Ophthalmic surgical complications in Werner's syndrome: report on 18 eyes of nine patients

In ten of 18 eyes from nine patients with Werner's syndrome cataract surgery was complicated by wound dehiscence and its consequences: peripheral anterior synechiae (4X), secondary epiretinal gliosis (4X), cystoid macular edema (3X) in the framework of Hruby-Irvine-Gass syndrome, unplanned filtering bleb (2X), and postoperative anterior ischemic optic neuropathy (1X). Additionally, corneal endothelial decompensation occurred in eight eyes. In view of the fibroblasts' reduced growth potential, we suggest small surgical incisions, extracapsular cataract surgery using phacoemulsification, intraocular irrigation solutions protecting corneal endothelium, nonabsorbable single knot sutures not removed before 1 year after surgery, and no local or systemic use of cortisone.

[Pharmacokinetics and pharmacodynamics of theophylline in geriatric patients with multiple diseases]

The pharmacokinetics of theophylline (200 mg i.v.) were determined in 20 geriatric patients with multiple diseases. Serum concentrations were fitted to an open 2-compartment model. Percent changes in venous pCO2 and pO2 were used as parameters of the pharmacodynamic action. Total clearance was decreased and elimination half-life of theophylline was found to be prolonged in the elderly patients compared with data of a study with young healthy volunteers. The stronger the pharmacodynamic action of theophylline (percent change of venous pCO2 after 30 min), the faster was its elimination and the lower were measured concentrations after 2, 6, and 12 h.

Age-dependent phagocytosis of erythrocytes by the isolated perfused rat liver after galactosamine hepatitis and alpha-naphthylisothiocyanate cholestasis

Isolated rat livers were perfused with an immunoglobulin-free fluid containing homologous rat erythrocytes suspended in an isotonic saline solution. Galactosamine hepatitis and alpha-naphthylisothiocyanate cholestasis were induced as experimental liver diseases. The glutamic oxalacetic transaminase (GOT) and guanosine triphosphate (GPT) activities, the potassium level as well as the redox quotients of lactate/pyruvate and beta-hydroxybutyrate/acetoacetate were determined as liver function parameters.

RESULTS

The same dose of galactosamine led to two different types of reaction. The group suffering more damage (rendering maximum GOT activities) phagocytosed significantly (p less than or equal to 0.05) more erythrocytes than the other group. Galactosamine hepatitis significantly slows down the phagocytosis of erythrocytes. The function of the mononuclear phagocytosing cells in the liver is intact. The alpha-naphthylisothiocyanate (ANIT) cholestasis significantly reduces the capacity of the mononuclear phagocytosing cells in the liver. Young erythrocytes were phagocytosed significantly better than old ones in either type of liver damage, in galactosamine hepatitis and in ANIT cholestasis as well as by healthy livers.

Plasma lipids and composition of red cells in four cases of Werner's syndrome

Four cases of accelerated aging, known as Werner's syndrome (WS), are presented. Plasma lipid and lipoprotein findings and lipid compositions of red cell membranes are compared to those of old and young healthy people. Typical clinical findings, as reported in the literature, confirmed the diagnosis. Furthermore, an elevated osmotic fragility of red blood cells (RBC) was observed. RBC membranes of WS patients showed phospholipid concentrations similar to those found in people aged over 70 years, which have been reported to be lower than those of mature donors aged below 30 years. Fatty acid patterns of RBC membranes and plasma phospholipids were indicative of some disturbance in phospholipid subclass distributions in WS-patients.

Pharmacokinetics and pharmacodynamics of furosemide in geriatric patients

Twenty geriatric patients with multiple diseases were administered a single intravenous dose of 40 mg furosemide. Furosemide plasma and urine concentrations were measured using a thin-layer chromatography method and were fitted to an open 2-compartment model. Furosemide half-life was prolonged two-fold in the elderly patients compared with a control group of younger adults. In the same way renal clearance and total clearance were markedly reduced in the geriatric group. The non-renal clearance and the volume of distribution were not significantly altered. There were many significant correlations between clinical and biochemical data and pharmacokinetic parameters, especially between blood pressure and the area under the curve (AUC O-infinity), total clearance and non-renal clearance of furosemide. Our data suggest a special function of alpha-2-globulins in binding of furosemide. Renal function (i.e. creatinine clearance) was shown to be an important parameter for estimating the elimination rate of furosemide. In addition, pharmacodynamic action (volume of excreted urine) was closely correlated with the elimination rate: furosemide is apparently triggering its own elimination.

[The effect of heparin, prednisolone and triamterene on the elimination of India ink by the reticulohistiocyte system of the isolated perfused rat liver]

The influence of heparin, prednisolone and triamterene on the elimination of colloidal carbon (India ink) by the reticulohistiocytary system of the isolated perfused rat liver was measured. The drugs were given directly to the perfusion medium. A significant reduction of the phagocytic capacity of Kupffer's cells for colloidal carbon under the influence of heparin, prednisolone and triamterene could be demonstrated.

The effect of different fat supplemented diets on the erythrocyte ghosts and plasma lipid composition of geriatric subjects

The responses of the lipid composition of erythrocyte ghosts and plasma phospholipid fatty acids of 20 female donors, aged older than 70 years, to different margarine and butter supplemented diets were investigated. On a low level of daily caloric intake (1900 kcal) there were no changes in phospholipid and cholesterol content of the red cell membranes, but statistically significant changes were found in erythrocyte and plasma phospholipid fatty acid patterns. These results demonstrate the influence of the fatty acid composition of the dietary fats with special reference to saturated, trans-isomeric monoene, and polyunsaturated acids.

Serum level, half-life and apparent volume of distribution of doxycycline in geriatric patients

The serum level, half-life and apparent volume of distribution of doxycycline were determined in geriatric patients. The serum level and apparent volume of distribution were higher than those reported for younger persons. The apparent volume of distribution was correlated with the serum iron and beta-globulin levels. The possible influence of binding of doxycycline to serum iron on its pharmacokinetics is discussed.

Steroid receptor activation: the glucocorticoid receptor as a model system

The glucocorticoid receptor has been used as a model for steroid receptor activation. Because of recent evidence for the essentially nuclear location of the unoccupied receptors of 1,25-dihydroxycholecalciferol and 17 beta-estradiol, the significance of the activation mechanism converting unactivated receptor complexes to DNA-binding forms is unclear for some receptors. Up to now the weight of evidence favors a cytoplasmic location of the unactivated glucocorticoid receptor. In this article we describe studies on the nature of the activation mechanism and of regulatory factors.

Methyl enol ethers as artefacts in capillary gas chromatographic profiles of aldehyde dimethyl acetals

Methyl enol ethers are detected within the capillary gas chromatographic profiles of aldehyde dimethyl acetals derived from human red cell plasmalogens or from a synthetic aldehyde mixture. They arise from the dimethyl acetals via methanol elimination as artefacts of the injection technique. In a nutritional experiment, the probands showed a rising proportion of dimethyl acetals in the phospholipid fraction of their erythrocyte ghosts; this fact is seen as an effect of the lipid composition of the milk fat administered.

ABO blood group system, age, sex, risk factors and cardiac infarction

In a retrospective study in 3100 patients of different ages the relationship between blood group and cardiac infarction was investigated in 450 patients. The patients were divided in two age groups: those who were 65 yr old and older and younger patients (age less than 65 yr). The predominance of blood group A in patients with cardiac infarction was highly significant in both age groups (P less than 0.005, two-tailed Chi-square test). Step-wise excluding all patients with at least one of the risk factors, hypertension, hyperuricemia, diabetes mellitus, smoking, and hyperlipemia similar results were found: the predominance of blood group A in the elderly patients with cardiac infarction was even higher than before excluding the risk factors (P less than 0.001). The predominance of blood group A was also demonstrated at a lower level in younger patients with cardiac infarction (P less than 0.05). Our investigation strongly suggests the existence of a genetic factor associated with blood group A and independent of the other risk factors which is also responsible for a greater incidence of cardiac infarction.

Aging in vivo and neuraminidase treatment of rat erythrocytes and their sequestration by the isolated perfused rat liver

The isolated perfused rat liver as a model for phagocytosis leaves the specific arrangement of macrophages in the original tissue structure intact. Therefore phagocytosis may occur under terms closely approaching physiological conditions. Separation of rat erythrocytes according to their density in 13% young, 75% mature and 12% old cells permits the establishment of differences in the mean cellular volume (MCV), mean cellular hemoglobin concentration (MCHC) and content of N-acetylneuraminic acid per red blood cell (NANA/RBC). Perfusion of these fractions does not result in significant differences of sequestration of the isolated liver. Enzymatic release of 90% of membrane-bound sialic acid causes a significant increase of 20% in the elimination of erythrocytes from the perfusate. Treatment with neuraminidase is a trigger for sequestration either by adherence or by complete phagocytosis. Incubation of neuraminidase-treated erythrocytes with plasma does not increase the removal rate of cells during perfusion.

Phagocytosis of erythrocyte membranes (white ghosts) from different species by the isolated perfused rat liver

Autologous and heterologous erythrocyte membranes (white ghosts) - suspended in a perfusion medium free of immunoglobulins, proteins and hemoglobin - were offered for phagocytosis to isolated perfused livers of different rat strains. The mononuclear phagocyte system of the liver was able to phagocytize these membranes without opsonization. An immunological reaction between Kupffer cells and red cell membranes cannot be excluded, since autologous cell membranes are phagocytized at a higher rate than heterologous cell membranes.

[Pharmacokinetics of naftidrofuryl in multimorbidity in geriatric patients]

The present pharmacokinetic study of a drug used in geriatric patients with multiple diseases reveals that the half-life in the elderly was extended for about three times as long as in the corresponding control group. There are significant positive as well as negative correlations between the kinetic data and routine parameters of the metabolism. These statistical correlations should be controlled by experimental studies.

[Furosemide--pharmacokinetics in geriatric patients with multimorbidity]

20 geriatric patients with multiple diseases were administered a single intravenous dose of 40 mg furosemide. Furosemide plasma and urine concentrations were measured using a thin-layer chromatography method (25) and were fitted to an open 2-compartment model. Furosemide half-life was prolonged twofold in the elderly patients compared with a control group of younger adults. In the same way renal clearance and total clearance were markedly reduced in the geriatric group. The nonrenal clearance and the volume of distribution (beta) were not significantly altered. There were many significant correlations between clinical and biochemical data and pharmacokinetic parameters, especially between blood pressure and the area under the curve (AUC 0-infinity), total clearance and nonrenal clearance of furosemide. Our data suggest a special function of alpha-2-globulins in binding of furosemide. Renal function (i.e. creatinine clearance) was shown to be an important parameter for estimating the elimination rate of furosemide.

Use of lipids to potentiate the antibacterial activity of aminoglycosides

Linolenyl alcohol has been shown to inhibit the in vitro growth of several species of gram-positive bacteria. Since the double bonds in linolenyl alcohol could undergo autooxidation, the antimicrobial activities of saturated primary alcohols of similar molecular sizes against Streptococcus mutans BHT were evaluated. Tridecan-1-ol was identified as the most active compound, eliciting a bacteriostatic effect at concentrations at which growth occurred in the presence of other saturated alcohols or linolenyl alcohol. Evidence is also presented that the combined use of tridecan-1-ol and gentamicin sulfate produces a synergistic effect that is bactericidal to S. mutans BHT. A similar bactericidal response was observed when tridecan-1-ol was combined with other aminoglycosides or tested alone against other strains of S. mutans.

[Rehabilitative treatment of cerebral apoplectic insults in advanced age and evaluating its effectiveness--results of a model project]

This report is of a two year study of stroke rehabilitation. Given certain conditions with specialized personnel and equipment the rehabilitation of elderly stroke patients can be managed co-operatively in hospitals and old age care centres. The rehabilitation of stroke affected is based on the support of multidisciplinary diagnosis and interdisciplinary teamwork between physicians, physiotherapists, occupational therapists, speech therapists, psychologists and social workers. Each patient requires an individual treatment program. In this study were 72 patients ranging in age from 42-87 years, average age 73 years. They had been judged as progressively degenerative and helpless following their stroke and consequently regarded as patients for a nursing home. Following special rehabilitation treatment 75% (54 patients) had improved enough that it was possible for them to return to their homes. Only 12.5% (9 patients) had to remain in a nursing home. 6.6% (4 patients) transferred to an old people's home. 6.9% (9 patients) were readmitted to hospital because of additional serious complications. The average duration of rehabilitative treatment was 72.3 days. The degree of hemiplegia and the patients ability to lead their own active daily independent life was reviewed before and after rehabilitation and used as control. 76.6% showed an improvement in their motor function. 61.1% returned to their own independent daily life as measured by ADL-Indices. (a. Barthel Index, b. ADL-Index-Katz-, c. Patient Classification for Long Term Care-Jones-, d. Crichton Royal Behavioural Rating Scale-Robinson-.).(ABSTRACT TRUNCATED AT 250 WORDS)