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Biomedical subjects

H Klinkmann

Publications and source records attributed to H Klinkmann.

At least 181 records · Page 10Linked to original sources
PubMed1978

Urinary fibrin degradation products--a three year comparative study.

Urinary fibrin degradation products (FDP) were determined by Merskey's passive haemagglutination test in 115 patients with biopsy proven chronic proliferative glomerulonephritis (GN), 94 with urinary tract infection (UTI), and 23 transplanted patients. The active GN values (12.3 microgram/ml) are significantly higher than those for latent GN (0.3 microgram/ml). Those for acute UTI (9.2 microgram/ml) are significantly higher than for chronic UTI (1.3 microgram/ml). In contrast to the reports published by others, the numerous 'false positive' and 'false negative' values make diagnosis of the activity unreliable. Some prognostic value can be expected in GN with the nephrotic syndrome (NS): patients with steroid-sensitive NS excrete no FDP and patients with steroid-resistant NS excrete larger quantities of FDP. We have confirmed that a rise in FDP level following kidney transplantation is indicative of an acute rejection crisis. However, since 10 of 27 rejections were FDP negative, the absence of FDP in the urine does not preclude rejection, so that the diagnostic value is restricted.

False Negative Reactions↗
PubMed1978

[Osmotherapy of acute kidney failure with special reference to plasma renin activity and mineral balance].

13 dogs were used to generate an acute toxic renal failure by sublimate. The alterations both of plasma renin activity (PRA) and of the acid-base and mineral balance were observed in uremia and after "osmotherapy" with mannitol (13 dogs). In the course of toxic renal failure the PRA increases on the average. A decompensated metabolic acidosis with general transmineralization is observed. Since in the stage of anuria the Na+ in urine fails to reach the macula densa cell canicularly, the theory is advanced that only the intracellular sodium in the macula densa cell is responsible for the regulation of the position of the vas deferens. Following "osmotherapy" the PRA is significantly lowered. The acidosis is still worsened under conditions of anuria. For the regulation of renin it has to be assumed that the enzyme in acute anuria after osmotherapy is being altered especially by volume receptors. Thus, osmotic therapy seems to be reasonable only with existing residual diuresis. This is valid especially for the administration of mannitol, because this substance remains strictly outside the cell.

Acute Kidney Injury↗
PubMed1976

[Chemotherapy in pyelonephritis].

In the present paper the most important general directions of the chemotherapy of the acute as well as the chronic pyelonephritis are explained. In adult age actual acute pyelonephritides are rare. In most cases acute attacks of chronic pyelonephritides are in question. Also in the acute pyelonephritides for the initial therapy the application of highly effective chemotherapeutics is recommended which lead to high tissue and serum levels. The exclusive application of nitrofurantoin or an only symptomatic therapy is not indicated in acute pyelonephritis. Only a consequent therapy of the acute form of the course gives the possibility to reduce the number of chronic pyelonephritides. The most favourable conditions for the treatment of chronic pyelonephritis with the aim of stopping the chronic process or eventually even a cure are given by the long-term therapy. For the initial therapy according to the antibiogramme a tissue effective chemotherapeutic remedy is administered. This was followed by a long-term prophylaxis of about 6 months. Taking into consideration the therapeutic mechanisms of the preparations and the severity of the clinical picture always the least toxical antibacterial remedies should be administered. The most important chemotherapeutics for the therapy of pyelonephritis, their side-effects and the peculiarities of their use in renal insufficiency are discussed.

Acute Disease↗
PubMed1976

Long-term study of humoral immune response in patients with chronic pyelonephritis.

Indirect immunofluorescence was used for the measurement of serum antibody titers against the hemologous urinary strain of infecting organism in patients with a clinical diagnosis of chronic pyelonephritis. The passive hemagglutination technique was employed for comparison. The antibody response of the patients was followed-up for a period of two to four years. In contrast to titers determined by hemagglutination, antibody titers determined by immunofluorescence were found to be persistently elevated, and the indirect immunofluorescence technique is considered a sensitive and reliable method for the serological diagnosis of chronic pyelonephritis.

Anti-Bacterial Agents↗
PubMed1975

[Indirect immunofluorescence in the serological diagnosis of chronic pyelonephritis (comparison with indirect haemagglutination and the Widal reaction (author's transl)].

Using indirect immunofluorescence, o-antibodies against the homologous causative organism were determined in 119 adults with chronic pyelonephritis, during a one to two-and-a-half year period. Humoral antibodies were determined in the same group of patients with the Widal reaction and indirect haemagglutination. The results were compared with those in a group of adults without renal disease, using the same serological reactions. In adults with chronic pyelonephritis the antibody titre (by immunofluorescence) was above normal limits (as obtained in the healthy group) in 63.1%. The corresponding results for the Widal reaction and indirect haemagglutination reaction were 16.5% and 12, respectively. Indirect immunofluorescence is thus clearly better than the other two serological methods in the diagnosis of chronic pyelonephritis.

Antibodies↗
PubMed1975

[Application of a mathematical model to the penetration of amino acids through a dialysis membrane in chronic hemodialysis].

With the help of a one-pool-model from the clearance values measured for 4 different dialysator models the elimination rates for amino acids are calculated with special regard to the essential amino acids. In these cases the body-weight of the patient also belongs to the calculation of the elimination of the amino acids. The loss of the amino acids under the dialysis procedes corresponding to an e-function and is particularly high during the first period of dialysis.

Amino Acids↗
PubMed1975

[Circulation and anesthesia].

In this paper a survey is given on the group of risk in patients with diseases of the circulatory system under the stress of anaesthesia with special regard to arterial hypertension, chronic ischaemic heart disease, disturbances of cardiac rhythm and global heart insufficiency besides the generally acknowledged therapeutic principles for cardiological patients of risk. On the conditions of a surgical intervention the author adopts a definite attitude to the partly still contrary problems of the preoperative antihypertensive treatment and to the prophylactic therapy with glycosides. The most important diagnostic and therapeutic facts concerning the necessary interdisciplinary cooperation between internist, anaesthesist and operator in preparation and performance of an operative intervention in patients with circulatory diseases are described.

Anesthesia, General↗