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E Renner

Publications and source records attributed to E Renner.

At least 37 records · Page 2Linked to original sources
PubMed1989

[The importance of the pathologist to the clinical decision in glomerular diseases].

The indication to treatment of glomerular diseases in adults can only be based on the morphologic findings by light-, immunofluorescent- and electronmicroscopic examination. The majority of clinically diagnosed glomerulonephritides cannot be successfully treated according to current knowledge. Clinical findings, therefore, must help to decide where a biopsy should be performed or where one can do without histologic evidence without any disadvantage for the patient. The diagnosis of "glomerular disease" can be made by examination of erythrocyte morphology in the urine and from urinary protein pattern by poyacrylic-gel-electrophoreses. Having obtained this diagnosis, the indication for biopsy is possible, if a system of clinically defined stage is applied, as acute-, oligosymptomatic- and chronic progressive glomerulonephritis syndrome. A biopsy should be taken in any case of the nephrotic syndrome and urgently in the case of rapidly progressive renal insufficiency. Combined immunosuppressive treatment eventually in conjunction with plasmaphoresis has improved the prognosis of RPGN essentially and a biopsy should then be taken as soon as possible. It would be desirable, therefore, for the clinician if he could get the pathologists findings even on weekends or on holidays, to avoid any delay in starting the treatment. Special treatment regimes usually are chosen according to morphologically defined subgroups of glomerulonephritides. The valuable help of the pathologist in these normal cases becomes most evident, where a histologic finding can't be ascribed to any defined group and no evaluated treatment regimen is available. This is demonstrated by some clinical cases.

Biopsy↗
PubMed1989

[Clinical aspects of endotheliotropic (hemolytic) nephroangiopathy].

Clinical syndromes as hemolytic-uremic-syndrome, thrombotic-thrombocytopenic-pupura and primary-malignant-hypertension not only present multiple clinical but also etiological and pathogenetical common characteristics. Thoenes and John developed in 1980 the unifying concept of endotheliotropic (hemolytic) nephroangiopathy for these diseases which are characterised by pathologic interaction between damaged endothelial cells and erythrocytes. This concept was increasingly discussed and accepted in the literature during the course of the last years. We describe the clinical manifestation of the subgroupes which were defined by Thoenes and John according to the vascular pattern of pathomorphologic intrarenal lesions. It can be shown that the classification based on pathomorphologic findings is very useful for the differentialdiagnostic characterisation and the prognostic evaluation in a given single case.

Endothelium, Vascular↗
PubMed1986

Effect of liver function on the metabolism of prednisone and prednisolone in humans.

The systemic availability of total prednisone and unbound prednisolone, and the urinary excretion of 6 beta-hydroxyprednisolone, were measured after an oral dose of prednisone and an i.v. dose of prednisolone in 22 patients covering a wide range of liver function (galactose elimination capacity ranging from 3.3 mg/min X kg body wt to 9.2 mg/min X kg body wt). The area under the plasma concentration versus time curves of prednisolone and of prednisone decreased with increasing galactose elimination capacity. This dependency of the steroid concentrations on liver function was attributed to a decreased metabolic clearance and not to an increased systemic availability of the steroid given p.o. in patients with impaired liver function. The fractional excretion and the fractional clearance of 6 beta-hydroxyprednisolone declined with decreasing metabolic clearance rate of prednisolone or with decreasing galactose elimination capacity. Thus, the enzymes involved in the 6 beta-hydroxylation are not spared as liver function declines, and the exposure to the biologically active unbound prednisolone is increased in patients with impaired liver function in relation to the amount of prednisone or prednisolone administered.

Adult↗
PubMed1985

High-performance liquid chromatographic determination of dimethylxanthine metabolites of caffeine in human plasma.

A normal-phase high-performance liquid chromatographic assay of caffeine and its metabolites, theophylline, theobromine and paraxanthine, in human plasma is described. The two internal standards ethyltheophylline and 1,3,7-trimethyluric acid are used simultaneously and cover the range of different polarities from caffeine to the three dimethylxanthines. Plasma (0.5 ml) in the presence of ammonium sulphate is extracted with chloroform--isopropanol (1:1, v/v). The extract is chromatographed with a LiChrosorb Si 60 5-micron column and a mobile phase of dichloromethane containing 2.5% of a formate buffer in methanol. Calibration is performed with six different calibration mixtures which take into account the large plasma concentration differences between caffeine and its metabolites in man. The method is suitable for the simultaneous determination of caffeine and its dimethylxanthine metabolites in plasma of healthy and diseased persons.

Ammonium Sulfate↗
PubMed1985

Fasting plasma caffeine concentration. A guide to the severity of chronic liver disease.

Fasting plasma caffeine concentrations (FPCC) were measured in 86 outpatients being examined for suspected or known liver disease. Seven patients (8%) who avoided caffeine consumption had nonmeasurable FPCC; they were dropped from further consideration. The remaining 79 subjects were divided into 4 diagnostic groups: surgical shunt (n = 11); alcoholic, posthepatitic, or primary biliary cirrhosis (n = 29); miscellaneous liver disease (n = 23); and normal liver (n = 16). FPCC was highest (mean, 17.8 mumol/l) in the shunt group, followed by the cirrhosis (12.3), miscellaneous liver diseases (4.6), and normal liver (2.1) groups. FPCC seemed to reflect severity of functional impairment, further supported by highly significant correlations with quantitative liver function tests, such as aminopyrine breath test (Rs = -0.89; n = 66), indocyanine green disappearance (Rs = -0.85; n = 65), and galactose elimination capacity (Rs = -0.70; n = 75). A careful dietary history showed no significant difference in caffeine consumption among the groups. It is suggested that in regular coffee drinkers FPCC might serve as a simple and convenient guide to the severity of functional impairment in chronic liver disease.

Adult↗
PubMed1983

Pharmacokinetics of brotizolam in renal failure.

Kinetics of brotizolam (0.25 mg) were studied in patients with different degrees of renal failure after single and repeated oral ingestion. Serum levels were analysed by radio-immunoassay. Patients were divided into three groups according to their renal function, i.e. creatinine clearance values of 45-80, 15-45, or less than 15 ml/min. The mean elimination half-life was 6.9-8.15 h, with a considerable variation of the peak concentration and elimination half-life in slight to moderate renal failure. There was no delay in elimination in severe renal failure and there was no drug accumulation. No dose adjustment is necessary for brotizolam in renal failure.

Adult↗
PubMed1983

[Roentgen study of the hand in primary biliary cirrhosis].

The radiographic findings in the hand of 12 patients with primary biliary cirrhosis are described. 8 patients had osteopenia, one of these radiographic signs of hyperparathyroidism. Erosive arthritis was present in 5 of the 12 cases. Hyperostosis at ligamentous attachments was seen in 3 patients. Chondrocalcinosis was present in one case.

Adult↗