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  • 1
    ISSN: 1591-9528
    Keywords: Renin ; Endotoxin Shock ; Orthostatic Shock ; Glucocorticoids ; Renin ; Endotoxin-Schock ; Orthostase ; Glucocorticoid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Sowohl im Endotoxinschock als auch unter orthostatischer Belastung kam es beim wachen Kaninchen zu einem deutlichen Anstieg der Plasma-Renin-Aktivität. Unter hohen Glucocorticoid-Dosen, die 5 min nach Endotoxin verabreicht wurden, normalisierte sich die Plasma-Renin-Aktivität innerhalb von 4 Std. Unter orthostatischer Belastung war mit der gleichen Glucocorticoid-Dosis keine statistisch gesicherte Wirkung auf den Anstieg der Plasma-Renin-Aktivität erreichbar.
    Notes: Summary The plasma-renin-activity was significantly increased in endotoxin as well as orthostatic shock in unanaesthesized rabbits. High doses of glucocorticoids, administered 5 min after the endotoxin-injection, normalized the plasma-renin-activity after 4 hrs. In orthostatic shock the same doses of glucocorticoids had only a mild effect on the increase of plasma-renin-activity, which was not of statistical significance.
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  • 2
    ISSN: 1432-1440
    Keywords: 18-OH-Corticosteron ; Aldosteron ; Radioimmunoassay ; Hypertonie ; Primärer Hyperaldosteronismus ; 18-OH-corticosterone ; Aldosterone ; Radioimmunoassay ; Hypertension ; Primary hyperaldosteronism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Aldosterone-18-glucuronide, free aldosterone, free 18-OH-deoxycorticosterone, and tetrahydroaldosterone radioimmunoassays were performed in urine samples from normal subjects, as well as from patients with essential hypertension and primary hyperaldosteronism. The aldosterone-18-glucuronide measurements were made on 1119 urine samples, with and without chromatographic separation, with antisera raised against 3 different types of aldosterone antigens. Good correlations were found between the values obtained with the different methods. However, the values measured without chromatography were usually higher and individual discrepancies between results obtained with and without chromatography were observed. The antiserum raised against an aldosterone-3-oxime antigen produced the most reliable results without prior chromatography, but the values were still higher than after chromatography in 4.33% of 854 cases. These values may be clinically misleading, and we therefore recommend the aldosterone-18-glucuronide estimation without chromatography as a screening method only. When the results of the aldosterone-18-glucuronide, free aldosterone, free 18-OH-deoxycorticosterone, and tetrahydroaldosterone assays were compared, free aldosterone was found to correlate the best with the results of all other assays. There were also correlations among the other assays. The aldosterone-18-glucuronide estimation is currently the most frequently used assay. This study revealed, however, that in patients with essential hypertension and primary aldosteronism, normal aldosterone-18-glucuronide levels can be accompanied by high free aldosterone and tetrahydroaldosterone levels. We conclude, therefore, that the aldosterone-18-glucuronide assay may not be sufficient to select all patients with hyperaldosteronism. Additionally, a radioimmunoassay of urinary free 18-OH-corticosterone was developed and used as an aid in the aldosterone diagnosis. The excretion levels were 1.5–6.5, with a mean value (± SD) of 4.0±1.44 µg/24 h. These values also correlated with the different aldosterone measurements, and correlated best with the free aldosterone values.
    Notes: Zusammenfassung Aldosteron-18-Glucuronid Bestimmungen wurden von Urinproben (n=1119) vor und nach Chromotagraphie mit Hilfe von Antikörpern durchgeführt, die gegen drei verschiedene Typen von Aldosteron Antigenen erzeugt wurden. Die Werte vor und nach Chromatographie zeigten eine hochsignifikante Korrelation. Dennoch lagen die Bestimmungen, die ohne einen Isolierungsschritt vorgenommen wurden, im allgemeinen höher und in Einzelfällen gab es Dissoziationen der Werte. Mit einem Aldosteron-3-oxim-Antiserum wurden die zuverlässigsten Bestimmungen ohne Chromatographie erzielt. Auch mit diesem Antiserum wurden jedoch überhöhte Werte in 4,33% der Tests (n=854) bestimmt, die als klinisch irreführend bezeichnet werden können. Die Technik ohne Chromatographie ist deswegen nur für Screening-Zwecke akzeptabel. Aldosteron-18-Glucuronid, freies Aldosteron, freies 18-Hydroxycorticosteron, freies 18-Hydroxydeoxycorticosteron und Tetrahydroaldosteron wurden radioimmunologisch aus Urinproben von Normalpatienten, von Patienten mit essentieller Hypertonie und mit primärem Hyperaldosteronismus bestimmt. Die Resultate wurden untereinander verglichen. Die verschiedenen Größen korrelierten signifikant miteinander, doch die Korrelationskoeffizienten waren sehr unterschiedlich. Die besten Korrelationen wurden errechnet, wenn freie Urinaldosteron Werte mit den anderen Größen verglichen wurden. Die Bestimmung von Aldosteron-18-Glucuronid ist zur Zeit die am meisten durchgeführte Bestimmung. Bei einer Gruppe von Patienten mit essentieller Hypertonie und auch bei Patienten mit primärem Hyperaldosteronismus waren die Aldosteron-18-Glucuronid Werte innerhalb des Normbereiches, während die Exkretion des freien Urin-Aldosterons und des Tetrahydroaldosterons erhöht war. Wir schließen daraus, daß die Bestimmung des Aldosteron-18-Glucuronids für die Diagnose einer Aldosteron Hyperproduktion nicht immer ausreicht. Es wurde zusätzlich ein Assay für freies 18-Hydroxycorticosteron im Urin entwickelt, um die Aldosteron Diagnostik zu stützen. Der Normalbereich war 1,5–6,5 µg/24 h. Der Durchschnitt (± SD) lag bei 4,0±1,44 µg/24 h. Diese Werte korrelieren besonders gut mit den Bestimmungen von freiem Aldosteron.
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  • 3
    ISSN: 1432-1440
    Keywords: Wasserbilanz ; Blutdruck ; Steroidausscheidung im Urin ; Water balance ; Blood pressure ; Urinary steroid excretion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The effects of subcutaneous injections of synthetic ACTH during 14 subsequent days has been studied in the rat. ACTH caused a loss in body weight which was related to a negative water balance. Blood pressure rose rapidly and reached values higher than 180 mm Hg in all rats after 10 days of ACTH administration. During this period, urinary excretion of corticosterone and 18-hydroxy-deoxycorticosterone (18-OH-DOC) was increased more than ten times, while aldosterone excretion was increased only during the first two days. After withdrawal of ACTH, excretion of steroids normalized, or in some cases was even suppressed and water balance and body weight gain returned to normal values. However, blood pressure remained slightly higher than in controls after ten days. The effects of ACTH on water balance and blood pressure resemble those of corticosterone in the rat. The rapidly induced and sustained changes in blood pressure by ACTH administration suggest that this may be an useful model of experimental hypertension.
    Notes: Zusammenfassung ACTH in Depotform wurde Ratten subcutan 14 Tage lang injiziert. Gemessen wurden die Veränderungen des Körpergewichtes im Verhältnis zur Wasserbilanz, des Blutdruckes und der Steroidausscheidung im Urin. Es fand sich eine Gewichtsabnahme, vorwiegend durch Wasserverlust bedingt und ein schneller Blutdruckanstieg bis zum 10. Tag. Während der Behandlung waren die Urinausscheidung von Corticosteron und 18-OH-Desoxycorticosteron um mehr als das zehnfache erhöht; die Aldosteronausscheidung war nur während der ersten zwei Tage erhöht. Nach Absetzen der ACTH-Therapie normalisierten sich Wasserbilanz und Steroidausscheidung weitgehend, während der Blutdruck nach 10 Tagen noch leicht erhöht war. Die Wirkungen von ACTH auf Wasserbilanz und Blutdruck gleichen im wesentlichen denen von Corticosteron, dessen Exkretion auch am stärksten stimuliert wurde. Die ACTH-Hypertonie der Ratte scheint durch einheitlich schnelle und anhaltende Blutdruckerhöhung ein geeignetes Modell zum Studium der Hochdruckentstehung zu sein.
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  • 4
    ISSN: 1432-198X
    Keywords: Key words Nephrotic syndrome ; Glucocorticoid receptors ; Glucocorticoids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The variable response of patients with idiopathic nephrotic syndrome (NS) to glucocorticoid (GC) treatment has not been explained. Earlier studies indicated that the response is limited by cellular GC receptors. We investigated these receptors in mononuclear leukocytes of 28 pediatric patients with NS divided into three groups: steroid-sensitive in relapse, steroid-sensitive in remission, and steroid-resistant. Density and binding affinity of GC receptors were determined by a dexamethasone binding assay; no significant differences were found between the three patient groups and between these and healthy controls, although a few patient values fell outside the range of controls. Total and free plasma concentrations of cortisol were low in all three patient groups. A weak positive correlation was found between the number of GC receptors and total plasma cortisol (r=0.36, P=0.03). The results suggest that factors other than GC receptors that mediate the cellular effects of GC are involved in the variable response of NS patients to GC.
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  • 5
    ISSN: 1530-0358
    Keywords: Proctocolectomy ; Ileostomy ; Ulcerative colitis ; Familial adenomatous polyposis ; Aldosterone ; Renal function ; Acid-base balance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Restorative proctocolectomy is a standard procedure in the surgical treatment of ulcerative colitis and familial adenomatous polyposis. The radical removal of the colorectum with construction of an ileostomy often results in high stoma losses. These may lead to changes in the electrolyte and acid-base balance and to alterations in renal and suprarenal gland function. METHODS: In this study 33 patients who received an ileoanal pouch before and after proctocolectomy were investigated at different time intervals for electrolyte changes, alteration of the acid-base balance, kidney function, and hormonal changes of the suprarenal glands. Measurements were performed before proctocolectomy, ten days after proctocolectomy with ileal pouch-anal anastomosis under protective loop ileostomy, before ileostomy closure, and 6 to 12 months after ileostomy closure. Neither acute renal failure nor other vital complications were observed. RESULTS: Statistical analysis showed a significant decrease of urine pH to 5.4±0.22 (before ileostomy closure) and metabolic acidosis (pH 7.32±0.04; base excess −1.3±5.6 (before ileostomy closure)). Likewise, we found a decrease in renal clearance to 86 ml/minute (before ileostomy closure) without signs of tubular damage. The most important change during the phase with ileostomy was a functional secondary hyperaldosteronism with aldosterone levels of 63.2±70.8 ng/dl (before ileostomy closure). In comparison with preoperative levels, there was a ten-fold increase in mineralocorticoid adrenal activity. Additionally, during the period with protective ileostomy, the hepatic synthesis of aldosterone-18-glucuronide was only slightly increased, and the cortisol/cortisone ratio was extremely decreased. CONCLUSIONS: These results show that restorative proctocolectomy with ileal pouch-anal anastomosis and protective loop ileostomy significantly influences fluid, electrolyte, and acid-base balance. Functional secondary hyperaldosteronism is of central importance for subsequent renal recompensation. Approximately one-half year after ileostomy closure, the endogenous hormones with mineralocorticoid effects returned to normal levels.
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  • 6
    ISSN: 1435-1803
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Untersucht wurden zeitabhängige Veränderungen in Struktur und Funktion der Mitochondrien, die durch einstündigen Verschluß und 2- bis 24stündige Reperfusion des Ramus circumflexus der linken Koronararterie erzeugt wurden. Diese Veränderungen wurden mit Veränderungen der myokardialen Ultrastruktur, dem Wassergehalt des Gewebes, der Infarktgröße und dem mitochondrialen Calciumgehalt korreliert. Das Herz wurde nach verschiedenen Reperfusionszeiten entnommen und die Mitochondrien aus ischämischen und nichtischämischen Gebieten des linken Ventrikels isoliert. Ebenso wurden Gewebeproben von ischämischem und nichtischämischem Myokard für Elektronenmikroskopie und Bestimmung des Wassergehaltes des Gewebes entnommen. Die Infarktgröße wurde durch die Anfärbung mit Nitroblau-Tetrazolium bestimmt. Der Sauerstoffverbrauch der Mitochondrien aus ischämischem und nichtischämischem Myokard wurdein vitro gemessen. Mitochondrien aus ischämischem Myokard zeigten eine zeitabhängige Abnahme des Sauerstoffverbrauchs und seiner Bindung an die Phosphorylierung von ADP. Die Elektronenmikroskopie zeigte eine fortschreitende Zerstörung der Ultrastruktur im ischämischen Myokard, einschließlich einer Zunahme der Calciumablagerungen in Mitochondrien, was mit erhöhten Calciumkonzentrationen in Mitochondrien aus dem gleichen Gebiet übereinstimmte. Im ischämischen Myokard war die Relation Feuchtgewicht/Trockengewicht signifikant erhöht. Eine geringe, aber signifikante Abnahme der Atmung wurde in Mitochondrien, die nach einigen Stunden Reperfusion aus nichtischämischem Myokard isoliert worden waren, beobachtet; aber nach 24 h Reperfusion fand sich normale Atmung. Letzteres weist darauf hin, daß auch das nichtischämische Gebiet von der regionalen Ischämie betroffen ist. Die Ergebnisse zeigen, daß vorübergehender Verschluß des Ramus circumflexus der linken Koronararterie und Reperfusion zu fortschreitender Zerstörung mitochondrialer Funktion und Struktur führen und daß diese Veränderungen von Änderungen des Electrolytstatus der Zelle begleitet werden.
    Notes: Summary Time-dependent changes in mitochondrial function and structure resulting from 1 hr of left circumflex coronary artery occlusion followed by 2 to 24 hrs of reperfusion were examined. These changes were correlated with changes in myocardial ultrastructure, tissue water content, infarct size and mitochondrial calcium content. The heart was removed after different periods of reperfusion, and mitochondria were isolated from ischemic and nonischemic regions of the left ventricle. Tissue samples from ischemic and nonischemic myocardium also were taken for electron microscopy and tissue water content determinations. Infarct size was measured by the nitroblue tetrazolium staining method. Oxygen consumption by mitochondria isolated from ischemic and nonischemic myocardium was measuredin vitro. Mitochondria from ischemic myocardium showed time-dependent decreases in rates of oxygen consumption and tightness of coupling. Electron microscopy revealed progressive ultrastructural deterioration in ischemic myocardium, including accumulation of calcium deposits within mitochondria, a finding corroborated by elevated concentrations of calcium in mitochondria isolated from the same area. Tissue wet-to-dry weight ratios were increased significantly in ischemic myocardium. A small, but significant, decrease in respiratory function was observed in mitochondria isolated from nonischemic myocardium several hrs after reperfusion; however, nomal respiration was observed 24 hrs after release of occlusion. This latter observation indicates that the nonischemic zone also is affected by regional ischemia. The results obtained indicate that temporary left circumflex artery occlusion and reperfusion result in progressively decreasing mitochondrial function and structure within the ischemic myocardium, and that these changes are accompanied by cellular electrolyte alterations.
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  • 7
    ISSN: 1435-1463
    Keywords: Betamethasone ; dexamethasone ; synthetic glucocorticoids ; betamethasone suppressiontest ; dexamethasone suppressiontest ; depression ; cortisol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Betamethasone induced cortisol suppressibility was examined in 62 drug free consecutively admitted psychiatric inpatients. Betamethasone was choosen instead of the commonly used dexamethasone, because its double half-life compared to dexamethasone and its higher tissue availability. After a base-line evaluation with blood samples drawn at 8 a.m., 4 p.m., and 11 p.m., 0.5 mg or 1.0 mg betamethasone was given orally at 11 p.m. Postbetamethasone cortisol as well as betamethasone blood levels were then measured at the same time points as on the baseline day. In the groups receiving 1.0 mg betamethasone non-depressed patients had significantly (p〈0.05) lower postbetamethasone cortisol levels than depressed patients for each time point measured whereas 0.5 mg betamethasone did not differentiate depressed from non-depressed patients. Patients with other depressions like schizoaffective psychosis -depressive subtype- or organic brain syndrome with depressive symptomatology demonstrated similar postbetamethasone cortisol profiles as the group of patients with major depression. Betamethasone plasma concentrations differed significantly (p〈 0.001) with respect to the oral dosage with higher values for the 1.0 mg betamethasone groups.
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