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Biomedical subjects

J Teichmann

Publications and source records attributed to J Teichmann.

At least 37 records · Page 2Linked to original sources

Evaluation of serum and urinary estrogen levels in male patients with HIV-infection.

Several endocrine functions are described which are altered in patients with human immunodeficiency virus infection. However, there is limited information available on estrogens and their function in these patients. The aim of this study was to relate the stage of the disease with urinary and serum estrogens and the influence of heroin consumption on gonadal steroids. Forty human immunodeficiency virus infected outpatients without AIDS or the clinical picture of AIDS were involved in this cross-sectional study. The subjects were divided in two groups: heroin addicts and non heroin addicts. Blood samples were taken and 24 h urines collected. Serum follicle stimulating hormone, luteinizing hormone, prolactin, estrone, estradiol, testosterone and urinary total estrogens were measured by commercially available radioimmunoassays. Prolactin levels were not affected in the patients. However, compared with controls, follicle stimulating hormone and luteinizing hormone were significantly higher for both groups tested. In contrast, the elevated serum estrone levels were significantly lower expressed in the patients with heroin abuse compared to those of the other group. Urinary estrogens in human immunodeficiency virus infected patients of both groups were found to be higher than those compared to healthy controls. Since these drugs are known to enhance estrogen levels, we conclude that other factors are modulating estrogen formation and degradation in these patients.

Adult↗

Whipple's disease - current status of diagnostics and therapy.

Whipple's disease is a multisystemic infectious disease whose pathogen, a gram-unstable actinomycete, has been characterized in the meantime by molecular-biological techniques (polymerase chain reaction). This infectious disease which was firstly described in 1907 by G.H. Whipple as intestinal lipodystrophy appears rarely and sporadically and can affect nearly every organ, in the course of which the small intestine is also concerned in the majority of patients. The symptoms and signs are polymorphous and depend on organic involvement and stage. This leads to significant difficulties concerning differential diagnosis and to a delay in diagnosis. Misjudging the syndromes provokes invalidism and death whereas correct therapy leads to a cure in most of the cases.

Biopsy↗

Ankylosing spondylitis and infections of the female urogenital tract.

Thirty-two female patients with confirmed ankylosing spondylitis (AS) and 33 women of similar age with pure ileitis terminalis Crohn were examined for genitourinary infection. Urethral syndrome was found in 15 out of 32 patients with AS: 11 of them had urethritis and 4 urethritis associated with vaginitis. Five women of the control group suffered from urethritis. In all cases with genitourinary infection, Chlamydia trachomatis was isolated. By comparing the AS-patients (urogenital infection group and the non-infected group) with regard to other present clinical parameters, it was found, as expected, that the erythrocyte sedimentation rate in the 1st hour was significantly higher in the infected group. In addition, the infected patients had a significantly higher incidence of enthesopathy, involvement of the spinal column, and higher C-reactive protein values (CRP > or = 5 mg/l). A family history of AS was equally present. Other clinical parameters, such as inflammatory involvement of the joints and HLA-B27 correlation, did not differ significantly between infected and non-infected patients.

Adult↗

Elderly onset rheumatoid arthritis and polymyalgia rheumatica: ultrasonographic study of the glenohumeral joints.

The glenohumeral joints of 32 patients (aged 60 or above) were examined using ultrasonography. Thirteen patients were suffering from characteristic polymyalgia rheumatica (PMR) symptoms. In contrast 19 other patients initially had similar complaints, but were diagnosed as having elderly onset rheumatoid arthritis (EORA) upon development of typical symptoms. Ultrasound examination revealed glenohumeral joint inflammation in 61% (8 out of 13) of the patients with PMR and 63.2% (12 out of 19) of the patients with EORA. These findings suggest that a subgroup of patients with PMR and EORA suffers from shoulder joint inflammation and this synovitis/bursitis/intraarticular effusion might play an important role in the understanding of their symptoms. We conclude that overlapping forms of PMR and a predominate rheumatoid factor negative subgroup of EORA might exist and should be further characterized.

Aged↗

Elevated serum-calcium and parathormone-levels in HIV afflicted female heroin addicts.

Alterations of calcium and bone metabolisms have been observed in numerous studies of small groups of male HIV-infected patients. However, our knowledge regarding the manifestation of AIDS-associated hypoparathyroidism in female subjects is limited. In order to investigate the influence of heroin on the calciotropic hormones we performed a cross-sectional study on 45 female patients with proven HIV infection. The following criteria were used for exclusion from the study: age less than 20/ more than 50 years; confinement to bed; wasting symptoms; treatment with agents containing ketoconazole, renal or hepatic insufficiency; clinical or echographic signs of liver cirrhosis; endocrine diseases, or treatment with drugs known to influence calcium metabolism. A reduced parathormone (PTH) level was found among the female HIV-infected patients. Additional long-term use of heroin resulted in a significant increase of PTH compared to sex- and age matched controls and a second group of non-HIV-afflicted heroin dependent females. Significantly lowered serum magnesium concentrations were found in all three groups. Both serum calcium and urinary excretion of calcium were elevated in the group of HIV-infected heroin addicts and were independent from low vitamin D3 levels (1,25-dihydroxycholecalciferol) and alterations of protein metabolism. Therefore, it is concluded that the changes of PTH secretion are mainly due to mechanisms both of the impaired immune defense of HIV-infected females and the additional effect of opiates.

Adult↗

Rapid spinal trabecular bone loss in female patients with ileitis terminalis Crohn and additional sacroiliac joint inflammation.

Patients with Crohn's disease are well known to have local and generalized osteopenia of varying degrees. The aim of this study was to investigate whether the additional involvement of the sacroiliac joint as an extraintestinal manifestation has an influence on bone turnover in female patients with Crohn's disease. Osteocalcin and other parameters of bone metabolism were measured in 79 female patients with Crohn's disease. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DEXA). Z scores were obtained by comparison with age- and sex-matched normal values. As regards the sacroiliac involvement (n = 26; group 1), we found a significantly lower BMD in the lumbar spine (L4) and in Ward's triangle of the femoral neck compared to controls (P < 0.05) and those patients (n = 53; group 2) with pure ileitis terminalis Crohn. Furthermore, the duration of the disease process in patients with Crohn's disease and extraintestinal involvement was markedly shorter than that of patients in group 2 (P < 0.05). In conclusion, osteoporosis in female patients with sacroiliac involvement manifested itself in a more severe way.

Adult↗

[The effect of ganglionectomy and cold exposure on the ventromedial hypothalamic nucleus, blood glucose and liver glycogen in regard to circadian rhythms].

To analyse the importance of the ventromedial hypothalamic nucleus (VMH) for the circadian regulation of the carbohydrate metabolism rats were investigated after bilateral cervical sympathetic ganglionectomy (SCGx) 30 d earlier and exposure to cold (10 degrees C) 72 h earlier. In order to assess the circadian rhythms of nuclear volume oscillations of the VMH, blood glucose, and liver glycogen 4 times a day (light-dark cycle: 14L:10D, light on 05.00 h) rats were sacrificed at midlight and middark as well as 1 h after the onset of the light and dark periods. The circadian curves were calculated in a model-free way by the procedures of locally adjusted polynomial approximation. Ganglion removal and exposure to cold resulted in an increase of blood sugar and of nuclear volume of the VMH, but only of its lateral part. The liver glycogen decreased. Additionally, both the coordination between the circadian curves of the nuclear volume and of the blood glucose as well as of the inverse curves of the liver glycogen was destroyed after SCGx. These results are in agreement with the conviction that the enhanced blood glucose activates the VMH. The augmentation of blood glucose was discussed in connection with influences of the likewise increased thyrotropin-releasing hormone and thyrotropin on the increased plasma levels of catecholamines, with secondary increased plasma levels of glucagon as well as decreased insulin levels after SCGx and exposure to cold. The sympathetic denervation of the pineal gland (SCGx) produced the mentioned desynchronization of the curves. At the present we are not able to explain the approximate restitution of the circadian rhythms after additional exposure to cold.

Animals↗

Metabolic clearance rates of catechol estrogens in rats.

MCRs of the catechol estrogens 4-hydroxyestradiol (4-OHE2) and 2-hydroxyestradiol (2-OHE2) and of the parent estrogen 17 beta-estradiol (E2) were determined in rats. Long term ovariectomized Wistar rats were infused with the steroids at a constant rate for 3 days via a catheter placed in the abdominal aorta. Blood samples were drawn discontinually by retroorbital puncture, and the serum concentrations of E2, 4-OHE2, and 2-OHE2 were measured by RIA. Steady state was reached within 24 h of infusion. Mean serum MCRs were calculated to be 740 +/- 117 ml/h for E2, 2700 +/- 1000 ml/h for 4-OHE2, and 8300 +/- 1700 ml/h for 2-OHE2. Thus, the MCRs of the catechol estrogens were definitely higher than the MCR of E2 resulting in an apparent ratio of 1:4:11 (E2:4-OHE2:2-OHE2).

Animals↗

Nitroprusside-hypotension: cerebral blood flow and cerebral oxygen consumption in neurosurgical patients.

The effects of nitroprusside-induced hypotension on cerebral blood flow and cerebral oxygen consumption were investigated in nine patients scheduled for cerebral arterial aneurysm surgery. Anesthesia was maintained with nitrous oxide/oxygen and fentanyl; muscle relaxation was achieved with pancuronium; PaCO2 was maintained at 4.79-5.32 kPa. Mean arterial pressure was reduced to 50 mmHg by nitroprusside infusion after opening of the dura. Measurements were recorded and blood samples were taken 15 min before induction of hypotension, during stable hypotension and 15 min after termination of nitroprusside infusion. Measurements included: cerebral blood flow, using the argon-washin technique, cardiac output (thermodilution), mean arterial pressure and heart rate. Cerebral blood flow averaged 56 +/- 6 min . 100 g before hypotension. Nitroprusside produced hypotension but did not significantly alter cerebral blood flow (61 +/- 7 ml/min . 100 g). Cerebral blood flow remained virtually at preinfusion values upon cessation of infusion (53 +/- 6 ml/min . 100 g). Cerebral oxygen uptake averaged 3 +/- 0.2 ml/min . 100 g before hypotension and did not change significantly during hypotension (3.3 +/- 0.3 ml/min . 100 g) and after termination of hypotension (2.7 +/- -0.3 ml/min . 100 g). In two patients nitroprusside produced a 17 and 20% increase, respectively, in cerebral blood flow with no change in cerebral oxygen consumption, together with a marked increase in cardiac output and heart rate.

Adolescent↗

[The effects of halothane-, nitroprusside- and trimethaphan-induced hypotension on cerebral blood flow and intracranial pressure (author's transl)].

Arterial hypotension to about 50 mm Hg mean pressure was induced in anaesthetized and artificially ventilated dogs by halothane, nitroprusside, and trimethaphan to study their effects on cerebral blood flow and intracranial pressure during hypotension. During nitroprusside induced hypotension there was a 32% increase in cerebral blood flow above control and a marked decrease in cerebral arteriovenous oxygen content difference indicating luxury perfusion of the brain. Cerebral blood flow remained high even 30 min after termination of hypotension. During halothane and trimethaphan hypotension cerebral blood flow remained unchanged. In all groups epidural pressure did not change substantially during hypotension but increased during recovery from nitroprusside hypotension by a maximum of 72% above control. It is concluded that during and after nitroprusside hypotension loss of cerebral autoregulation occurs which may result in a marked rise in intracranial pressure. Special vulnerability seems to exist shortly after termination of induced hypotension when arterial pressure begins to rise and brain perfusion follows a pressure-flow relationship.

Animals↗

[Effects of isovolaemic haemodilution on pulmonary gas exchange and haemodynamics (author's transl)].

In experiments on 11 closed chest dogs the behaviour of pulmonary gas exchange and haemodynamics during isovolaemic haemodilution with 6% dextran was studied. The dogs were ventilated artificially (IPPB, PEEP = 0) with room air. After haemodilution a slight increase of arterial PO2 from 86 to 92 mm Hg was found. In another series of experiments an inspiratory O2-concentration of 25% was applied resulting in an increase of arterial PO2 from 106 to 113 mm Hg. In both series a decrease of alveolararterial PO2 gradients was observed. Effective pulmonary capillary blood flow varied in accordance with changes of cardiac output. Thus intrapulmonary shunt is supposed to have remained constant. The changes of pulmonary O2 diffusing capacity could be explained by the effect of haemodilution per se. At the end of the experiments ventilation was changed by adding a positive endexpiratory pressure of 8 cm H2O resulting in a decrease of arterial PO2 and a steep fall of cardiac output. In conclusion, isovolaemic haemodilution leads to only negligible variations of pulmonary gas exchange which should not be of any clinical importance.

Animals↗

[Pulmonary gas exchange during isovolaemic haemodilution (author's transl)].

In experiments on 6 closed chest dogs the behaviour of pulmonary gas exchange during isovolaemic haemodilution with 6% dextran was studied. The dogs were ventilated artificially using an inspiratory gas mixture containing 25% O2. A slight increase of arterial Po2 values was found. This change was accompanied by a decrease in alveolar-arterial Po2 and Pco2 gradients. The size of effective pulmonary capillary blood flow varied in accordance with the size of cardiac output. The changes of pulmonary O2 diffusing capacity could be explained by the effect of haemodilution per se.

Animals↗