Three adult dialysis patients developed ascites after having received repeatedly the plasma substitute hydroxyethyl starch (HES 40/0.5). In two cases (total dose 180, and 330 g HES, respectively) the ascites was reversible after discontinuation of the HES administration. In the third case (total dose 915 g HES) the ascites could be controlled only by implantation of a Denver shunt. In this latter case it was shown by histological, electron microscopical, and biochemical findings that the ascites was caused by hepatic sinusoidal obstruction due to an extreme storage of HES in the sinusoidal lining cells. Additional storage was detected in hepatocytes, bile duct epithelia, endothelial cells, and fibroblasts in the portal tracts. Biochemically HES was found in liver tissue at a concentration of 4% (w/w). Although in renal impairment plasma clearance of HES is not significantly different from normal individuals, long-term administration of HES must be regarded inadvisable because of tissue storage which apparently is especially significant in this condition.
This paper describes the clinical experience of a therapy concept involving advanced functions of a new dialysis machine system (5008 Therapy System, Fresenius Medical Care, Bad Homburg Germany) that is able to provide adequate Kt/V for patients, while consuming lower amounts of dialysate, water and energy during the treatment. The novel “AutoFlow” function of this therapy system adjusts automatically the dialysate flow rate according to the effective blood flow rate of the individual patient without compromising the dose of dialysis the patient receives. The new therapy system of Fresenius Medical Care enables a more widespread application of advanced convective treatment modalities in a more affordable manner. (Int J Artif Organs 2007; 30: 577–82)
Lysozyme is absent from normal cerebrospinal fluid (C.S.F.) and in C.S.F. from children with viral meningitis. Appreciable amounts of lysozyme were noted in C.S.F. from children with bacterial meningitis (0.23 +/- 0.14 mg/100 ml) and cerebral convulsions (0-0.82 mg/100 ml). The C.S.F.-lysozyme content is a sensitive indicator for bacterial meningitis and important in the differential diagnosis between viral and bacterial meningitis. The beta2-microglobulin content of C.S.F. in healthy children was 0.11 +/- 0.05 mg/100 ml; in children with viral meningitis 0.20 +/- 0.06 mg/100 ml and in children with bacterial meningitis 0.44 +/- 0.17 mg/100 ml. Children with cerebral convulsions had also a rise in C.S.F. beta2-microglobulin.
The effectiveness of a mixture of five analogues of essential amino acids and the remaining four essential amino acids as compared to a preceeding treatment period of the nine essential amino acids was evaluated in 16 chronic uremic patients fed a low-protein diet. During amino acid analogues supplementation, there was a tendency for blood urea nitrogen to fall whereas creatinine did not change. Serum phosphate decreased in most patients, whereas serum calcium rose in some subjects. Protein metabolism, as judged by serum transferrin, Clq, C3c, total complement activity, was improved. Furthermore, the concentrations of prealbumin and retinol-binding protein, which are elevated in uremia, showed a further increase that might favor a vitamin A intoxication.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.