[General intensive care medicine for internal diseases--first experiences at the newly opened intensive care unit at the 2d Vienna Medical University Department].
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Biomedical subjects
Publications and source records attributed to C Wolf.
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In 25 patients with chronic exocrine pancreatic insufficiency and 37 controls, the PABA test was compared with the concentration of chymotrypsin in stool. In additional 16 patients the test could not be evaluated (rate 21%). By determination of the PABA levels in serum before and one hour after ingestion of N-benzoyl-L-tyrosyl-PABA the test can be shortened and simplified: 1 hour serum levels in 9 patients with exocrine pancreatic insufficiency were 0.5 +/- 0.5 nMol/ml compared with 8 controls with 6.4 +/- 2.0 nMol/ml. PABA serum levels correlated significantly with chymotrypsin in stool. Compared with the conventional PABA test, since it is easily applicable in outpatients and the results are not influenced by medication or food.
8 healthy male volunteers performed jogging (as an example of an aerobic metabolic condition) and squash (as an example of an intermittently anaerobic metabolic condition). The platelets sensitivity to prostacyclin (PGI2) decreased after jogging. After squash, a statistically significant (p 0,001) decrease in the sensitivity of the platelets could be seen. Our findings suggest that an early alteration of platelet sensitivity might play a key role in maintaining the hemostatic balance and could be of greater importance than the vascular wall PGI2-synthesis, as the sensitivity changes immediately, whereas the PGI2-formation change is a long-term process.
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After hysterectomy and bilateral annexectomy for bilateral ovarian carcinoma, a 34 years old woman was treated by radiotherapy and chemotherapy associating adriamycin, vincristin and 5-fluoro-uracil. After this treatment, proteinuria and progressive renal failure developed. Renal biopsy showed prominent glomerular lesions with mesangiolysis and some necrotic arteriolar lesions. The role of radiotherapy and chemotherapy in the pathogenesis of these lesions is discussed.
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Renal involvement is a common cause of death in patients with systemic sclerosis (diffuse scleroderma). The poor prognosis is due to malignant hypertension and rapid deterioration of renal function. Therefore bilateral nephrectomy followed by hemodialysis and transplantation are proposed to avoid fatal outcome. The authors describe the case of a 37 year-old male suffering from diffuse scleroderma, and who developed malignant hypertension and renal failure. The renal biopsy and biological investigations showed thrombotic microangiopathy. The plasma renin activity was in a very high range. Control of hypertension and improvement of renal function were obtained by major antihypertensive drugs, i.e. intra-muscular clonidine, propranolol and dihydralazine. 14 months later, plasma creatinine is 2 mg/100 ml and blood pressure is 140/80 mm Hg. This case and similar ones reviewed in the literature demonstrate that bilateral nephrectomy should be performed in "scleroderma renal crisis" only after failure of very potent antihypertensive therapy.
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Studies were performed on 12 patients with idiopathic hypercalciuria to evaluate the hypothesis that the acid load accompanying potassium acid phosphate would adversely affect renal calcium reabsorption and citrate excretion compared to the neutral form of the phosphate salt. During acute clearance studies, neutral phosphate (NP) led to a fall in FECa (2.2 +/- 0.6% to 0.8 +/- 0.1%, P less than 0.02) and no change in titratable acidity (TA) or net acid excretion (NAE). Acid phosphate (AP) did not reduce FECa acutely, and led to a rise in TA (22 +/- 4 to 62 +/- 6 muEq/min, P less than 0.02) and NAE (46 +/- 6 to 6 89 +/- 7 muEq/min, P less than 0.02). During chronic administration, AP resulted in higher urinary calcium excretion in both absorptive (187 +/- 29 vs. 141 +/- 18 mg/day, P less than 0.02) and renal hypercalciuric patients (233 +/- 24 vs. 173 +/- 190.02 mg/day, P less than 0.02). Also, TA and NAE were higher following AP, whereas citrate excretion was lower (375.4 +/- 64.6 vs. 633.4 +/- 28.8 mg/day, P less than 0.01). These data suggest that the reported ineffectiveness of AP in the therapy of nephrolithiasis may be related to the deleterious effects of the acid load on calcium and citrate metabolism.
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Since 1969 bibliographie informes that growing numbers of apprentices and young workers are absent from work in spite of their obviously good health-state. All reported results of several studies and investigation-programms show that in most of the described cases problems of juvenile adaptability are linked with. Difficulties arise when young people change over from school education to vocational training. At first the paper deals with the differently used terminus adaptation. Three empirical principles from available studies may be deduced. They are interpreted under the point of view of school-doctors, works-doctors and vocational-school-instructors. Recommendations for school-doctors finish the paper.
This study supports the possibility for multiple subcellular forms of lipoprotein lipase. 1. The total activity of lipoprotein lipase per g of intact epididymal adipose tissue from fed rats is much higher than that from starved rats. 2. The isolated fat-cells of fed and of starved rats have lipoprotein lipase of almost the same activity per g of fat-pads. The isolated fat-cells of starved rats have a much higher proportion of total activity per g of the intact tissue than do those of fed rats. 3. Under the conditions of homogenization used, only a small proportion of the total activity per g of intact tissue from fed rats was associated with the fat layer which floated to the top of the homogenate during low-speed centrifugation. The different proportions of the specific enzyme activity found in each subcellular fraction are described. 4. Lipoprotein lipase from plasma membranes and microsomal fractions from starved and fed rats was purified by affinity chromatography. 5. The total activity of microsomal lipoprotein lipase per g of intact adipose tissue is enhanced by a normal diet. 6. In intact epididymal adipose tissue from fed rats, the activity per g of tissue of lipoprotein lipase of plasma membranes is much higher than that in the same fraction from starved rats. By contrast, the activities per g of tissue in plasma membranes obtained from starved or from fed rats by collagenase treatment were similar.