[Microangiopathic hemolytic anemia]. / Die mikroangiopathische hämolytische Anämie.

It is reported on a more infrequent or too little regarded clinical picture within the form circle of the disseminated intravasal coagulation disturbances, the microangiopathic haemolytic anaemia (MHA). Diagnostically heuristic is the clinical triad haemolytic anaemia, thrombocytopenia and haemorrhagic diathesis. The microangiopathic haemolytic anaemia is described on the basis of a casuistics, the present knowledge about pathogenesis and therapy are discussed.

[Nail-patella syndrome]. / Nagel-Patella-Syndrom.

In a case report the rare nail-patella-syndrome is presented. Typical and pathognomonic signs are: nail aplasia or dystrophy, iliac horns, hypoplasia or aplasia of the patellae, elbow dysplasia and a nephropathy with electron microscopic demonstrable collagen-like deposition in the glomerular basal membrane. The clinical relevance is determined by the course of the renal disease.

[The secretory performance of eccrine sweat glands from the nephrologic viewpoint--II: Middle molecules]. / Zur sekretorischen Leistung ekkriner Schweissdrüsen aus nephrologischer Sicht-Teil II: Mittelmoleküle.

By means of gel-chromatographic investigations in the serum, sweat, urine and ultrafiltrate of healthy test persons, patients with renal insufficiency at the stage of the compensated and decompensated retention and of patients undergoing dialysis in the eccrine sweat substances in the area of so-called molecules of medium size from 1,100 to 2,050 Dalton are made evident. On account of the well-known heterogeneity of the gel-chromatographically separated fraction the concentration of the molecules of medium size is not unequivocally to be determined. It is, judged according to the peak hights of the chromatograms, less than 1/12 of the concentrations in the serum and the urine, but approximately corresponds to the content in the ultrafiltrate of patients undergoing haemodialysis. In patients with renal diseases the secretory possibility of the eccrine sudoriferous gland for molecules of medium size is not disturbed. A compensatory increased secretion of medium-size molecules via sweat in chronic renal insufficiency is not to be proved. The method of the gel-chromatography and the importance of the medium-size molecules for the pathogenesis of uraemia are critically discussed.

[Studies of dialysis patients using the 14C aminophenazone breath test]. / Untersuchungen von Dialysepatienten mit dem 14C-Aminophenazon-Atemtest.

In 12 endstage kidney disease patients (8 liver healthy and 4 with liver diseases) the activities of cytochrome P450-dependentmixed functional oxidases system (MFO) of the liver were studied by using the 14C-aminophenazon breath test before and after dialysis. We were interested in the influence of uremia and dialysis treatment on MFO-activity. Our results show that uremia seems to have a pressing influence on MFO-activity. The activity was only significantly increased after dialysis in the group of patients without liver disease. We observed that the MFO-activity was reduced in patients with liver diseases. This is a restriction of the liver metabolic demethylation capacity. It is unclear if the 14C-aminophenazone breath test in dialysis patients is qualified to estimate metabolic capacity of the liver. Differentiation between the influence of uremia and of the liver disease on the alteration of MFO-activity cannot be made.

[Analysis of the body fluids using SDS-gradient gel electrophoresis]. / Untersuchungen von Körperflüssigkeiten mittels SDS-Gradientengelelektrophorese.

In the present report we describe a horizontal SDS-electrophoresis in thin- or ultrathin-layer polyacrylamide pore-gradient gel polymerized on polyester films for the estimation of proteins in several human body fluids. Up to 25 samples can be analyzed side by side under identical conditions. The combination of Coomassie blue staining with silver-staining allows the analysis of fluids containing low protein content also without concentrative techniques.

[The elderly dialysis patient]. / Der ältere Dialysepatient.

By the experience of two smaller dialysis centers the prognosis and problems of dialysis therapy in older patients are described. The age in the onset of dialysis treatment ranged from 45 to 54 years. In the beginning of dialysis the average life expectancy of older patients is markedly lower in comparison with younger patients, but remarkable in single cases with more than 4 and 5 years. The problems of adaptation and complications do require much attention and allowance. Contra-indications to dialysis therapy in older patients could not be explained. The demand for a stronger consideration of this patient group in planning of dialysis capacity is established through an international comparison and a possible rehabilitation of the patients.

[Osteoradionecrosis resulting from cobalt-60 therapy for head and neck tumors (author's transl)]. / Osteoradionekrose bei Kobalt-60-Therapie im Kopf-Hals-Bereich.

From 1966--1974, 628 patients were irradiated with Cobalt-60 as treatment for tumors of the head and neck. Tumor doses ranged from 6200 R to 8000 R. An osteoradionecrosis was discovered in 17 patients, and was mostly localized in the mandible. Most of the patients developed the necrosis during the first two years following completion of their radiation, although necrosis was also found up to 9 years following therapy. Prophylactic treatment of teeth should be completed before beginning radiation therapy, but such does not exclude the risk of necrosis.

[Therapy of thromboembolic diseases in old age (author's transl)]. / Die Behandlung thromboembolischer Krankheiten im höheren Lebensalter.

It can be established, that thromboembolic diseases in higher age are suited for a thrombolitical therapy and for a treatment with anticoagulations also. In higher age of the patients we should pay attention especially to possible contraindications and a thrombolitical therapy should be carried out under clinical conditions. The results of treatment justify our therapy, because the mortality of the patients treated with anticoagulations lies clearly under the mortality of those patients without anticoagulations.

[Early clinical symptoms and therapy of haemorrhages in old age (author's transl)]. / Frühsymptomatik und Therapie van Blutungen beim alten Menschen

There is hardly a bleeding, where the extrinsic-and/or the intrinsic-system of the coagulation does not take part in. Haemorrhages represent a symptom only, and it is always to clear, if they are come from a local process of illness or from a general tendency of haemorrhage. There is point to the clinical differences of great bleeding (coagulopathy) and bleedings like points (the causes lie in the thrombocytes or in a vascular damage). The early clinical symptoms and the therapy of haemorrhages by the old human without the primary disturbance of the coagulate-system are discussed.

[Problems of coagulation analysis in diagnosing inflammatory and thrombotic venous diseases in ageing (author's transl)]. / Gerinnungsanalytische Probleme bei der Diagnostik entzündlicher und thrombotischer Venenerkrankungen im Alter

Diagnosing inflammatory and thrombotic venous diseases by analysing coagulation is difficult because the results obtained with this method are not certain. Not all persons concerned use scintigraphy, the ultrasonic methods, infrared photography and phlebography as routine diagnostic methods. The surest way of diagnosing inflammatory and thrombotic venous diseases is still to bear in mind the limitations and the criteria mentioned and to combine the clinical and paraclinical methods into a diagnostic mosaic.