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Biomedical subjects

U Binswanger

Publications and source records attributed to U Binswanger.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Replacement of aluminum-containing phosphate binders by calcium and magnesium carbonates in long-term hemodialysis].

Aluminium-containing phosphate binders were replaced by a calcium and magnesium carbonate-containing antacid in 20 patients on long-term haemodialysis, over a three-month period in all of them, for 12 months in ten. After two months the serum aluminium level fell (mean +/- SD) from 3.0 +/- 1.6 to 1.4 +/- 0.5 mumol/l (P less than 0.001). After three months the serum phosphate level had fallen from 1.8 +/- 0.4 to 1.5 +/- 0.4 mumol/l (P less than 0.05), while during the same period parathormone (PTH-NH2) fell from 1.4 +/- 1.4 to 0.8 +/- 0.7 ng/ml (P less than 0.05). Serum total calcium concentration rose after two months from 2.2 +/- 0.2 to 2.4 +/- 0.2 mmol/l (P less than 0.001). In a third of patients the uraemic acidosis was corrected, standard bicarbonate rising from 18 +/- 2 to 21 +/- 3 mmol/l (P less than 0.05). Serum pH, potassium, sodium, magnesium and alkaline phosphatase did not change significantly. Hypercalcaemia was an expected disadvantage: repeated symptom-free episodes of hypercalcaemia occurred in six of 20 patients during the first three months and in a further two up to 12 months. These episodes were successfully controlled by a reduction of CaCO3/MgCO3 dosage and readministration of Al(OH)3. Extraosseous calcifications were not observed.

Adolescent↗
PubMed1989

Successful pregnancy in advanced renal failure without dialysis.

We describe a successful pregnancy in a 22-year-old patient with advanced renal failure, who gave birth to a living boy in the 35th week of pregnancy. At the time of spontaneous delivery the mother had a serum creatinine of 851 mumol/l. No dialysis treatment had been instituted during this successful pregnancy.

Adult↗
PubMed1989

Unidirectional duodenal and jejunal calcium and phosphorus transport in the rat: effects of dietary phosphorus depletion, ethane-1-hydroxy-1,1-diphosphonate and 1,25 dihydroxycholecalciferol.

Unidirectional calcium (Ca) and phosphorus (Pi) transport was studied in vitro by means of a modified Using technique in the absence of electrochemical gradients between the mucosal and serosal buffer medium. Duodenum and jejunum of male albino Sprague-Dawley rats were investigated after Pi depletion alone (0.03% diet-Pi), Pi depletion and EHDP treatment (40 mg/kg per day s.c. X 4), and Pi depletion, EHDP and 1,25(OH)2D3 (500 pmol i.v. X 2) treatment. Mucosal-to-serosal Ca and Pi fluxes (Jms) changed in parallel, depending on the 1,25(OH)2D3-status of the animals. Regarding serosal-to-mucosal fluxes (Jsm), Pi depletion resulted in an increase in Jsm for Ca and Pi, associated with a rise in Gt and Isc in the duodenum but not in the jejunum. EHDP administered to block synthesis of 1,25(OH)2D3 caused further augmentation in duodenal Jsm for calcium but not phosphorus, which was paralleled by an increase in Gt and Isc. After repletion with 1,25(OH)2D3, an increase in Jsm for Ca and Pi and a rise in Gt and Isc were observed in the duodenum and in the jejunum. Serosal-to-mucosal fluxes for Ca and Pi were related to tissue conductance (Gt) in the duodenum (r = 0.89, P less than 0.001 and r = 0.84; P less than 0.001, respectively), as well as in the jejunum (r = 0.55; P less than 0.01 and r = 0.66; P less than 0.001, respectively). Changes in Jsm also paralleled changes in transmural shortcircuit current (Isc). The data are compatible with the assumption of an increase in Jsm for Ca and Pi and a rise in Gt, both reflecting an increase in water recycling across the tight junctions caused by a rise in sodium absorption. They provide further evidence that the overall effect of 1,25(OH)2D3 on intestinal Ca and Pi transport is to increase both cell-mediated active mucosal-to-serosal transport and paracellular diffusional serosal-to-mucosal ion movement.

Animals↗
PubMed1989

Neuroleptic-induced extrapyramidal symptoms and serum calcium levels. Results of a pilot study.

In a prospective study, the association between neuroleptic-induced extrapyramidal symptoms (EPS) and serum calcium levels with special regard to ionized calcium was investigated. The sample included 24 newly admitted psychotic patients who received neuroleptic treatment. The 11 patients in whom EPS developed had significant lower ionized calcium levels and a significant lower ionized calcium/total calcium ratio in the predrug period than the 13 patients without EPS. The difference in predrug total calcium between the same two groups did not reach significance. There was no decrease of calcium levels at the time of onset of EPS. pH values showed a significant negative correlation to ionized calcium levels. Protein levels were within the normal limits during neuroleptic treatment.

Adult↗
PubMed1989

[Erythropoiesis and serum erythropoietin concentrations before and after kidney allotransplantation].

Hematological parameters and serum erythropoietin (EPO) levels were measured before and sequentially after grafting in 50 consecutive cadaver renal transplant recipients. EPO was estimated using a sensitive radioimmunoassay. Values for nonanemic controls were 15-25 mU/ml. Mean hematological values before transplantation were as follows: hemoglobin 9.7 +/- 2.4 g/dl; hematocrit 29 +/- 8%; corrected reticulocytes count 15 +/- 8% and EPO 29 +/- 23 (11-131) mU/ml. In the entire studied population, 35 patients had inadequate low EPO levels for their degree of anemia. In the whole population, there was a significant positive exponential correlation between EPO and hematocrit (r = 0.31; p less than 0.05). In the subset of patients with underlying cystic kidney disease and in hemodialysis patients treated with recombinant human EPO, hemoglobin, hematocrit and EPO levels were higher when compared to hemodialysis or CAPD patients with other kidney diseases. Following successful renal transplantation, EPO increased to 45 +/- 31 mU/ml at 1 month and then decreased to 25 +/- 18, 18 +/- 7 and 19 +/- 4 mU/ml at 3,6 and 9 months, respectively. Within the 1st month after transplantation there was a 4-fold increase in reticulocytes from 9 +/- 5 to 38 +/- 14%, followed by a slow decrease over the next several months to 23 +/- 11% at 9 months. In contrast, the hematocrit level rose more gradually from 28 +/- 7 to 44 +/- 6% at 9 months. In 25 of 36 patients with a functioning graft who were followed for more than 6 months, anemia was corrected and 11 patients remained slightly anemic with a mean hematocrit level of 36 +/- 4%.

Erythropoiesis↗
PubMed1988

[Kaposi's sarcoma following kidney transplantation: remission following reduction of immunosuppression and consequent HIV infection].

Kaposi's sarcoma (KS) in renal allograft recipients is a rare though serious complication of immunosuppressive treatment. Therapeutic procedures such as surgical excision and local irradiation are inappropriate, since the endothelial-originated tumor is often multicentric. However, systemic treatment such as chemotherapy entails further immunosuppression. We observed a patient with renal allograft who developed disseminated KS of legs and trunk while receiving azathioprine, cyclosporin and prednisone after intensive rejection therapy with high dose corticosteroids, antithymocyte globulin and transplant irradiation. At that time the immunological status was similar to that of an AIDS patient, though HIV serology was negative. Azathioprine was withdrawn while cyclosporin and prednisone were continued. KS disappeared shortly after without a decrease in allograft function, and immunological parameters tended to normalize. When KS had disappeared almost completely the patient became infected with HIV. Complete remission was not hampered, nor was there recurrence of KS. The late appearance of HIV-antigenemia with seroconversion in the course of the tumor makes HIV unlikely as a causative factor. The predisposing factors for KS after renal transplantation are discussed: 1. Amplification of immunosuppression due to rejection therapy, 2. Genetic predisposition such as HLA DR5 antigen, 3. Cytomegalovirus infections. For therapy of iatrogenic KS we propose reduction of immunosuppressive therapy before additional chemotherapy is initiated.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Calcium and inorganic phosphate secretion of rat ileum in vitro. Influence of uremia and 1,25 (OH)2D3 inhibition.

The unidirectional ileal transport of calcium (Ca) and inorganic phosphorus (Pi) of rats was measured in vitro with the modified Ussing technique. Animal preparation included 5/6 nephrectomy and EHDP treatment. They were compared to controls as well as to 1,25 (OH)2D3 supplemented rats. The results show that the ileum is a secretory organ for Ca and Pi, the serosa to mucosa transport (Jsm) exceeds the mucosa to serosa transport (Jms). Ca and Pi transport in sm direction is 1,25 (OH)2D3 independent but exhibits a mutual strong correlation. Our observations together with published data are in favor of mainly paracellular, non electrogenic sm transport of both ions. However, the factor controlling sm transport of Ca and Pi remains unidentified. The mucosa to serosa transport (Jms) in the ileum is low for both ions. Ca ms is stimulated by 1,25 (OH)2D3, Pi ms is unchanged.

Animals↗
PubMed1988

Ionized calcium and neuroleptic-induced extrapyramidal symptoms.

In a prospective study, the association between neuroleptic-induced extrapyramidal symptoms (EPS) and serum calcium levels with special regard to ionized calcium was investigated. The sample included 24 newly admitted psychcotic patients who received neuroleptic treatment. The 11 patients in whom EPS developed had significant, lower ionized calcium levels in the drug-free period than the 13 patients without EPS.

Adult↗
PubMed1987

[Successful treatment of anemia in hemolysis patients using recombinant human erythropoietin. Maintenance dosage and serum concentration].

Recombinant human erythropoietin (r-huEpo) was administered i.v. to eight anemic patients on hemodialysis in increasing doses 3 times a week. 7 out of 8 patients showed an increase in hemoglobin level by 2 g/dl over the baseline of 7.9 +/- 0.8 g/dl after a mean period of 8 +/- 2 weeks. During treatment a cumulative dose of 692 +/- 358 IU/kgBW erythropoietin was given. Before the rise in hemoglobin, reticulocytes increased from 1.6 +/- 0.7% initially to 5 +/- 1.6%. The serum ferritin concentration decreased from 426 (range 19-1223) to 250 (5-707) micrograms/l. No side effects were observed. Mean blood pressure before dialysis increased slightly from 125 mmHg to 137 mmHg systolic, and diastolic pressure from 75 to 80 mmHg. Maintenance doses to maintain hemoglobin values between 10 und 12 g/dl varied from 2 X 72 IU/kgBW to 3 X 168 IU/kgBW per week. Measurement of serum levels of erythropoietin by radioimmunoassay showed deficiency of the hormone in the patients with chronic renal failure: before treatment mean serum values were 4 +/- 6.4 mU/ml and during maintenance doses with r-huEpo 33.7 +/- 8.1 mU/ml, which is within normal ranges related to hematocrit. These data show erythropoietin to be effective in ameliorating anemia during hemodialysis treatment.

Adult↗
PubMed1987

[Treatment of peritonitis during continuous ambulatory peritoneal dialysis (CAPD) with co-trimoxazole, cefazolin or vancomycin].

Three initial treatment schedules of peritonitis during continuous ambulatory peritoneal dialysis are analysed. In 20 patients 56 episodes of peritonitis were treated by co-trimoxazole, 29 episodes in 20 patients by cefazolin, and 29 infections in 22 patients by vancomycin. The efficiency of the treatment modes was comparable. Vancomycin was found to be appropriate in particular because of the resistance characteristics of bacterial isolates.

Anti-Bacterial Agents↗
PubMed1987

[Reversible azathioprine associated dysmyeloproliferative syndrome after kidney allotransplantation].

Three recipients of kidney allotransplants developed dysmyeloproliferative syndromes which were fully reversible after switching from azathioprine to cyclosporin A for immunosuppression. Similar bone marrow changes described in the literature progressed to leukemia. Whether the abnormalities observed in our patients could be early stages of the disease described in the literature and whether a fatal development can be prevented by changing the immunosuppressive therapy remains to be elucidated.

Adult↗
PubMed1987

Catheter-related complications during continuous ambulatory peritoneal dialysis (CAPD): a retrospective study on sixty-two double-cuff Tenckhoff catheters.

From May 1980 to April 1985, a total of 62 double-cuff Tenckhoff catheters were surgically implanted in 54 patients through a low medial laparotomy. The follow-up on continuous ambulatory peritoneal dialysis accounted for 1,029 patient-monthly. The patients who used a detachable double-bag system developed a total of four exit-site infections, one tunnel infection, three outer cuff erosions, four catheter dislocations, and two dialysate leaks. In five patients, the catheter had to be removed (one exit-site infection, two catheter breaks, and two catheter dislocations). Cumulative catheter survival using the method of life-time analysis was 81% and 70% after 1 and 2 years, respectively, considering all catheters implanted, and 92% and 92%, respectively, when peritonitis-related removal was excluded.

Catheterization↗
PubMed1986

[Idiopathic hypercalciuria--recent pathogenetic and diagnostic aspects].

The term "hypercalciuria" is not uniformly applied. Recent investigations show that the upper normal limits of 24-hour calciuria are above the originally defined 7.5 mmol in men in 6.25 mmol in women. There is no clear evidence that 24-hour calciuria is more often increased in idiopathic calcium stone formers than in healthy controls with normal calcium metabolism. Because of a disordered regulation of 1,25-dihydroxy-vitamin D3-production, the serum-1,25-dihydroxy-vitamin D3 is increased in idiopathic calcium stone formers. A calcium loading test during undisturbed individual calcium homeostasis reveals increased intestinal calcium absorption in calcium stone formers. Metabolic evaluations are often not performed under the same conditions as those in which the stone formation occurred. As long as the primary metabolic defect has not been identified, classification into "absorptive" and "renal hypercalciuria" does not seem to be justified.

Calcium↗