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D Nolte

Publications and source records attributed to D Nolte.

At least 91 records · Page 5Linked to original sources

Leukotrienes as mediators in ischemia-reperfusion injury in a microcirculation model in the hamster.

Leukotriene (LT)B4 promotes leukocyte chemotaxis and adhesion to the endothelium of postcapillary venules. The cysteinyl leukotrienes, LTC4, LTD4, and LTE4, elicit macromolecular leakage from this vessel segment. Both leukocyte adhesion to the endothelium and macromolecular leakage from postcapillary venules hallmark the microcirculatory failure after ischemia-reperfusion, suggesting a role of leukotrienes as mediators of ischemia-reperfusion injury. Using the dorsal skinfold chamber model for intravital fluorescence microscopy of the microcirculation in striated muscle in awake hamsters and sequential RP-HPLC and RIA for leukotrienes, we demonstrate in this study that (a) the leukotrienes (LT)B4 and LTD4 elicit leukocyte/endothelium interaction and macromolecular leakage from postcapillary venules, respectively, that (b) leukotrienes accumulate in the tissue after ischemia and reperfusion, and that (c) selective inhibition of leukotriene biosynthesis (by MK-886) prevents both postischemic leukotriene accumulation and the microcirculatory changes after ischemia-reperfusion, while blocking of LTD4/E4 receptors (by MK-571) inhibits postischemic macromolecular leakage. These results demonstrate a key role of leukotrienes in ischemia-reperfusion injury in striated muscle in vivo.

Animals↗

Role of leukotrienes in leukocyte adhesion following systemic administration of oxidatively modified human low density lipoprotein in hamsters.

In vitro studies indicate that oxidatively modified low density lipoprotein (oxLDL) promotes leukocyte adhesion to the vascular endothelium, a constant feature of early atherogenesis. Using intravital fluorescence microscopy in the dorsal skinfold chamber model in awake Syrian golden hamsters, we studied whether (a) oxLDL elicits leukocyte/endothelium interaction in vivo, and whether (b) leukotrienes play a mediator role in this event. Leukocyte/endothelium interaction was assessed in the time course after intravenous injection of native human LDL (4 mg/kg body wt) and of oxLDL (7.5 microM Cu++, 6 h, 37 degrees C) into control hamsters and into hamsters, pretreated with the selective leukotriene biosynthesis inhibitor MK-886 (20 mumol/kg, i.v.). While no effect was seen after injection of native LDL, oxLDL elicited an immediate induction of leukocyte adhesion to the endothelium of arterioles and postcapillary venules. Total and differential leukocyte counts suggest that all leukocyte subsets were likewise affected by oxLDL with no specific preference for monocytes. Stimulation of leukocyte adhesion was entirely prevented in inhibitor-treated animals, suggesting the important mediator role of leukotrienes in oxLDL-induced leukocyte/endothelium interaction.

Adult↗

[Value of non-plethysmographic methods in determining airway resistance].

To examine whether the complicated method of body plethysmography can be replaced by non-plethysmographic methods, such as oscilloresistometry (Ros), the closing pressure method (Run) or the forced expiration volume method (FEV1), the authors studied the results obtained with 247 hospitalised patients between 18 and 81 years of age suffering from, or free from, airway obstruction. Although satisfactory correlations were obtained by linear and curvilinear regression analysis, considerable differences were seen in individual patients suffering from obstructions to a higher degree. Oscilloresistometry showed at the standard value limit of the airway resistance applicable in body plethysmography (0.30 kPa/l/s) a sensitivity of 89%, whereas the specificity was only 62%. Almost identical values of sensitivity (92%) and specificity (61%) were attained by the closing pressure method only if the standard value limit was set a little higher, namely, at 0.35 kPa/l/s. FEV1, which is easiest to measure, was able to objectivate an airway obstruction in a manner comparable to that of Ros and Run; there was in fact even a closer statistical correlation between the body plethysmographic resistance mographic methods are suitable for screening examinations on account of their sensitivity. However, if the results on the examination are not in keeping with the overall clinical findings, further diagnostic clarification must be sought by performing a body plethysmographic measurement.

Adolescent↗

Indications of different oxygen sources.

Elderly patients with limited prognosis and limited activities are sufficiently supplied by oxygen concentrators with or without portable oxygen gas cylinders. Younger patients with promising life expectancy should be candidates for transtracheal catheter and for liquid oxygen with or without oxygen saving systems.

Activities of Daily Living↗

Peripheral neuropathies in patients with chronic obstructive pulmonary disease: a multicenter prevalence study.

To investigate the prevalence and type of peripheral neuropathies (PNP) in patients with chronic obstructive pulmonary disease (COPD), we studied lung function and blood gases, clinical signs of PNP, and neurophysiological function in 151 patients with COPD without known risk factors for PNP. Mean (SD) age was 65 (10) years, mean arterial PO2 was 59 (9) mmHg, mean ratio of forced expiratory volume in the first second to vital capacity (FEV1.0/VC) was 42 (12%). Thirty patients (20%) had clinically detectable and 6 (4%) had subclinical PNP of mild degree. Fourteen (9%) of the patients with clinically detectable PNP had symptoms due to PNP. Prevalence of PNP increased with severity of hypoxemia (p less than 0.05) and was more pronounced in the lower than in the upper limbs. Age and the degree of hypoxemia were predictors to differentiate between COPD patients with and without PNP. Although the cause of PNP in COPD patients remains unknown, our observations suggest that chronic hypoxemia may contribute to PNP.

Adult↗

[Prevalence of polyneuropathies in patients with chronic obstructive lung disease].

A multicentric study of 151 COLD patients confirmed the increased prevalence of peripheral polyneuropathies (PNP) in hypoxaemic patients with chronic obstructive lung disease (COLD). 43 (28%) of these 151 COLD patients showed a clinically manifest PNP, whereas in a comparative group of 32 asthmatics there were only 2 clinical PNP cases. Patients with known risk factors for PNP were not included in the study. The polyneuropathy observed in such patients is usually mild, mainly sensorial, distal and leg-accentuated. Of 52 COLD patients with a PaO2 up to 55 Torr, polyneuropathy was seen in 21 (40%), and of 59 COLD patients with a PaO2 above 60 Torr, 10 (17%) had polyneuropathy. In multifactorial genesis (as would be expected), the degree of severity of hypoxaemia (calculated as reduction of the actual PaO2 value below the age-adjusted nominal value), as well as the age of the patient, are statistically significant predictors of clinically manifest PNP.

Aged↗

[Pneumologic diagnosis in general practice].

Many pneumological conditions can be clarified in the doctor's office with the aid of simple investigations. In addition to a carefully taken history and a physical examination, the standard program should include a chest film and a simple lung function test. The further diagnostic measures should not be schematic, but should be based on "decision-analytical" criteria. This is demonstrated on the basis of decision-taking diagrams for a number of important pneumological differential diagnoses.

Humans↗