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Biomedical subjects

H Brass

Publications and source records attributed to H Brass.

At least 37 records · Page 2Linked to original sources

Immunogenicity of recombinant hepatitis B vaccine in dialysis patients.

Eighty-eight dialysis patients were vaccinated with recombinant hepatitis B vaccine prepared in yeast. Fourty-nine patients were immunized 3 times (months 0, 1, 6) intragluteally with 40 micrograms hepatitis B surface antigen (HBsAg) per dose. Only 32 of them (65.3%) showed anti-HBs concentrations above 10 IU/l with a geometric mean titer (GMT) of 180.7 IU/l after 3 vaccinations, whereas all of the 16 healthy controls, vaccinated 3 times with a 10-micrograms dose of the same vaccine batch, had specific antibodies higher than 10 IU/l (GMT 897.4 IU/l). Responses of patients were slightly higher than those of dialysis patients vaccinated in an earlier study with plasma-derived vaccine according to the same schedule. Results in 20 patients immunized 6 times intragluteally with 40 micrograms HBsAg/dose in monthly intervals were not better (at month 7, 65% showed anti-HBs concentrations greater than 10 IU/l; GMT = 126.6 IU/l), and 19 patients receiving 6 times 20 micrograms HBsAg monthly showed significantly lower responses (anti-HBs greater than 10 IU/l in 42% of vaccinees, GMT = 89.5 IU/l). The vaccine was tolerated well; side-effects were slight, and no serious adverse reactions were observed. In conclusion, recombinant hepatitis B vaccine is comparable to plasma-derived vaccine also in the case of dialysis patients; a 6-dose schedule does not seem to have much advantage compared to the conventional 3-dose regimen.

Adult↗

[Familial Mediterranean fever with amyloidosis. Recent pathogenetic and therapeutic aspects].

Familial Mediterranean fever was diagnosed in a 34-year-old Turkish patient with severe nephrotic oedema. Immunohistochemical classification of a biopsy specimen showed amyloidosis of the AA-type. There was a definite increase of serum amyloid-A-protein (SAA). The typical recurrent fever, attacks of abdominal pain with symptoms of subileus and joint swelling could be treated successfully with colchicine, the oedema with diuretics. The progression of renal failure and proteinuria as indicator of the degree of amyloid-induced renal damage remained unaffected by this treatment. With dimethyl-sulfoxide (DMSO) a marked improvement in renal function and a lowering of the SAA level could be achieved. Thus this treatment inhibits the progression of amyloidosis of the AA-type in Mediterranean fever and may be considered for other forms of AA-type amyloidoses. It is possible that the lowering of the SAA-serum concentration and the improvement of renal function is due to an antiphlogistic effect of DMSO, the mechanism of action of which is so far unknown.

Adult↗

[Elimination of meproscillarin by hemoperfusion (author's transl)].

Starting from toxic concentrations of the new scilla glycoside 14-hydroxy-3beta-[(4-O-methyl-alpha-L-rhamnopyranosyl)-oxy]-14beta-bufa-4,20,22-trienolide (meproscillarin, Clift) 5 in vitro hemoperfusions with the hemoperfusion system Haemocol are described. The test showed that meproscillarin may be rapidly eliminated from the blood by adsorption to activated charcoal (hemoperfusion). The text provides basic information for possible intoxications.

Adsorption↗

[The internist's view of hematuria (author's transl)].

The symptoms of hematuria are easily and accurately detected through careful sediment diagnosis. The path from initial indications to diagnosis often means a major expenditure of laboratory methods, of bioptic excisions, and of radiologic procedures for the examination. Above all, vascular and infected lesions of the kidneys and of the eliminative urinary tracts can cause hematuria, which in every case requires clarification.

Acute Disease↗

Uremic cardiomyopathy: studies on cardiac function in the guinea pig.

The effects of creatinine (5.6-22.6 mg/100 ml), guanidinosuccinic acid (8.7-35.2 mg/100 ml) and of urea (60-600 mg/100 ml) on the mechanical function and oxygen consumption in isolated guinea pig hearts have been assessed. None of the parameters measured (dp/dt max, dp/dt min and Q O2) was significantly affected by creatinine or guanidinosuccinic acid. However, urea significantly reduced mechanical activity and caused a marked increase of oxygen consumption, indicating impairment of heart function expressed as a diminution of the ratio formula (see text). Pretreatment with creatinine and guanidinosuccinic acid did not alter the effect of norepinephrine on mechanical activity and oxygen consumption when compared with the effects of norepinephrine (1 X 10(-8) g/ml and 1 X 10(-7) g/ml) given alone. In contrast, urea pretreatment lowered the norepinephrine induced increase of left ventricular pressure rise/fall and of oxygen consumption. In addition, reduction of the increase in the ratio formula (see text): after urea perfusion indicates diminution of the "economic" effect of norepinephrine.

Animals↗

[Renal thrombotic microangiopathy with benign hypertension and uremia secondary to oral contraceptives (author's transl)].

A 34-year-old woman developed uremia secondary to severe renal thrombotic microangiopathy after 3 years intake of oral contraceptives. In this particular case manifestation of end stage renal failure was preceded by an unusually long lasting period of nine months with benign hypertension. Even during the final stage (3-4 weeks) prior to complete development of uremia only once hemolysis but no malignant hypertension was observed. Only close long term follow up including renal biopsy and subtile functional tests may provide information whether and/or when hypertension due to oral contraceptives turns to become--at least in part--renal hypertension and also becomes persistent. This observation does not give evidence that benign hypertension causes renovascular damage and thus renal failure. Plasma renin activity was found to be basically elevated and furthermore stimulated e.g. by dialyses. However, this single observation does not permit any conclusion about a pathogenetic role of renin in creating hypertension by e.g. renal vasoconstriction or--despite hypertension--collapse of the capillary network.

Adult↗

[Changes of left ventricular transverse diameter and of contractility after haemodialysis (author's transl)].

In 26 patients (8 women, 18 men; mean age 47 +/- 3 years) who participated in a regular dialysis programme twice weekly the left ventricular diameter, the mean velocity of fibre shortening, the ventricular wall thickness, and the muscle mass were determined echocardiographically. Left ventricular muscle mass (187 +/- 13 g), left ventricular posterobasal wall thickness (14,7 +/- 0,6 mm) and septal thickness (16,4 +/- 0,8 mm) were pathologically increased due to chronic pressure and volume overloading. After an average dialysis time of 12 hours the body weight was reduced by 2,6 +/- 0,4 kg (+ 1,0 to -7,8 kg). The left ventricular transverse diameter changed from 55,3 to 50,2 mm (P less than 0,001) which correlated with a decrease of the enddiastolic volume from 160 +/- 11 to 125 +/- 10 ml (P less than 0,01(. Despite increased cardiac frequency and unchanged diastolic and systolic pressure no significant increase of the mean velocity of fibre shortening (0,93 +/- 0,06 vector 1,13 +/- 0,09 circ/s) occurred. The results show that loss of fluid during haemodialysis led to a significant decrease of the enddiastolic transverse diameter and the enddiastolic left ventricular volume. However, dialysis does not lead to an increase of the mean velocity of fibre shortening as a parameter of improved contractility.

Adult↗

[Amyloidosis in familial mediterranean fever: clinical and renal-biopsy features (author's transl)].

In two Turkish female patients, aged 14 and 29 years, with familial mediterranean fever amyloidosis of the perireticular type was found. The disease was characterized by feverish bouts, abdominal colics, and joint involvements. The younger patient had the diagnosis confirmed at an early stage by renal biopsy, and under heparin and azathioprine the clinical signs, especially the nephrotic syndrome, regressed over a period of seven months. The second patient died of treatment-resistant shock in acute renal failure, due to rapidly progressing renal amyloidosis.

Acute Kidney Injury↗