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  • 1
    In: Nephron, S. Karger AG, Vol. 78, No. 1 ( 1998), p. 28-32
    Abstract: Chronic renal failure induces anemia and a short erythrocyte life span. Red blood cell (RBC) osmotic fragility is the resistance of RBC hemolysis to osmotic changes that is used to evaluate RBC friability. To find the cause of shortened red cell survival in uremic patients, we evaluated the RBC osmotic fragility in 57 chronic hemodialyzed patients. Each patient had received 12 h of dialysis per week continuously prior to being enrolled in the study. Nineteen healthy volunteers served as a control group. Biochemistry, hemoglobin, electrolyte, osmolarity, β 〈 sub 〉 2 〈 /sub 〉 -microglobulin, and intact parathyroid hormone were examined before and after the dialysis session. To evaluate the osmotic fragility of RBC, blood samples were collected in heparinized test tubes. Fifty microliters of the RBC of each individual was then incubated in solutions containing a series of various concentrations of NaCl ranging from 0 to 0.6%. The concentration of NaCl at which 50% of RBCs were lysed was considered the median osmotic fragility (MOF). The results showed that the MOF was significantly greater in hemodialyzed patients before dialysis than in the control group (0.41 ± 0.03 vs. 0.39 ± 0.02%). The osmotic resistance to hemolysis was also recorded after dialysis (MOF 0.38 ± 0.03%). Correlation analysis showed that the MOF was significantly correlated with urea nitrogen, serum osmolarity, and intact parathyroid hormone level. In addition, the osmotic fragility was higher in patients who had a predialysis intact parathyroid hormone level 〉 100 pg/dl. In conclusion, hemodialysis can improve the osmotic fragility. The mechanism underlying this improvement may be the removal of low molecular weight uremic toxins, resulting in normalization of serum osmolarity. Our results indicate that parathyroid hormone is probably a major factor influencing RBC osmotic fragility in chronic renal failure.
    Type of Medium: Online Resource
    ISSN: 1660-8151 , 2235-3186
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1998
    detail.hit.zdb_id: 2810853-X
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  • 2
    In: Blood Purification, S. Karger AG, Vol. 21, No. 6 ( 2003), p. 369-375
    Abstract: 〈 i 〉 Aims: 〈 /i 〉 Secondary hyperparathyroidism (HPT) worsens anemia and may cause hyporesponsiveness to recombinant human erythropoietin therapy (r-HuEPO). To investigate the effect of parathyroidectomy (PTX) on iron homeostasis and erythropoiesis, we conducted a prospective study in chronic hemodialysis patients who underwent PTX. 〈 i 〉 Methods: 〈 /i 〉 Thirty-two patients were enrolled in this study. Based on the increases in hemoglobin level after PTX, patients were divided into responders and nonresponders. Iron homeostasis and erythropoiesis were assessed before and 1 and 3 months after PTX, hemoglobin and parathyroid hormone levels were monitored until 6 months after PTX. 〈 i 〉 Results: 〈 /i 〉 In the responders, increased hemoglobin levels were observed in 15 patients at 1 and 3 months after PTX (8.0 ± 0.8 g/dl vs. 9.2 ± 1.3 and 10.1 ± 0.9 g/dl, p 〈 0.05). The nonresponders had higher pre-PTX hemoglobin levels than the responders (10.3 ± 1.6 g/dl vs. 8.0 ± 0.8 g/dl, p 〈 0.05). There was no further increase in hemoglobin at 6 months compared to 3 months after PTX in both groups. In neither group did PTX affect serum ferritin, transferrin saturation and serum erythropoietin level. Serum soluble transferrin receptor (sTfR) concentration was found to be higher in responders than in nonresponders (3.32 ± 1.28 mg/l vs. 1.70 ± 0.31 mg/l, p 〈 0.05). 〈 i 〉 Conclusions: 〈 /i 〉 We conclude that PTX can improve anemia in hemodialysis patients with severe hyperparathyroidism and greater resistance to r-HuEPO therapy. The reversing of anemia does not involve altering iron mobilization. Pre-PTX hemoglobin and serum sTfR levels can predict the effect of PTX on correcting anemia.
    Type of Medium: Online Resource
    ISSN: 0253-5068 , 1421-9735
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2003
    detail.hit.zdb_id: 1482025-0
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  • 3
    In: Respiration, S. Karger AG, Vol. 75, No. 3 ( 2008), p. 288-295
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Inhaled nitric oxide (INO) can improve hypoxemia and reduce pulmonary hypertension, but there is a wide range of response to INO. 〈 i 〉 Objectives: 〈 /i 〉 The aim of this study was to evaluate the effect of different INO concentrations in acute respiratory distress syndrome (ARDS) patients. 〈 i 〉 Methods: 〈 /i 〉 Thirty-two adult ARDS patients who were supported by mechanical ventilator were included. INO was given at a concentration of 1, 5, 10, 20 and 40 ppm, sequentially. Arterial blood gas and mean pulmonary artery pressure (MPAP) were measured 30 min after INO concentrations changed. 〈 i 〉 Results: 〈 /i 〉 There was a significant increase in PaO 〈 sub 〉 2 〈 /sub 〉 /FiO 〈 sub 〉 2 〈 /sub 〉 (p 〈 0.0001) and a decrease in pulmonary vascular resistance index and MPAP (p 〈 0.0001) after INO use. INO concentrations required for improving oxygenation were in the range of 1–20 ppm, whereas concentrations required for decreasing MPAP were in the range of 1–40 ppm. PaO 〈 sub 〉 2 〈 /sub 〉 /FiO 〈 sub 〉 2 〈 /sub 〉 worsened when the INO dose was adjusted above 20 ppm. Sixty-nine percent of ARDS patients were responders; 31% of them were nonresponders. Among responders, 64% of patients responded at 1 ppm, 36% at 5 ppm. 〈 i 〉 Conclusions: 〈 /i 〉 The optimal doses for improving oxygenation and reducing PAP differ. The maximum PaO 〈 sub 〉 2 〈 /sub 〉 /FiO 〈 sub 〉 2 〈 /sub 〉 was observed at a lower INO concentration than that required for the minimal MPAP. There was no further improvement in PaO 〈 sub 〉 2 〈 /sub 〉 /FiO 〈 sub 〉 2 〈 /sub 〉 when the INO dose was adjusted above 20 ppm. Higher doses of INO treatment worsened oxygenation.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 1464419-8
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  • 4
    In: Cardiology, S. Karger AG, Vol. 104, No. 4 ( 2005), p. 171-175
    Abstract: The study population consisted of 16 patients with rheumatic mitral stenosis undergoing percutaneous transluminal mitral valvuloplasty (group 1). The plasma levels of tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) in the femoral vein and the right and left atria before valvuloplasty were determined by ELISA. Additionally, we measured plasma concentrations of TNF-α and IL-10 in the venous blood obtained from 19 control patients, including 12 healthy volunteers in sinus rhythm (group 2) and 7 patients in permanent lone atrial fibrillation (group 3). The venous plasma levels of TNF-α were significantly elevated in group 1 patients compared with group 2 patients (p 〈 0.002). Correlation analysis demonstrated that there was a significantly direct relationship between the plasma TNF-α and IL-10 concentrations in the left atrial, right atrial and peripheral venous blood (p 〈 0.008, r = 0.640; p 〈 0.04, r = 0.538; p 〈 0.03, r = 0.571, respectively). In conclusion, the plasma concentrations of TNF-α of patients with rheumatic mitral stenosis were significantly higher than those of healthy volunteers. In addition, there was a significantly direct relationship between the soluble TNF-α and IL-10 concentrations in the atrial and peripheral venous blood, indicating a balance between circulating TNF-α and IL-10 levels in patients with rheumatic mitral stenosis.
    Type of Medium: Online Resource
    ISSN: 0008-6312 , 1421-9751
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1482041-9
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  • 5
    In: Cardiology, S. Karger AG, Vol. 100, No. 3 ( 2003), p. 136-142
    Abstract: The study population consisted of 234 consecutive patients hospitalized for acute exacerbation of congestive heart failure secondary to non-ischemic cardiomyopathy. Of the 234 patients, there were 55 in-hospital deaths. Their medical records were deliberatively reviewed and the association of 38 clinical, hemodynamic and biochemical variables with in-hospital mortality was evaluated by multiple stepwise logistic regression analysis. The following variables were statistically associated with in-hospital mortality: profound cardiogenic shock, severe hyponatremia, the presence of ventricular arrhythmias, history of stroke, the presence of acute renal failure, and requirement of dobutamine therapy. In stratified analyses, the rates of in-hospital mortality rose rapidly as the number of risk factors increased: 0 risk factors, 2.5%; 1 risk factor, 5.1%; 2 risk factors, 36.4%; 3 risk factors, 75%, and no less than 4 risk factors, 100%. In conclusion, our study identified 6 variables that correlated with in-hospital death in patients with heart failure secondary to non-ischemic cardiomyopathy. The identification of these variables may allow more accurate risk stratification of individuals at risk of in-hospital mortality in this clinical setting.
    Type of Medium: Online Resource
    ISSN: 0008-6312 , 1421-9751
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2003
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  • 6
    Online Resource
    Online Resource
    S. Karger AG ; 2005
    In:  Respiration Vol. 72, No. 6 ( 2005), p. 612-616
    In: Respiration, S. Karger AG, Vol. 72, No. 6 ( 2005), p. 612-616
    Abstract: 〈 i 〉 Background: 〈 /i 〉 The relationship between allergic markers and PC 〈 sub 〉 20 〈 /sub 〉 (provocative concentration causing a 20% fall in FEV 〈 sub 〉 1 〈 /sub 〉 ) in adults with positive methacholine challenge test (MCT) is still subject to discussion. 〈 i 〉 Objective: 〈 /i 〉 The goal of this study is to determine whether the degree of bronchial hyperresponsiveness (BHR) is correlated with the severity of atopy or not. 〈 i 〉 Methods: 〈 /i 〉 Forty patients with persistent cough and/or unexplained episodes of dyspnea exhibiting a normal baseline pulmonary function test and positive MCT were enrolled in this study. They were divided into two groups according to their Phadiatop response (positive and negative), and three groups by PC 〈 sub 〉 20 〈 /sub 〉 level: PC 〈 sub 〉 20 〈 /sub 〉 〈 1.25 mg/ml, 1.25 mg/ml ≤ PC 〈 sub 〉 20 〈 /sub 〉 〈 5 mg/ml, and 5 mg/ml ≤ PC 〈 sub 〉 20 〈 /sub 〉 〈 25 mg/ml. 〈 i 〉 Results: 〈 /i 〉 Twenty-three patients (57.5%) were Phadiatop positive. Of the 23 Phadiatop-positive patients, 20 patients (87%) were positive for specific serum IgE to 〈 i 〉 Dermatophagoides pteronyssinus 〈 /i 〉 (D1) and 〈 i 〉 Dermatophagoides farinae 〈 /i 〉 (D2). The total serum IgE and eosinophil cationic protein (ECP) level of the Phadiatop-positive group were higher than those of the Phadiatop-negative group (p 〈 0.0001 and p = 0.005, respectively). The age, gender, FEV 〈 sub 〉 1 〈 /sub 〉 /FVC ratio, ECP and total serum IgE level were not significantly different in the three PC 〈 sub 〉 20 〈 /sub 〉 subgroups. The Phadiatop response and PC 〈 sub 〉 20 〈 /sub 〉 level were significantly correlated (p = 0.0063). For Phadiatop-positive adults, PC 〈 sub 〉 20 〈 /sub 〉 level was not significantly correlated with total serum IgE and specific serum IgE to D1 and D2. 〈 i 〉 Conclusion: 〈 /i 〉 Atopy is related to adults with positive MCT. However, the degree of BHR to methacholine is not significantly correlated with the severity of atopy.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1464419-8
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  • 7
    In: Ophthalmologica, S. Karger AG, Vol. 217, No. 1 ( 2003), p. 24-30
    Abstract: 〈 i 〉 Purpose: 〈 /i 〉 We compare the intermediate-term outcome of initial trabeculectomy with adjunctive mitomycin C use versus initial trabeculectomy alone for juvenile primary open-angle glaucoma. 〈 i 〉 Methods: 〈 /i 〉 This retrospective consecutive analysis included 44 eyes from 36 patients with juvenile primary-open angle glaucoma, all of whom underwent either initial trabeculectomy with adjunctive mitomycin C use (15 eyes) or initial trabeculectomy alone without mitomycin C use (29 eyes). We compared the success rate and complications between the two groups in a three-year follow-up period following surgery. 〈 i 〉 Results: 〈 /i 〉 Three years subsequent to surgery, the cumulative success probability was 73% for the mitomycin C group and 68% for the control group, there being no real difference between the two groups (p = 0.89). A greater incidence of hypotony maculopathy was found amongst the mitomycin C group than was the case for the control group (20 versus 0%, respectively, p = 0.034). A lower intraocular pressure amongst the mitomycin C group was noted as compared with the control group (10.8 ± 3.0 versus 13.3 ± 3.8 mm Hg, respectively, p = 0.017) amongst the successfully treated patients. 〈 i 〉 Conclusions: 〈 /i 〉 Despite the lower intraocular pressure level for the successfully treated patients from the trabeculectomy with mitomycin C group, and a greater incidence of resultant hypotony maculopathy for this group as compared with the trabeculectomy alone group, there appeared to be no significant difference in the cumulative success probability for this group as compared with the trabeculectomy alone group. Therefore, we caution against the use of an initial trabeculectomy with mitomycin C for juvenile primary open-angle glaucoma.
    Type of Medium: Online Resource
    ISSN: 0030-3755 , 1423-0267
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    Language: English
    Publisher: S. Karger AG
    Publication Date: 2003
    detail.hit.zdb_id: 1483531-9
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  • 8
    Online Resource
    Online Resource
    S. Karger AG ; 2005
    In:  Cerebrovascular Diseases Vol. 20, No. 2 ( 2005), p. 120-128
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 20, No. 2 ( 2005), p. 120-128
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Platelets play an important role in atherosclerosis and thromboembolic events. We examined the relationship between platelet activity and outcomes after an ischemic stroke. 〈 i 〉 Methods: 〈 /i 〉 Using flow cytometry, we serially measured the fractions of circulating platelet activity (CD62p expression) after an ischemic stroke in early ( 〈 48 h), recent (day 7), convalescent (day 21) and chronic (day 90) phases in 92 consecutive patients with an ischemic stroke. Patients were classified into high (CD62p expression 〉 3.16%) and low (CD62p expression ≤3.16%) platelet activity groups according to the median value of CD62p expression in the early phase of a stroke. 〈 i 〉 Results: 〈 /i 〉 The composite end point – death, recurrent stroke and severe neurological impairment (alive in care), defined as a score of 〉 13 on the National Institutes of Health Stroke Scale – within the first 30 days and at an interval of 8.2 ± 1.5 months of follow-up was determined for each group. In the first 30 days, the composite end point occurred in 37.0% of patients in the high platelet activity group as compared with 6.5% in the low platelet activity group (p = 0.0004). At a mean follow-up of 8.2 ± 1.5 months, the composite end point occurred in 36.6% of patients in the high platelet activity group as compared with 10.9% in the low platelet activity group (p = 0.0044). Multiple stepwise logistic regression analysis displayed that high platelet activity (p = 0.011), age (p = 0.013) and the presence of coronary artery disease (p = 0.021) were independently associated with adverse outcomes at the intermediate-term follow-up. 〈 i 〉 Conclusions: 〈 /i 〉 Results of this study showed that high platelet activity is strongly associated with adverse clinical outcomes after an early ischemic stroke.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1482069-9
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  • 9
    In: Cardiology, S. Karger AG, Vol. 102, No. 4 ( 2004), p. 206-214
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Distal embolization and no reflow are likely during primary percutaneous coronary intervention (PCI) on the large infarct-related artery (IRA), which mostly contains high-burden thrombus formation (HBTF) and plaque burden. Mechanical devices to prevent distal atheroembolism may be of importance for preserving reperfusion and microvascular integrity in IRA. 〈 i 〉 Methods and Results: 〈 /i 〉 Between May 2002 and December 2002, transradial application (TRA) of the PercuSurge GuardWire™ device with 7-french arterial sheath was performed in 39 consecutive patients who experienced early ( 〉 12 h and ≤7 days) or recent ( 〉 7 days and 〈 14 days) myocardial infarction (MI) associated with large IRA (vessel size ≧3.5 mm with HBTF; group 1). Between January 2001 and April 2002, 64 consecutive patients who had early or recent MI associated with HBTF in IRA of a vessel size ≧3.5 mm received TRA of PCI with adjunctive tirofiban therapy but without using the adjunctive PercuSurge GuardWire device (group 2). The angiographic and clinical outcomes of both groups were compared in a chronologically consecutive manner. The procedural success rate and post-PCI myocardial blush grades were significantly higher in group 1 than in group 2 patients (all p values 〈 0.05), whereas a combined incidence of vascular and bleeding complications and 30-day major adverse cardiac events (defined as death, reinfarction and repeated PCI of IRA) were significantly higher in group 2 than in group 1 patients (all p values 〈 0.05). 〈 i 〉 Conclusions: 〈 /i 〉 Our data suggested that TRA using the PercuSurge GuardWire device during PCI for patients with early or recent MI and HBTF in IRA was safe and feasible. This mechanical device provided more additional benefit to patients in this clinical setting than a combination of conventional PCI and tirofiban therapy.
    Type of Medium: Online Resource
    ISSN: 0008-6312 , 1421-9751
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2004
    detail.hit.zdb_id: 1482041-9
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  • 10
    In: Medical Principles and Practice, S. Karger AG, Vol. 28, No. 3 ( 2019), p. 273-279
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 Recent studies have reported that reduced excretion of urinary uromodulin is associated with renal tubular function and risks of progressive kidney disease. Gouty nephropathy is usually seen in patients with gout. Patients with chronic gouty nephropathy are characterized by the deposition of monosodium urate crystals primarily involving the collecting ducts in the medulla. We postulated that this correlation may be specific to gout and may serve as a useful biomarker for chronic kidney disease (CKD). 〈 b 〉 〈 i 〉 Materials and Methods: 〈 /i 〉 〈 /b 〉 〈 i 〉 〈 /i 〉 A total of 114 Taiwanese patients diagnosed with gout ( 〈 i 〉 n 〈 /i 〉 = 72), CKD ( 〈 i 〉 n 〈 /i 〉 = 26), or healthy volunteers ( 〈 i 〉 n 〈 /i 〉 = 16) were prospectively enrolled for this study from the Rheumatology and Nephrology Outpatient Clinics of our institution. We obtained urine and blood samples on patient visits to the outpatient clinics. Demographic data were obtained from medical records. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 〈 i 〉 〈 /i 〉 In patients with gout, the spot urinary uromodulin/creatinine ratio (uUMCR; mg/g) in patients with CKD was significantly lower than that in those without CKD (CKD group: 2.2; non-CKD group: 5.6, 〈 i 〉 p 〈 /i 〉 = 0.005). Multivariate analysis revealed that patients with CKD and gout had a lower uUMCR than those with gout alone ( 〈 i 〉 p = 〈 /i 〉 0.028). A significant association was not observed in our non-gout cohort. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 〈 i 〉 〈 /i 〉 The association of decreased uUMCR with CKD status was identified only in patients with gout in the present study. We believe that uUMCR might serve as an indicator of differential CKD in patients with gout.
    Type of Medium: Online Resource
    ISSN: 1011-7571 , 1423-0151
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1482963-0
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