Renal replacement therapy in type 2 diabetic patients: 10 years' experience.

The objective of this study was to determine the impact of renal transplantation and hemodialysis treatment on outcome of elderly diabetic patients with end-stage renal disease (ESRD) among other factors related to survival. Results of treatment of ESRD in 78 patients with non-insulin-dependent diabetes mellitus (type 2) showed a survival rate of 58% at 1 year and 14% at 5 years, independent of treatment modality. Patients who received a renal allograft had a higher survival rate as compared with patients on hemodialysis treatment (5-year survival, 59% v 2%; P < 0.005). Diabetic patients with a history of myocardial infarction, stroke, or peripheral gangrene before onset of renal replacement therapy had a worse prognosis in comparison to patients without vascular complications (5-year survival, 2% v 21%; P < 0.05). Analysis of patients who survived less than 6 months and more than 24 months was performed. Long-term survivors were slightly younger, had diabetes for a shorter period, and showed a better metabolic control of diabetes mellitus. Sixteen long-term survivors received a renal allograft. In contrast, only three short-term survivors were transplanted. Furthermore, short-term survivors also had a greater than 70% incidence of severe vascular complications before renal replacement therapy. A history of myocardial infarction, stroke, or peripheral gangrene is an independent predictor of decreased survival, irrespective of whether the patients were transplanted or maintained on chronic hemodialysis treatment. In contrast, renal transplantation improved survival of elderly diabetic patients without vascular complications and should be the treatment of choice in this specific group of patients.     

Berufliche Wiedereingliederung nach kardiologischer Rehabilitation

Return to work in patients after cardiac rehabilitation Objectives: The objectives of the present study were to determine prospectively return to work and its predictors in patients after cardiac rehabilitation.     

Bestimmung des CO2-Absorptionskoeffizienten zwischen 15 und 38° C in Wasser und Plasma

Summary The CO₂ solubility coefficient has been estimated in plasma of ox blood between 15° C and 38° C and in plasma of human blood at 37° C. The figures of 38° C agree well with those of Van Slyke et al. The calculation ofph with the Henderson-Hasselbalch equation with the estimated value for -CO₂ at 37° C (0,515) shows a shift of appr. 0,01 units in comparison to the use of the earlier calculated value (0,526). At 20° C the application of the estimated value changes the calculatedph up to 0,02 units.

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Herrn Prof. Dr. A. Kohlrausch zum 75. Geburtstag gewidmet.     

Local application of prostaglandin F2 alpha to primigravid interruption patients in first trimester

A comparison was made between three methods of local prostaglandin F2 alpha application for medicamentous induction of interruption in 375 primigravidae in the first trimester. They were extra-amniotic transcervical application, intracervical instillation of gel, and intracervical application, using a portio adaptor according to Fikentscher/Semm. Retrospective and prospective analyses were made of 125 unselected patients for each of the three methods, and the portio adaptor technique proved to be most effective of all with regard to non-invasive cervix dilatation. This method, when compared to others, was found to be best acceptable to patients and medical personnel alike, with no risk of subsequent ascending infection and with lowest prostaglandin consumption.     

Diaplacental carcinogenesis: Tumor localization and tumor incidence in NMRI mice after diaplacental initiation with DMBA and urethane and postnatal promotion with the phorbol ester TPA in a modified 2-stage Berenblum/Mottram experiment

Summary Diaplacental initiation with the carcinogens DMBA or urethane followed by repeated topical treatment of mice of the F₁ generation with the tumor promoter TPA leads to the formation of benign and malignant tumors on the skin of the back as well as in other tissues and organs. The tumor yield in this modified 2-stage Berenblum/Mottram experiment considerably exceeds the number of spontaneously formed tumors and of tumors produced by initiation alone. Further differences can be demonstrated in the malignancy rate, the formation of multiple tumors in various organs, additional non-neoplastic alterations and in a reduction of the lifetime of the animals. The effect of the tumor promoter TPA is not restricted to carcinogenesis in the back skin. Obviously, TPA is able to activate inititated tumor cells in internal organs to form tumors. This, in turn, implies the absorption of the substance via the blood vessels and its distribution throughout the body. The preferential occurrence of tumors in the genital tract of female mice (carcinomas and sarcomas of the vaginal wall, granulosa cell tumors of the ovaries) points to a possible hormonal involvement; in this context, relevance to prenatally induced tumors in human pathology is discussed. The results emphasize the important role of prenatal carcinogenesis and indicate the increased risk to man by either prenatal initiation or postnatal promotion.     

Influence of various cationic amphiphilic drugs on the phase-transition temperature of phosphatidylcholine liposomes

The influence of 16 cationic amphiphilic compounds from various pharmacological groups on the phase-transition temperature (T_t) of dipalmitoyl-phosphatidylcholine (DPPC) liposomes was investigated using the method of differential scanning calorimetry. All drugs, the hydrophobicity of which varied in a wide range, depressed T_t. Biphasic dose-effect curves were obtained when the reduction of T_t (ΔT_t) was plotted vs the molar ratio of drug/DPPC; beyond a plateau, T_t could again be reduced markedly by increasing the molar ratio. Concomitantly with the depression of T_t, the width of the transition peak changed in a characteristic way: it broadened during the (first) steep part of the dose-effect curves and became narrow like a control transition when the plateau of the dose-effect curves was reached. At still higher ratios the peak broadened again and eventually vanished, probably due to a detergent-like effect of the drug. Increasing hydrophobicity of the compounds shifted the dose-effect curves to lower molar ratios and enhanced the ΔT_t, attained at the plateau phase. It is proposed that the different potencies of the drugs to depress T_t result from different binding equilibria between the compounds and DPPC membranes, the individual equilibrium being determined by hydrophobia attraction and electrostatic repulsion.     

UV versus chemical polymerization of glycol methacrylate (GMA) in enzyme histochemistry.

The influence of the mode of polymerization of GMA on the enzyme activities of differently fixed rat livers was studied. It was found that with increasing time of UV-polymerization several enzyme activities were inhibited whereas chemical polymerization was comparatively less harmful. The histochemical reactivity of substrates such as glycogen was not impaired by the mode of polymerization, which is in contrast to the increased basophilia of DNA and RNA after UV-polymerization.     

Fluorometric determination of the quality of FITC-anti influenza conjugates (author's transl)]

A fluorometric method for the evaluation of FITC-anti influenza conjugates is described. The titre and that dilution required for the complete detection of antigens can be determined. It is possible to verify the probability of detection in per cent for any dilution stage and to compare objectively different batches. For this microtest only 0,2 ml conjugate are necessary.