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Biomedical subjects

W Fiehn

Publications and source records attributed to W Fiehn.

At least 37 records · Page 2Linked to original sources
PubMed1998

Apolipoprotein E polymorphism and renal function in German type 1 and type 2 diabetic patients.

OBJECTIVE: To examine the association of renal function in diabetic patients with apolipoprotein (apo) E polymorphism. RESEARCH DESIGN AND METHODS: Apo E genotypes, lipid and lipoprotein serum levels, creatinine clearance (CCr), and excretion of marker proteins were determined in German type 1 (IDDM; n = 162) and type 2 (NIDDM; n = 124) diabetic patients. Albumin and immunoglobulin (Ig) G are considered to reflect charge-size permselectivity of the glomerular capillary basement membrane, and increased alpha 1-microglobulin (MG) excretion indicates compromised reabsorptive capacity of the renal tubules. RESULTS: Patients with NIDDM had higher lipid levels and lower CCrs than patients with IDDM. In patients with IDDM, age- and sex-adjusted analysis of variance showed an association between apo E genotypes and CCr, and the Jonckheere-Terpstra test demonstrated a decreasing glomerular filtration rate in the following order of genotypes: epsilon 4 epsilon 4/epsilon 4 epsilon 3 > epsilon 3 epsilon 3 > epsilon 2 epsilon 2/epsilon 2 epsilon 3. Multiple linear regression analyses revealed that in patients with IDDM, the epsilon 2 allele was a negative predictor of CCr and a positive predictor of urinary excretion of albumin, IgG and alpha 1-MG independent from HDL and LDL cholesterol, TG concentration, age, and sex. CONCLUSIONS: Apo E polymorphism influences serum lipoprotein levels in patients with IDDM and NIDDM. Apo E polymorphism may be a renal risk factor of clinical relevance in normolipidemic patients with IDDM.

Adult↗
PubMed1997

Medical findings and predictors of long-term physical outcome in anorexia nervosa: a prospective, 12-year follow-up study.

BACKGROUND: Patients with anorexia nervosa (AN) run a high risk of becoming chronically ill and of dying. In the acute phase of their illness they present with numerous physical and laboratory abnormalities. However, little is known about the long-term prognostic value of these findings or about the medical morbidity in large samples of consecutively treated patients in the long-term. METHODS: We evaluated 84 consecutive female patients with AN who were studied again an average of 11.9 years later. The ability of some of the laboratory data obtained at the initial examination to predict a fatal or chronic course was analysed by discriminant and multiple regression analyses. RESULTS: Abnormally low serum albumin levels (< or = 36 g/l) and a low weight (< or = 60% of average body weight) at the initial examination were variables best able to predict a lethal course. In addition, high serum creatinine and uric acid levels predicted a chronic course. Most of the initial abnormal laboratory findings were reversible with a normal food intake. At a 12-year follow-up 67% of the chronic anorexic patients and 27% of those in the good/intermediate outcome group (compared to 8% morbidity in normal controls) presented with medical co-morbidity, in particular osteoporosis and renal disease. The standardized mortality ratio was 9.6. CONCLUSIONS: Laboratory findings obtained at the initial examination may be helpful in predicting a fatal or chronic course of AN. An evaluation of the long-term outcome of eating disorders should include an assessment of the medical co-morbidity.

Adolescent↗
PubMed1997

Western blotting of NC1 type IV collagen fragments in human plasma.

Collagen IV matrix of glomerular basement membrane may be involved in the development of various renal diseases, e.g. diabetic nephropathy. An immunoblotting method for the detection of the carboxy-terminal non-collagenous (NC1) domain of type IV collagen in plasma was developed. The high sensitivity down to the picogram range enabled characterization of NC1(IV) fragments in human blood for the first time. Both Western blotting and gel filtration chromatography coupled with an enzyme-linked immunoassay surprisingly revealed that the NC1(IV)-related components are bound to the fibrin clot forming during blood coagulation. About 40% of the NC1(IV) fragments in plasma had an apparent molecular mass higher than 340,000. Abnormal NC1(IV) immunoblot patterns were observed in about 50% of patients with insulin-dependent (n = 20) and non-insulin-dependent (n = 20) diabetes mellitus compared with less than 7% in healthy control subjects (n = 30). There were no obvious associations between abnormal immunoblots and stage of nephropathy or glycaemic control in diabetic subjects.

Adult↗
PubMed1997

Hyperhomocyst(e)inemia and endothelial dysfunction in IDDM.

OBJECTIVE: While elevated blood levels of homocyst(e)ine represent an independent risk factor for macrovascular disease, we assessed the link between hyperhomocyst(e)inemia and diabetic microvascular diseases. RESEARCH DESIGN AND METHODS: Plasma levels of homocyst(e)ine and thrombomodulin (TM), markers of endothelial cell damage, were measured before and 3 h after oral methionine loading in 75 patients with IDDM and 40 healthy control subjects matched for sex and age. Exclusion criteria were hyperlipidemia, hypertension, smoking, or positive family history for cardiovascular disease. RESULTS: IDDM patients had higher pre- and postload plasma levels of homocyst(e)ine than did healthy control subjects (12.0 vs. 7.7 mumol/l and 27.6 vs. 16.0 mumol/l; P < 0.001). Of 75 IDDM patients, 26 had plasma homocyst(e)ine levels above the normal range (means +/- 2 SD of values obtained in the control group). These IDDM patients with hyperhomocyst(e)inemia had higher plasma TM levels (62.2 vs. 38.2 ng/ml, P < 0.001), higher albumin excretion rates (485 vs. 115 mg/l, P < 0.005), and a higher prevalence of late diabetic complications (nephropathy, 76 vs. 33%; retinopathy, 69 vs. 51%; neuropathy, 57 vs. 41%; and macroangiopathy, 57 vs. 33%) compared with IDDM patients with normal plasma homocyst(e)ine. In vitro experiments with human umbilical vein cells showed an increased release of TM into the culture supernatant only when endothelial cells were pretreated with advanced glycation end product (AGE)-albumin before L-homocystine was added. A synergistic action of homocyst(e)ine and AGEs might contribute to vascular complications in patients with diabetes. CONCLUSIONS: Hyperhomocyst(e)inemia is common in nephropathic diabetic patients and may contribute to the enhanced morbidity and mortality from cardiovascular diseases characteristically observed in IDDM patients with diabetic nephropathy.

Administration, Oral↗
PubMed1995

[Carbohydrate-deficient transferrin. A new, highly specific marker for chronic alcohol consumption].

To test the value of carbohydrate-deficient transferrin (CDT) as a marker for chronic alcohol consumption, its concentration was measured in the serum of 74 patients (48 men, 26 women; mean age 48 [18-71] years) with various alcohol-related liver diseases, ten patients (six men, four women; mean age 61 [24-90] years) with non-alcohol related liver diseases and 30 healthy controls (12 men, 18 women; mean age 37 [19-84] years). In the healthy women the mean CDT concentration was 19.7 +/- 6.1 U/L, in healthy men 15.4 +/- 4.1 U/l (P < 0.05). The upper limit of normal (mean + 2 standard deviations) was 31.9 U/l in women and 23.6 U/l in men. Serum CDT levels were significantly raised in chronic alcohol abuse, depending on the degree of liver damage. The CDT level in alcohol-dependent women without liver disease was 31.1 +/- 4.3 U/l (P < 0.05), while in those with liver damage it was 42.3 +/- 14.2 U/l (not significant). The mean CDT concentration in male alcoholics without liver damage was 35.5 +/- 5.0 U/l (P < 0.01 compared with controls). In male alcoholics with liver damage the mean CDT level was 53.4 +/- 9.0 U/l (P < 0.001). In none of the ten patients with non-alcohol related liver disease was the CDT level above the upper limit of normal. The sensitivity of CDT as a marker for chronic alcohol consumption was 57% (42% for women, 65% for men) with a 100% specificity. For serum-gamma-glutamyl transferase the sensitivity was 87%, but its specificity only 73%. Because of its high specificity the serum CDT level is an added useful marker for demonstrating chronic alcohol consumption.

Adult↗
PubMed1995

Recent infection as a risk factor for cerebrovascular ischemia.

BACKGROUND AND PURPOSE: Previous infection is discussed as a risk factor for ischemic stroke in children and younger adults. We tested the hypothesis that the role of recent infection in cerebrovascular ischemia is not restricted to younger patients and investigated which infections are mainly relevant in this respect. METHODS: We performed a case-control study with 197 patients aged 18 to 80 years with acute cerebrovascular ischemia and 197 randomly selected control subjects matched for sex, age, and area of residence. RESULTS: Infection within 1 week before ictus or examination was significantly more common among patients (38 of 197) than control subjects (10 of 197; odds ratio [OR], 4.5; 95% confidence interval [CI], 2.1 to 9.7). Patients more often had febrile and subfebrile infections (> or = 37.5 degrees C) than control subjects (29 of 197 versus 5 of 197; OR, 7.0; 95% CI, 2.5 to 20). Respiratory tract infections were most common in both groups. Bacterial infections dominated among patients but not among control subjects. Infection increased the risk for cerebrovascular ischemia in all age groups; this reached significance for patients aged 51 to 60 and 61 to 70 years. The profile of vascular risk factors was similar in patients with and patients without previous infection. Infection remained a significant risk factor when previous stroke, hypertension, diabetes mellitus, coronary heart disease, and current smoking were included as covariates in a logistic model (OR, 4.6; 95% CI, 1.9 to 11.3). CONCLUSIONS: Recent infection, primarily of bacterial origin, may be a risk factor for cerebrovascular ischemia in older as well as younger patients.

Adolescent↗
PubMed1995

[Comparison between local and systemic administration of cyclosporin A on the effective level in conjunctiva, aqueous humor and serum].

Cyclosporine is an important tool for the therapy of immunological diseases of the cornea and conjunctiva, as well as the treatment of patients with high-risk corneal grafts. However, potentially severe systemic side effects are disadvantageous. The purpose of our study was to determine if topical ocular application leads to about the same concentrations in ocular tissues as systemic application. Therefore, the concentration of cyclosporine in conjunctiva, aqueous humor and blood was measured by radioimmunoassay in six patients with systemic administration of cyclosporine and ten patients who received one drop of topical cyclosporine 2% four times prior to cataract surgery. All patients with systemic application showed measurable concentrations of cyclosporine in blood, as did four patients in the group receiving topical cyclosporine. There was no significant difference between both groups concerning cyclosporine concentration in aqueous humor. The level of cyclosporine in the conjunctiva was significantly higher after topical application (P < 0.02). In conclusion, therapy with cyclosporine eye drops results in levels in the conjunctiva and aqueous humor that are comparable to or even higher than those after systemic application if the last application was no more than 18h prior to the measurement. Therefore, topical ocular application of cyclosporine, which reduces or eliminates the drug's systemic side effects, can be used to induce local immunosuppressive activity, particularly in the treatment of superficial immunological diseases and after limbal allograft transplantation.

Administration, Oral↗
PubMed1994

[Detection of anti-Candida antibodies of the classes IgM, IgG and IgA using enzyme immunoassay in sequential serum samples of hospitalized patients].

Anti-Candida antibodies were determined in 2053 sera with an indirect hemagglutination test (HAT; Labor Diagnostika, Heiden, Germany) and with an enzyme immunoassay (ELISA) which detects IgG antibodies (Institut Virion, Würzburg, Germany). Antigen diagnostics was performed with the Cand-Tec-test (Ramco, Houston, USA). Eighty-eight sera from sixteen patients which were positive for IgG antibodies were screened for IgA and IgM antibodies by ELISA. A humoral immune response during the hospital stay of the sixteen patients was detected first by the HAT. The HAT was also reactive when the IgG and/or IgA antibodies rose above the upper reference value and the IgM antibody level remained unchanged. Synchronous changes of IgG, IgM and IgA antibody concentrations even within the normal range are detected by the HAT several days before one or more of these antibodies rose above the upper reference value. In most patients the IgM immune response preceded an increase in IgG and/or IgA antibody concentration by several days. In patients in whom the serum HAT titer remains constant as a consequence of a decreasing IgM antibody level and an increasing IgG antibody concentration, the selective determination of IgM antibodies by ELISA may yield additional information, e.g. a drop in IgM antibodies may be due to a successful therapy. In several patients antigen detection and antibody screening by HAT should be complemented by an immunoglobulin specific measurement of anti-Candida antibodies.

Antibodies, Fungal↗
PubMed1994

Increased messenger RNA levels for low-density lipoprotein receptor and 3-hydroxy-3-methylglutaryl coenzyme A reductase in rat liver after long-term ethanol ingestion.

Because long-term alcohol intake leads to severe alterations of cholesterol metabolism resulting in both elevated serum cholesterol levels and increased hepatic concentrations of cholesterol esters, we investigated the effect of long-term ethanol consumption on the hepatic messenger RNA (mRNA) content of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase and low-density lipoprotein receptor, two major regulatory factors in cholesterol metabolism, and of apoprotein E. Twenty-four male Sprague-Dawley rats were pair-fed nutritionally adequate liquid diets containing 36% of total calories as either ethanol or isocaloric carbohydrates for 3 wk. In addition, the lipid content of the diets was varied, resulting in 35%, 17.5%, and 8.8% of total calories corresponding to a daily intake of cholesterol of between 1.2 and 6.3 mg/kg body wt. Although increasing dietary cholesterol intake resulted in a significant decrease of hepatic mRNA for low-density lipoprotein receptor and HMG-CoA reductase (p < 0.05), long-term ethanol consumption led to a significant increase of the mRNA for both proteins (p < 0.01), and this increase was predominantly obvious in animals fed a low-cholesterol diet. In contrast, mRNA content of apoprotein E was found to be significantly lower in livers from rats fed ethanol for a prolonged period of time as compared with controls (p < 0.01), and this effect was found to be still present, although less pronounced, after low cholesterol intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1993

Lipoprotein(a) serum levels and apolipoprotein(a) phenotypes in children with chronic renal disease.

Lipoprotein(a) [Lp(a)] has recently been characterized as a genetically determined risk factor for atherosclerosis and thrombosis. Normally, Lp(a) serum levels are closely related to the apo(a) phenotype. We studied Lp(a) serum levels and apo(a) phenotypes in 136 young subjects, aged 0.8-24.7 y, including patients with glomerular disease and normal renal function (n = 28), patients with chronic renal failure (n = 20), patients treated by hemodialysis (n = 10), peritoneal dialysis (n = 16), and renal transplantation (n = 23), and in controls (n = 39). Of all, 21 patients had proteinuria in the nephrotic range. The distribution of Lp(a) levels in normal subjects was skewed to the left with 97% having levels below 300 mg/L. A subpopulation with increased Lp(a) levels (13-42%) could be detected in all groups with renal disease, and increased mean serum Lp(a) levels were found in patients with nephrotic range proteinuria, in patients with chronic renal failure, and in patients on peritoneal dialysis. Serum Lp(a) levels were not correlated with age, gender, type of renal disease, renal function or severity of proteinuria, but were correlated with the apo(a) phenotype. For a given phenotype, Lp(a) levels tended to be higher in patients than in controls. We conclude that increased Lp(a) serum levels are frequently found in young patients with chronic renal disease, possibly predisposing them to an increased risk for atherosclerosis and thrombosis.

Adolescent↗
PubMed1992

The clinical significance of measuring different anti-dsDNA antibodies by using the Farr assay, an enzyme immunoassay and a Crithidia luciliae immunofluorescence test.

Anti-double-stranded DNA (dsDNA) antibodies are highly specific for the diagnosis of systemic lupus erythematosus (SLE) but are heterogeneous in respect to, for example, avidity, class and cross-reactivity. Sera from 2061 patients were measured by three methods: an enzyme-linked immunosorbent assay (ELISA), an indirect immunofluorescence test with Crithidia luciliae as substrate (CLIF), and the Farr assay, a radioimmunological method based on the ammonium sulfate precipitation of immune complexes. The different anti-dsDNA antibody determinations were evaluated by analysis of patient records. The reason for a reactive Farr assay in 14 patients was predominantly the measurement of antibodies of the IgM class, which are not detected by the ELISA. The detection of additional antibodies to dsDNA of the IgA class, to single-stranded DNA or to histones plays a minor role. In comparison with the Farr assay, we found more positive results with the ELISA, which additionally detects anti-dsDNA antibodies of low avidity. The ELISA might also yield positive values in conditions such as chronic liver diseases, various infections and connective tissue diseases other than SLE. Avoiding the disadvantages of radioactivity, the ELISA is well suited as a screening test for dsDNA antibodies. However, positive results should be confirmed by the CLIF test or preferably by the Farr assay, thus combining sensitivity with specificity.

Animals↗
PubMed1991

[Excretion of beta-N-acetylglucosaminidase in urine in type I and type II diabetic patients with and without nephropathy].

The clinical aspects of the excretion of beta-N-acetylglucosaminidase (beta-NAG, EC 3.2.1.30) in urine of type I and type II diabetics with and without nephropathy are evaluated. Correlation between concentration of albumin and of beta-NAG activity in urine is determined and the circadian rhythm of beta-NAG excretion in urine is examined, the indication of glomerular and tubulointerstitial damage is discussed. Longitudinal studies should demonstrate, whether an increased beta-NAG activity in urine of diabetics with normoalbuminuria is an indicator of nephropathy or a predictor of nephropathy if raised albuminuria is observed.

Acetylglucosaminidase↗
PubMed1990

[Value of squamous cell epithelial-associated (SCC-) antigens in early diagnosis of oral carcinoma].

The diagnostic value of plasma concentration of the squamous cell carcinoma antigen was examined in 75 cases of pretherapeutic squamous cell carcinoma of the oral cavity. A pathologic plasma level was found in 32% of the tumour patients at time of diagnosis. The incidence of elevated SCC- values was inversely correlated to the tumour grading. A direct correlation of the sonographically measured total tumour volume was seen. As predominantly more extended tumours show pathologic values, SCC-Antigen is not a marker for the screening in the diagnosis of the early cancer of oral cavity. That emphasizes the importance of the precise clinical examination of each patient. In cases of elevated pretherapeutic values SCC-Antigen is very useful for therapy--monitoring and follow-up.

Antigens, Neoplasm↗
PubMed1989

[Enzyme chemical studies of pericardial fluid].

The authors examined the enzyme activities of LDH, CK, GOT, GPT and gamma-GT in blood-free pericardial fluid. The cases were divided into seven groups: a shot in the head with instant death, sudden cardiac death, poisoning, brain death with a long survival time, sudden infant death syndrome, and asphyxia. Taking all five enzymes into consideration, the cases of cardiac death differed significantly on the 1% level from the head shooting. However, concerning CK sudden cardiac death differed on the 5% level from the deaths as a result of poisoning. The wide range of the results, however, does not permit any reliable association of one single value with any of the respective groups.

Adult↗