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Biomedical subjects

E Quellhorst

Publications and source records attributed to E Quellhorst.

At least 19 recordsLinked to original sources
PubMed1979

[Meproscillarin in patients with renal failure and concomitant heart failure (author's transl)].

Meproscillarin is a glycoside with a high bioavailability (about 70%) and an elimination independent of the renal function. It was to be investigated whether a good cardiac effectiveness can be demonstrated during oral long-term application of meproscillarin to patients with renal failure. 29 patients with renal failure of varying degree and concomitant heart failure were daily given an oral dose of 0.75 mg of meproscillarin over 14 days. The effectiveness of the glycoside was measured as change of the electromechanical systole (QS2c) and the quotient of the diameter of heart and thorax (C/T) from the 1st--15th day. The plasma levels of the glycoside were determined on the 1st, 8th, and 15th day. There was a significant shortening of QS2c (by mean = 27 ms, P less than 0.005) and a marked decrease in the size of the heart (P less than 0.0025); heart rate and PQ-interval were only insignificantly influenced. Plasma levels of 0.95 ng/ml were found after 8 days of treatment compared to 1.25 ng/ml after 15 days. As the pharmacokinetics of the glycoside is practically not influenced by the renal function, meproscillarin represents an alternative in the treatment of patients with heart failure and impaired renal function.

Adult↗
PubMed1979

[Diuretic resistant ascites in hepatic cirrhosis and renal insufficiency (author's transl)].

In decompensated hepatic cirrhosis the glomerular filtration rate is reduced. Use of diuretics frequently leads to hyponatraemia, hypotension, hypovolaemia and oliguria. The ensuing renal insufficiency is reversible when the peritoneal fluid is redirected into the vascular system. For this purpose a subcutaneously implantable pump developed by Agishi was used in a 37-year-old patient permitting drainage of the ascites from the peritoneal cavity into the superior vena cava using an actively operated pumping mechanism. Use of the pump in the patient abolished the ascites, considerably improved renal function, equilibrated electrolyte metabolism and improved renal response to diuretics.

Adult↗
PubMed1978

Clinical and technical aspects of hemofiltration.

The removal of uremic substances in hemofiltration, in contrast to hemodialysis, is achieved by means of a convective transport across membranes of high porosity. Since 1974, more than 30 patients with chronic renal insufficiency have been treated with regular hemofiltration three times weekly for four to five hours each. After completing a pilot study, a controlled study to compare hemodialysis and hemofiltration was initiated during January, 1978. A normalization of blood pressure in patients with severe hypertension, and remarkable stability of the circulatory system, even after dehydration in patients who had hypotension in spite of fluid overload, could be demonstrated. Hemofiltration is preferred, especially in older patients with cardiovascular or cerebrovascular problems, because of its lower frequency of hypotensive episodes compared to dialysis. An important aim--the miniaturization of the artificial kidney--has not yet been achieved, however, because of the necessity for an extensive monitoring system for the exact proportioning of the sterile substitution fluid. First results in the application of a fluid regeneration system consising of a charcoal cartridge and a bioelectric cell, for degradation of urea, are presented.

Blood Pressure↗
PubMed1978

[Elimination rate of meproscillarin following repeated application in patients with reduced renal function (author's transl)].

It was to be investigated whether the elimination rate of 14-hydroxy-3beta-[(4-O-methyl-alpha-L-rhamnopyranosyl)oxy]-14beta-bufa-4,20,22-trienolide (meproscillarin, Clift) is influenced by the renal function after discontinuance of long-term application. A group of 9 patients with renal insufficiency of varying extent associated with heart failure received 0.75 mg of meproscillarin per day over a period of 14 days. The plasma levels of the glycoside were measured by means of the 86rubidium erythrocyte assay up to 60 h after the last dose. After discontinuance of the glycoside the mean plasma half-life was 45.8 (S.-X = 6 h), a value corresponding to the results obtained in healthy test persons (49.3 h). Thus it could be demonstrated that the rapid elimination rate (and thereby the rate of inactivation) of meproscillarin is not influenced by renal function even after discontinuance of long-term application.

Adult↗
PubMed1977

Peritoneal dialysis in small laboratory animals.

Healthy rats and guinea-pigs were treated with a simple method of continuous peritoneal dialysis for 12, 24 and 48 h. Increasing with time, both animal species developed severe hypoproteinemia and hemoconcentration due to protein loss into the dialyzate fluid. These changes were associated with a high mortality rate, when Sterofundin was used for dialysis. Therefore, protein loss should be substituted and the type of dialyzate must be considered in experimental long-term dialysis using these small laboratory animals.

Animals↗
PubMed1977

[Treatment of glomerulonephritis with heparin (author's transl)].

32 patients with different histologically proven forms of glomerulonephritis were treated with heparin for an average of 31 days. A dosage of heparin was chosen, which allowed an increase in thrombin time to 20-40 seconds. Histological findings alone do not allow any prediction concerning the therapeutic success of heparin treatment in glomerulonephritis. According to our results and comparable information given in the literature, the following therapeutic scheme can be recommended: Best results are seen in patients with a slow decrease of GFR (i.e. less than 30 ml/min) during the year preceding the beginning of the treatment. In rapid progredient glomerulonephritis, however, as in patients without any changes of GFR during this time, predictions as to the course of illness cannot be made. A high level of fibrin split products in serum may be expected to be the most valuable sign of therapeutic effect, as could be documented in 7 out of 8 successfully treated patients. Hypertension and proteinuria were not influenced by the treatment. Because of severe side effects the heparin treatment of glomerulonephritis should not be initiated in patients with severe hypertension.

Blood Coagulation Tests↗
PubMed1977

[Dialysis treatment of advanced diabetic nephropathy (author's transl)].

Dialysis treatment of patients with diabetic nephropathy turns out to be difficult because of numerous late complications which arise in addition to the renal disease and which often influence the direction of the course of the disease. But this experience does not in the least justify the exclusion generally of patients with diabetic nephropathy from dialysis the-rapy. Hemodialysis and peritoneal dialysis are equally suitable for the treatment of renal insufficiency; patients with accumulated hemorrhagic complications (e. g. vitreous hemorrhages) should be treated by peritoneal dialysis for preference, and those with a predominant hypertension by hemodialysis. Early preparation for dialysis treatment is of great importance.

Blood Glucose↗
PubMed1977

Effect of dialysate calcium concentration on plasma parathyroid hormone during hemodialysis.

The effect of changes in the dialysate calcium concentration on calcium fractions and parathyroid hormone species in plasma during hemodialysis has been examined. C-terminal immunoreactive parathyroid hormone was suppressed when plasma calcium increased by greater than 25% whereas N-terminal fragments demonstrated an increase. The significance of this is discussed in light of present knowledge of parathyroid hormone metabolism.

Adult↗