Biomedical subjects
Publications and source records attributed to S Kayser.
Inflammatory lesions in the liver simulating tumor formation are rare. Eleven cases have so far been reported in the literature, most of them in recent years. We present an additional case of an "inflammatory pseudotumor" in a 17-year-old male. The inflammatory pseudotumor should be kept in mind in the differential diagnosis of hepatic space-occupying lesions.
Sodium uptake by rat adrenal glomerulosa cells was stimulated by intracellular acidosis evoked by Na+-propionate. This process was inhibited by 5-(N,N-hexamethylene) amiloride (HMA), a known inhibitor of the Na+-H+ exchange. These experiments demonstrate the existence of the Na+-H+ exchange in glomerulosa cells. Although amiloride inhibited the angiotensin II- and adrenocorticotropic hormone (ACTH)-induced aldosterone response, HMA, a more specific inhibitor of Na+-H+ exchange, failed to do that. 45Ca2+ influx and efflux were dependent on intra- and extracellular Na+ concentrations. Amiloride analogues, known to inhibit Na+-Ca2+ exchange, reduced basal 45Ca influx. Although we could not reveal the activation of Na+-Ca2+ exchange by angiotensin II, inhibitors of Na+-Ca2+ exchange also inhibited the angiotensin- and ACTH-induced aldosterone response of glomerulosa cells. Our results suggest that Na+-Ca2+ exchange supports the maintenance of basal Ca2+ level in the cytoplasma of glomerulosa cells, and amiloride derivatives inhibit aldosterone production by reducing Ca2+ level below resting values.
Systemic and coronary hemodynamic, metabolic and humoral effects of a new intravenous angiotensin-converting enzyme inhibitor, enalaprilat, were evaluated in 14 patients with chronic heart failure. Onset of hemodynamic action occurred within 15 minutes and persisted for 6 hours. At the time of peak effect, there was a significant reduction in mean arterial pressure (-21%) and pulmonary capillary wedge pressure (-33%). Systemic vascular resistance decreased by 32% and stroke volume index increased by 20%. These systemic hemodynamic changes indicate improved left ventricular function. There was a substantial sustained reduction in rate-pressure product initially without a change in coronary sinus blood flow or myocardial oxygen consumption. There was also reduced myocardial oxygen extraction and augmented coronary sinus oxygen saturation at 30 minutes and 1 hour. In three patients, abnormal myocardial lactate extraction, present before enalaprilat, changed to uptake after enalaprilat, indicating amelioration of myocardial ischemia that was not clinically manifest. Systemic catecholamine levels and myocardial catecholamine balance did not change. Plasma renin activity increased and plasma aldosterone decreased. These findings suggest that enalaprilat produces inhibition of the angiotensin-converting enzyme and consequent beneficial systemic hemodynamic changes in heart failure. In some patients with heart failure, silent myocardial ischemia at rest can occur and can be alleviated with enalaprilat. Decreased myocardial oxygen extraction, increased coronary sinus oxygen saturation and lack of expected decrease in coronary sinus blood flow despite reduced rate-pressure product suggest transient coronary vasodilation by enalaprilat.
A five-step systematic technique used for answering drug information requests is described. Step 1 is classification of the request. Step II involves determination of exactly what information is being requested and why, and ensuring that all pertinent background data are obtained. Step III is a systematic search of the literature, beginning with general references and progressing through secondary sources to primary articles. Step IV is formulation of the accumulated data into an appropriate writtern of verbal response. Step V involves reclassification of the request which may be necessary if there is a change in its scope.
A 45-year-old woman was admitted to hospital following acute onset of lower back pain. Clinical and laboratory investigations established a lumbar paraspinal soft tissue infection with Mycoplasma hominis associated with severe spondylarthrosis at L5/S1. A relationship to a recently performed hysterectomy must be considered.
It is reported about a case of congenital afirinogenaemia on a newborn female. The treatment is described. Congenital afirinogenaemia is a rare autosomal recessive disorder. There are 250 cases in world literature, mostly with consanguineous parents. Bleeding is usually mild, so that treatment should not be prophylactic, because any blood product might cause complication, like AIDS. Only acute haemorrhage should be treated with fresh frozen plasma or fibrinogen concentrates.