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Biomedical subjects

W Müller

Publications and source records attributed to W Müller.

At least 1,333 records · Page 74Linked to original sources
PubMedDate not supplied

Continuous arteriovenous hemofiltration as emergency procedure in severe hyperkalemia.

Severe hyperkalemia due to acute renal failure occurred in a preterm infant of a diabetic mother. Despite infusions of calcium gluconate, sodium bicarbonate, glucose, and insulin, the rapidly increasing serum potassium concentration resulted in ventricular flutter. After cardiac resuscitation, continuous arteriovenous hemofiltration was started for potassium elimination. Within 3 h of extracorporeal renal replacement therapy, serum potassium was lowered from 9.4 to below 7 mEq/l. Because of persisting oliguria continuous arteriovenous hemofiltration was continued for 60 h. The infant was discharged from the hospital at the age of 4 weeks with normal physical and neurological findings.

Acute Kidney Injury↗
PubMedDate not supplied

[Synovial level of interleukin 1 and C3a in chronic polyarthritis, psoriatic arthritis and activated arthritis].

Concentrations of interleukin-1 (IL-1), C3a des Arg and immune complexes (IC) were investigated in knee effusions of patients with rheumatoid arthritis (RA; n = 36), psoriatic arthritis (Ps.A., n = 19) and osteoarthritis (n = 7). Maximal concentrations of IC and C3a des Arg were found in RA patients, high IL-1-activities could be demonstrated in patients with Ps.A. and seropositive RA. We found significant correlations between IL-1 and C3a des Arg, IL-1 and IC and C3a des Arg, and IC in Ps.A. patients, but not in RA or osteoarthritis patients. The role of IL-1 in the chronic inflammatory response and joint destruction in inflammatory joint diseases is discussed.

Adult↗
PubMedDate not supplied

[The temporomandibular joint from the rheumatologic viewpoint].

Temporomandibular joint affections in rheumatic disease are described. They were seen in inflamed joint diseases, mostly in rheumatoid arthritis, and less so in juvenile rheumatoid arthritis, psoriatic arthritis, Reiter's syndrome, ankylosing spondylitis, and collagen vascular disease. In osteoarthrosis, the temporomandibular joint affection occurs frequently but pain seems to occur most infrequently. We must bear in mind that a painful temporomandibular joint could be a symptom of myalgia, especially fibrositis syndrome with its painful tendon.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Chlorambucil pulse therapy in progressive chronic polyarthritis. Initial results of an open multicenter study].

The first preliminary clinical results with chlorambucil pulse-therapy in patients with refractory rheumatoid arthritis are reported, with a dose of chlorambucil below that which might risk inducing leukaemia. The clinical response was good in 15 out of 19 patients; symptoms and objective findings of rheumatoid arthritis had significantly improved. However, multiple toxic reactions have been identified in our patients.

Adult↗
PubMedDate not supplied

[Serum hyaluronic acid and aminoterminal procollagen III peptide in inflammatory and degenerative joint diseases].

Serum levels of hyaluronic acid (HA) and the amino-terminal type III procollagen peptide (NP-III-P) were determined simultaneously by specific immunoassays in patients with rheumatoid arthritis (n = 41), osteoarthritis (n = 43), ankylosing spondylitis (n = 7), psoriatic arthritis (n = 6), and reactive arthritis (n = 6). Increased serum levels of both HA and NP-III-P, were found in rheumatoid arthritis and - although less pronounced - in osteoarthritis, differing significantly from age- and sex-matched controls (n = 77). Furthermore, patients suffering from active rheumatoid arthritis showed higher serum levels of both antigens than patients with inactive disease, and significant correlations were found in rheumatoid arthritis between acute phase plasma proteins, HA and NP-III-P, respectively. In contrast, determination of low molecular weight fractions of NP-III-P by Fab- assay proved not to be useful in regard to clinical application. No significant effects of anti-inflammatory treatment were evident in any of the parameters. In rheumatoid patients, the serum concentrations of HA were found to correlate positively with the serum reactivity of NP-III-P related antigens (r = 0.692) and with the excretion of urinary pyridinoline (r = 0.455). Thus, both parameters seem to reflect similar mechanisms of connective tissue activation and may be related to inflammatory activity in joint diseases.

Adult↗
PubMedDate not supplied

Impaired proliferative response to concanavalin A in patients with rheumatoid arthritis: a consequence of drug-induced T-lymphocyte damage.

The proliferation of peripheral mononuclear cells in response to pokeweed mitogen (PWM) and concanavalin A (Con A) was studied in rheumatoid arthritis (RA). In order to discover possible defects in either of the cell types involved, enriched T-cells from RA patients and healthy controls were stimulated in cultures reconstituted with purified autologous or allogeneic monocytes. A diminished response to Con A but not to PWM was observed. Whereas RA monocytes were shown to exhibit intact accessory functions, the reduction in response to Con A had to be attributed to an impaired proliferative capacity of the patients' T-cells. This defect was shown as unlikely to be related to the disease itself, but rather to be caused by therapies involving corticosteroids and immunosuppressive drugs.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Monocytes/macrophages in synovial tissue in chronic polyarthritis and arthrosis--differentiating from monoclonal antibodies].

Using monoclonal antibodies directed towards distinct cell surface antigens of the monocyte/macrophage lineage, we tried to disclose diagnostically relevant differences in the distribution pattern of monocytes and macrophages in cryostate sectioned synovial tissue samples from patients with rheumatoid arthritis and osteoarthrosis, psoriatic arthritis (n = 1) and a healthy control subject. As compared to osteoarthrosis, we found that in rheumatoid arthritis, accessory cells of the T- and B-cell immune response are pronounced in the basis areas of the superficial cell layers, indicating an active inflammatory process of immunological origin. Applying monoclonal antibodies specific for monocytes and immature macrophages of connective tissue, we confirmed the finding of an enhanced migration of those cells from the peripheral blood stream into the inflamed synovial tissue. Despite those findings, we were not able to demonstrate significant immuno-morphological differences between tissue from patients with rheumatoid arthritis and osteoarthrosis.

Adult↗
PubMedDate not supplied

[ Serum osteocalcin in chronic polyarthritis in stage III].

Osteocalcin, a major noncollagenous protein component of bone matrix which reflects the level of new bone formation, was measured in serum by radioimmunoassay, in 45 patients with rheumatoid arthritis (RA) (Steinbrocker stage III) and in 45 age- and sex-matched healthy subjects. According to the literature, serum osteocalcin concentrations were slightly decreased in the RA group but this was not statistically significant. Only RA patients on corticosteroid therapy had statistically significant decreased osteocalcin levels, compared with normal controls. No correlation was determined in the RA patients between serum osteocalcin levels and levels of C-reactive protein, erythrocyte sedimentation rate, circulating immune complexes (Clq binding assay) and rheumatoid factors of the IgA, IgG or IgM class.

Adult↗
PubMedDate not supplied

[Value of arthrosonography in the evaluation of exudative and proliferative synovitis].

The characterization of synovial tissue in rheumatoid arthritis (proliferative or exsudative synovitis), which is important in deciding between local therapies of arthritis, was examined by arthrosonography, computerized axial tomography and arthroscopy. The arthroscopic examination yields the highest significance in characterizing rheumatoid synovial tissue. Compared to arthroscopy, arthrosonographic diagnosis was correct in 70% of our cases. The arthrosonographic results were much influenced by the different concentrations of fibrin in the synovial effusions.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Significance of interleukin 1 and related monokines in the pathogenesis of chronic polyarthritis].

Activated monocytes/macrophages secrete monokines, regulatory proteins which are capable of initiating and maintaining immune processes as well as having an effect on other non immunocompetent cells. In rheumatoid arthritis the monokine Interleukin-1 (IL-1) was detected in the synovial fluid. IL-1 activates immunocompetent cells in the synovial membrane. It also stimulates rheumatoid synovial cells to markedly increase the collagenase-production and release of prostaglandin E2 and lysosomal acid hydrolase. The proliferation of fibroblasts is enhanced by IL-1. IL-1 has also been shown to be responsible for stimulating the production of cartilage-degrading enzymes and to lead to degradation of the cartilage matrix. It can enhance the rate of Ca++-release in the bone, but may also stimulate the production of collagen and glycosaminoglycans by osteocytes. Drug-induced inhibition of secretion, release or function of IL-1 may have an immune-modulating, antiinflammatory and antiproliferative effects.

Anti-Inflammatory Agents↗
PubMedDate not supplied

[Dihydrocyclosporin D--a new immunosuppressive?].

The first preliminary clinical results with a new Cyclosporin derivative (Dihydrocyclosporin-D) are reported. The compound has no obvious nephrotoxic effect; but it exhibits a hepatotoxic effect, and frequently leads to hypertension. The clinical efficiency cannot yet be judged with certainty.

Blood Pressure↗
PubMedDate not supplied

[Liberation of the oxygen radical from peripheral human phagocytes (granulocytes and monocytes) in patients with chronic polyarthritis].

Monocytes from patients with definite or classical rheumatoid arthritis show a significantly higher release of O2-radicals in the chemiluminescence assay (2925 X 10(3) cpm) than those of healthy volunteers (267 X 10(3) cpm) (p = 0.01). This difference does not appear in a similar test with granulocytes, which in both groups tested show a mean chemiluminescence of 2739 X 10(3) and 2547 X 10(3) cpm. The chemiluminescence of monocytes is clearly time-course dependent: in the morning we saw the least response, at noon the highest. Following our results, corticosteroids lower chemiluminescence significantly (p = 0.05), while non steroidal antirheumatic drugs and long-term therapy with gold compounds, etc., do not affect chemiluminescence.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Initial results of the clinical use of the immunostimulant bestatin (3-amino-2-hydroxy-4-phenylbutyryl leucine) in patients with chronic polyarthritis].

We tested the efficacy of the immunomodulator Bestatin, which has been successfully applied in Japan, in a preliminary open study in ten patients with classical or definite rheumatoid arthritis. Patients whose arthritis was characterized by a low humoral activity showed a partial remission of the disease after six months' application of increasing doses of 10-60 mg in 48 hours. We found a significant increase in superoxide release from peripheral monocytes. Humoral parameters of inflammation such as erythrocyte sedimentation rate, C3a complement fraction, prostaglandin E2, and thromboxane B2 decreased. Concerning the subpopulations of lymphocytes we found a slight increase of activated T-lymphocytes and a decrease of O-cells and B-cells. The T-helper/T-suppressor ratio remained unchanged. The rheumatoid factor and the antinuclear antibodies showed no alteration under the treatment. Two weeks after withdrawal of Bestatin the improvement of the clinical and humoral parameter of the inflammation in rheumatoid arthritis vanished. No serious side effects were seen. Our results contribute to a long-term controlled study of the immunomodulator Bestatin as basic drug in the treatment of rheumatoid arthritis.

Adjuvants, Immunologic↗