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Biomedical subjects

K Langer

Publications and source records attributed to K Langer.

95 records · Page 6Linked to original sources
PubMedDate not supplied

Amino acid solutions for premature neonates during the first week of life: the role of N-acetyl-L-cysteine and N-acetyl-L-tyrosine.

Tyrosine and cyst(e)ine are amino acids that are thought to be essential for preterm neonates. These amino acids have low stability (cyst(e)ine) or low solubility (tyrosine) and are therefore usually present only in small amounts in amino acid solutions. Acetylation improves the stability and solubility of amino acids, facilitating a higher concentration in the solution. We compared three commercially available amino acid solutions, Aminovenös-N-päd 10%, Vaminolact 6.5%, and Primène 10%, administered to 20 low-birth-weight neonates on total parenteral nutrition from postnatal day 2 onward. Aminovenös-N-päd 10% contains acetylated tyrosine and acetylated cysteine; the other solutions do not contain acetylated amino acids and differ in the amount of tyrosine and cysteine added. On postnatal day 7, plasma amino acids were measured together with urinary excretion of amino acids and the total nitrogen excretion; 38% of the intake of N-acetyl-L-tyrosine and 53% of the intake of N-acetyl-L-cysteine were excreted in urine. Plasma levels of N-acetyl-L-tyrosine (331 +/- 74 mumol/L) and N-acetyl-L-cysteine (18 +/- 29 mumol/L) were higher than those of tyrosine (105 +/- 108 mumol/L) and cystine (11 +/- 9 mumol/L), respectively. Plasma tyrosine levels in the groups receiving small amounts of tyrosine remained just below the reference range. We show a linear correlation of plasma cystine with the intake of cysteine (r = .75, p = 0.01), but not with N-acetyl-L-cysteine. The estimated intake of cysteine should be 500 mumol.kg-1.d-1 in order to obtain levels comparable with those shown in normal term, breast-fed neonates. Nitrogen retention did not differ among the three groups (247 to 273 mg.kg-1.d-1).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcysteine↗
PubMedDate not supplied

The role of the physical therapist in hospice care.

The role of the physical therapist in hospice care is different from the role the therapist plays when a member of a rehabilitation team. This article will address the need for a fundamental role change and offer suggestions for ways physical therapists can contribute to the care of the hospice patient. In working with hospice patients, therapists must, for the most part, change from a controlling role to one of listener and problem-solver. In this manner, therapists can: Assist the patient to maintain functional abilities for as long as possible; Reduce the burden of care for the caregivers; Assist in pain control. Physical therapists can provide hospice nurses with valuable assistance in caring for hospice patients.

Activities of Daily Living↗
PubMedDate not supplied

Steal syndrome after kidney transplantation caused by A-V fistula at the thigh.

The cases of two low-weight children are reported, who became dialysis patients at the age of 2.5 and 5.5 years, respectively, and were hemodialyzed by way of a bovine artgraft A-V fistula at the thigh. One year later, both patients were successfully transplanted with a cadaveric kidney. Immunosuppression was carried out in the first 3 weeks with prednisone, azathioprine and ciclosporin, later on with prednisone and ciclosporin. The first patient (A-V fistula at the right thigh) was transplanted on the right fossa iliaca. After an acute rejection episode 11 days after kidney transplantation, successfully treated by prednisolone pulse therapy, there was another episode similar to rejection after 5 weeks. This episode was complicated by a hypertensive crisis with convulsion. Again bolus injections of prednisolone were performed, but kidney function declined rapidly. Diagnostics (perfusion scintigraphy with Tc-DTPA, digital substraction angiography) demonstrated hypoperfusion of the graft, caused by a steal syndrome due to the A-V fistula in the groin. Ligation of the fistula resulted in rapid improvement of renal function and decrease in blood pressure occurred. The second patient was transplanted on the fossa iliaca contralaterally of the A-V fistula in the groin. Twenty-one days after kidney transplantation we saw a rejection episode accompanied by cytomegalovirus (CMV) infection. After bolus injection of prednisolone and CMV-antibody treatment in the beginning, stabilization of kidney function was seen. But the following week we experienced an unexplainable deterioration of graft function followed by progressive acute renal failure. Again, a steal syndrome due to the contralateral A-V fistula could be demonstrated. After ligation of the A-V fistula renal function normalized within 14 days. Currently graft function is satisfactory in both patients.

Arteriovenous Shunt, Surgical↗
PubMedDate not supplied

[The delivery of loperamide to the brain by using polybutyl cyanoacrylate nanoparticles].

The possibility of using polysorbate 80-coated nanoparticles for the delivery of the water insoluble opioid (lyonist loperamide across the blood-brain barrier was investigated. The analgesic effect after i.v. injection of the preparations was used as the indication of drug transport through this barrier. Intravenous injection of the particulate formulation resulted in a long and significant analgesic effect. A polysorbate 80 loperamide solution induced a much less pronounced and very short analgesia. Uncoated nanoparticles loaded with loperamide were unable to produce analgesia. Polysorbate 80-coated PBCA nanoparticles loaded with loperamide led to the transport of loperamide to the brain.

Analgesics↗