Aluminum, zinc and copper concentrations in plasma in chronic renal insufficiency.

Plasma aluminium, zinc and copper were determined in 68 patients with chronic renal insufficiency and in 20 healthy individuals. In the renal insufficiency group 16 patients had received aluminium containing substances particularly phosphate binding drugs (aluminium hydroxide) for a long time. We observed that only the patients taking aluminium hydroxide showed elevated aluminium levels in plasma (controls: 0.86 +/- 0.27 mumoles/l; renal insufficiency: 3.05 +/- 1.63 mumoles/l). In two of these patients with symptoms of "dialysis dementia", plasma aluminium concentrations were markedly increased. The zinc concentrations in plasma of patients with renal insufficiency were slightly decreased (controls: 14.48 +/- 2.65 mumoles/l; renal insufficiency: 11.77 +/- 2.35 mumoles/l); the plasma copper concentrations were slightly increased (controls: 17.3 +/- 2.83 mumoles/l; renal insufficiency: 22.98 +/- 4.7 mumoles/l). There was a distinct decrease of plasma zinc concentrations in patients with raised aluminium levels. The clinical aspects of these changes are discussed.

Renal excretion of magnesium and trace elements during cisplatin treatment.

Plasma and urine concentrations of platinum, magnesium, zinc and copper were measured in 15 patients treated with cisplatin. The renal excretion rates of platinum, magnesium, zinc and copper were markedly increased. In plasma markedly elevated levels of platinum could be found and were accompanied by decreased concentrations of magnesium, potassium and calcium. The plasma concentrations of zinc and copper showed only slight changes. Our results indicate, that cisplatin may influence renal excretion of some electrolytes and trace elements by a specific factor and/or by alteration in renal function.

Hemofiltration in myoglobinuric acute renal failure.

The frequency of myoglobinuric renal failure is estimated between 8 and 20%. Despite early onset of therapy often the use of renal substitution by hemodialysis or hemofiltration is required. This study of the clinical course of nine patients with myoglobinuric acute renal failure reveals continuous arterio-venous hemofiltration (CAVH) to have an effective clearance for myoglobin. Thus, the time until recovery of renal function as well as the frequency of secondary complications in rhabdomyolysis induced acute renal failure can be distinctly reduced.

Elemental and trace element distribution in medical samples: analysis by proton-induced X-ray emission.

The analysis of trace elements is performed by proton-induced X-ray emission. The process is most effective if the velocity of the exciting particles--protons--is similar to the velocity of the electron on its orbit in the simple atomic model of Bohr. For K-shell electrons of the elements with 15 less than or equal to z less than or equal to 40 this requires proton energies of a few MeV, available from electrostatic van de Graaf accelerator machines. After knocking out the K-shell electron, the empty place is filled up by electrons jumping from higher orbits with simultaneous emission of characteristic X-rays, which are registered with a cooled Si (Li) detector. By a set of electrodes the beam can be swept across the specimen surface. Therefore this method yields an excellent correlation of trace element distribution within the morphological structure of organic tissue. In the present study the sweep went along a line perpendicular to the arterial wall layers (aortic, renal artery and heart muscle) of normotensive and spontaneously hypertensive rats. Along this line all elements and trace elements are recorded simultaneously. These are P, S, Cl, K, Ca, Fe, Cu, Zn, Br and Sr. The trace element content of the aortic wall and the renal artery, of 22 spontaneously hypertensive and 11 normotensive rats and of human heart muscle was investigated. The results demonstrate that Zn was only detected in the muscle-containing layers of the arteries. There was no different distribution between hypertensive and normotensive rats. However, Ca2+ was mainly detected in the smooth muscle-containing tunica media of hypertensive rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical aspects of selenium metabolism.

Whereas defined selenium deficiency diseases are well characterized in animals, analogous syndromes in humans are unknown or occur only rarely under conditions of extreme selenium depletion. However, selenium deficiency has since been recognized to play important secondary roles in a variety of human diseases, and several of these can be prevented or treated by means of selenium supplementation. In clinical practice, the selenium status of patients should be monitored routinely, and corrective measures should be instituted to replete the Se body stores of patients where necessary. Interactions of Se with other elements are also of potentially great clinical significance. The importance of such interactions is exemplified by the effects of cadmium on selenium metabolism in spontaneously hypertensive rats.

[Rare variants and unusual course of Cushing's syndrome]. / Seltene Varianten und Verlaufsformen des Cushing-Syndroms.

Cushing's syndrome is a rarely observed disease with a poor prognosis when not treated appropriately. Knowledge of clinical features of the different forms of the disease together with a specific and subtle method of cortisol detection is indispensable for an early out-patient diagnostic program. In this study the characteristic features of the rare benign and malignant forms of Cushing's syndrome are presented in typical case-reports. As it has been proven in clinical experience, the necessary diagnostic measures for clarification of the syndrome consists of only few methods reliable concerning their diagnostic validity. The success of any curative treatment of the benign forms or any palliative measure of the malignant forms essentially depends on early diagnosis and differentiation of the various appearances of Cushing's disease.