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  • 1
    ISSN: 1432-2307
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary From birth to 13 years the liver parenchyma contains only diploid nuclei. A small tetraploid collective, first appearing at 13 years, is always demonstrable at 40 years and increases from that time to senility. The binucleate cells behave in the same manner. Large nuclei of octoploid and higher values reveal an increase from 60 years and reach their maximum after 70 years. The development of polyploid nuclei is a consequence of mitotic disturbances which normally take place first at the end of the growing period — during the transition from cellular multiplication (i.e. partially exponential growth) to cellular replacement; and second, during aging. During the steady state period the physiological replacement of liver cells is guaranteed by regular cellular and nuclear divisions. Aberrations of the typical human karyogram are demonstrated in some cases of hepatitis, posthepatitic conditions and cirrhoses. A number of polyploid nuclei, greater than to be expected for the respective time of life, may signify former regeneration processes or indicate a disturbance of the physiological replacement of cells (the mildest grade of hepatocellular damage). Consequently, the determination of such an abnormal number of polyploid nuclei is of diagnostic value.
    Notes: Zusammenfassung Bis zum 13. Lebensjahr enthÄlt das Leberparenchym fast ausschlie\lich diploide Kerne. Ein kleines tetraploides Kollektiv tritt mit dem 13. Lebensjahr erstmals in Erscheinung, ist mit dem 40. Lebensjahr konstant nachweisbar und nimmt im Laufe der weiteren Entwicklung bis ins Senium hinein an Umfang zu. Die zweikernigen Zellen verhalten sich gleichsinnig. Gro\kerne der oktoploiden Grö\enordnung und darüber lassen erst ab dem 6. Lebens Jahrzehnt eine deutliche Zunahme erkennen, die in der 7. Lebensdekade ihr Maximum erreicht. Die Entstehung polyploider Kerne wird auf Störungen der Zell- und Kernteilungen zurückgeführt, die normalerweise einmal am Ende der Wachstumsperiode — beim übergang vom cellulÄren Vermehrungswachstum zum Ersatzwachstum —, zum anderen beim Altern des Organismus in den Vordergrund treten. Im „steady state“ der Lebenshöhe wird der physiologische Zellersatz durch regelhafte Zell- und Kernteilungen gewÄhrleistet. An FÄllen von Virushepatitis, Zustand nach Hepatitis und Cirrhose werden gewisse Abweichungen vom normalen Karyogramm dargestellt. Eine für die jeweilige Lebensstufe zu hohe Zahl an polyploiden Kernen weist entweder auf abgelaufene Regenerationsprozesse oder auf eine BeeintrÄchtigung des physiologischen Zellersatzes — und damit auf leichteste Grade einer hepatocellulÄren SchÄdigung — hin. Die Feststellung eines solchen abnormen ZahlenverhÄltnisses hat also diagnostischen Wert.
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  • 2
    ISSN: 1432-2307
    Keywords: Hepatic veno-occlusive disease ; Renal transplantation ; Azathioprine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The paper presents the morphological findings and clinical data of 4 patients with veno-occlusive disease of the liver developing after immunosuppressive therapy with azathioprine and prednisolone. The pathogenesis and a possible causal relationship of hepatic veno-occlusive disease with long term azathioprine therapy are discussed.
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  • 3
    ISSN: 1420-9071
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary In rat cecal mucosa, Na−K-ATPase specific activity and sodium and fluid absorption were increased by giving polyethylene glycol administration with the drinking water. Whereas cyclic AMP levels were unchanged, cyclic GMP was reduced by about 50%. This finding suggests a regulatory role of cyclic GMP in intestinal sodium and fluid absorption.
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  • 4
    ISSN: 1420-9071
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Cyclic GMP concentrations were measured in rat cecum mucosa in vivo when the net absorption of sodium, chloride and fluid was stimulated by methylprednisolone (MP). Whereas Na−K-ATPase specific activity was increased by MP, suggesting enhanced active sodium transport, cyclic GMP levels remained unaffected.
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  • 5
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
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  • 6
    ISSN: 1432-1440
    Keywords: Antibiotics ; C. difficile ; Enterocolitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A toxin produced by Clostridium difficile has been implicated in the pathogenesis of antibiotic-associated colitis. It is not known how often the microorganism is encountered in Germany particularly in high risk patients. Therefore, following a lethal case of colitis, stool samples of 90 patients and 30 staff members of an intensive care unit were screened routinely for C. difficile over 2 months. The organism was found in 6 of 41 patients treated with antibiotics (14.6%); four of them apparently acquired C. difficile while in hospital whereas in 2 a pre-existing carrier state could not be excluded. Colitis developed in 3 of the 6 patients as judged from endoscopy or a positive cytotoxin assay; in 2 patients (not subjected to endoscopy) colitis was suspected on clinical grounds, and 1 patient became an asymptomatic carrier. C. difficile was not found in 49 patients without antibiotic medication, in the health personal and in 12 patients of a general ward. Patients harbouring C. difficile were clustered in certain bed sites of the unit. Environmental studies recovered the microorganism from bed pan washing mashines of bedridden and from toilets of ambulant patients but not from other sites like the hands of the personal. These results suggest that chronic carriers of C. difficile, as far as they are identified by current bacteriological methods, are rare in Germany (not more than 2 out of 132 persons investigated, i.e. 1.5%). The frequent finding of C. difficile in patients treated in certain bed sites supports the view that the infection may be acquired from exogenous sources. Antibiotic-associated colitis should be considered more often when intensive care patients are treated with antibiotics.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 49 (1971), S. 436-437 
    ISSN: 1432-1440
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über die Anwendung von Clofibrat bei zwei Patienten mit einem Diabetes insipidus centralis berichtet. Unter dieser Behandlung kam es zu einer weitgehenden Normalisierung der Diurese, zu einem Anstieg der Urinosmolalität und zu einem Abfall der Freiwasser-Clearance. Nebeneffekte wurden nicht beobachtet. Orientierende Tierexperimente mit Clofibrat (Diabetes insipidus-Ratten, Wistar-Ratten in Wasserdiurese, Amphibienmembranen) zeigten keinen signifikanten Effekt auf Diurese, Urinosmolalität bzw. den hydroosmotischen Wasserfluß. Der Wirkungsmechanismus des Clofibrat beim Diabetes insipidus könnte dem des Chlorpropamid entsprechen, ist jedoch im einzelnen noch ungeklärt.
    Notes: Summary Two patients withdiabetes insipidus centralis were treated with clofibrate, an agent usually administered to lower serum lipid level. Both patients showed satisfactory improvement as regards diuresis, urine osmolality, and free water clearance. No side effects of clofibrate therapy were observed.—In preliminary experiments in rats with hereditarydiabetes insipidus, in a group of rats undergoing water diuresis and in frog and toad skin, clofibrate did not significantly affect diuresis, urine osmolality, or transmural osmotic water flow. Although the mechanism of action of clofibrate in the patients withdiabetes insipidus is as yet poorly understood, some evidence suggests that clofibrate may act in a manner similar to that of chlorpropamide.
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  • 8
    ISSN: 1432-1440
    Keywords: Cyclic GMP ; Atrial natriuretic factor ; Platelets ; Receptors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thirty-seven patients with volume-retaining disorders (liver cirrhosis with ascites,n=8; heart failure NYHA III–IV,n=12; endstage renal failure,n=17) and twelve healthy age-matched controls were given a small dose (33 μg) of hANF (human atrial natriuretic factor). We tested the resulting hemodynamic and renal effects as well as the effect on plasma cyclic GMP levels and compared them with the properties of platelet ANF receptors. The ANF injection evoked an increase in cyclic GMP plasma levels of 19.3±2.2 nM in healthy controls. This increase tended to be smaller in the cirrhosis group (15.5±3.3 nM) and in the heart failure group (16.8±2.3 nM) than in the dialysis group (20.5±2.5 nM). The invasion rates of cyclic GMP were comparable in all groups, but the evasion rates increased more in the heart failure and endstage renal failure groups (27.9±7.7 min and 26.1±3.4 min, respectively) than in the cirrhosis and control groups (14.9±1.9 min and 14.2±1.9 min, respectively). Patients with endstage renal failure and congestive heart failure showed a smaller decrease in diastolic blood pressure than controls and patients with liver cirrhosis. Renal actions of ANF were diminished in cirrhosis and heart failure patients. Binding capacities of platelet ANF receptors were higher in the control group (12.2±1.5 receptors/cell) than in the patient groups (cirrhosis, 7.8±1.2; endstage renal failure, 8.0±0.9; heart insufficiency, 8.0±1.0 receptors/ cell), with no differences among the patient groups. Binding affinities were not significantly different. Correlation analysis showed that the relationship between the actions of ANF and the increases in plasma cyclic GMP levels is loose and cannot predict the hemodynamic or renal effects of exogenous ANF in a given patient. Although the behavior of plasma cyclic GMP levels fails to predict the responsiveness of the body to ANF in a given patient, it does reflect the differences between the patient groups and the control group. In contrast, we found no correlation between the properties of platelet ANF receptors and ANF action.
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  • 9
    ISSN: 1432-1440
    Keywords: Diabetes insipidus ; Carbamazepin ; ADH ; antidiuresis ; Diabetes insipidus ; Carbamazepin ; ADH ; Antidiurese
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Zur Frage der antidiuretischen Wirksamkeit von Carbamazepin beim Diabetes insipidus (D.i.) wurden Untersuchungen am isolierten Blasen-Epithel von Amphibien, an Ratten mit einem hereditären D.i. und an normalen Ratten unter den Bedingungen der Wasserdiurese durchgeführt. Am Blasenepithel von Bufo marinus war eine signifikante Zunahme des transmuralen osmotischen Wasserflusses und der elektrischen Aktivität weder nach Carbamazepin allein noch bei zusätzlicher Gabe minimaler ADH-Dosen nachweisbar. Es wurde im Gegenteil auch nach maximalen Vasopressindosen bei den Carbamazepin-inkubierten Membranen eine verminderte Wirkung beobachtet. An wachen und narkotisierten D.i.-Ratten ließ sich weder durch Carbamazepin allein noch durch zusätzliche Zufuhr geringer ADH-Mengen eine Abnahme der Diurese oder eine Zunahme der Urinosmolalität erzielen. Wistarratten zeigten dagegen unter den Bedingungen der Wasserdiurese etwa 2 Std nach oraler Gabe von Carbamazepin einen deutlichen Rückgang der Diurese und eine Zunahme der Urinosmolalität. Die zusätzliche Anwesenheit minimaler ADH-Dosen blieb ohne Einfluß. Aufgrund dieser Befunde scheint ein peripherer (d.h. renaler), dem Chlorpropamid ähnlicher Wirkungsmechanismus von Carbamazepin ausgeschlossen zu sein. Man muß im Gegenteil für die antidiuretische Wirksamkeit des Medikaments einen zentralen Angriffspunkt diskutieren.
    Notes: Summary In order to elucidate the mechanism by which Carbamazepin induces antidiuresis in diabetes insipidus (D.i.) patients, studies were performed in isolated toad bladder, in rats with hereditary D.i. and in normal Wistar rats undergoing water diuresis. In toad bladders (Bufo marinus), Carbamazepin produced no increase in transepithelial osmotic water flow or in transepithelial electrical activity, nor could an increase be obtained by combining Carbamazepin with minimal amounts of ADH. On the contrary, following Carbamazepin a slight decrease in these parameters was observed, and a diminished response to subsequent addition of maximal doses of ADH. These effects were probably non-specific. In D.i. rats—either conscious or anesthetized—diuresis and urine osmolality remained unchanged after Carbamazepin alone or together with small amounts of ADH. Wistar rats during water diuresis, however, responded to Carbamazepin with a reversible reduction in urine flow and a concomitant increase in urine osmolality. These changes were most pronounced approximately two hours after oral administration. Minimal amounts of ADH were without further effect. These results argue against a peripheral (=renal) effect of Carbamazepin but suggest that Carbamazepin may induce antidiuresis by a central mode of action, possibly stimulating ADH production and/or release.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 58 (1980), S. 337-345 
    ISSN: 1432-1440
    Keywords: Antibiotics ; Clostridium difficile ; Diarrhoea ; Enterocolitis ; Antibiotika ; Clostridium difficile ; Diarrhoe ; Enterocolitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Viele Antibiotika, besonders Lincomycine, können Durchfälle mit und ohne Enterocolitis hervorrufen. Die Pathogenese der Diarrhoen ohne Colitis ist ungeklärt; eine kolloidosmotische Wasserbindung im Colon durch bakteriell nicht abgebaute endogene Glykoproteine wird erwogen. Die Ursache der Enterocolitis ist seit zwei Jahren bekannt. Zugrunde liegt eine Proliferation toxinbildender Clostridien im Lumen, erwiesen für Cl. difficile. Verbesserte Nachweismethoden für Toxin und Erreger befinden sich in der Entwicklung. Endoskopisch sind Pseudomembranen charakteristisch, aber nicht antibiotika-spezifisch, sie können fehlen oder der Diagnostik entgehen. Die Inzidenz der Enterocolitis ist auffällig wechselnd, eine Rolle asymptomatischer Clostridienträger möglich. Der potentiell tödliche Verlauf erfordert eine rasche Diagnostik und Therapie, mit Absetzen des Antibiotikums, intensiven unterstützenden Maßnahmen und zumindest in schweren Fällen oralem Vancomycin.
    Notes: Summary Many antibiotics, particularly the lincomycins, may cause diarrhoea with or without enterocolitis. The pathogenesis of antibiotic-associated diarrhoea without colitis is uncertain; colloidosmotic water binding in the colon by endogenous glycoproteins undegraded by colonic bacteria is considered. Antibiotic-associated enterocolitis is now known to be due to toxin-producing clostridia, proven for Cl. difficile. Improved methods for the detection of toxin and clostridia are presently being studied. Endoscopically, pseudomembranes are characteristic but not antibiotic-specific, they may be absent or missed diagnostically. A possible role of asymptomatic clostridiacarriers in enterocolitis clustering remains to be determined. The potentially lethal course of the disease requires rapid diagnosis and therapy, with discontinuation of the antibiotic, intensive supportive measures and, at least in severe disease, oral vancomycin.
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