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Biomedical subjects

J Lindner

Publications and source records attributed to J Lindner.

At least 55 records · Page 3Linked to original sources

[Acute phase proteins in acute pancreatitis].

The submitted investigation deals with the value of assessment of selected reactants of the acute stage in patients with acute pancreatitis and their follow-up in the course of the disease. For the investigation C-reactive protein, alpha-1-antitrypsin and haptaglobin were selected. In addition to the prognostic impact the authors focused attention on assessment of the dynamics of individual proteins and their importance for the early detection of complications in acute pancreatitis with different etiologies. The high CRP level on admission of severe cases of pancreatitis--mean 166.9 mg/l (range from 100 to 320 mg/l)--correlated with other signs suggesting severe pancreatitis and the latter was confirmed by computed tomography (CT), surgery or post-mortem examination in 90% of the patients with a CRP level above 100 mg/l. This correlation was not confirmed for alpha-1-antitrypsin or haptaglobin.

Acute Disease↗

[Lung function and prevalence of irritation of eyes and respiratory airways on days with elevated ozone concentrations].

In order to evaluate potential health effects on days with elevated ozone concentrations, lung function parameters and subjective votes on irritations of eyes and airways were taken repeatedly from subjects belonging to four assumed ozone risk groups and one control group (at least 40 subjects each) - senior citizens, juvenile asthmatics, forestry workers, athletes and clerks - in comparison of days with elevated (at least 100 micrograms/m3) and low ozone concentrations (at most 80 micrograms/m3). The results show no relevant ozone effects for the groups, "senior citizens" and "athletes", only minor pulmonary effects for "juvenile asthmatics", but significantly higher airway resistances on "ozone days" for "forestry workers" (by 21%) and "clerks" (by 16%). On days with moderately elevated levels of ozone in the environment it is assumed that ozone itself has minor influence on pulmonary responses compared to that of other constituents of the air in certain location like forest or indoors.

Adolescent↗

Identification of the site of uptake of the E. coli heat-labile enterotoxin, LTB.

The results of this study demonstrate that the B subunit of the E. coli heat labile toxin (LTB) binds to the brush border of intestinal epithelial cells in a highly specific, lectin-like manner. Uptake of LTB and transcytosis to the basolateral side of the enterocytes can be observed within 1 h after feeding, and occurs through both the villous epithelial cells and the epithelial cells overlying lymphoid follicles and Peyer's patches. Binding and uptake most probably occur via receptor-mediated endocytosis, with GM1 ganglioside and galactoproteins on the enterocyte cell surface acting as specific ligands to which the LTB binds. Cell ELISA data, together with the observed distribution of immunocompetent cells and the localization of LTB binding, suggest that LTB which is taken up by the villous enterocytes enters the circulation and subsequently generates an IgG immune response in the spleen. At the same time, LTB which is taken up via the patch associated epithelium generates a local IgG and IgA immune response within the Peyer's patches and intestinal lymphoid follicles.

Animals↗

[Evaluation of laparoscopic and laparotomy cholecystectomy by comparing the dynamics of acute phase proteins].

The authors investigated in two groups of surgical patients subjected to laparoscopic (n = 10) and laparotomic (n = 10) cholecystectomy changes in the levels of nine acute stage proteins. The objective was to evaluate the extent of surgical stress of the two surgical procedures with regard to changes of serum levels of albumin, transfirrin, prealbumin, alpha 1-antitrypsin, alpha 1-acid glycoprotein, alpha 2-macroglobulin, haptoglobin, ceruloplasmin and C-reactive protein. Before operation no significant differences (p < 0.05) were found between the investigated indicators. Changes of acute stage proteins up to the third day following surgery indicate a lower surgical trauma and more favourable course during the early postoperative period in patients operated by the laparoscopic route.

Acute-Phase Proteins↗

[The importance of perforators in surgical treatment of varices of the lower extremities].

The authors discuss the role of insufficient perforating veins in the surgical treatment of primary varicosities of the lower extremities. They evaluated the frequency and site of insufficient perforating veins in 284 patients, operated in 1989-1991. Insufficient perforating veins were found in 21.8% operated patients. Most frequently insufficiency of perforating veins of Cockett's group was found, i.e. in 77.4%. Patients who were operated on account of a relapse of varicosities had insufficient perforating veins in 38% and in patients with trophic skin changes insufficient perforating veins were found in 78.5%. The haemodynamic role of perforating veins and their importance with regard to relapses of varicosities is discussed. The authors describe their own diagnostic and therapeutic procedure.

Adult↗

[Propofol, isoflurane and neuroleptanesthesia. Ophthalmic surgery in geriatric patients].

Ophthalmic surgeons require anaesthesia to ensure that the patient is completely relaxed for microsurgical operations and that the intraocular pressure is reduced. These conditions must be maintained throughout the operation. In addition to these requirements, the anaesthetist mostly deals with elderly patients with multiple diseases. Although earlier studies have shown which general or local anaesthesia is preferred for which patients and operations, studies on which general anaesthesia technique is ideal to fulfil these requirements are still lacking. The aim of this study was to show which technique causes the least stress for a geriatric patient undergoing an ophthalmic operation, propofol/fentanyl anaesthesia, isoflurane anaesthesia or neuroleptanaesthesia. PATIENTS AND METHODS. Sixty patients aged 60 years and above were included in this study. After being randomly allocated to either propofol/fentanyl (continuous propofol infusion), isoflurane or neuroleptanaesthesia, they underwent ophthalmic surgery. Intraoperative complications (cardiocirculatory changes) and surgical conditions were recorded. After the operation, patient vigilance and post-operative pain reactions (nominal pain score) were assessed over 8 h by means of simple reaction tests and the Juhl index. Within the first 2 h after surgery, cardiocirculatory changes were also documented and arterial blood gases measured. RESULTS. The treatment groups did not differ with respect to general biometric data, preoperative risk or operations carried out. Intraoperative cardiocirculatory changes and the resulting therapy (positive inotropic drugs, volume replacement fluids) were similar in all groups. The surgical conditions were equally good in all groups. Apart from a lower rate pressure product in the first 60 min after propofol/fentanyl anaesthesia, there were no postoperative differences in cardiocirculatory parameters or blood gases. After isoflurane anaesthesia the time until the patients were able to give their names and perform the finger-nose test properly was longer than that after neurolept-anaesthesia or propofol anaesthesia. After propofol anaesthesia the patients could perform simple tests earlier and were more alert over the whole monitoring period than after isoflurane or neuroleptanaesthesia. On the other hand, the patients in the neuroleptanaesthesia group had fewer pain complaints than those in the two groups compared. DISCUSSION. None of the anaesthesia techniques used in this study showed an intraoperative advantage. This is not surprising since all anaesthetics, with the exception of ketamine, reduce intraocular pressure. The prerequisite, however, is careful monitoring of anaesthesia in elderly patients in order to avoid cardiocirculatory changes, mild hyperventilation and coughing and pressing at the end of the operation. Until this point in time no change in the depth of anaesthesia is allowed. Therefore, it seems on the whole that there are benefits from propofol-fentanyl anaesthesia because of the fact that in comparison with the rather techniques, elderly patients become alert again faster. However, sufficient postoperative pain therapy is necessary to free the patients of pain to the same degree as with neuroleptanaesthesia. In most cases peripherally acting analgesic substances with no interference with vigilance are sufficient.

Aged↗

Low incidence of antibody formation due to long-term interferon-alpha 2c treatment of cancer patients.

In order to study the long-term immunogenicity of interferon-alpha 2c (Berofor) in cancer patients, serum was collected starting in 1983 from study patients with various proliferative diseases who received interferon-alpha 2c at different doses, according to different schedules, and via different routes. A total of 1992 samples were tested for the presence of anti-interferon-alpha 2c antibodies. Due to long-term interferon-alpha 2c treatment, 346 patients were eligible for induction of neutralizing anti-interferon antibodies over a treatment period of 2-52 months. Most patients were treated for longer than 6 months. Of the 346 patients, three patients (0.87%) exhibited measurable titers of neutralizing antibodies following therapy with interferon-alpha 2c. One hundred and sixty-three patients suffered from non-Hodgkin lymphomas, leukemias, and preleukemias. One patient with chronic myeloid leukemia experienced antibody induction under therapy. The other 183 patients had solid tumors. Two of them reacted with antibody production. All titers were very low (1:12, 1:8, and 1:64). Compared with figures reported for other interferon-alpha preparations, the propensity of interferon-alpha 2c to induce neutralizing antibodies seems to be very low. This property might be related to arginines occurring as critical residues in positions 23 and 34 of the interferon-alpha 2c molecule.

Antibody Formation↗

[Coronary heart disease and insulin concentration in type II diabetic patients--results of a diabetes intervention study].

There is experimental, clinical and epidemiological evidence that elevated insulin levels are associated with development of atherosclerosis. Early results came from studies in non-diabetics, but the situation with respect to diabetes is more complex and not so clear. The Diabetes Intervention Study is a population-based follow-up study in newly detected type II diabetics (30- to 55-yr-old). After 5 years 431 men and 320 women received a complex check up with oral glucose tolerance tests and measurements of plasma insulin and glucose levels, fasting and 2h post-load. Regarding the metabolic parameters, the fasting and postprandial insulin levels were higher among the patients having coronary heart disease (15% of men, 36% of women), as compared to patients without this disease. In multivariate analysis sex, age, antihypertensive treatment, blood pressure, body mass index, and fasting insulin levels were independently associated with the prevalence of coronary heart disease in patients with non-insulin dependent diabetes mellitus (NIDDM) treated with diet and/or oral antidiabetics. Body mass index and triglycerides were the only variables that independently correlated to insulin: fasting insulin = 0.4 (body mass index) + 0.1 (triglycerides) - 4,2. In future prospective studies of diabetics relating insulin concentrations to the development of vascular disease are of particular interest and necessity. Because hyperinsulinemia may contribute to accelerated atherosclerosis in NIDDM-patients, the aim of the treatment of type II-diabetes should be to correct hyperglycemia without aggravating insulin levels and other cardiovascular risk factors.

Adult↗

Combined administration of a gonadotropin-releasing hormone antagonist and testosterone in men induces reversible azoospermia without loss of libido.

GnRH antagonists suppress pituitary and gonadal function by competing with endogenous GnRH for binding to receptors on pituitary gonadotrophs. We studied the effects of GnRH antagonist administration to men in a protocol simulating a likely male contraceptive regimen combined with a low dose of testosterone. The GnRH antagonist Nal-Glu was given daily (10 mg, sc) for 20 weeks to eight normal men, and a low dose of testosterone enanthate (25 mg, sc) was given every week. Sperm counts started declining during week 4, and complete azoospermia was reached within 6-12 weeks in six of the eight subjects. Subjects 7 and 8, whose sperm counts and serum gonadotropin levels were not suppressed after 10 weeks, were given 20 mg Nal-Glu starting at week 10. One became azoospermic at week 16, while the other's total sperm counts continued declining and reached a nadir of 1.4 million by week 20. Sperm motility and viability in this subject were completely suppressed after week 14. Sperm counts returned to baseline levels 12-14 weeks after the end of Nal-Glu administration. The mean serum LH level of the first six subjects decreased from 3 +/- 03. U/L at baseline to less than 0.1 U/L until week 20, and then levels returned to baseline. FSH levels similarly decreased from a combined mean of 3.6 +/- 0.9 U/L at baseline to below 0.3 U/L after 4 weeks of Nal-Glu administration. Serum mean testosterone levels between weekly injections of testosterone enanthate ranged from 27.4 +/- 5.9 to 4.8 +/- 1.4 nmol/L, but remained in the hypogonadal range (less than 10 nmol/L) for 4 of the 7 days. None of the subjects, however, complained of decreased libido or potency, as assessed by a questionnaire. No systemic or significant local side-effects were observed, other than a minimal reaction at the injection site. These data suggest that complete sustained azoospermia can be achieved in man, without loss of libido, by chronic administration of a GnRH antagonist plus testosterone.

Adult↗

Regulation of pituitary glycoprotein alpha-subunit secretion after administration of a luteinizing hormone-releasing hormone antagonist in normal men.

Pituitary glycoprotein hormones are composed of two different subunits, the alpha- and beta-subunits. The alpha-subunit is common to all FSH, LH, and TSH, while the beta-subunit is specific for each of these hormones. We studied the effects of a potent LHRH antagonist on alpha-subunit and LH secretion in normal men. The LHRH antagonist Nal-Glu, ([Ac-D2Nal1,D4ClPhe2,D3Pal3,Arg5,DGlu6(AA) ,Ala10]LHRH), was given (10 mg daily) as one injection of 5 mg every 12 h. Blood samples were drawn every 24 h, and on days 1 and 7 a day curve was established by drawing hourly blood samples for 26 h. Mean serum alpha-subunit levels decreased progressively (P less than 0.001) from 2.9 +/- 0.49 micrograms/L at baseline to a nadir of 1.4 +/- 0.27 micrograms/L on day 8. In contrast, mean immunoreactive LH (IR-LH) levels decreased rapidly from 3.2 +/- 0.6 U/L at baseline to 0.9 +/- 0.08 U/L on day 2 and remained suppressed (P less than 0.001) throughout the treatment period. On day 1 after the administration of Nal-Glu mean alpha-subunit levels decreased, although not significantly (P = 0.054), from 3.0 +/- 0.6 micrograms/L at baseline to a nadir of 2.0 +/- 0.3 micrograms/L at 17 h. alpha-Subunit remained at this level for the remainder of day 1. On day 7, however, the baseline serum alpha-subunit level was 1.5 +/- 0.3 micrograms/L, significantly suppressed (P less than 0.01) compared to the level on day 1, and no further decrease was seen after administration of Nal-Glu. IR-LH on day 1 before the first injection of 5 mg Nal-Glu was 3.5 +/- 0.8 U/L. Then, IR-LH levels decreased significantly (P less than 0.001) to a nadir of 0.9 +/- 0.1 U/L and remained at this level throughout day 1. IR-LH levels on day 7 were at or below 1.0 U/L throughout the sampling period. These results indicate that alpha-subunit secretion can be partially suppressed after chronic administration of a LHRH antagonist. Furthermore, LH serum levels dissociate from those of pituitary glycoprotein alpha-subunit after administration of LHRH antagonist analogs.

Adult↗

Persistence of concordant luteinizing hormone (LH), testosterone, and alpha-subunit pulses after LH-releasing hormone antagonist administration in normal men.

LHRH antagonists suppress pituitary and gonadal function by competing with endogenous LHRH for binding to gonadotroph receptors. To determine the mechanism of suppression of gonadotropin secretion we studied the effects of a single dose of a LHRH antagonist on the pulsatile activity of serum bioactive LH (Bio-LH), immunoreactive LH (IR-LH), alpha-subunit, and testosterone for 24 h in normal men. The LHRH antagonist, Nal-Glu [( Ac-D2Nal1,D4ClPhe2,D3Pal3,Arg5,DGlu6-(AA), DAla10]LHRH) was given as a single sc injection of 5 mg to five normal men. Blood samples were collected every 10 min during a 10-h baseline period and for 14 h after administration of the antagonist. IR-LH, alpha-subunit, and testosterone were measured in triplicate, and Bio-LH in duplicate. Pulses were then evaluated using Cluster analysis; all replicates were entered in the pulse analysis. After administration of the Nal-Glu antagonist, IR-LH levels decreased (P less than 0.001) from 2.81 +/- 0.06 at baseline to a nadir of 0.75 +/- 0.02 U/L. Bio-LH levels followed the same pattern, decreasing by 89% (P less than 0.001) from 4.54 +/- 0.13 to a nadir of 0.51 +/- 0.13 U/L 6.8 h after the injection of Nal-Glu. In contrast, serum alpha-subunit levels did not change (P greater than 0.05) during the 14-h period after antagonist administration (0.85 +/- 0.01 and 0.75 +/- 0.01 microgram/L before and after Nal-Glu, respectively). Serum testosterone levels decreased by more than 80%, from 17.6 +/- 0.2 at baseline to a mean nadir of 3.3 +/- 0.7 nmol/L 12.8 h after Nal-Glu administration. Pulse frequency and the number of significant pulses remained the same for all of the measured hormones during the 10-h baseline period and the 14 h after Nal-Glu administration. In contrast, the pulse amplitude of IR-LH, Bio-LH, and testosterone decreased significantly after injection of the antagonist. The pulse amplitude of the alpha-subunit also declined, albeit not significantly. Coincidence analysis revealed that during both the 10-h baseline and the 14-h post-Nal-Glu period there was a highly significant (P less than 10(-5) nonrandom synchrony between peaks of IR-LH, Bio-LH, alpha-subunit, and testosterone. These results suggest that coordinate pulsatile secretion of IR-LH, Bio-LH, and testosterone persists after the administration of 5 mg Nal-Glu LHRH antagonist.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Mode of suppression of pituitary and gonadal function after acute or prolonged administration of a luteinizing hormone-releasing hormone antagonist in normal men.

LHRH antagonists compete with endogenous LHRH for binding to receptors on pituitary gonadotrophs and thereby inhibit gonadotropin secretion and, consequently, gonadal function. We studied the pituitary and gonadal suppression following single doses and short term administration (1-3 weeks) of a recently developed LHRH antagonist in normal men. First, the antagonist Nal-Glu ([Ac-D2Nal1, D4ClPhe2,D3Pal3,Arg5,DGlu6(AA),DAla10]LHRH ), was given as a single sc injection to five normal men at three dose levels of 1, 5, and 20 mg (study I). Serum FSH, immunoreactive LH (IR-LH), bioactive LH (bio-LH), testosterone, and estradiol were measured before and at frequent intervals for 48 h after Nal-Glu administration. Mean serum FSH decreased (P less than 0.001) by 28.9 +/- 5.4% (+/- SE), 38.2 +/- 7.9%, and 44.5 +/- 3.6% after the 1-, 5-, and 20-mg doses, respectively. Mean serum IR-LH decreased (P less than 0.001) by 39.0 +/- 13.8%, 53.2 +/- 10.0%, and 53.1 +/- 14.4% after the three doses. Serum bio-LH levels and the ratio of bio-LH/IR-LH decreased (P less than 0.001) after the 20-mg dose by 87.8% and 78.5%, respectively. Serum testosterone levels decreased (P less than 0.001) more than 78.5% after all Nal-Glu doses. The duration of testosterone suppression, but not the nadir reached, was dose dependent (P = 0.012). Serum estradiol levels also decreased (P less than 0.001), but the rate of decrease was slower than that of serum testosterone. The apparent plasma disappearance half-life of Nal-Glu after administration of 5 mg was 12.8 +/- 2.7 h. The Nal-Glu antagonist also was given daily as a single sc injection of 5 mg to eight normal men for 21 days (study II) or twice daily to five men for 7 days (study III). In study II, serum FSH, IR-LH, bio-LH, testosterone, estradiol, and 17-hydroxy-progesterone were measured daily, immediately before the next injection, and on days 1, 7, and 21 in frequent blood samples drawn for 24 h. The mean serum testosterone level in study II decreased (P less than 0.001) from 17.6 +/- 2.2 to 4.1 +/- 1.0 nmol/L on day 1, increased (P less than 0.05) between days 2 and 8, and then progressively decreased to below 2 nmol/L from day 18 until 24 h after the end of the study. Serum FSH, IR-LH, and bio-LH levels paralleled those of testosterone.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[Anthropometric differences in the physical development of apprentices of various occupational groups].

Anthropometrical examinations were conducted longitudinally on 400 male and 140 female adolescents on application for vocational training and in their second year of training. Male adolescents who chose professions entailing severe physical strain and female adolescents opting for professions entailing medium physical strain demonstrate a less favourable physical condition at the time when they selected their profession than did adolescents in either group intended to enter physically less strenuous professions. These differences which relate to physical maturity were restored by the second year of training. All that remained were special characteristics related to the individual's constitution, with a tendency to pyknomorphia in professional groups where the physical strain is greater. The muscular mass and active body mass in the case of female adolescents subject to medium physical strain show a relative decline compared with a very high fat proportion of 24.6%. According to Conrad's body type definition, a tendency to leptosomia was observed in male adolescents up to the second year of training compared with a tendency to pyknomorphia in female adolescents.

Adolescent↗

[Intensive basic therapy decreases the need for drug treatment and improves glucose control: an important result of the diabetes intervention study].

In a period of five years in the diabetes intervention study (DIS), 1,139 diabetics aged 30-55 years, who in a 6-week screening phase had been classified as dietetically manageable, were treated in a controlled randomized study with intensified non-medicamentous basic therapy and--in a double blind trial--with 1,6 g clofibric acid. The essential components of the basic therapy were a fat-modified diet (so-called prudent diet) and recommendations for endurance training. Thus in comparison to the control group we succeeded in performing a ca. 40% decrease of the application of oral antidiabetic drugs. The fasting blood values were, nevertheless, with 155 mg% significantly lower than in the control group (169 mg%). Clofibric acid had no influence neither on the necessity to use insulin or oral antidiabetic drugs nor to the control of glycaemia.

Clinical Trials as Topic↗

Maintenance of the ratio of bioactive to immunoreactive follicle-stimulating hormone in normal men during chronic luteinizing hormone-releasing hormone agonist administration.

Chronic administration of LHRH agonist analogs to humans reduces gonadal function through pituitary desensitization. Serum immunoreactive gonadotropin levels are modestly reduced, whereas serum bioactive LH levels are drastically suppressed. The effects on bioactive FSH levels, however, are not known. In this study, serum bioactive FSH was measured using an in vitro granulosa cell aromatase bioassay in four normal men given a LHRH agonist, [D-Trp6,Pro9-NEt]LHRH (LHRHA; 500 micrograms/day for 16 weeks), by sc infusion and testosterone enanthate (TE; 100 mg, im every 2 weeks) and in five men given 500 micrograms/day LHRHA by daily sc injection for 20 weeks and TE (100 mg every 2 weeks) from weeks 10 through 20. During the first study, serum immunoreactive FSH levels (IR-FSH) decreased by 56.5 +/- 4.8% (+/- SEM), and serum bioactive FSH (Bio-FSH) level decreased by 57.6 +/- 6.4%. The ratio of Bio-FSH to IR-FSH did not change. During the second study, both serum IR-FSH and Bio-FSH levels followed a triphasic pattern, decreasing slightly but not significantly immediately after initiation of LHRHA administration, progressively increasing to a peak (P less than 0.5 vs, baseline) at week 10, and then, after addition of TE to this regimen, decreasing slightly again. The Bio-FSH to IR-FSH ratio, as in the first study, did not change. When serum obtained at week 10 during the second study, just before initiation of TE, was chromatographed on a Sephadex G-100 column, IR-LH eluted in two distinct peaks, while IR-FSH eluted as a single peak. These results demonstrate that in normal men chronic LHRHA administration alone for up to 10 weeks or LHRHA plus TE for up to 16 weeks does not alter the qualitative characteristics of secreted FSH, since there was no dissociation between serum IR- and Bio-FSH levels.

Adult↗

[Presentation of an insulin-treated patient group within the scope of a 5-year study of the Diabetes Intervention Study (DIS)].

The diabetes intervention study (DIS) is an intervention and examination programme which in dietetically conducible diabetics who freshly became manifest shall decrease the incidence of cardiovascular diseases and analyse the influence of various steps of intervention on the course of diabetes. In the course of 5 years 54 out of 988 patients were insulinized by reason of deteriorations of metabolism. There were no significant differences between the intervention and control group concerning age, sex, index of ideal weight, fasting blood glucose, quantity of injected insulin and duration of the insulin treatment. By means of a C-peptide short-time test following glucagon stimulation an attempt of differentiation into type 1 and type 2 diabetics, was performed and compared with the results in literature.

Blood Glucose↗