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排序方式: 共有304条查询结果,搜索用时 15 毫秒
1.
Renal excretion of endothelin in children 总被引:1,自引:0,他引:1
István Máttyus L. B. Zimmerhackl A. Schwarz M. Brandis M. Miltényi T. Tulassay 《Pediatric nephrology (Berlin, Germany)》1997,11(4):513-521
Endothelin (ET) is a peptide with profound vasoconstrictive potential. First isolated from porcine endothelial cell supernatant,
it is produced also by smooth muscle, epithelial and circulating cells. Besides vasoconstriction, a wide spectrum of biological
activities of ET (via activation of membrane receptors) has been described. These include regulation of other hormones and
neurotransmitters, cellular growth and proliferation, bronchoconstriction, and, in the kidney, natriuresis and water diuresis.
ET exerts its effects mainly in an autocrine and paracrine fashion. A high concentration of ET is found in urine, compared
with plasma originating mainly from the kidney itself. In this review we focus on the role of urinary excretion of ET in children.
ET excretion was determined under different physiological and pathological conditions. In premature infants and newborns,
the daily excretion of ET (corrected for body surface) was higher than in older children; it was constant, and comparable
to the values in healthy adults after the age of 2 years. Renal ET excretion correlated positively with urine flow in both
healthy and sick children. Conditions with tubular and/or collecting duct cell damage, such as severe hypoxia, hemolytic-uremic
syndrome, renal transplantation, diabetes mellitus, chronic renal failure, and contrast media cytotoxicity were characterized
by elevated urinary excretion of ET. In conclusion, the renal excretion of ET is influenced by several factors, probably reflecting
the intrarenal ET production. ET has a low specificity with regard to renal injury.
Received May 7, 1996; received in revised form January 14, 1997; accepted January 17, 1997 相似文献
2.
Magnetic resonance (MR) imaging has been used in the temporomandibular joint (TMJ) primarily to define the disk position. This report examines altered morphology and signal intensity characteristics of the TMJ disk as they relate to the severity of internal derangement. Two hundred sixteen joints in 133 patients with a history of such derangement. were imaged with MR. Disk position, signal intensity, morphology, and the presence of osteoarthritis were determined for each joint. The normal disk was not anteriorly displaced and had a normal "bow-tie" shape. A grade 1 disk was anteriorly displaced and had a normal shape; a grade 2 disk was anteriorly displaced and had an abnormal shape. Forty (19%) joints were considered normal; none of these exhibited osteoarthritis. One hundred thirty-nine (64%) joints were grade 1; osteoarthritis was found in 17%. Thirty-seven (17%) were grade 2; osteoarthritis was found in 95%. All forty normal joints had high or intermediate signal intensity in the disk. Osteoarthritic joints had a higher percentage of disks with diminished intensity (P less than .0001). Severe or untreated osteoarthritis is known to be a complication of TMJ internal derangements; hence this grading system seems to correlate with the severity of internal derangement. 相似文献
3.
4.
Renal gluconeogenesis and increased glucose utilization in shock 总被引:1,自引:0,他引:1
5.
Michael Steinhausen Frederick D. Dallenbach Rudolf Jäckh Niranjan Parekh Bernd Zimmerhackl Rainer Zimmermann 《Virchows Archiv : an international journal of pathology》1979,384(1):65-84
Summary After occlusion of the renal veins rats die quickly in progressive shock (within 4.5 h), but after ligating the renal hilum of both Kidneys they survive 27 h. To learn why renal vein occlusion is so rapidly lethal, and what substances are given off and by what method from the hemorrhagically infarcted kidneys, we studied eight groups of rats, each containing at least seven animals. The groups differed in the combination of hilar structures (renal veins, ureters, lymphatics) ligated. We compared: survival times, changes in blood pressure, blood volume, levels of plasma kinins, adenosine, and lactate, changes of blood pH, responses to Indomethacin, Trasylol®, and plasma expanders, tubular and capillary flow rates, histopathological changes in organs and cerebral blood flow and changes in the blood coagulation system. Our results suggest that the venous stasis, anoxia, and hemorrhagic necrosis caused by bilateral venous occlusion release into renal lymphatics toxic substances which reach the systemic circulation and induce irreversible shock. We have excluded prostaglandins and adenosine as the toxic substances inducing shock but could not rule out an action of the kallikrein-kinin-system. We postulate that the striking degenerative changes occurring in the arterioles of the brain after bilateral venous occlusion may mean these vessels are especially susceptible to high levels of lactic acid and that this may explain why these animals die so quickly. Our conclusions should help not only in understanding why high levels of lactate in shock portend a poor prognosis but also help in formulating appropriate therapy for circulatory failure of renal origin and for protracted hypotension after extensive tissue injury.The studies were supported by the German Research Foundation within the SFB 90 Cardiovasculäres SystemPresented in part: Jäckh and Steinhausen, 1976; Dallenbach et al., 1978; Zimmerhackl et al., 1979We dedicate this paper to Wilhelm Doerr, Dr. med., Professor of Pathology, University of Heidelberg on the occasion of his 65th birthday (August 25th, 1979) 相似文献
6.
Beate Ermisch F. Hildebrandt L. B. Zimmerhackl M. Pohl N. Gordjani H. Niederhoff D. Matern H. H. Seydewitz W. Lehnert J. U. Leititis M. Brandis 《Monatsschrift für Kinderheilkunde》1997,145(7):714-718
Zusammenfassung
Das hyperammon?mische Koma ist eine akut lebensbedrohliche Stoffwechselentgleisung. Die h?ufigsten kongenitalen Ursachen sind
Enzymdefekte im Harnstoffzyklus und im Abbau von organischen S?uren. Die Frühdiagnose und eine sofortige aggressive Therapie
sind die entscheidenden Voraussetzungen zur Vermeidung irreversibler Hirnsch?den und letaler Verl?ufe. Das Therapieziel ist
eine rasche Senkung des Ammoniaks und anderer neurotoxischer Metaboliten. Die therapeutischen Grundprinzipien beinhalten 1.
eine restriktive Proteinzufuhr unter dem Erhalt essentieller Aminos?uren, 2. die Unterbrechung des Proteinkatabolismus mittels
hochkalorischer Ern?hrung, 3. eine medikament?se Aktivierung alternativer Wege der Stickstoffausscheidung sowie 4. apparative
Blutreinigungsverfahren. Das optimale Dialyseverfahren ist umstritten. Wir haben 4 Neugeborene und S?uglinge in einem hyperammon?mischen
Koma im Rahmen von Stoffwechselerkrankungen mittels H?modialyse oder H?mofiltration behandelt. Die Kasuistiken best?tigen
die Effektivit?t und Komplikationsarmut beider Verfahren.
Diskussion: In der Behandlung von lebensbedrohlichen Hyperammon?mien bei Neugeborenen und S?uglingen sind H?modialysen und H?mofiltrationen
die Behandlungsmethoden der Wahl. Die invasive Blutreinigung ist mit einer konsequenten di?tetischen und medikament?sen Therapie
zu optimieren. Der prognostische Nutzen einer effizienten Blutreinigung bei ausgepr?gter Hyperammon?mie rechtfertigt einen
unverzüglichen Transport in das n?chstgelegene p?diatrische Dialysezentrum.
相似文献
7.
M. Uhl L. B. Zimmerhackl A. Frankenschmidt J. Laubenberger M. Langer 《Monatsschrift für Kinderheilkunde》1997,145(12):1304-1306
Zusammenfassung
Ziel: Untersucht wurde die Treffsicherheit der MRT bei der Lokalisationsdiagnostik nichtpalpabler Hoden.
Material und Methode: 17 Jungen im Alter von 11 Monaten bis 9 Jahren wurden zur Lokalisationsdiagnostik eines oder beider nichtpalpabler Hoden
(insgesamt 20 Hoden) mittels MRT (1T-Ger?t, Magnetom Expert, Siemens) im Zeitraum von 1992–1995 untersucht. Die Lokalisationen
wurden in: Bauchhoden und hohe und tief gelegene Leistenhoden eingeteilt. Die Patienten wurden anschlie?end laparoskopisch
oder offen operiert und der evtl. vorhandene hochstehende Hoden im Skrotum fixiert.
Ergebnisse: 16 Hoden (80%) wurden durch die MRT-Diagnostik pr?operativ richtig lokalisiert bzw. eine Anorchie richtig diagnostiziert.
Zwei Hoden (10%) wurden falsch lokalisiert, 2 Hoden (10%) wurden in der MRT beschrieben, obwohl eine Anorchie vorlag. Von
unseren 5 Anorchief?llen konnten mittels MRT nur 3 diagnostiziert werden.
Schlu?folgerung: Die MRT erreicht eine gute Trefferquote (80% positive Vorhersagewahrscheinlichkeit) in der pr?operativen Lokalisationsdiagnostik
des nichtpalpablen Hodens. Da die MRT eine Anorchie nicht mit ausreichender Sicherheit von einem Kryptorchismus differenzieren
kann, kann ein fehlender Hodennachweis in der MRT die endoskopische Diagnostik nicht substituieren. Bei geplanter endoskopischer
Diagnostik kann im Regelfall auf die pr?operative MRT-Diagnostik verzichtet werden.
相似文献
8.
9.
Summary
Studies from Europe indicate that infections with enterohemorrhagic Escherichia coli (EHEC) non-O157:H7 strains are increasing in frequency as a cause of hemolytic-uremic syndrome (HUS). In 1997 a prospective
study was performed in Germany and Austria to assess the distribution of EHEC serotypes, to characterize the clinical course
and to examine environmental aspects. 95 children with a diagnosis of HUS were evaluated in Germany and Austria. Diarrhea,
which was bloody in 67%, was reported in 97% of patients. Oligo-/anuria occurred in 76% of patients, of which 63% required
dialysis. Two patients showed neurological sequelae at the 2-month follow-up, both of them were infected with non-O157;H7
serotypes. Case fatality in the acute stage was 3/95, in two of these patients EHEC was isolated. Stool and serum specimens
were analyzed for the presence of EHEC and antibodies against O157 lipopolysaccharide (LPS). Serotype O157:H7 was identified
in 36/58 (62%) isolates, 22 strains (38%) belonged to non-O157:H7. Combining stool culture with serology, EHEC infection was
documented in 88% of patients, including three patients without diarrhea. Non-O157:H7 serotypes occurred in 77% of children
up to 36 months of age and were the most prevalent serotype in children up to 12 months of age.
Received: February 9, 1999 · Accepted: September 19, 1999 相似文献
10.
Johannes Hofer Andreas R. Janecke L.B. Zimmerhackl Magdalena Riedl Alejandra Rosales Thomas Giner Gerard Cortina Carola J. Haindl Barbara Petzelberger Miriam Pawlik Verena Jeller Udo Vester Bettina Gadner Michael van Husen Michael L. Moritz Reinhard Würzner Therese Jungraithmayr for the German-Austrian HUS Study Group 《Clinical journal of the American Society of Nephrology》2013,8(3):407-415