[Comparative study of the analysis of lipoproteins with different electrophoretic methods (author's transl)]. / Lipoproteinanalytik. Vergleichende Studie verschiedenen elektrophoretischen Verfahren.

In 100 unselected sera the lipids were analysed with different methods. A commonly used method of the lipoprotein-electrophoresis, which evaluates the pherogram after staining with lipid-strains, was compared with the quantitative lipoproteinelectrophoresis according to Wieland and Seidel. The analyses were supplemented through the enzymatic estimation of total cholesterol and triglycerides. Only in 55 cases the results were identical. The improved diagnosis of lipoproteins is due to the complete and reproducible demonstration of HDL (high density lipoproteins) bands, which are found with the staining methods only in half of the cases. On the contrary the relative proportion of the VLDL (very low density lipoproteins) is increased three-fold with the staining methods.

[Influence of "prudent" diet and clofibrate upon apolipoprotein B in hyperlipoproteinemia type IIa (author's transl)]. / Einfluss von Diät und Clofibrat auf Apolipoprotein B bei Hyperlipoproteinämie vom Typ IIa.

If patients with hyperlipoproteinemia type IIa are treated with diet and additionally over a period of two weeks with 2 grams of Clofibrate daily, the cholesterol-level in the serum decreases. This decrease is caused mainly by a reduction of the apolipoprotein B and the LDL-cholesterol in serum. If elevated cholesterol-levels in the serum are reduced through a "prudent" diet, the concentration of apolipoprotein B in serum remains the same. It is not fully understood which influence a diet, which is rich in poly-unsaturated fatty acids and has a low content of saturated fatty acids and carbohydrates, has upon the lipoproteins in the serum. The mode of action of this diet and its significance for the concentration of HDL need further investigation.

[Clofibrate in type IIa hyperlipoproteinemia. Reduction of apolipoprotein B (author's transl)]. / Clofibrat bei Hyperlipoproteinämie Typ IIa. Verminderung von Apolipoprotein B.

After changing over from the usual eating habits to a "reasonable" restricted diet rich in polyene saturated fats and saturated fatty acids, additional treatment with 1 g clofibrate twice daily produces a significant reduction of concentration of total cholesterol and Apo B by about 24% in the serum of patients with Type IIa hyperlipoproteinemia after 2 weeks. In contrast to this the serum concentration of triglycerides and phospholipids shows an insignificant tendency to fall during the whole duration of the trial. The results suggest that the additional cholesterol reducing action of clofibrate in patients with hyperlipoproteinemia Type IIa who have already been treated by diet is mainly achieved by the reduction of LDL-cholesterol, the atherogenic properties of which are well known.

Vasodilation by urapidil in the treatment of chronic congestive heart failure in addition to angiotensin-converting enzyme inhibitors is not beneficial: results of a placebo-controlled, double-blind study.

BACKGROUND: The therapeutic benefit of an angiotensin-converting enzyme (ACE) inhibitor in combination with a different type of vasodilator is unknown. METHODS AND RESULTS: To evaluate the effects of a combined therapy on quality of life, exercise tolerance, and hemodynamic parameters, patients with severe heart failure (New York Heart Association classes III and IV, ejection fraction below 35%) who were on ACE inhibitor therapy were randomly assigned to additional double-blind treatment with urapidil (60-120 mg/d) or placebo for 12 weeks. After enrollment of 36 patients, the study was terminated early because no beneficial effects on exercise tolerance and hemodynamic parameters could be shown for the urapidil treatment, and a trend toward increased mortality of the urapidil group was observed (odds ratio, 4.92 [0.49-49.6]; P = .167). CONCLUSION: The combination of urapidil with an ACE inhibitor in the treatment of severe chronic congestive heart failure does not seem to offer any advantages over therapy with an ACE inhibitor alone and may have potentially harmful effects.

[Chances in the serum lipid values after conversion to a "reasonable" diet (author's transl)]. / Veränderungen der Serumlipidwerte nach Umstellung auf eine "vernünftige" Diät

Six to ten days after conversion from usual alimentary habits to a so-called "reasonable" regimen, the serum concentrations of different lipid fractions were examined under standardized conditions, in a total of 325 in-patients, who had not been pre-treated, and 268 of whom showed - after diverse examinations - a hyperlipoproteinaemia; the other 57 patients had normal lipid values. This diet food is vitamin-rich, poor in calories, protein-rich with a 20 per cent to 25 per cent part of calories, poor in carbohydrates (maximum 120 g/day), and extensively renouncing monomeric and dimeric carbohydrates; furthermore, it contains a percentage of 40 to 45 calories of lipids with a standardized part of multiple-unsaturated fatty acids. During the period of observation, there was in none of the patients an alteration of the body-weight exceeding 1 kg. During the period of the regimen, the following highly significant decreases - without any medicamentous measures - were stated with regard to the serum concentrations: Total cholesterol (average) 9.9 per cent, triglycerides (average) 23.1 per cent, beta-cholesterol (average) 17.6 per cent, and phosphatides (average) 14.2 per cent - all percentages being in relation to the reference values. A hyperproteinaemia (type IIa/Fredrickson) disappeared in 14 out of 18 cases, a hyperlipoproteinaemia (type IIb) in 14 out of 44 cases, and the same happened with this disease type IV in 114 out of 206 cases. A change of type was stated 16 times.

[Errors in practising a so-called "reasonable" regimen (author's transl)]. / Fehler bei sogenannter "vernünftiger" Diät

The significant decrease of the serum concentrations of total cholesterol, triglycerides, phosphatides, beta-cholesterol, and beta-lipoproteins, which usually is observed after conversion from normal eating habits to a "reasonable" diet, is prevented by supplementary and unverifiable consumption of confectionery and/or by alcohol abuse in irregular intervals. The so-called "reasonable" regimen is a high-fat and protein-rich diet food containing more than 50 per cent of multiple-unsaturated fatty acid in the fat supply. The fact that the average serum concentrations of the divers lipid fractions within the entire group of the 30 patients examined (patients who - admittedly - were practising a luxury form of consumption) showed merely insignificant fluctuations, is in no way a justification for the conclusion that a "reasonable" diet will at any time ostensively represent a protection against the effect of luxury consumption on the serum lipids.