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Biomedical subjects

H Kaffarnik

Publications and source records attributed to H Kaffarnik.

At least 73 records · Page 4Linked to original sources
PubMed1980

Creatinekinase in hyperlipoproteinemic patients treated with clofibrate.

Elevations of serum CK levels in patients treated with clofibrate have been reported in many case reports since the primary description of the acute muscular syndrome in 1968. The main point of interest in the beginning of our study were difficulties in differential diagnosis of acute heart attacks in patients treated with clofibrate. Since the rapid CK MB assays have become available, this difficulty has been eliminated. No equivocal answer was given in single case reports with regard to the prognosis of drug-induced increases of this skeletal muscular enzyme. Our experience collected in a now 5 years lasting follow-up study shows that isolated CK-elevations without clinical symptoms do not coincide with the development of skeletal muscular damage or disease.

Clofibrate↗
PubMed1979

[Current aspects of rheumatoid arthritis].

According to recent investigations two factors might play an essential role in the pathogenesis of rheumatoid arthritis (R.A.). Besides genetic components, i.e. the HLA-system and familial aggregation, the immune processes, mediating tissue inflammation and injury, are acknowledged as having established roles in the pathogenesis of R.A. The present report reemphasizes recent data concerning the autoimmunity and the immunologic network with trends of therapy in R.A. In view of the effectiveness of new nonsteroidal antiinflammatory drugs, a double-blind study of suxibuzon vs. indomethacin in 30 patients with active R.A. is described in detail. Both drugs were active and similar in their efficacy at 4 weeks as judged by clinical and laboratory measurements. No serious toxic side-effects were observed in both treatment regimens.

Administration, Oral↗
PubMed1979

[Red cell metabolism and function in shock (author's transl)].

In patients with shock the metabolism and O2-function of the erythrocytes were studied following separation according to cell-age by density layer centrifugation using a new supporting medium. Metabolic acidosis in patients with postoperative shock (n=8) and in patients with shock due to severe congestive heart failure (n=12) provoked decreased levels of 2,3-diphosphoglycerate, ADP, ATP and reduced glutathione. Raised lactate/pyruvate ratios were observed also in both groups, whereas the O2-function of the erythrocytes was markedly disturbed in all patients. Patients of both groups received glucocorticoid-infusions resulting in a significant improvement of the extent and pattern of the red cell metabolic disorder.

Adult↗
PubMed1979

[Inherited hemolytic anemia due to pyruvate kinase deficiency: II. Density-layer centrifugation of erythrocytes (author's transl)].

Heterogeneous clinical features of inherited hemolytic anemia due to pyruvate kinase (PK) deficiency were observed in three related homozygous patients. Erythrocytes were separated into old and young cells by means of density-layer centrifugation using a new supporting medium: Stractan-Urografin gradients. Those fractions containing older RBC disclosed defective PK which resulted in an impaired metabolism. Following an intake of chloramphenicol the clinical course of one female family member converted to acute monocytic leukemia. Thus, the report of a PK instability trait, in one family member associated with pancytopenia which converted in leukemia, suggests that inherited red cell enzyme deficiency might be also an expression of the vulnerability of the hematopoietic stem cells.

Adult↗
PubMed1979

Effect of polyenyl phosphatidyl choline on clofibrate-induced increase in LDL cholesterol.

In a double-blind, randomised, cross-over trial clofibrate and a combination of polyenyl phosphatidyl choline (PPC) plus clofibrate were tested in 67 patients with hyperlipoproteinemia. Each treatment lasted for 4 weeks and was separated by a 4 week placebo period. The daily doses were clofibrate 1.2 g and PPC 1.8 g + clofibrate 1.2 g. respectively. The results revealed that polypenyl phosphatidyl choline prevented the elevation of LDL-cholesterol induced by clofibrate treatment, and that the lipid-lowering potency of the combination did not differ significantly from that of clofibrate. Since elevation of LDL-cholesterol is considered to increase the risk of coronary heart disease, the combination appears to offer a therapeutic advantage. Despite the significance of this clinical observation, a final decision may only be obtained from a prospective, long term investigation in patients with coronary heart diseases and hyperlipoproteinemia.

Adult↗
PubMed1979

[Echocardiography in the elderly (author's transl)].

We report on questions and echocardiographic diagnoses in older patients and put out special views: value of ECG in coronary heart disease and in diagnosis of cardiomyopathy, for differentiation of systolic murmurs in the aged and detection of dilatation and atrial thrombosis.

Aged↗
PubMed1978

[Biochemistry and clinical significance of oral exocrine pancreatic function test by means of fluoresceinedilaurate (author's transl)].

Column chromatography of extracts and secretions of the pancreas as well as of sera from patients suffering from inflammations of this organ yields three esterases different from each other in molecular size. These enzymes could be shown to be not identical with lipase. They may be classified as aryl-esterases considering their activities in hydrolyzing synthetic substrates such as esters of fluoresceine with fatty acids. Fluoresceinedilaurate, therefore, proved to be very advantageous in an orally performed test of exocrine pancreatic function. Healthy persons show in this procedure relative excretion of fluoresceine during ten hours of 66.3 +/- 30.4%, patients suffering from pancreatic diseases only 12.7 +/- 9.8% of the dye.

Esterases↗
PubMed1978

[Drug treatment of hypercholesterolemia. Experience with a combination of dextrothyroxine and betapyridylcarbinol (author's transel)].

22 patients of our lipid ambulance with hypercholesterolemia received 6 mg highly purified dextrothyroxine (group 1, n = 10) or 900 mg beta-pyridylcarbinol (group 2, n = 12) for 12 weeks and both groups for another 8 weeks a combination of 4 mg dextrothyroxine and 600 mg beta-pyridylcarbinol daily. Most of the patients with an age from 8 to 57 years showed a family history of hypercholesterolemia, some of them suffered from coronary insufficiency. 20 patients completed the therapeutic progrand of 20 weeks. Total cholesterol decreases in both groups during monotherapy significantly, and still more during the combination, singificant in group 1. LDL cholesterol showed greater decrease during mono- and combination therqpy. The frequency of side effects was higher in the monotherqpy periods: increase of preexisting angina pectoris in one case during dextrothyroxine, severe flush in two cases during beta-pyridylcarbinol, gastrointestinal disturbances three times in both groups together. During the combined treatment minimal gastrointestinal symptoms were reported from one patient. The lower incidence and severity of side effects in spite of similar or better effects recommend the combination of dextrothyroxin and beta-pyridylcarbinol for longterm therapy of moderate hypercholesterolemia.

Adolescent↗
PubMed1978

Plasma lipids, triglyceride/fatty acid pattern, and plasma insulin in fasted healthy volunteers during continuous ingestion of ethanol. Influence of lipolysis inhibited by nicotinic acid.

Healthy fasted volunteers were subjected to an acute oral ethanol load over 12 h after a diet of 3 days with high linolenic acid content. Free fatty acids, triglycerides, glycerol, phospholipids, cholesterol and insulin, as well as the fatty acid pattern of triglycerides in the plasma, were determined during the test. The test was repeated with nicotinic acid added. The lipid values obtained and the comparisons of fatty acid composition both indicate that the predominant role of peripheral lipolysis in the genesis of acute ethanol-induced hypertriglyceridemia, in spite of the possibility of enhanced synthesis of palmitic acid in the liver.

Adipose Tissue↗
PubMed1978

[Ethanol and lipid metabolism (author's transl)].

Fatty liver and hyperlipoproteinemia are the main clinical manifestations of interrelationships between ethanol and fat metabolism. Elevation of VLDL is observed more, hyperchylomicronemia less frequently. In metabolic healthy volunteers reversible hypertriglyceridemia can be provoked as well. The pathogenesis of ethanol-induced hyperlipoproteinemia is based on metabolic alterations directly dependent on the oxidation of ethanol in the liver as well as on indirect effects: Besides decreased oxidation and increased de-novo-synthesis by the liver, the sources of fatty acids for the enhanced production of VLDL are the adipose tissue and alimentary fat. VLDL concentrations have been shown to correlate with risk of atherogenesis in the middle-aged. Enhancement of alpha/beta (HDL/LDL)-cholesterol which would indicate an antiatherogenetic effect have been observed in relation to ethanol intake. At the moment it is premature to conclude that ethanol-induced changes in plasma lipoproteins may favour or delay atherogenesis.

Adipose Tissue↗
PubMed1978

[Insulin and pro-insulin secretion following intravenous administration of tolbutamide, glisoxepide and glibenclamide].

12 metabolically healthy subjects were i.v. administered equipotent doses (ED30) of tolbutamide (7.5 mg/kg), glisoxepide (0.02 mg/kg) and glibenclamide (0.006 mg/kg). Prior to and 2, 5, 8, 10, 20, 40, 60 and 120 min after the injection the following serum parameters were determined: blood glucose, immunologically measurable insulin (IMI) with the double-antibody method (Hales and Randle) and proinsulin (IMP) enzymatically (ISP-method). The maximum level of insulin follows the injection of tolbutamide with a value of 70.5 micronU/ml after 2 min, of glisoxepide after 5 min (67.0 micronU/ml) and of glibenclamide after 20 min (32.3 micronU/ml). The proinsulin fraction of the total insulin shows a level of 12.5 micronU/ml before the test. After the administration of the three compounds proinsulin increases, too, but reaches only 20-40% of the total immunoreactive insulin. The amount of secreted insulin and proinsulin during the 120-min test is rather the same for the three substances. The average increase of insulin is nearly identical for tolbutamide and glisoxepide, whereas it is less for glibenclamide. Both the mean blood sugar depression and the highest mean increase of proinsulin is reached after glisoxepide. The significance of the one-chain precursor of insulin as a part of the sulfonylurea stimulated total insulin for glucose depression is discussed.

Blood Glucose↗
PubMed1978

[Coronary artery reserve in patients with hyperlipoproteinemias (author's transl)].

The coronary reserve was measured in 119 patients with different types of primary hyperlipoproteinemia. Cardiovascular diseased with clinical manifestation were excluded. 90 patients of same age with normal serum lipids served as controls. The groups did not differ in other risk factors as blood pressure or overweight (the latter excluded in hyperlipoproteinemia type IV). The controls showed decreased coronary reserve in 8%, type IIa patients in 36%, IIb patients in 18% and type IV patients in 23%. The frequency of restriction in coronary flow increased with age: in hyperlipoproteinemic patients of 50 years and more it was found in nearly 40%. Further interesting results were the significantly higher systolic and diastolic blood pressures reached during exercise in our hyperlipoproteinemic patients.

Adolescent↗
PubMed1977

[Beta-sitosterin in the treatment of essential type II hyperlipoproteinemias].

The effect of Beta-Sitosterol (Sitosterin Delalande) on plasma lipids in 20 pretreated patients with type IIa and IIb familial hyperlipoproteinemia is reported. 6-18 g of the drug were given for a time of two to twelve months. In 11 patients the plasma cholesterol level decreased between 10 and 30%. Since Beta-Sitosterol has no effect on plasma triglycerides, an additional hypertriglyceridemia must be taken care of and treated if necessary. Beta-Sitosterol can be called an effective substance in the treatment of hypercholesterinemia. In addition the diet cure becomes easier.

Adult↗
PubMed1976

[Changes of erythrocyte membrane lipids in ethanol induced hyperlipidemia (Zieve's syndrome) (author's transl)].

In 11 patients with alcohol-induced hyperlipemia, of whom 6 showed a Zieve Syndrome increased phospholipids, triglycerides and total cholesterol were found in the red cells stromal. The gasliquid chromatographic analysis of the phospholipid fatty acids showed increased contents of saturated and monounsaturated fatty acids C 16-C 18 smaller contents of longchain highly unsaturated fatty acids. The changes in the fatty acid pattern mainly occurred in patients with Zieve Syndrome and could be important for the mechanism of the hemolytic anemia. Theses findings could be in connexion with vitamin E deficiency.

Adult↗