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Biomedical subjects

G Wambach

Publications and source records attributed to G Wambach.

At least 91 records · Page 5Linked to original sources
PubMed1981

[Clinical aspects and treatment of the hypertensive emergency (author's transl)].

The term "hypertensive emergency" includes all clinical syndromes which are triggered by a rapid rise in the arterial blood pressure and are improved by medicinal lowering of the blood pressure. Among them are hypertensive encephalopathy, acute rise in blood pressure with left heart failure and acute rise in blood pressure complicated by intracerebral hemorrhage or a dissecting aortic aneurysm. Parenteral application of dihydralazine, diazoxide and clonidine are suitable for immediate lowering of blood pressure medicinally and sodium nitroprusside under clinical supervision. In phaeochromocytoma Regitin is the drug of choice.

Antihypertensive Agents↗
PubMed1981

[Increased cardiovascular arteriosclerosis risk in patients with analgesic nephropathy (author's transl)].

The retrospective investigation of 54 patients with analgesic nephropathy showed the relatively early occurrence of coronary sclerosis and an increased frequency of arteriosclerotic renal artery stenosis. Angina pectoris was found in 14 patients with a mean age of 48 1/2 years. Summation of risk factors is the probable cause of the tendency for arteriosclerosis: hypercholesterolaemia and hypertriglyceridaemia was found in 29 patients, arterial hypertension in 42 patients, which was so severe in half of the patients that combined treatment with two or more drugs was necessary. The causes of lipid metabolism disturbances as well as the pathogenesis of arterial hypertension are not known. Arteriosclerotic renal artery stenoses observed in 8 patients are not likely to be the cause of hypertension.

Adult↗
PubMed1981

Na-K-ATPase in erythrocyte ghosts is not a marker for primary hypertension.

In search for a diagnostic marker for essential hypertension, we investigated the activity of the ouabain sensitive Na-K-ATPase and the ouabain insensitive ATPase in erythrocyte ghosts of 57 patients with essential hypertension, 12 patients with renal hypertension, 6 patients with Cushing's syndrome and 4 patients with primary hyperaldosteronism. Na-K-ATPase-activity was increased in patients with essential hypertension and in patients with renal hypertension compared with controls with a considerable overlap. Na-K-ATPase-activity was increased in all patients with Cushing's syndrome but was not different from the control group in patients with Conn's syndrome. Ouabain-insensitive ATPase-activity was similar in all patients and in normotensive controls. The serum of patients with essential hypertension did not exhibit an ouabain-like ATPase-inhibiting activity when incubated with erythrocyte ghosts of normotensive controls. In our hands, determination of the Na-K-ATPase-activity in erythrocyte ghosts cannot be used as a diagnostic marker for essential hypertension.

Adult↗
PubMed1980

[The clinical picture of panateritis nodosa].

The clinical picture of the panarteritis nodosa is characterized by vague early symptoms, manifestations in various organs and a changing prognosis. In seven patients with histologically proven panarteritis nodosa the clinical course was followed up over a long period. The commonest early symptoms were fever of unknown origin and a considerable loss of weight. Three out of seven patients showed in the initial phase a hypertension, in two other patients the blood pressure rose as the disease progressed. Those patients, whose renal function was impaired when the diagnosis was established, had a poor prognosis in spite of immunosuppressive therapy and dialysis. The life expectancy of these patients was between two and 16 months (in average 6,4 months). On the other side the clinical course in two patients without renal failure was more favourable; they are alive eight months and 15 years respectively after the diagnosis was confirmed.

Cerebral Hemorrhage↗
PubMed1980

Increased activity of the Na-K-ATPase in red cell-ghosts of patients with Cushing's syndrome: possible significance for the pathogenesis of glucocorticoid-induced hypertension.

The Na-K-ATPase activity of erythrocyte ghosts was increased in 6 patients with Cushing's syndrome compared with 28 control subjects (0.986 +/- 0.291 versus 0.259 +/- 0.1 microM Pi . h-1 . mg-1, p less than 0.001). Ouabain insensitive Mg-ATPase activity was similar in both groups. These data support the concept of an activation of the Na-pump in patients with glucocorticoid excess.

Adult↗
PubMed1980

Extrarenal prorenin and renin in anephric patients.

Active renin was detected in 6 of 7 anephric patients (mean value: 0.72 +/- 0.27 microU/ml, n = 7; normals: 19.7 +/- 2.4 microU/ml, n = 10), using an assay method without intrinsic acid- or cryoactivation. Prorenin, measured as the difference between plasma renin concentration (PRC) before and after acid-activation in vitro, was present in considerable amounts in all patients (32.4 +/- 3.5 microU/ml; normals: 80.7 +/- 9.7 microU/ml). PRC after cryoactivation at--5 degrees C during 1 week was insignificantly lower than after acid-activation in the patients. There was a linear correlation between PRC after either activation procedure (p less than 0.01). Supine or upright posture did not influence active or inactive renin in the anephric subjects. Our studies show that low but significant levels of active renin and a considerable amount of prorenin are detectable in anephric patients. The data suggest that prorenin in normal subjects in a significant proportion is of extrarenal origin. Orthostasis has no effect on extrarenal active or inactive renin.

Adult↗
PubMed1980

Sodium-potassium-dependent ATPase activity in erythrocyte ghosts of patients with primary and secondary hypertension.

1. We have investigated the function of the Na+-K+ pump in the erythrocytes of patients with various types of hypertension by measuring the activity of ouabain-sensitive Na+-K+-dependent ATPase and ouabain-insensitive ATPase in the erythrocyte ghosts of these patients. 2. Mean Na+-K+-ATPase activity was increased threefold in six patients with Cushing's syndrome and hypertension (0.985 +/- SD 0.288 mumol of phosphate h-1 mg-1) compared with that in 49 control subjects (0.334 +/- 0.147 mumol of phosphate h-1 mg-1) (P < 0.0025), but not in four patients with primary aldosteronism (0.278 +/- 0.108 mumol of phosphate h-1 mg-1). 3. Na+-K+-ATPase activity slightly exceeded the control range in 57 patients with primary hypertension (0.410 +/- 0.245 mumol of phosphate h-1 mg-1; P < 0.025) and in 12 patients with renal hypertension (0.475 +/- 0.250 mumol of phosphate h-1 mg-1) (P < 0.025). 4. There was no difference in ouabain-insensitive ATPase between the controls and the different types of hypertension. 5. The data support the hypothesis of an activation of the Na+ pump in patients with glucocorticoid excess. This helps to explain previous observations of a redistribution of sodium and water to the extracellular compartment in experimental glucocorticoid-induced hypertension.

Adult↗
PubMed1980

Hypercholesterolaemia and hypertriglyceridaemia in patients with analgesic nephropathy.

Patients with analgesic nephropathy are reported to have a higher risk of atherosclerosis. One possible reason for this is a high incidence of hyperlipaemia in patients with analgesic nephropathy. In a retrospective study, serum cholesterol and serum triglyceride concentrations of patients with analgesic nephropathy and moderately restricted renal function were significantly higher compared to a control group with other renal diseases of similar age and degree of renal insufficiency. Hyperlipaemia in analgesic nephropathy is not explained by end-stage renal failure on one side or protein loss as in nephrotic syndrome on the other side. Some possible mechanisms for hyperlipaemia in analgesic nephropathy are discussed.

Adult↗
PubMed1980

Regulation of serum-progesterone in patients with essential hypertension.

Increased levels of progesterone in serum have been reported in male patients with essential hypertension (EH). We, therefore, investigated serum progesterone levels in relation to excretion of aldosterone after 4 days of low Na+ intake and 6 days following high Na+ diets, in 11 normotensive controls, 22 male patients with EH and 8 male patients with hypertension of renal origin (RH). In the group of normotensive controls, the concentration of progesterone in serum averaged 228 +/- 90 and 186 +/- 93 (mean +/- SD) pg/ml during low and high regimens of Na+ intake, respectively, despite a fall in the excretion of aldosterone from 22.8 +/- 9 to 1.8 +/- 1.4 microgram/24 h. Similarly, in patients with EH, serum progesterone remained unchanged during either low or high Na+ intake regimens: 197 +/- 73 and 219 +/- 83 pg/ml, respectively. In patients with RH, serum progesterone tended to be lower during both low and high Na+ diets: 167 +/- 61 and 185 +/- 72 pg/ml, respectively. In 5 normotensive controls, diurnal variations of progesterone and cortisol were significantly correlated (r = 0.726, p < 0.005). The results of the present study suggest, that progesterone is not involved in metabolism of Na+, either in normotensive or hypertensive male subjects. Correlation between circadian variations of progesterone and cortisol suggests, that progesterone levels are modified by ACTH secretion.

Adult↗
PubMed1979

Acid- and cryoactivation of renin in human plasma.

Inactive renin in normal human plasma was activated in vitro either by cryoactivation (incubation at 0 degrees C/-5 degrees C up to 3 months) or acid-activation (dialysis to pH 3.0 for 48 h followed by diaylsis to pH 7.5). Plasma-renin-concentration was similar after either activation procedure (96 +/- 50 microU/ml vs 100 +/- 43 microU/ml). There was no further significant acid-activable renin after cryoactivation. These data suggest that conversion of inactive to active renin by optimized procedures is complete. The term "total renin" for activation results under these conditions seems to be valid.

Dialysis↗
PubMed1979

[The saralasin test in the diagnosis of hypertension (author's transl)].

The saralasin test was performed in 68 hypertensives. A clear-cut dependence of the test results on initial plasma-renin concentration and particular sodium balance was demonstrated. Because of this dependence the saralasin test should be performed only under constant conditions. A mild stimulation of the renin-angiotension system by salt restriction to a mean sodium excretion of 50 mmol daily and 80 mg furosemide by mouth 12 hours before the test seems best. In this way essential and renovascular hypertension could be distinguished with considerable reliability (P less than 0.001). Among patients with essential hypertension one could clearly separate those with high plasma-renin concentration from those with a normal or low one. Among patients with renovascular hypertension those with haemodynamically significant renal artery stenosis could with high probability be distinguished from those with non-effective stenosis. A positive saralasin test without testing the function of the normal contralateral kidney does not provide an indication for operation.

Adult↗
PubMed1979

[Sodium-potassium-adenosine triphosphatase-activity in red cell ghosts of patients with essential hypertension (author's transl)].

Increased sodium concentration and high influx of Na22 are reported in erythrocytes of patients with essential hypertension. It was speculated, that these findings are due to a disturbed transport for sodium across red cell membranes. We found a significantly increased activity of the ouabainsensitive Na-K-ATP'ase in red cell ghosts of 27 patients with essential hypertension compaired with 32 normotensive controls. There existed no difference in Mg-ATP'ase-activity between the two groups. These findings suggest an increased activity of the Na-pump in red cell membranes of patients with essential hypertension.

Erythrocyte Membrane↗