel conscious". Mechanical intestinal obstruction, bleeding and perforation must be kept in mind for differential diagnosis.

Angiography

[Solitary plasmacytoma of the scapula and clavicle].

A 59 year old female patient with a large solitary medullary plasmocytoma of two years duration of the right scapula and clavicle is presented. The patient refused operation and received telecobalt radiation therapy. The palpable swelling and pain disappeared. Bone marrow puncture, blood and urine analyses were quite normal. An individualized therapeutic procedure is recommended for such cases.

Bone Neoplasms

[Hypertension and multiple renal arteries. Comparative studies on the frequency of multiple renal arteries in hypertensive patients and normotensives].

The frequency of multiple renal arteries in 394 aortographies was found to be 29.2%. The results were then grouped according to the indication for the investigation and according to the recorded blood pressure readings into a hypertensive and a normotensive group. Comparison of these two groups showed no significant difference in the frequency of multiple renal arteries. There were also no significant differences comparing double and multiple arterial supply of one kidney or one-sided or double occurrence of multiple renal arteries.

Aortography