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Biomedical subjects

W Samtleben

Publications and source records attributed to W Samtleben.

At least 91 records · Page 5Linked to original sources
PubMed1983

Plasma exchange in systemic lupus erythematosus.

Of 20 patients who presented to our hospital with the histologically confirmed diagnosis of SLE, nine met the criteria of presence of both a rapidly progressive disease state and contraindications for conventional therapy required for admission to our plasma exchange programme. Five patients improved; two patients progressed to end-stage renal failure; two patients died as a result of complications of advanced SLE. Severe lupus erythematosus (SLE) is usually treated with a combination of steroids and cytotoxic drugs. Even when treated with high dose therapy some patients develop life-threatening complications, such as renal failure, heart failure and respiratory insufficiency. Moreover, both treatment with high dose of corticosteroids and long lasting cytotoxic therapy may produce troublesome side-effects, including severe infections, gastroduodenal ulcers, bone marrow depressions and lymphomas (1, 2). One of the manifestation of SLE is the presence of antibodies against ds-DNA and ss-DNA. These antibodies can either react with DNA bound to te basement membrane and induce an inflammatory reaction (3), or can form circulating immune complexes which deposit in tissues and may impair the function of lymphocytes or macrophages in the RES (4, 5). The presence of anti-DNA-antibodies appears to be secondary to enhanced B-cell activity along with a depression of suppressor T-cells function proteins mediating the inflammatory process, such as fibrinogen, may deposit in membranes already compromised by the disease. Even though the pathogenic mechanisms operating in SLE are not completely understood, it can be expected, from a theoretical point of view, that the extracorporeal removal of any immunopathogens could improve the disease state.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

Mass transfer in membrane plasma exchange.

In vitro and in vivo sieving coefficients (SC) have been determined for a spectrum of proteins ranging in molecular weight from 66,500 daltons (albumin) to 2.4 million (beta-lipoprotein) daltons for three commercially available membrane plasma separation devices: the Plasmaflo 0.1, Plasmaflo 02, and Plasmaflux. A model relating serum level of a protein to pretherapy level, plasma volume, plasma filtration rate, membrane SC, and duration of treatment has been used to investigate the influence of SC on exchange efficiency. Comparison of predicted and clinically obtained reductions in serum solute levels demonstrated the validity of the model. The results of the analysis suggest that all three plasma separators are capable of delivering equally acceptable therapy. The model further demonstrates the decreasing effectiveness, and increased cost in terms of replacement fluid per unit of solute removed, with prolonged treatment times.

Biological Transport↗
PubMed1982

[Treatment of emergency situations in autoimmune diseases with plasma exchange].

Plasma exchange has been applied successfully to treat severely ill patients with autoimmune diseases in recent years. We report on 12 patients with systemic lupus erythematosus (SLE), myasthenia gravis (MG), and Goodpasturés syndrome (GS), that have been treated with membrane plasma separation. Two to three liters of plasma were exchanged per session. Three to nine treatments were done within 1--4 weeks. Human albumin solution was used for replacement of the discarded plasma. Improvement was seen in 3 out of 5 SLE patients, in all 5 myasthenic patients and in one of the two patients with GS. Plasma exchange in combination with immunosuppressive therapy is indicated in states of active autoimmune diseases, not controllable by routine immunosuppression. For long-term treatment, however, immunosuppressive medication should be used.

Adolescent↗
PubMed1981

[Gynaecological problems in women patients on dialysis treatment and in women following renal transplants (author's transl)].

Women patients on permanent dialysis treatment or after transplants display on the whole an increased rate of malignomas; however, it has so far not been possible to assess the relevant incidence in a uniform manner. Hence, regular gynaecological examination should be the rule in order to detect and treat carcinoma risk changes in the genital region. Within the framework of a special gynaecological consultation for renal patients we found in 81 women patients under dialysis treatment one patient with carcinoma of the cervix and one patient with corpus carcinoma. In two cases a cystic ovarial tumour was operated on. To date the 21 patients who had undergone renal transplant surgery did not show any malignant change in the genital region. Choice of contraceptives should rule out the intrauterine device because of the increased hazard of infection under immunosuppressive treatment. Ovulation inhibitors with higher oestrogen doses represent an additional hypertensive risk. Treatment with low-dosage gestagens should produce the lowest rate of side effects.

Adolescent↗
PubMed1980

Plasma-separation in myasthenia gravis: a new method of rapid plasma exchange.

A patient with myasthenic crisis was successfully treated with a new method of plasma exchange using a hollow-fiber filter connected to a standard dialysis pump. The filter allows PE to be performed at more clinical centers and probably at lower costs than current methods applying blood cell separators.

Acetylcholine↗
PubMed1980

[Pregnancy following renal transplants (author's transl)].

Women with uremia are usually infertile. Following successful renal transplants ovarian function resumes and conception becomes possible. Two cases of pregnancy following renal transplants are reported. The first patient had a Caesarean section at 33 weeks gestation for maternal indications, the second patient had a Caesarean section at 36 weeks gestation because of premature spontaneous rupture of the membranes. Both mothers and infants are in satisfactory condition. The problems of pregnancies following renal transplants are discussed and the literature since 1963 is reviewed. Pregnancy following renal transplantation is a high risk pregnancy for both the mother and the fetus. These high risks are acceptable if close supervision of the pregnancy by the nephrologist, gynaecologist and paediatrician are possible and if co-operation of the mother is satisfactory.

Adult↗
PubMed1979

Malignant granular cell tumor.

The malignant granular cell tumor ist a rare soft tissue neoplasia which is chiefly localized in the sceletal muscles. The uncertain histogenesis gave rise to different terms. The clinical course is often protracted but fatal. Diagnosis, differential diagnosis, and treatment are discussed in the light of a case report concerning a malignant granular cell tumor in a 28-year-old man.

Adenocarcinoma↗
PubMed1978

Sorbent membranes used in a conventional dialyzer format. In vitro and clinical evaluation.

The possibility of installing sorbent membranes into proven dialyzer configurations could result in certain advantages over dialyzers with conventional membranes. A sorbent membrane dialyzer might prove superior in that it allows a higher clearance in the middle molecule molecular weight range, thereby shortening dialysis time and possibly allowing a reduction in the amount of dialysate fluid required. Finally, this device could be used without dialysate if the technician's goal is to eliminate a single substance readily adsorbed by charcoal. For example, this would apply to the treatment of certain intoxications. In vitro data were established for six substances in the molecular weight range of 60 to 5200 daltons and compared to corresponding results for conventional Cuprophan dialyzers. Clinical evaluation of sorbent membrane dialyzers for patients with uremia and intoxication, both with and without use of dialysate, has proven effective with no adverse reactions.

Adsorption↗