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Biomedical subjects

U Smidt

Publications and source records attributed to U Smidt.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Effects of long-term antihypertensive treatment on kidney function in diabetic nephropathy.

The purpose of our prospective study was to evaluate the long-term effect of aggressive antihypertensive treatment on glomerular filtration rate and albuminuria in young female and male patients with insulin-dependent diabetes mellitus with diabetic nephropathy and blood pressure greater than 90 mm Hg. Eight patients received treatment with metoprolol (200-400 mg/day), hydralazine (100-200 mg/day), and furosemide (80-500 mg/day). The untreated control group consisted of eight patients matched for age (mean 32 years), diabetes duration (mean 17 years), and sex (two female and six male patients). All patients except one had diabetic retinopathy. Glomerular filtration rate was measured after a single intravenous injection of 51Cr-labeled ethylenediaminetetraacetic acid. Urinary albumin concentration was determined with a radial immunodiffusion method. The investigations were performed two to four times per year in each patient. The mean observation period was 59 and 27 months in the treated and untreated groups respectively. Due to a considerable rise in arterial blood pressure, it was considered unethical to prolong the observation in the untreated group. Arterial blood pressure rose from 140/96 +/- 4/1 to 150/100 +/- 3/2 mm Hg; albuminuria increased from 1517 +/- 502 to 1911 +/- 120 micrograms/min; and glomerular filtration rate decreased by a mean of 0.84 +/- 0.17 ml/min/mo in the untreated group. Antihypertensive treatment induced blood pressure reduction 151/100 +/- 3/2 to 131/87 +/- 2/1 mm Hg; diminished albuminuria 1467 +/- 515 to 729 +/- 65 micrograms/min; and caused a slow rate of decline in GFR, mean 0.37 +/- 0.08 ml/min/mo.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Emphysema as possible explanation for the alteration of expiratory PO2 and PCO2 curves.

The present explanation of the shape of deformed expiratory partial pressure curves of O2, CO2, N2 and foreign gases as being caused by sequential convective emptying of compartments with decreasing VA/Q is put into question, since the same deformation can be observed in healthy subjects during simultaneous breathing of helium and SF6, where the SF6 curve is deformed and the helium curve has a normal shape. The high molecular weight of SF6 causes a delay of its gaseous diffusion from the peripheral air spaces of the lung. A similar delay can be caused by emphysematous changes such as a longer distance for diffusion, an increased alveolar volume and a reduction of the number of small airways, where the gas has to pass through. Different data from cross-sectional and longitudinal studies, from induced changes of bronchomotor tone, from comparison of patients with relatively pure emphysema and patients with airway obstruction and from autopsy suggest that stratification and serial inhomogeneities, caused by emphysema, are at least a reasonable, if not a better explanation for the deformation than the VA/Q concept with sequential emptying of parallel units.

Adult↗
PubMedDate not supplied

Past, present and future of the therapy of emphysema.

Senile atrophic emphysema was for a long time a term used to describe the pulmonary structure of elderly people. Since emphysema occurs mostly in elderly people, it was understood as the premature occurrence of a more or less normal ageing process. Therefore, almost no therapy seemed to be possible. Later emphysema was thought to be the consequence of airway obstruction, where the narrowed bronchi behave as check valves, so that the trapped air leads to overinflation and rupture of the alveoli. Thus bronchodilators were tried in the prevention of emphysema. This concept was partially successful, but also without bronchial obstruction emphysema can develop and progress. Experiments by Gross suggested that emphysema is a self-digesting process in the course of inflammatory defence of the body. Thus the inflammatory process itself became the target of the therapy. Additional therapy was tried by teaching special types of breathing and by breathing exercises, but had rather small success. Today our interest is focused on the imbalance of oxidants and antioxidants as the main reason for the self-digesting process. We hope to correct this imbalance, but we must be careful not to block a useful defence mechanism of the body.

Humans↗