[Tubular phosphate-handling after successful kidney transplantation (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Graf.
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We compared the microbiological and chemical composition of dental plaque from subjects with hereditary fructose intolerance who restrict their dietary sugar intake with that of control subjects who do not. The two groups showed no significant differences in chemical composition of plaque: the mean protein, carbohydrate, calcium, magnesium, and phosphate contents were similar. Dental plaque from both groups contained similar numbers of total colony-forming units per microgram of plaque protein, and Streptococcus sanguis, an indigenous nonpathogen, was isolated with equal frequency from plaque samples of both groups. However, potentially odontopathic Streptococcus mutans and Lactobacillus were isolated three to four times more frequently from plaque samples of control subjects than from plaque samples of subjects with hereditary fructose intolerance. Clearly, diet (sucrose in particular) influences the colonization and multiplication of specific cariogenic organisms in dental plaque.
Persons with HFI follow a lifelong, self-imposed, sucrose-restricted diet in which foods containing sucrose are consumed infrequently. Our subjects with HFI had a total sucrose intake that was approximately 5% that of control subjects and had a caries score (DMFS) that was less than 10% that of control subjects. No significant differences were found in the oral hygiene status (plaque or oral hygiene indexes) of the two groups. Foods containing starch, in the absence of sucrose, are not articularly inducive to caries. The daily intake of sucrose of the control group was less than expected. Consumption of sucrose is, therefore, less than estimates calculated by per capita sucrose disappearance. We consider that caries is initiated when the sucrose content of the diet and the frequency of ingestion exceed a low limit.
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We have treated 77 tibial fractures according to Sarmiento's principles. This technic was applied two weeks after the initial time of the fracture, and allowed a total weight bearing with complete joint mobility. It needed a functional below-the-knee brace which ends on the knee like a PTB prosthesis. The role of soft tissues (periosteum and interosseous membrane) was important to be considered in the stabilisation of fractures. The results were satisfactory, healing times being comparable to those observed after other orthopaedic methods. Sarmiento's method seems worthwhile because of it's innocuity, effectiveness and the quality of the final result. It realises an important progress compared with the usual Boehler's method. Nevertheless indications have to be discussed for compound fractures and according to the soft tissues damages.
In order to elucidate the pathogenesis of haemodialysis related hypoxaemia, lung function studies, measurements of intra-thoracic fluid changes, leucocytes and complement activity were made in 12 patients during a routine six hours dialysis using cellulose membranes. Coincidently with the fall in arterial oxygen tension, lung function was significantly impaired, paralleled by a decrease in transthoracic impedance, leucopenia and a decrease in plasma complement activity. It therefore is suggested that blood membrane interaction leads to complement-mediated pulmonary leucostasis evoking mild pulmonary oedema with impaired oxygen diffusion, resulting in hypoxaemia.
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As persistent bone loss is a major problem of chronic steroid therapy the effects of 3 weeks therapy with 1 alpha hydroxycholecalciferol were studied in 10 kidney transplant recipients on chronic steroid therapy. Treatment resulted in a significant increase in intestinal calcium absorption, paralleled by a significant decrease of serum iPTH, whereas neither plasma calcium nor urinary calcium excretion rose significantly, suggesting a positive calcium balance throughout the study. It is therefore suggested that administration of active vitamin D metabolites is an effective protection against one of the pathogenic mechanisms of steroid induced osteopenia.
Aluminium kinetics in patients with endstage renal failure and chronic intermittent haemodialysis have been studied. All patients revealed elevated predialytic serum aluminum levels. Because of a significant correlation between daily intake of aluminiumhydroxyd and serum aluminium levels it is concluded that the intestinal aluminium absorption plays an etiological role in the development of hyperaluminaemia. Plasma aluminium levels at the end of a regular dialysis procedure are significant lower compared to predialytic values. Similarly a significant decrease of aluminium concentration was observed in the plasma after passage through the dialyzer. This is due to the fact that the aluminium content of the dialysate used in our unit (0.1-0.3 mumol/l) is lower than the ultrafiltrable fraction of the plasma aluminium measured in vivo. Therefore a negative aluminium-balance during haemodialysis has to be assumed in our patients. Extreme aluminium-accummulation seems to be avoided and we therefore never experienced aluminium intoxication and dialysis dementia in our center. To assess a negative aluminium balance during haemodialysis, because of high protein binding of aluminium, a dialysate with an extreme low aluminium content has to be recommended.
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A study was carried out in 25 patients on chronic intermittent haemodialysis on the effect of increasing the dialysate calcium concentration from 1.5 to 1.75 mMol/l on calcium and phosphorus metabolism. In 16 patients the increase in the dialysate calcium resulted in a sufficiently large increase in the plasma Ca level to suppress the parathyroid glands. The calcium influx during dialysis in these patients was sufficient to abolish the effects of diminished calcium absorption from the intestine due to loss of endocrine renal function. The remaining 9 patients showed no suppression of parathyroid gland activity and could be separated into two different groups, one requiring calcium supplementation and the other group manifesting signs of autonomic hyperparathyroidism. The five patients showing a higher calcium requirement were started on active vitamin D metabolites. In the remaining 4 patients parathyroidectomy will probably be inevitable if progression of the clinical manifestations of hyperparathyroidism occurs. Close control of plasma phosphorus levels is mandatory to avoid an increase in the calcium phosphate product or the danger of hypophosphataemic osteomalacia.
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Conditions for the ligation with T4 induced DNA ligase of two DNA molecules via their complementary sticky ends have been established which lead preferentially to the formation of hybrid molecules. This is demonstrated with two combinations of parent molecules varying greatly in their relative molecular weights. In one case the intact hybrid molecule could be directly isolated. In addition a DNA dependent quantitative electrophoretic assay for DNA ligase activity is described which does not need a radioactively labeled substrate. The ligation procedure has been shown to be useful in molecular cloning experiments.
alpha-Satellite DNA from African green monkey cells was analysed with restriction nucleases in some detail confirming and complementing our earlier results. With EcoRI and HaeIII (or BsuRI isoschizomer), about 25 and 10%, respectively, of the satellite DNA were cleaved into a series of fragments of the 172 bp repeat length and multiples thereof. To allow studies with fragments of homogeneous sequence unit length, HindIII fragments were covalently joined with the plasmid pBR 313. After transformation 19 clones were obtained, containing up to three monomer fragments. Nine of the clones were characterized by digestion with EcoRI. Three of these had cleavage sites for this nuclease in the satellite DNA portion. In the six clones tested with HaeIII no cleavage site was detected in the cloned DNA. The results are discussed in relation to the nucleotide sequence data recently published by Rosenberg et al. (1978) and in the context of random and nonrandom processes in satellite DNA evolution