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Biomedical subjects

M Brandl

Publications and source records attributed to M Brandl.

At least 55 records · Page 3Linked to original sources
PubMed1989

Protein-restricted diets in chronic renal failure: a four year follow-up shows limited indications.

Several retrospective and prospective studies confirmed the beneficial effect of dietary protein restriction (DPR) on the downhill course of renal function in chronic kidney disease. The long-term results of this therapeutic modality may be different than the short-term effects. In our nephrology outpatient department, a prospective randomized trial has been in progress since April, 1982. In 1984, we reported a general beneficial effect of our diet after two years of follow-up. Two hundred and forty-eight patients with initial creatinine clearances between 10 and 60 ml/min entered the trial. Patients were stratified for sex, age and degree of renal insufficiency. One hundred and twenty-nine patients were randomly assigned to a DPR-group (0.4 to 0.6 g/kg/day); 118 patients to a control group. Patients on DPR visited the dietitian every three months during the first 24 months of the study; thereafter, as with the controls, the dietitian visits were only for specific needs. Urea excretion decreased significantly in DPR patients as a sign of good compliance and stayed at that level, even without frequent visits to the dietitian. Biochemical parameters showed no signs of malnutrition. Amino acid profiles were related to the degree of renal failure. The diet appeared to have a selective effect on the progression rate of renal failure: only patients with primary glomerular disease responded to the diet. Furthermore, there were striking intersex differences. Males showed a more rapid decline towards end-stage renal failure, but responded in a positive way to the diet, whereas female patients did not benefit from the dietary manipulation at all.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Biochemical and hormonal parameters in patients with multiple trauma.

We measured amount, course and duration of different parameters in order to assess metabolic-endocrine changes in patients with multiple trauma and the final outcome. Injures were initially quantified according to the Injury Severity Score. Serum levels of lactate, creatinine, bilirubin, somatomedin and thyroid hormons were measured in 51 patients (39 survivors, 12 deceased patients) for six days following the injury. In addition, neopterin levels were measured in 26 patients (19 survivors, 7 deceased patients). The patients were devided into two groups (survivors vs non-survivors). Global Index Scores and Septic Severity Scores were significantly different at the 1% and 5% level (p less than 0.05 to p less than 0.01). The same statistical differences were shown for lactate, somatomedin, neopterin and thyroid hormones.

Biomarkers↗
PubMed1988

Plasma amino and keto acids in chronic renal failure.

During both early and late stages of chronic renal insufficiency the response of BCKA to the disease state, as indicated by plasma levels, differs from that of BCAA. Val is the only BCAA whose concentration changes under the conditions of our study, and this only during the more advanced stages of disease. In contrast, all three BCKA declined, KIVA and KICA even in mild renal failure, showing that already during the early stages of the disease these BCKA levels are decreased. BCKA are more sensitive parameters than the corresponding amino acids with regard to the metabolic dysfunctions characteristic of this disease. Modern analytical methods allow more exact and reliable knowledge of these indicators and thus a better understanding of biochemical mechanisms, possibly resulting in better therapy.

Amino Acids↗
PubMed1988

Metabolites of microorganisms. 247. Phenazines from Streptomyces antibioticus, strain Tü 2706.

From a strain of Streptomyces antibioticus seven yellow phenazines were isolated. The antibacterially most active antibiotic was identified as (-)-saphenamycin, a second one with compound DC-86-Y (saphenic acid). Three compounds were new: Saphenic acid methyl ether, 6-acetylphenazine-1-carboxylic acid and an inseparable mixture of fatty acid esters of saphenic acid. Two simple phenazines were phenazine-1-carboxylic acid (tubermycin B) and unsubstituted phenazine, which was isolated for the first time from a microorganism.

Microbial Sensitivity Tests↗
PubMed1988

Metabolites of microorganisms. 248. Synthetic analogs of saphenamycin.

A synthesis of racemie saphenic acid is described. From this acid 9 ester derivatives of saphenamycin were prepared. Those with aromatic acid components showed high activity against many Gram-positive and some Gram-negative bacteria. Of the esters with aliphatic acid moieties only the acetate and, to a lesser extent, the butyrate showed considerable anti-bacterial activities, whereas esters with higher fatty acids showed strongly reduced, if any, activities against some test organisms. Similar results were obtained with ID50 values against the eucaryotic tumor cell line CCRF/CEM. The salicylate, which is structurally similar to saphenamycin, was most active.

Anti-Bacterial Agents↗
PubMed1987

Parenteral nutrition with an amino acid solution containing a mixture of dipeptides. Evidence for efficient utilization of dipeptides in man.

Ten healthy human subjects received parenteral nutrition consisting of 80 g of a dipeptide-amino acid mixture and 900 carbohydrate calories infused over a period of 12 h, and then fasted for another period of 12 h. The dipeptides included in the mixture were: glycyl-L-glutamine, glycyl-L-tyrosine, glycyl-L-leucine, glycyl-L-isoleucine, and glycyl-L-valine. Parenteral nutrition with the dipeptide-amino acid mixture was without any adverse reaction in any of the subjects. The urinary excretion of the 5 dipeptides during parenteral nutrition ranged between 1 and 2% of the amount infused. Plasma concentrations of dipeptides during parenteral nutrition, which ranged from 8-96 microM reflected their plasma half-lives. Glycyl-L-glutamine had the longest half-life, glycyl-L-leucine and glycyl-L-tyrosine the shortest half-lives. During parenteral nutrition there were increases in plasma amino acid concentrations including those of glutamine and tyrosine. Discontinuation of parenteral nutrition resulted in the disappearance of dipeptides from plasma, and the dissipation of increased plasma amino acid concentrations. In conclusion, the present results show efficient utilization of glycyl-dipeptides as substrates for parenteral nutrition in man. The results further show that the structure of amino acids in the C-terminal position has a significant influence on the metabolism of dipeptides.

Adult↗
PubMed1987

[Significance of percutaneous endoscopically controlled gastrostomy in the prevention and therapy of esophagotracheal fistula following long-term intubation].

An esophago-tracheal fistula, which developed during long-term artificial ventilation, is a vital threat to the life of a patient. The esophago-tracheal fistula is caused by pressure lesion of the mucosa of the posterior tracheal and anterior esophageal wall. The adverse mechanic factors are the blocked tube cuff on the one hand and the nasogastric tube being usually required for enteral nutrition on the other hand. Replacement of a nasogastric tube through a percutaneous, endoscopically controlled gastrostomy relieves the esophagus and thus prevents pressure lesion of the anterior esophageal wall. A percutaneous endoscopic gastrostomy, if performed in time, is suggested to reduce the incidence of an esophago-tracheal fistula, which develops in the course of long-term artificial ventilation.

Enteral Nutrition↗
PubMed1986

Protein nutrition and amino acid metabolism after 4 weeks of total parenteral nutrition with a mixture of 14 dipeptides: serendipitous observations on effects of sepsis in baboons.

We investigated parameters of nutrition, metabolism, and organ function after 4 wk of total parenteral nutrition (TPN) in baboons receiving either dipeptides or amino acids as the nitrogen source. The two groups showed no significant difference with respect to gain in body weight, nitrogen balance, plasma and muscle concentrations of amino acids, plasma concentrations of proteins, and leucine incorporation into muscle protein. All dipeptides were efficiently utilized as evidenced by trace concentrations of dipeptides in plasma and urine; they produced no deleterious effect on the function of liver, kidney, or immune system. Development of infection in several baboons increased urinary excretion of urea nitrogen but had no effect on urinary excretion of dipeptides and amino acids with the single exception of taurine, which was greatly increased. In conclusion, the data show long-term efficacy and safety of the dipeptide mixture as the sole nitrogen source for TPN.

Amino Acids↗
PubMed1986

A concentrated mixture of amino acids and dipeptides for total parenteral nutrition.

Using a subhuman primate (baboon) we have investigated the utility of a 20% mixture of amino acids and dipeptides as the nitrogen source for total parental nutrition. The mixture, besides containing all 8 essential amino acids and a number of non-essential amino acids (glutamate, aspartate, arginine, histidine, serine, ornithine and alanine), contained 6 dipeptides (Gly-Ile, Gly-Leu, Gly-Val, Gly-Tyr, Gly-Gln, and Ala-Gln) and acetyl-cysteine. A week of total parenteral nutrition was preceded by one week of oral feeding. The caloric intake and composition during the two periods was identical except for the nitrogen source, which was intact protein during the oral period, and the mixture of amino acids and dipeptides during the parenteral period. There was no significant difference between gain in body weight or nitrogen balance during the two periods. There were selective increases in plasma and muscle concentrations of amino acids during the parenteral period, which appeared to reflect the amino acid enrichment of the nitrogen source. The efficient utilization of dipeptides was evidenced by their small concentrations in plasma and urine. The urinary excretion of dipeptides was about 1% of the amount infused. This efficiency of dipeptide utilization persisted even when the infusion rate of the amino acid and dipeptide mixture was increased by 7-fold. There was no alteration in liver, kidney, and immune function during the parenteral period. The data indicate the efficacy and safety of the mixture of amino acids and dipeptides as the nitrogen source for parenteral nutrition.

Amino Acids↗
PubMed1986

[Comparative studies of CPAP systems using a respiration simulator. I. Evaluation criteria].

Assessment of the performance of modern ventilators that combine spontaneous breathing and mechanical ventilation is orientated not only towards the assessment of the inspiratory and expiratory resistance within the system, but also towards the functional criteria for the inspiratory and expiratory valves. This conclusion is particularly valid for CPAP procedures, as in this case patients must perform the entire work of breathing by themselves. As it has proved to be extremely problematic to carry out comparative testing of ventilators on patients in the intensive care unit, a breathing simulator has been developed, the use of which has enabled us to have a "patient" at our disposal who can tolerate the procedures for measuring the performance of ventilators with IMV and with CPAP without injury. The pressure-flow characteristics and the work of breathing can thus be measured under constant conditions and with various ventilation systems. Exact analysis of the pressure curve pattern under standardized conditions proved to be of value for assessing the suitability of CPAP in the case of both demand-valve systems and continuous flow systems. Appropriate assessment criteria have been worked out; the course of the test and the results for two ventilators are discussed as an example, using these criteria.

Evaluation Studies as Topic↗
PubMed1986

[Determination of dobutamine levels in human plasma--methodological and clinical aspects].

We developed a simple method for the routine determination of dobutamine in human plasma. With a relatively small amount of equipment--such as HPLC pump, RP 18-column, sample valve, fluorescence detector and an integrator--dobutamine levels could be determined quickly after a simple extraction procedure on Bond-Elut-CN-columns. In the case of critically ill patients suffering from different kinds of shock we found a wide variation of plasma levels in arterial blood samples. Even with an exact application of dobutamine in relatively low doses of about 2.5 micrograms/kg BW/min to 5 micrograms/kg BW/min, levels reached from 26.8 to 181 micrograms/ml. In our opinion, one reason for these variations might be a differing volume of distribution caused by varying intravascular volumes in critically ill patients. A further possibility might be a different degree of sulfoconjugation of dobutamine. Therefore, the occasional occurrence of tachycardia under dobutamine therapy could be caused by relatively high plasma levels of free dobutamine.

Chromatography, High Pressure Liquid↗
PubMed1984

Efficacy of a synthetic dipeptide mixture as the source of amino acids for total parenteral nutrition in a subhuman primate (baboon). Plasma concentration, metabolic clearance, and urinary excretion of a series of dipeptides.

To assess the efficacy and safety of oligopeptides as substrates for total parenteral nutrition, we investigated the effects of intravenous infusion of a synthetic dipeptide mixture, as compared with a corresponding amino acid mixture, on a range of parameters of nutrition, metabolism, and organ function in baboons. In all respects the two periods of total parenteral nutrition, each lasting for 1 wk, were identical except for the difference between the forms of amino acids in the parenteral solutions, being in free form in one period and in dipeptide form in the other. The dipeptide mixture was composed of a series of 12 dipeptides each containing glycine in the N-terminal position and either an essential or nonessential amino acid in the carboxyl position. The infusion of the dipeptide mixture and the amino acid mixture had similar effects on parameters of protein nutrition (e.g., nitrogen balance, plasma aminogram, urinary excretion of 3-methylhistidine) and metabolism (such as plasma concentrations of insulin, glucose, lipids). During infusion of the dipeptide mixture, rapid metabolic clearance resulted in a barely detectable concentration of most dipeptides in plasma. Total loss of dipeptides was 1.3% +/- 0.1% of the infused amount. The functions of liver, kidney, bone marrow, and the immune system remained the same before and during the two periods of treatment. In conclusion, the data showed that (a) there was efficient utilization of dipeptides when infused as a mixture and (b) parameters of nutrition, metabolism, and organ function were well maintained after 1 wk of total parenteral nutrition with the dipeptide mixture acting as the sole nitrogen source.

Amino Acids↗