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Biomedical subjects

O Mehls

Publications and source records attributed to O Mehls.

At least 181 records · Page 10Linked to original sources
PubMed1988

Improvement of growth and food utilization by human recombinant growth hormone in uremia.

We compared growth rate, food conversion ratio and morphology of the growth zone in female Sprague-Dawley rats with subtotal nephrectomy or sham operation. Both groups were either given vehicle or 1.4 IU/day recombinant human growth hormone (GH) by s.c. osmotic minipump, or 2.5 IU twice daily intraperitoneally for 14 or 20 days, respectively. Compared to uremic rats infused with vehicle, infusion of GH significantly (P less than 0.01) improved growth; that is, it increased gain of weight (delta 27.0 +/- 7.7 g vs. 11.6 +/- 4.9 g) and length (delta 1.8 +/- 0.3 cm vs. 1.12 +/- 0.44 cm) in ad libitum fed uremic rats. This was accompanied by increased food utilization ratio (0.146 vs. 0.065 g weight gain per g food intake). A similar increment of growth and food utilization ratio was also observed in GH versus solvent infused controls, either pairfed as for the uremic animals or fed ad libitum. Despite administration of GH, growth was not completely restored to normal in uremic animals. Circulating immunoreactive IGF I was not significantly increased by GH infusion in either uremic animals or controls. Histological analyses of the proximal tibia showed increased rate of longitudinal growth, as evaluated by tetracyclin-labeling, and increased volumetric density of primary spongiosa with unchanged width of primary spongiosa trabecules when GH was infused in uremic animals. The data suggest that growth impairment in the uremic rat is partially responsive to GH, and this is not accompanied by an increase of circulating IGF I. Therapeutic trials with recombinant GH in uremic children appear justified.

Animal Nutritional Physiological Phenomena↗
PubMed1988

[Gingival hyperplasia and serous papules due to cyclosporin treatment].

After 3 months of immunosuppressive treatment with cyclosporin because of a focal segmental glomerulosclerosis, a 13-year-old female developed marked gingival hyperplasia, hypertrichosis of the arms and papulo-vesicular skin lesions on the left leg. Histological and immunohistological examinations of the gingivae showed hyperplasia of the mucosa with perivascular infiltrates of plasma and B cells in the submucosa. The lesions on the leg revealed signs of cutaneous vascular inflammation with eosinophils, but there was no evidence of leucocytoclastic vasculitis. Ten months after discontinuation of cyclosporin, the lesions had nearly regressed. The patient's renal function deteriorated progressively to the point of terminal insufficiency.

Adolescent↗
PubMed1987

Recent advances and controversies in childhood renal osteodystrophy.

Renal osteodystrophy starts very early in chronic renal failure. Although vitamin D levels are normal in patients with 70-80% function, the levels are not appropriate to the prevailing biochemical milieu. Renal osteodystrophy may contribute to renal growth failure but a correlation between the degree of renal osteodystrophy and growth failure is not observed. Catch-up growth cannot be obtained over a longer period of time with vitamin D. The main reason for osteomalacia is Al intoxication. Aluminium osteopathy is more common in pediatric renal patients than anticipated. The mechanism whereby Al produces its effect on bone is uncertain. Guidelines for the diagnosis and therapy of renal osteopathy are presented. Prophylaxis of renal osteopathy can be attempted by phosphate restriction and/or vitamin D and by avoiding Al-containing drugs. All vitamin D compounds can be used for treatment and all have their advantages and disadvantages.

Child↗
PubMed1987

Hemostasis and thromboembolism in children with nephrotic syndrome: differences from adults.

Eleven of 204 children with nephrotic syndrome had thrombotic complications: arterial thrombosis in five, venous thrombosis in four, and pulmonary embolism in two. Fifty-one episodes of thromboembolism were recognized in 116 adult patients with nephrotic syndrome. Despite the lower incidence, thromboembolic complications tended to be more severe in children. In vitro indices of hemostasis and clinical evidence of thromboembolic complications were compared in children and adults. Antithrombin III concentrations and activities were abnormal in seven of 10 children, but in only two of 32 adults. In both groups, alpha 2-macroglobulin was elevated, but more markedly so in children. No evidence for circulating granulocyte-derived proteases (elastase/antielastase complexes) was noted in either group. Protein C was significantly elevated in children with nephrotic syndrome, but was normal in adults. Children also differed from adults with nephrotic syndrome in laboratory evidence of subthreshold disseminated intravascular coagulation (i.e., elevated soluble fibrinogen monomeric complexes and fibrin degradation products) and indicators of in vivo platelet activation (elevated beta-thromboglobulin). The more severe coagulation abnormalities in children may be linked to the more pronounced hypoalbuminemia.

Adolescent↗
PubMed1986

Urinary sIgA in children with urinary tract infection.

Urinary secretory IgA (sIgA) was measured using a specific ELISA with insolubilized anti-IgA and enzyme-linked antisecretory component. This test was applied to unprocessed urine from healthy children and from children with urinary tract infection. Normal range was a function of age. In 175 healthy children the excretion rate of sIgA was low in infants younger than 6 months but was constant between ages 6 months to 15 years (median 0.69 mg/gm creatinine, range 0.15 to 3.4 mg/gm creatinine), whereas sIgA concentration (milligrams per liter of urine) increased continuously with age. No sex difference was noted. There were no significant circadian changes or day-to-day variability. Thirty girls, age 1 to 16 years, were examined; they had a history of recurrent symptomatic episodes of urinary tract infection but had anatomically normal tracts and no symptoms, and no bacteriuria at the time of study. sIgA excretion rate was significantly lower (0.45 mg/gm, creatinine, 0.08 to 0.75 mg/gm creatinine) than in controls. In contrast, 11 girls examined at the time of symptomatic urinary tract infections, and who had normal urinary tracts, had significantly (P less than 0.01) higher sIgA excretion rates (1.4 mg/gm creatinine, 0.8 to 3.4 mg/gm creatinine) than those in either control subjects or girls without symptoms at the time of study. Urinary sIgA excretion rates were highest (2.0 mg/gm creatinine, 0.44 to 3.69 mg/gm creatinine) in children with symptomatic urinary tract infections who had an abnormal urinary tract. We conclude that low urinary sIgA values may be a marker for recurrent symptomatic bacteriuria in girls with normal urinary tracts.

Adolescent↗
PubMed1986

[Continuous ambulatory peritoneal dialysis (CAPD) in children and adolescents].

Continuous ambulatory peritoneal dialysis (CAPD) is a relatively new blood purification method applicable as an alternative to intermittent hemodialysis in the treatment of end-stage renal disease. In this report we discussed the results of more than five years of CAPD in 32 children and adolescents aged 0.1 to 18 years treated for up to 22 months as well as the advantages and disadvantages of this technique in comparison to hemodialysis. Technical survival after one year of treatment increased from 48% in patients treated before 1983 to 84% in patients treated thereafter. Simplicity of technical procedure and lack of pain are considered the major advantages. Thus home dialysis can be performed even under adverse conditions (e.g. in infants). Infections of the abdominal cavity and the catheter tunnel are severe complications of CAPD. In the course of the last two years the frequency of peritonitis dropped to one episode per treatment year. We want to stress that successful treatment can be achieved by adequately training patients and their parents to perform home dialysis on their own and by surveying patients regularly according to standardized treatment guidelines in a pediatric nephrology unit.

Adolescent↗
PubMed1985

Congenital hypokalemia with hypercalciuria in preterm infants: a hyperprostaglandinuric tubular syndrome different from Bartter syndrome.

A congenital hypokalemic tubular disorder is described with many features resembling Bartter syndrome. Additional features include prenatal onset with polyhydramnios and premature labor; failure to thrive; episodes of fever, vomiting, diarrhea, and renal electrolyte and water wastage; hypercalciuria; nephrocalcinosis; and osteopenia. Unlike Bartter syndrome, there is no defect in tubular reabsorption of chloride. Urinary levels of prostaglandin E2 and 7 alpha-hydroxy-5,11-diketotetranorprosta-1,16-dioic acid are selectively elevated, indicating marked stimulation of renal and systemic PGE2 production. Chronic suppression of PGE2 activity by indomethacin corrects most of the abnormalities, and there is an immediate decompensation of the disease on indomethacin withdrawal. We conclude that these preterm infants have a distinct variety of hypokalemic tubular disorders rather than a variant of Bartter syndrome, because renal and systemic hyperprostaglandinism ranks high in the pathogenic chain of events, and the suppression of PGE2 hyperactivity is associated with significant improvement in the development (and probably in the prognosis) of the affected children.

Bartter Syndrome↗
PubMed1985

Myocardial hypertrophy in rats with renal insufficiency.

Increased defatted dry wt of the heart and increased heart calcium content were observed in subtotally nephrectomized male Sprague-Dawley rats compared with sham-operated pairfed controls. Increased heart wt contrasted with no change of the weight of viscera (liver, spleen) and markedly decreased weight of striated muscle. Heart wt was unchanged after 5 days of renal insufficiency, but significantly increased after 14 or 21 days. Increased heart wt persisted despite effective beta adrenoreceptor blockade (2 X 10 mg metroprolol/kg/day i.p.) or effective alpha-1-adrenoreceptor blockade (2 X 2 mg prazosin/kg/day i.p.). Increased heart wt was also demonstrable despite normalization of basal blood pressure (intraarterial blood pressure measurement in conscious animals): blood pressure was lowered in one series with hydralazine/nadolol in drinking water (calculated to deliver 20 and 2 mg/kg/day, respectively) and in another series with furosemide in drinking water (15 mg/kg/day) combined with metoprolol (2 X 10 mg/kg/day i.p.). Increased heart wt was also noted despite correction of anemia by blood transfusion (Hct greater than 40%) and after parathyroidectomy in animals kept eucalcemic with high dietary calcium. Micromorphometry of left ventricular myocardium in perfusion-fixed tissue showed no significant change of the relative proportion of connective tissue and myocardial fibers. Myocardial isomyosin pattern was changed with an increase of fast-migrating V1 isomyosin in animals with renal insufficiency compared to sham-operated pairfed controls.

Adenosine Triphosphatases↗
PubMed1985

[Late prognosis of kidney transplantation in children].

During a 15-year period 67 renal transplantations were performed in 60 patients aged 3 to 19 years. Cadaver donors were preferred (90%). By giving conventional immunosuppressive drugs (corticosteroids, azathioprine), graft survival was increased dramatically, attaining 82% after 1/2-5 years. Growth retardation remained a critical complication. Full rehabilitation was noted in 88% of all patients followed up for more than one year.

Adolescent↗
PubMed1985

Adult height in paediatric patients with chronic renal failure.

Forty-nine paediatric patients at different stages of chronic renal failure were followed until adult height was attained. Mean age at completion of growth was close to normal. Adult height was evaluated against population-specific standards. It was less than 2 SD under the mean in two of 18 patients on conservative treatment, five of 18 during dialysis and none of 13 after transplantation, but correlation with mode of treatment did not reach significance. These findings contradict previous data stating that most of these children become small adults. Although analysis of the data suggests that many children with renal failure remain below their genetic potential of growth, final stunting appears infrequent.

Adolescent↗