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Biomedical subjects

H Sperschneider

Publications and source records attributed to H Sperschneider.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Diagnosis of vitamin B12 deficiency in chronic kidney insufficiency].

It is difficult to assess the vitamin B12 metabolism in chronic renal insufficiency. In varying numbers out of a total of 88 nephropathy patients with varying degrees of insufficiency (22 patients without restriction of kidney function, 53 patients with chronic renal insufficiency in the stage of compensated retention and 13 haemodialysis patients) the Schilling test was performed and the serum vitamin B12 level was measured in fasting and 4, 6, 8 and 10 hours after oral administration of 2000 micrograms of vitamin B12. Regardless of the volume of urine, the Schilling test must be treated critically with serum creatinine values between 150 and 300 mumol/l and beyond 300 mumol/l it is no longer of diagnostic value. Serum vitamin B12 measurement after oral administration of 2000 micrograms of vitamin B12 allows vitamin resorption in the ileum to be qualitatively demonstrated on the basis of the curve. In most renal insufficiency patients the serum vitamin B12 level was increased, but this does not exclude the possibility of vitamin B12 deficiency.

Adolescent↗
PubMed1984

Pharmacokinetic and pharmacodynamic effects of furosemide in patients with impaired renal function.

Three groups of patients with kidney diseases were investigated: I. creatinine in serum less than 100 mumol/l, II. creatinine in serum 100-250 mumol/l, III. creatinine in serum greater than 250 mumol/l. After intravenous injection of 40 mg and 80 mg furosemide, serum concentrations and urinary excretion of the unchanged drug were measured fluorometrically. Moreover, urinary excretion of water, electrolytes, creatinine and urea nitrogen were estimated in order to check the pharmacodynamic effect of the drug. The pharmacokinetic parameters calculated were similar in group I and II. In group III t 1/2 was prolonged, renal clearance of furosemide was diminished. The diuretic effect of furosemide was noticeable during the first 4 hours following the injection of 40 mg in all 3 groups. Doubling the dose did not enhance the effect. Creatinine and urea nitrogen excretion in urine were not influenced by furosemide.

Creatinine↗
PubMed1984

[Diagnostic and therapeutic attempts in so-called progressive dialysis encephalopathy].

57 patients from a chronic intermittent haemodialysis programme underwent 198 EEG examinations over a period of 5 years with follow-up. The results show that regular EEG examinations allow incipient dialysis encephalopathy to be recognized already at the pre-clinical stage. Whereas therapeutic measures always had no effect on the full clinical picture of dialysis encephalopathy and all patients died, in all but one case lengthening the dialysis time prevented the syndrome from reaching the clinical stage and in 6 cases EEG changes were reversed.

Adult↗
PubMed1983

Serum vitamin E levels in patients with chronic renal failure.

27 patients with chronic renal failure, 21 patients on chronic intermittent dialysis treatment and 27 healthy controls were tested for serum level of vitamin E estimated spectrophotometrically. Both patient groups had significant higher mean values (12.1 +/- 1.2 and 7.2 +/- 0.8 micrograms/ml respectively) in comparison with normal controls 4.6 +/- 0.7 micrograms/ml). No correlation was found to serum creatinine, hematologic values, protein and lipoprotein concentration, nor to mode and duration of treatment regimes. Vitamin E was not extracted from blood throughout dialysis. Under normal conditions of conservative or dialysis treatment of chronic renal failure patients vitamin E seems not to be a factor concerning uremic symptoms and there is no need for supplementation.

Adult↗
PubMed1983

[Amino acid loss and protein spectrum of the peritoneal dialysate during continuous peritoneal dialysis].

The loss of amino acids and the protein spectrum in the dialysate during continuous peritoneal dialysis were evaluated in 6 patients with normal kidney function in the context of a study on psoriasis therapy. On the 10th day the protein loss was lower than on the 1st day of therapy. The total loss of amino acids was only 0.6 g/day with a dialysate volume of 6 1/24 h and was thus lower than the losses quoted in the literature for an exchange volume of 10 1/24 h. As a whole the loss of amino acids apparently plays only a subordinate role as an influencing factor on protein metabolism in continuous peritoneal dialysis.

Adult↗
PubMed1982

[The effect of hemoperfusion with XAD-4 resin on biological constituents of the blood].

13 patients who had undergone a haemoperfusion therapy with Amberlite XAD-4 resin (Haemoresin, Braun, F.R.G.) because of acute intoxication were examined for adsorption of biological material from the blood. Treatment lasting on average 4 hours at a blood-circulation rate of 200 ml/min resulted in a 43% reduction of thrombocytes and in changes in the concentrations of proteins, complement factors, triglycerides, aldosterone and testosterone. Low-molecular substances and electrolytes were however, except for sodium, only slightly influenced. Thus this haemoperfusion system is only suitable for shortterm application and cannot be used without substitution for chronic treatment of terminal renal insufficiency.

Adolescent↗
PubMed1982

Influence of hemoperfusion with XAD-4 resin on the concentration of biologic constituents in the blood.

13 patients, who had been subjected to hemoperfusion with Amberlite XAD-4 resin (Haemoresin, Fa. Braun), because of acute intoxications, were examined for the adsorption of bioactive material from the blood. A mean treatment period of four hours at a blood flow rate of 200 ml/min. resulted in a marked thrombocyte decrease by 43% and changes in the concentrations of proteins, complement components C3 and C4 (16-26%) triglycerides (33%), aldosterone (33%) and testosterone (20%). Low molecular weight substances and electrolytes, however, were only slightly or not affected. Thus hemoperfusion system with its poor biocompatibility and inability to remove BUN, electrolytes and water is only suitable for short-term treatment and cannot be used without detailed control of possible side effects and perhaps substitution for treatment of chronic renal or hepatic failure. Hemoperfusion has proved an efficient method of treating various exogenous intoxications. The adsorption of biologically active material from the blood constitutes several side effects which contraindicate long-term treatment, above all of endogenous intoxications such as chronic renal failure and hepatic failure. With the type of adsorber used - various charcoal preparations, resins etc. such as uncoated material or coated with different substances - these side effects vary and have not yet been investigated in a systematic, comparative and comprehensive way. The present investigations are meant to check the adsorption behaviour of Amberlite XAD-4 Resin in vivo towards some selected blood constituents and the influence of hemoperfusion on the concentrations.

Adolescent↗
PubMed1982

Middle molecular weight substances in the cerebrospinal fluid of uremic patients.

The pathogenesis of neuropathy and encephalopathy in patients with renal failure remains unknown. Possible factors include particularly aluminium intoxication, accumulation of certain middle molecular substances (MMS) and disturbances of tryptophan metabolism. Serum and CSF taken post-mortem from 8 uremic subjects who had been treated conservatively and from 4 patients on a chronic intermittent hemodialysis program who had dialysis dementia were subjected to MMS fractionation. Although MMS could not be detected in the CSF of normal controls, these substances were found in the CSF of uremic subjects in a pattern similar to that found in serum, although their concentrations were clearly lower than in serum. Their appearance could be due to impairment of the blood-CSF barrier. Uremic patients who had been treated conservatively had significantly increased CSF tryptophan concentrations when compared to the control subjects, but the CSF tryptophan concentrations of patients with dialysis dementia were in the normal range. Thus the pathogenesis of dialysis dementia cannot be related to the accumulation of MMS or to disturbances of tryptophan metabolism in the CSF.

Adult↗
PubMed1981

[Detoxication by hemoperfusion].

In 13 patients (2 males, 11 females, 15-70 years of age) on account of severe intoxications with hypnotics sedatives, psychopharmaca, in most cases mixed intoxications, with propranolol and halogenized hydrocarbons a 4--8-hour haemoperfusion treatment with amberlite XAD-4-Resin was performed. 11 patients survived, 1 patient died in irreversible cardiogenic shock of a propranolol intoxication, another patient of the sequels of a crotylbarbital and methaqualone intoxication. The curves of the course of the blood concentration of the individual substances showed a good elimination for phenobarbital and crotylbarbital, methaqualone, meprobamat and didropyridine as well as trichlorethylene, a less good elimination for nitrazepam, propranolol and tetrachlorethylene, Altogether the effectiveness of the detoxication clearly higher in the time unit, compared with the dialysis.

Adolescent↗
PubMed1981

[Analysis of middle molecules in the cerebrospinal fluid of uremic patients].

The pathogenesis of the uraemic polyneuro-encephalopathy is unclear. Among the many possible factors also accumulations of certain medium molecule fractions of peptides and disturbances of the tryptophan metabolism shall play a role. Of 8 deceased conservatively treated uraemics and 4 patients of the chronic haemodialysis programme with a dementia of dialysis serum and postmortally got cerebrospinal liquor underwent a medium molecule fractioning. While in the liquor of normal persons no medium molecules could be proved, these substances were found in the liquor of uraemics in a nearly serum-identical pattern with clearly reduced concentrations. First of all their provenience by a toxically injured blood liquor barrier is to be explained. In contrast to the control values only conservatively treated uraemics showed significantly increased tryptophan concentrations in the liquor. However, the tryptophan concentrations of the patients with dementia were within the normal area.

Adult↗
PubMed1981

[Peritoneal dialysis treatment in psoriasis vulgaris].

In 8 patients (4 males, 4 females, at the age from 23 to 64 years) with a since 2 to 32 years existing generalised psoriasis vulgaris of pure plaque type a treatment with peritoneal dialysis was performed over a period of 1-6 months with on an average 18 treatment days. A full remission of the changes did not appear in any case, only in one patient a transitory involution of the skin changes and of the arthropathy could be established. In 5 patients the picture of the disease remained uninfluenced, 2 showed a deterioration. Wether this failure of the treatment is conditioned by an inadequate, too little intensive treatment, must, in comparison to the reports of literature, be regarded as little probable. By reason of our results the treatment with peritoneal dialysis according to the scheme mentioned cannot be recommended.

Adult↗
PubMed1981

Dialysability of benzodiazepines by haemodialysis and controlled sequential ultrafiltration (CSU) in vitro.

The efficacy of haemodialysis and controlled sequential ultrafiltration (CSU) for the elimination of three hypnotic and 6 benzodiazepine drugs was compared in vitro. In comparison to haemodialysis the efficacy of ultrafiltration by CSU was poor, as the mean per cent of CSU/haemodialysis (mg/hr) for 5 benzodiazepines was only 0.6-4.0% and for three hypnotics, phenobarbital 3.4%, pyrithyldione 8.2% and glutethimide 2.5% of the haemodialysis values. In haemodialysis in vitro phenobarbital, pyrithyldione, glutethimide and chlordiazepoxide were significantly and markedly more dialysable than 5 other benzodiazepines. The mean clearance of six benzodiazepine derivatives was about 2 to 3 times higher at blood flow rates of 200 ml/min. than 100 ml/min. In CSU experiments in vitro it was possible to remove approximately (as the mean percent of the initial dose) only the amount of five benzodiazepines corresponding to the per cent of the protein unbound fraction in the plasma (correlation r = 0.975, P less than 0.01). Only low amounts of three hypnotics, especially glutethimide, were removed by CSU in vitro.

Benzodiazepines↗
PubMed1981

[Cell proliferation kinetics in the small intestine of rats with injured kidneys (author's transl)].

Cell proliferation studies were performed in the duodenum, jejunum and ileum of 10 rats 5 months after 5/6 nephrectomy. The control group consisted of 8 unoperated rats. The results showed no differences in the labeling index, in the localisation of the proliferation within the crypts of Lieberkühn and in the migration of labeled cells from the crypts to the top of the villi in both groups. These results may be explained by the small degree of renal insufficiency.

Animals↗
PubMed1981

[Local low-dose streptokinase therapy of shunt thrombosis in chronic hemodialysis patients].

In two patients undergoing haemodialysis on account of a thrombosis of the saphena transplant a local thrombolytic treatment with 50,000 units Awelysin was performed 2--3 times a day. In the two cases after 4 or 5 days a recanalisation developed, in one patient, however, a new thrombosis developed. As prerequisite for the success a sufficiently high shunt flow before the thrombosis is regarded. The exact coagulation-physiological control in the transposition phase from heparin to oral anticoagulants is particularly important.

Adult↗
PubMed1980

[The unusual case: Wegener's granulomatosis].

In a casuistic report of a case of Wegener's granulomatosis the diagnostic and therapeutic problems of a relatively rare clinical picture are described. Special emphasis is laid on the variety of organic manifestations and on the fact that bioptic investigations have not resulted in typical findings leading to diagnosis. Despite immunosuppressive therapy the lethal exitus cannot be influenced.

Adult↗
PubMed1980

[EEG and ENG findings in patients with chronic renal insufficiency and in hemodialysis patients].

In 15 patients with renal insufficiency at the stage of the compensated retention and 13 patients of the chronic haemodialysis programe no relations between clinical findings, maximum motor nerve conduction speed (peroneal nerve, median nerve), visually evaluated EEG and actual metabolic parameters could be statistically secured. During haemodialysis either an increase of the EEG changes increased or the findings remained constant.

Adult↗