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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Internist 41 (2000), S. M047 
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Tagungen der Hessischen Internisten sind inzwischen zu einer Institution geworden. Sie heben sich in vielfacher Weise von anderen Fortbildungsveranstaltungen ab, besonders durch die hohe Qualifikation der Referenten, aber auch durch das besondere Ambiente. Mehr als 2.500 Teilnehmer aus allen Teilen der Bundesrepublik, die die letztjährige Tagung Hessischer Internisten besucht hatten, sind ein deutliches Votum für unser Konzept der freiwilligen ärztlichen Fortbildung.
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  • 2
    ISSN: 0009-8981
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1041
    Keywords: atrial natriuretic peptide (hANP) ; hypoglycaemia ; metabolic stress ; plasma renin activity ; cortisol ; aldosterone ; catecholamines ; pituitary function ; growth hormone ; ACTH ; adrenaline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary A double-blind placebo-controlled study using the double-dummy technique has been done to examine whether the responses of pituitary and adrenal hormones to insulin-induced hypoglycaemia were impaired by a pharmacological dose of human atrial natriuretic peptide (human ANF-(99-126), hANP). After an overnight fast eight male healthy volunteers (aged 23–40 years) received in random order i.v. bolus injections of insulin 0.125 U·kg−1 + placebo, hANP 100 µg + placebo, insulin + hANP, or both placebo preparations. In the insulin-only experiment, human growth hormone, adrenocorticotrophic hormone, cortisol, aldosterone, plasma renin activity, adrenaline, and noradrenaline were all stimulated by hypoglycaemia. In the hANP-only experiment there were no hormonal changes other than decreases in plasma renin activity and aldosterone concentration. In the insulin + hANP experiment the nadir of blood glucose was decreased to 1.3 from the 2.0 mmol·1−1 found in the insulin-only experiment. The exaggerated hypoglycaemia resulted in increased stimulation of human growth hormone, adrenocorticotrophic hormone and adrenaline when compared to the insulin-only experiment. The rise in the cortisol and aldosterone concentrations was only slightly increased, and the stimulation of plasma renin activity was blunted. Unexpectedly, hANP was found to enhance the hypoglycaemic action of insulin, most probably by inhibiting insulin degradation within the liver. There was no evidence of an inhibitory effect of hANP on the stimulation of pituitary or adrenal hormones during insulin-induced hypoglycaemia. The reduction in renin may indicate an inhibitory action of hANP on catecholaminergic effects within the kidney.
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  • 4
    ISSN: 1432-1041
    Keywords: captopril ; congestive heart failure ; plasma aldosterone ; plasma prolactin ; metoclopramide ; dexamethasone suppression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary After long-term captopril treatment, an inappropriate increase in aldosterone levels has been observed in hypertensive patients. It is not known, whether a similar change would occur in patients with severe congestive heart failure, and whether it is due to a decrease in endogenous dopaminergic inhibition of aldosterone secretion or to aldosterone stimulation by ACTH or an ACTH-related peptide. Therefore, the aldosterone and prolactin responses to metoclopramide have been studied in 10 patients with severe congestive heart failure (NYHA Class III or IV) after 6 months of captopril treatment, before and 11 h after pretreatment with dexamethasone. 7 placebo-treated patients served as double-blind controls. In captopril-treated patients, the supine aldosterone levels exceeded the normal range and were as high as in placebo-treated patients. The responsiveness of aldosterone and prolactin to metoclopramide was not influenced by captopril. Only in the placebo group were the aldosterone levels decreased by dexamethasone. Captopril increased plasma renin activity and serum potassium, and decreased supine epinephrine and norepinephrine and serum sodium. Thus, previous reports of inappropriately high aldosterone levels after long-term captopril treatment were confirmed in patients with severe congestive heart failure. It is concluded that increased aldosterone is due neither to a decrease in endogenous dopaminergic inhibition nor to dexamethasone-suppressible stimulation of aldosterone secretion.
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  • 5
    ISSN: 1433-8580
    Keywords: Adrenal medulla ; Dopamine ; Aldosterone Secretion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Evidence has accumulated that aldosterone secretion is under endogenous dopaminergic inhibition. To examine potential sources of the dopamine thus inhibitorily acting in the adrenal zona glomerulosa, the responsiveness of aldosterone, plasma renin activity, prolactin, and plasma catecholamines to haloperidol, a dopaminergic antagonist, was studied in rats 6 weeks after unilateral adrenalectomy (Group B), 6 weeks after unilateral adrenal demedullation followed by contralateral adrenalectomy 5 days later (Group C), and in controls without any pretreatment (Group A). In Group C, there were increases in basal levels of norepinephrine (P 〈 0.01), prolactin (P 〈 0.02), and aldosterone (P 〈 0.01). Basal plasma renin activity was also increased (P 〈 0.05), epinephrine concentrations were decreased. Two hours after haloperidol 1 mg/kg b.wt. i.p., aldosterone levels were increased in Groups A + B (P〈0.01) but unresponsive in Group C. Haloperidol-induced stimulation of prolactin and norepinephrine was not impaired by the surgical procedures. Epinephrine levels were increased by haloperidol only in groups A + B (P 〈 0.002). In none of the groups were plasma renin activity or dopamine levels influenced by haloperidol. It is concluded that dopaminergic inhibition of aldosterone production is brought about neither by circulating dopamine nor by potential dopaminergic nerves accompanying arterial blood supply of the adrenal cortex but by dopamine originating directly in adrenal medulla.
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  • 6
    ISSN: 1432-1440
    Keywords: Osteocalcin ; Renal transplantation ; Secondary hyperparathyroidism ; Steroid induced bone disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Osteocalcin serum levels reflect bone turnover. In renal insufficiency secondary hyperparathyroidism and reduced renal clearance might be responsible for elevated serum levels of osteocalcin. Renal transplantation might improve renal osteodystrophy and therefore could influence osteocalcin serum levels. We determined the influence of renal transplantation on osteocalcin levels in 37 consecutive patients (25m/12f) by RIA. Blood samples were collected prior to, 3 days, 28 days, 6 months and 12 months after renal transplantation. Prior to renal transplantation osteocalcin levels were significantly elevated (x±s: 23.4±12.8 ng/ml) compared to healthy volunteers (4.1±1.4 ng/ml). Following renal transplantation osteocalcin decreased significantly (9.4±8.9 ng/ml) 3 days and (7.1±7.8 ng/ml) 28 days. However, 6 and 12 months following renal transplantation the mean osteocalcin level increased again (8.3±5.7 ng/ml, 12.1±15.4 ng/ml). At 6 months 11 and at 12 months only 6 of 37 patients had osteocalcin levels in the normal range. 12 months following renal transplantation 21 out of 37 patients with elevated osteocalcin levels had parathyroid hormone levels above the normal range. Additionally to increased osteocalcin levels patients prior to renal transplantation had elevated alkaline phosphatase. Alkaline phosphatase had following renal transplantation a similar pattern as osteocalcin with initial decrease and secondary increase 6 and 12 months after renal transplantation. Parathyroid hormone was elevated in all patients before renal transplantation. Following renal transplantation mean parathyroid hormone levels fell significantly, however remained above normal range in 57% of these 37 patients. Osteocalcin serum levels correlated positively with alkaline phosphatase (rs=0.43−0.62;p〈0.011) and parathyroid hormone (0.3−0.66p〈0.07). This correlation of osteocalcin with alkaline phosphatase and parathyroid hormone prior to and after renal transplantation suggests that osteocalcin may be a confirmative parameter in renal osteodystrophy in patients on chronic intermittent hemodialysis and following renal transplantation.
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  • 7
    ISSN: 1432-198X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Pflügers Archiv 250 (1948), S. 474-491 
    ISSN: 1432-2013
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Es wurde gezeigt, daß Reduktion der Eiweißzufuhr bei Mäusen zu einer vorübergehenden Aktivitätssteigerung führt. Diese tritt gewöhnlich erst einen oder mehrere Tage nach Beginn der verringerten Eiweißzufuhr ein, erreicht in etwa 1 Woche ein Maximum, das sich ebenso lange hält, um mit langsamem Absinken der Aktivität in die bereits früher beschriebene Aktivitätssenkung bei langfristiger Ernährung mit wenig Eiweiß überzugehen. Die Aktivitätssteigerung findet sich jedoch in der Regel nicht bei Zufuhren, die nur unterhalb des motorisch-bestimmten Eiweißminimum liegen, sondern erst bei Unterschreitung des sog. physiologischen Minimums bis herunter zu praktisch eiweißfreier Nahrung. Der Effekt wurde direkt im Aktogramm und indirekt im Umsatzversuch nachgewiesen, wobei es absolut zur Erhöhung des Gesamtumsatzes um 50% und je Gewichtseinheit zur Verdoppelung kommen kann. Die methodische Sicherung des Effektes und die näheren Bedingungen für sein Eintreten werden beschrieben. Die gezeigte Aktivitätssteigerung wird mit den Erfolgen von Eiweißentziehungskuren beim vorher vollernährten Menschen in Zusammenhang gebracht.
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  • 9
    ISSN: 1432-198X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 10
    ISSN: 1432-1440
    Keywords: Diabetes mellitus ; Hypertension ; Sodium homeostasis ; Human atrial natriuretic peptide ; Kidney function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Potential impairment of the efficacy of human atrial natiuretic peptide (human ANF-(99-126), hANP), the most potent endogenous natriuretic agent in healthy subjects, was examined in eight male normotensive patients with uncomplicated type 1 diabetes mellitus (aged 22–37 years). After giving informed consent, patients and eight male control subjects (aged 22–28 years) received in a random double-blind study design i.v. bolus injections of 100 µg hANP (Bissendorf peptide) or placebo. At base-line, patients differed from controls in elevated creatinine clearance (P〈0.05) and in mild postprandial hyperglycemia. Whereas the responses of urinary cyclic guanosine monophosphate, the second messenger of hANP, were found to be normal in patients, the diuretic and natriuretic effects of hANP were grossly impaired when compared to controls (P〈0.01); hANP resulted in increased plasma protein concentrations only in controls (P〈0.05 vs patients). In both groups, creatinine clearance remained uninfluenced by hANP. There were similar decreases in plasma renin activity, aldosterone, levels, and blood pressure (systolic more than diastolic) in both groups (P〈0.05 vs placebo). Heart rate and blood glucose remained unchanged. Thus, there is evidence for a decreased responsiveness to hANP exclusively of renal fluid, sodium, and chloride excretion in uncomplicated type 1 diabetes mellitus. The mechanisms responsible for this phenomenon remain obscure, neither a down regulation at the hANP receptor sites nor an hANP-induced shift from intra- to extravascular fluid volume are likely to be involved in its probably diabetes-specific pathogenesis.
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