Search PubMed⌕ Search

Biomedical subjects

F W Reutter

Publications and source records attributed to F W Reutter.

At least 19 recordsLinked to original sources
PubMed1996

Familial glomerulopathy with giant fibrillar (fibronectin-positive) deposits: 15-year follow-up in a large kindred.

A 15-year clinical follow-up is reported for a familial glomerulopathy characterized on light microscopy by the glomerular deposition of giant fibrillary deposits (Virchows Arch A Pathol Anat Histol 388:313-326, 1980). On electron microscopy, the deposits consist of randomly oriented fibrils (12 to 16 nm in width and 120 to 170 nm in length). These deposits show positive immunoreactivity for fibronectin. One hundred fifty-seven of 197 family members within five generations were investigated. The disease is characterized by the occurrence of albuminuria in the third to fourth decades of life and slow progression to end-stage renal disease over a period of 15 to 20 years with the occurrence of generalized distal tubular acidosis (renal tubular acidosis type IV), hypertension, and the nephrotic syndrome. The frequent occurrence of otherwise unexplained microalbuminuria in young individuals of generations IV and V could be indicative of incipient glomerular disease. In one affected male individual and in his unaffected sister, renal cell carcinoma was diagnosed, raising the possibility that this familial glomerulopathy might be associated with an increased risk to develop renal cell cancer by direct or indirect (associated genetic predisposition) mechanisms. The disease relapsed in one renal transplant, raising the possibility of the presence of a transferable factor that could be part of the deposited fibrillar material or, alternatively, interfere with the glomerular handling of the deposited material.

Acidosis, Renal Tubular↗
PubMed1989

[Swiss simvastatin multicenter study: 1. Efficacy of 10 mg simvastatin daily in patients with primary hypercholesterolemia].

In a Swiss multicenter study with determination of lipid and lipoprotein parameters in a central laboratory, the efficacy of simvastatin, MSD, was evaluated in patients with primary hypercholesterolemia. Lipid and lipoprotein values were determined in 109 patients before and after 6 weeks' therapy with 10 mg simvastatin per day. A significant decrease in total cholesterol, LDL-cholesterol and apo B, of 21.1, 25.8 and 24.1% respectively, was observed. No influence of simvastatin on apo A-II was found, but HDL-cholesterol and apo A-I were slightly increased (+6.1 and 4.4% respectively). The data show that HMG-CoA reductase inhibitors constitute a new class of effective drugs for the treatment of hypercholesterolemia.

Adult↗
PubMed1989

[Atrioventricular block in Lyme carditis].

Lyme disease, due to infection with Borrelia burgdorferi transmitted by ticks, is most frequently manifested by arthritis and neurological complications. In approximately 8% of cases, however, carditis, usually reflected in AV block, is the leading symptom. The case histories of 2 males and 1 female aged 23 to 37 years with AV block caused by Borrelia burgdorferi are presented. Main symptoms were exertional dyspnea, palpitations, dizziness and syncope. One patient was treated with diclofenac and two with penicillin. The course was uniformally benign and cardiac abnormalities disappeared within 1-3 weeks.

Adult↗
PubMed1988

[McArdle disease: differential diagnosis of the increase in creatine kinase induced by the exercise test].

In a Turkish couple presenting atypical precordial pain, muscle pain and a massive increase of creatine kinase during and one day after bicycle ergometry, suspicion of McArdle's disease was confirmed by a pathologic ischemic forearm worktest, a pathologic serial stimulation test and by pathologic glycogen content with lack of myophosphorylase activity on histochemical examination of thigh muscle tissue. Characteristic signs of McArdle's disease such as muscle weakness, muscle pain and muscle swelling, especially after exertion, were detected only after specific questioning of the patients. McArdle's disease was also detected by phosphor nuclear resonance in the two male children. Frequent consanguinity in the small isolated mountain village where the family originated explains why all four members of two generations are affected by the autosomal recessive disease.

Adult↗
PubMed1987

[Sarcoidosis of the kidney].

Of 123 patients with sarcoidosis observed from 1971 to 1986, 4 had histologically proven renal involvement. Hypercalcemia was present in all of these 4 patients, hypercreatinemia in 3 and urolithiasis in one. Histologically renal interstitial nephritis or fibrosis was found in all 4 cases, and 3 cases showed sarcoid-like renale granulomas. In addition, nephrocalcinosis or mesangioproliferative glomerulonephritis was present in one patient each. Corticosteroid therapy corrected hypercalcemia in 3 patients and improved renal function in the patient with glomerulonephritis and in the case with interstitial fibrosis. One patient died of granulomatous myocarditis, renal insufficiency having been unaffected by corticosteroids.

Adult↗
PubMed1986

[Renal involvement in Legionnaires' disease].

9 consecutive cases of Legionnaires' disease are presented, all of which involved either a pathological urinary sediment or acute renal insufficiency. Diabetic glomerular sclerosis and terminal septic shock in one patient accounted per se for the urinary findings and terminal oliguric renal failure. In the remaining 8 patients the renal abnormalities are interpreted as manifestations of Legionnaires' disease: these were acute renal insufficiency in 6, requiring dialysis treatment in 4, proteinuria in 7, hematuria in 5, leukocyturia in 5 and cylindruria in 3 patients. One patient died of pneumonia and one patient, without Legionella-related renal involvement, of septic shock. Renal histology of 5 patients showed acute interstitial nephritis in one and diffuse sclerosing interstitial nephritis in a second patient, whose biopsy was obtained after 3 months' hemodialysis treatment. In 3 patients renal biopsy findings were explained by preexisting renal pathology, i.e. diabetic nephropathy, chronic transplant rejection and shock kidney respectively. Renal failure requiring hemodialysis and urinary abnormalities were largely reversible.

Acute Kidney Injury↗
PubMed1986

[Malignant pericardial effusion--a sign of unfavorable prognosis?].

Malignant pericardial effusion (MPE) resulting in cardiac tamponade is a rare complication in neoplastic disease. From January 1975 to December 1984 the authors observed 22 patients with cytologically verified malignant pericardial effusion. The most frequent primary tumors were non-small cell lung cancer (6), breast cancer (5), non-Hodgkin lymphoma (4) and mesothelioma (4). 50% of the patients presented with MPE as the initial manifestation of the tumor. In the other group of patients MPE appeared after an average of 11 months following the diagnosis of malignant disease. The most frequent symptoms and clinical findings were dyspnea (100%), jugular venous distention (91%), and tachycardia (82%). During the first 24 hours after pericardiocentesis a median volume of 675 ml of predominantly serosanguinous effusion was drained. Besides intrapericardial drug instillation, patients also received local radiotherapy and systemic chemotherapy. At the time when MPE was diagnosed 77% of the patients exhibited advanced malignant disease. Mean survival time was 140 days. Malignant pericardial effusion is therefore regarded as an unfavorable prognostic factor.

Cardiac Catheterization↗
PubMed1986

Efficacy of imipenem/cilastatin in patients with severe bacterial infections.

In this study imipenem/cilastatin was used successfully to treat 21 patients with a variety of severe infections caused by Gram-positive and Gram-negative aerobic bacteria. Overall clinical cure was achieved in 18 of 21 patients. Fourteen of 16 infecting organisms were eradicated by imipenem. In spite of in-vitro susceptibility to imipenem before therapy two species of Pseudomonas (Pseudomonas aeruginosa and Ps. fluorescens) could not be eliminated in two patients. Resistance developed in the strain of Ps. aeruginosa during treatment of a patient with pneumonia for eight days. The pneumonia was considered to be clinically cured. The strain of Ps. fluorescens became resistant during therapy in a patient suffering from an acute exacerbation of severe chronic bronchitis in whom the antibiotic treatment had failed. Imipenem/cilastatin proved to be highly effective and well tolerated in this group of patients.

Adult↗
PubMed1985

[Acute iodine poisoning associated with sialadenitis, allergic vasculitis and conjunctivitis following administration of iodine-containing contrast media].

Sialadenitis ("iodide mumps") and allergic vasculitis are rare sequelae to administration of iodinated contrast media. The condition is characterized by rapid, painless, bilateral enlargement of salivary glands following administration of iodinated contrast media. An 81-year-old female patient with moderate renal failure is described in whom marked sialadenitis, allergic vasculitis with (in part) bloody blisters developed following excretory urography and digital subtraction angiography of the renal arteries. Additional but mild symptoms included fever and conjunctivitis. All lesions subsided completely within four weeks. A relation between blood iodine concentration and extent of the lesions could be demonstrated. The highest iodine level in serum determined was 70 600 micrograms/100 ml.

Acute Disease↗
PubMed1984

[Malignant testicular tumor treated with cytostatic drugs in a case of kidney transplantation for familial cystic kidney].

The case is presented of a 29-year-old male who developed embryonal testicular carcinoma two months after successful transplantation of a cadaver kidney because of end stage renal disease due to polycystic disease. After surgical removal of the carcinoma and 3 courses of chemotherapy with bleomycin and vinblastine, complete remission was induced which has now lasted for 14 months. In addition to the usual toxicity of cytotoxic therapy, transplant function decreased intermittently but renal function recovered under close monitoring and dose-adaptation of immunosuppressive medication with cyclosporin and prednisolone.

Adult↗
PubMed1984

[Rare forms of hypertension (neurofibromatosis and cholesterol embolization].

In the past year 5 patients with uncommon secondary hypertension have been observed at the Medical Clinic, Cantonal Hospital of St Gall, Switzerland. Two patients had generalized neurofibromatosis with specific vascular lesions of the renal arteries, while 3 older patients showed clinical and morphologic signs of repeated renal cholesterol embolization. Experience with these 5 patients shows that angiography should chiefly be used in young patients with suspected secondary hypertension. Older patients with common vascular sclerosis should undergo angiography only where the indication is urgent, in view of the risk of renal cholesterol embolization. In 3 of 5 patients a lasting improvement in hypertension was achieved by antihypertensive drug therapy. Two older patients with cholesterol embolization died from complications such as uremia and therapy-resistant hypertension.

Adult↗
PubMed1983

Pharmacokinetics of metioprim in normal subjects and patients with impaired renal function.

The pharmacokinetics of metioprim, a new competitive inhibitor of bacterial dihydrofolate reductases, were studied after a single oral dose of 100 mg in two young healthy subjects, four elderly volunteers, and eight patients with impaired renal function. The pharmacokinetic parameters of unchanged metioprim were derived by analyzing plasma level curves using a two-compartment model. Plasma half-lives determined for the beta phase were 10.5 to 11.5 h in young volunteers, 12.0 to 12.9 h in elderly subjects, and 13.2 to 15.3 h in patients with renal impairment. A significant correlation between the overall elimination rate constant and the creatinine clearance was demonstrated.

Adult↗
PubMed1981

[Clinical demonstrations. Legionnaires' disease. Tumor-associated nephrotic syndrome. Primary oxalosis].

In a clinical demonstration, case reports on 3 patients are presented: 1. In a 27-year-old male who developed severe multicentric atypical pneumonia, CNS, liver and renal involvement and signs of rhabdomyolyses suggested infection with Legionella pneumophila. Diagnosis was confirmed by the presence of Dieterle-stain positive organisms and positive culture of lung biopsy tissue. Antibiotic treatment, especially erythromycin, and prolonged mechanical respiration produced complete recovery. 2. The presence of chylomycrons Rin ascitic and pleural fluid in a patient with epimembranous glomerulonephritis and nephrotic syndrome was the first sign of malignant non-Hodgkin lymphoma. Chemotherapy with cyclophosphamid, oncovin and prednisone induced remission of tumor and nephrotic syndrome, which promptly recurred parallel to later reactivation of the malignancy. Paraneoplastically induced nephrotic syndrome, especially due to lymphoma, may precede the malignancy by months. 3. In a 52-year-old male with terminal renal failure due to primary oxalosis a cadaver renal transplant functioned for only 14 months because of oxalate deposits in the transplant. Hemodialysis before and after transplantation modified the clinical course. In place of uremia, the clinical picture was dominated by oxalate-induced gangrenous arteriopathy, arthritis, and heart disease.

Abdominal Neoplasms↗
PubMed1980

Familial glomerulopathy with giant fibrillar deposits.

Proteinuria and microhaematuria were observed in three siblings and one first-degree cousin. Histological examination of three kidney biopsies and one autopsy specimen shows the same diffuse glomerular lesions in all patients, characterized by mainly subendothelial but frequently transmembranous and mesangial deposits of a unique fibrillar structure, visible by electron microscopy. Examination by immunfluorescence gave inconstant findings. No serological abnormalities could be established. To our knowledge, such a pecular form of familial glomerulopathy has not been described so far.

Adult↗