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Biomedical subjects

C Spieker

Publications and source records attributed to C Spieker.

At least 55 records · Page 3Linked to original sources
PubMed1993

Ca2+ ATPase activity in essential and renal hypertension.

In 15 patients with essential hypertension, 16 patients with renal hypertension and in 12 healthy subjects Ca2+ ATPase activity was determined in red blood cells both in the basal state and after maximal stimulation with calmodulin. Normal subjects showed a basal and maximal activity of 7.1 +/- 3.6 and 16.0 +/- 2.3 pmol phosphate/min.10(6) RBC, respectively. Renal hypertensives had a similar basal Ca2+ ATPase activity (5.4 +/- 4.1 pmol phosphate/min.10(6) RBC) and a lowered maximal Ca2+ ATPase activity (9.8 +/- 5.4 pmol phosphate/min.10(6) RBC, p < 0.05). In essential hypertensives basal and maximal Ca2+ ATPase activity was 9.0 +/- 5.3 and 35.4 +/- 14.4 pmol phosphate/min.10(6) RBC, respectively, the latter being significantly increased (p < 0.01). This finding, which is in contrast to earlier results indicating a lowered Ca2+ ATPase activity in essential hypertension, may be explained as a consequence of an increased Ca2+ influx in essential hypertension. A lowered Ca2+ ATPase activity does not seem to be involved in the pathogenesis of essential hypertension.

Adult↗
PubMed1993

New data about the effects of oral physiological magnesium supplementation on several cardiovascular risk factors (lipids and blood pressure).

In the present study the effect of oral physiological magnesium supplementation on atherogenic risk factors such as serum lipids and blood pressure was examined. Sixty-nine patients with hyperlipidaemia of Frederickson types IV and IIb were investigated with regard to renal function, blood pressure, serum cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol, and plasma and erythrocytic magnesium concentrations. All patients were on cholesterol-poor (< 90 mg cholesterol/d) and energy-restricted diet (< 1200 kcal/d). Thirty-seven patients received 500 mg magnesium (oral) daily as a supplement. All measurements were performed before and four weeks after starting treatment. The results of our study show that oral physiological magnesium supplementation in addition to the usual dietary measures can be beneficial with regard to serum triglycerides (values, means +/- SD, decreased from 198.17 +/- 47.01 to 163.20 +/- 40.55 mg/dl, P < 0.05), but exerts no positive effect on blood pressure or serum cholesterol. Furthermore, erythrocyte magnesium concentration increased significantly during oral physiological magnesium supplementation (values, means +/- SD, increased from 1.72 +/- 0.22 to 1.91 +/- 0.18 mmol/litre, P < 0.05), whereas plasma magnesium concentrations did not change significantly.

Blood Pressure↗
PubMed1993

Therapeutic efficiency of phlebotomy in posttransplant hypertension associated with erythrocytosis.

Hypertension is a major complication in kidney transplantation and contributes to the high cardiovascular mortality of renal transplanted recipients. The aim of the present study was to evaluate the therapeutic effect of phlebotomy on blood pressure in posttransplant hypertension associated with erythrocytosis. In 12 renal transplanted patients (7 male, 5 female, aged 29-52 years) with erythrocytosis (defined by hematocrit > 52% or hemoglobin > 170 g/l), a 24-hour-monitoring of blood-pressure and heart rate (SpaceLabs SL90207) was performed before, 2 and 6 weeks after phlebotomy. Patients with iron-deficiency and/or transplant rejection were excluded from the study. Ten of 12 patients were on antihypertensive treatment before phlebotomy. Phlebotomy (500 ml) was repeated three times on average within the first two weeks, until hematocrit decreased below 45%. The phlebotomy therapy lowered the hematocrit after two weeks from 54.8 +/- 2.8% to 44.3 +/- 4.2% and 43.0 +/- 5.6% after six weeks. Before phlebotomy, the blood pressure was systolic 153.2 +/- 15.1 mmHg and diastolic 95.2 +/- 9.5 mmHg. After repeated phlebotomy, there was a significant decrease of blood pressure to systolic 139.0 +/- 14.1 and diastolic 85.3 +/- 8.2 mmHg (p < 0.01). Without change of hematocrit and hemoglobin, there was no further change of blood pressure after six weeks (systolic 140.1 +/- 9.9 mmHg, diastolic 86.3 +/- 9.5 mmHg). The heart rate did not change significantly during the therapy. The antihypertensive treatment could be reduced in most of the patients. The present study demonstrates the therapeutic effect of phlebotomy in posttransplant hypertension associated with erythrocytosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

A vasopressor factor partially purified from human parathyroid glands.

Recently, a parathyroid hypertensive factor was postulated to play a role in the pathogenesis of hypertension in genetically hypertensive rats. Therefore it was examined, whether in human parathyroid glands a vasopressor substance can be detected. For this purpose, homogenates of hyperplastic parathyroid glands from 20 patients with tertiary hyperparathyroidism were deproteinized and fractionated by gel chromatography. The fractions obtained were tested for vasopressor activity in isolated perfused rat kidneys. A vasopressor fraction containing substances of 0.6-2.5 kDa was identified in the parathyroid glands. The responsible product was heat sensitive, peptidase-, trypsin- and carboxypeptidase y- sensitive and hydrophilic, as it did not bind to hydrophobic reversed-phase gel. These results suggest that parathyroid glands contain a hydrophilic peptide-like vasopressor substance different from the parathyroid hormone.

Angiotensin II↗
PubMed1992

[Pentamidine inhalation in prevention of pneumocystis carinii pneumonia in treatment of rejection with monoclonal antibody Orthoclone (OKT-3)].

The use of the monoclonal antibody OKT-3 (Orthoclone) is associated with an increased risk of pneumocystis carinii pneumonia. In a retrospective study, the efficiency of a prophylactic inhalation of pentamidine during acute renal allograft rejection therapy with OKT-3 was investigated. From July 1988 until October 1989 32 renal transplanted patients with acute rejection refractory to steroids had been treated with OKT-3. Twelve of the patients developed a pneumonia (four pneumococcus, one klebsiella, one cytomegalovirus), in six cases, a pneumocystis carinii infection was diagnosed in the bronchial lavage. Four of these patients with pneumocystis carinii pneumonia died despite high dose treatment with cotrimoxazole. From November 1989, a prophylactic inhalation of pentamidine was performed during acute renal allograft rejection therapy with OKT-3. From 33 patients, in eleven cases, a pneumonia was diagnosed (three pneumococcus, one klebsiella, two legionella, three cytomegalovirus, one candida), one patient developed a pneumocystis carinii pneumonia, which was successfully treated with cotrimoxazole. No patient in this group died because of pulmonary infection. The results suggest, that a prophylactic inhalation of pentamidine in severely immunosuppressed solid organ transplant recipients can prevent pneumocystis carinii pneumonia.

Administration, Inhalation↗
PubMed1991

Evaluation of the Ca2+ distribution in aortic tissue of spontaneously hypertensive and normotensive rats.

In the present study, particle-induced X-ray emission (PIXE) was used to get information on the spatial distribution of Ca2+ in aortas of spontaneously hypertensive rats (SHR) and normotensive controls aged 1 week, 4 weeks, and 12 weeks. To differentiate changes in Ca2+ metabolism in hypertensive arteries from secondary phenomena due to the arteriosclerosis, the animals were examined in the earliest stage of hypertension. It was found that the Ca2+ content was not elevated in the aortic smooth muscle of SHR aged 1 week (n = 11), as compared to normotensive controls (n = 10) (186.8 +/- 89.9 micrograms Ca2+/g tissue v 254.0 +/- 173.3 micrograms Ca2+/g). The Ca2+ content was raised (P less than .05) in the aortic smooth muscle of SHR aged 4 weeks (n = 13), as compared to 12 WKY rats (4 weeks) (726.0 +/- 130.4 micrograms Ca2+/g tissue v 440.3 +/- 214.4 micrograms Ca2+/g) and in 17 SHR (3 months), as compared to 13 WKY rats, respectively (3390.1 +/- 729.9 micrograms Ca2+/g tissue v 1632.1 +/- 569.5 micrograms Ca2+/g). The results confirm the age-related increase in the arterial Ca2+ content in normotensive rats and demonstrate additionally that this age-related rise in arterial Ca2+ content is accelerated in SHR.

Animals↗
PubMed1991

Na+, K(+)-ATPase inhibition and intracellular electrolyte content in essential and secondary hypertension.

A crucial role of humoral factors in the pathogenesis of primary hypertension is discussed. In 1982 Hamlyn et al demonstrated the presence of a Na+, K(+)-ATPase inhibitor in the plasma of essential hypertensives and showed a significant correlation of the Na+, K(+)-ATPase inhibition with the blood pressure. In this study we examined whether an Na+, K(+)-ATPase inhibitor could be found in the blood of essential hypertensives as compared to patients with secondary hypertension (renal hypertension, renal artery stenosis, pheochromocytoma). Second, the possible correlation between an inhibition of Na+, K(+)-ATPase and the intracellular electrolyte composition was examined. The results demonstrate a similar reduction of Na+, K(+)-ATPase inhibition in both essential hypertensives and secondary hypertensives as compared to normotensive controls. Further, the intracellular electrolyte composition (Na+, Na; K+, Ca) does not show a significant correlation to the degree of Na+, K(+)-ATPase inhibition, whereas a significant correlation between the degree of Na+, K(+)-ATPase inhibition and intracellular Cl- concentration could be demonstrated. The present study shows that an endogenous Na+, K(+)-ATPase inhibitor is also present in secondary forms of hypertension, thus implying that a specific role in the pathogenesis of primary hypertension for an Na+, K(+)-inhibitor is unlikely.

Adult↗
PubMed1991

Cardiovascular side effects after renal allograft rejection therapy with Orthoclone: prevention with nitrendipine.

Orthoclone (OKT-3), a monoclonal antibody, is an effective immunosuppressant in organ graft recipients. One of the reported side effects is serious pulmonary edema, heart failure, hyperdynamia, and elevation of blood pressure. It should be assessed whether patients treated with OKT-3 benefit from antihypertensive therapy with a calcium channel blocker before and during the allograft rejection therapy to prevent from cardiovascular side effects. To assess a preventive cardiovascular effect of therapy with nitrendipine before and during the OKT-3 rejection therapy, the patients studied (n = 28) were randomly allocated to two study groups. Group a without nitrendipine comprised 15 patients, and group b with 2 x 10 mg of nitrendipine daily comprised 13 patients. In study group a (without nitrendipine therapy), in 8 of 15 patients, there was a short-lasting increase in blood pressure during 3 h after the first injection of OKT-3 by 20.0 +/- 12.8 (systolic)/10.1 +/- 6.7 (diastolic) mm Hg. Whereas this initial rise of blood pressure on the first day was accompanied by an increase in heart rate by 24.1 +/- 10.8 beats/min, the longer-lasting increase in blood pressure at day 2 was not associated with significant changes in heart rate. In group b (patients receiving 2 x 10 mg of nitrendipine before OKT-3 therapy was started and during the whole treatment course), in 3 of 13 patients, a short increase in blood pressure (13.7 +/- 2.9/7.8 +/- 5.1 mm Hg) was recorded 5 h after the first dose of OKT-3.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Fever, dyspnea].

A 52-year-old female complained about non-distinct symptoms such as fatigue, night sweats and bone pain. Because of a febrile bronchitis, chest X-ray was performed, which disclosed enlarged hilar nodes and intestinal and acinar pulmonary infiltrates. Endobronchial biopsy and cultures from bronchial aspirate permitted to diagnose infection by legionella concomitant with sarcoidosis. After antibiotic treatment for legionellosis over four weeks, immunosuppressive therapy for sarcoidosis was initiated with glucocorticoids.

Diagnosis, Differential↗
PubMed1989

[Bing-Neel syndrome. Polyneuropathy within the scope of paraproteinemia].

A rare cause of polyneuropathy, first described in 1936, is the Bing-Neel syndrome. This polyneuropathy develops on the basis of a paraproteinemia. Five patients in whom the symptom constellation presented, were examined. All patients complained of motor or sensory deficiencies affecting the limbs, but had no evidence of malignant disease. Four patients had IgM paraprotein, one an IgG paraprotein in the serum. In two patients, the bone marrow revealed lymphocytic infiltration in the sense of an immunocytoma, in one other patient, a plasmacytoma was detected in the bone marrow. Three patients were treated in accordance with the Knospe regimen, the patient with the plasmocytoma with the Alexanian regimen. In one case satisfactory regression of the symptoms was observed, in the other two cases a moderate improvement occurred.

Aged↗
PubMed1989

Electron-probe X-ray microanalysis of sodium ion content in vascular smooth muscle cells from spontaneously hypertensive and normotensive rats.

In aortic smooth muscle cells from 12 spontaneously hypertensive rats (SHR) of the Münster strain and 11 normotensive Wistar-Kyoto rats (WKY), the intracellular Na+ content was measured by electron-probe microanalysis. Measurements were performed in aortic cryosections 3 microns thick; the Na+ content was 12.5 +/- 2.4 g/kg dry weight in SHR versus 6.96 +/- 1.1 g/kg dry weight in WKY (P less than 0.01). Thus, aortic smooth muscle cells from SHR are characterized by a markedly elevated intracellular Na+ content compared with normotensive cells. This may either be due to genetically determined disturbances in transmembrane Na+ transport or to a circulating factor affecting Na+ transport. Cellular Na+ handling may be disturbed in SHR aortic smooth muscle as it is in hypertensive blood cells.

Animals↗
PubMed1989

Evaluation of the therapeutic effect of transdermal beta-blocker therapy in patients with essential hypertension.

Transdermal drug delivery has been applied to various agents in an effort to decrease the frequency of drug administration and improvement of the patients compliance. In the present study, it could be demonstrated that transdermal monotherapy (BIO TSD) with a beta-blocker (20 mg mepindolol) in patients with essential hypertension led to an effective 24 h blood pressure lowering effect within 1 week (160.1 +/- 6.1 mmHg/95.8 +/- 8.3 mmHg vs. 136.8 +/- 7.2 mmHg/84.3 +/- 5.0 mmHg; p less than 0.05). Also a reduction of excessive blood pressure peaks in the circadian blood pressure profiles was observed. Studies comparing transdermal with oral beta-blocker administration in hypertensive patients would further substantiate the value of this new therapeutic system as an antihypertensive treatment.

Administration, Cutaneous↗