Relationship between generation and plasma concentration of anorganic phosphorus. In vivo studies on dialysis patients and in vitro studies on erythrocytes.

The plasma concentration of inorganic phosphorus (Pi) was determined before, during and after hemodialysis in 28 patients with chronic renal failure. Pi plasma concentration decreased rapidly when hemodialysis was started but did not fall below normal levels during continued dialysis. These changes of Pi concentration were fitted to a model of Pi kinetics in which Pi delivery to plasma is a nonlinear function of the extracellular Pi concentration. In separate in vitro studies, erythrocytes from six subjects with normal renal function and from 14 patients with chronic renal failure were incubated in homologous plasma with various amounts of Pi added. All other factors known to affect the Pi shift between intra- and extracellular fluid compartments (pH, calcium concentration) were kept constant. The relation between Pi concentration in plasma used for incubation and in red cells after 1h incubation suggested a mechanism in which a high plasma concentration results in movement of Pi into red cells where Pi is stored most probably in glucose esters. At low Pi plasma concentration Pi is delivered to plasma at a rate which cannot be explained solely by passive movement of intracellular Pi to plasma but requires additional generation from intracellular storage forms. The generation and delivery of Pi in patients and in their erythrocytes indicate a simple cell-mediated Pi homeostasis counter-acting abnormal fluctuations of plasma Pi.

[Trimethoprim as a monosubstance and cotrimoxazole in infections of the efferent urinary tract]. / Trimethoprim als Monosubstanz und Cotrimoxazol bei Infektionen der ableitenden Harnwege.

In a randomized single blind study the efficiency of Trimethoprim as a monosubstance used in the therapy of urinary tract infections was compared to that of Cotrimoxazole. There was a total of 40 patients available 20 of whom were given 2 X 200 mg Trimethoprim throughout 10 days whereas the other 20 patients were given 2 X 160 mg Trimethoprim + 800 mg Sulphamethoxazole in the same period. All patients were hospitalized during treatment. The urine was bacteriologically checked at the beginning of the treatment and after 7, 14 and 28 days respectively. The therapy was equally successful in both groups, both from the clinical and the bacteriological point of view (Trimethoprim 17, Cotrimoxazole 18); a statistically significant difference was not to be proved. In the Trimethoprim group there was one relapse, in the Cotrimoxazole group there were two. Undesirable side effects occurred in both groups with a larger number of them occurring in the Cotrimoxazole group. Cotrimoxazole and Trimethoprim proved equally efficient from a clinical point of view. The proportion of side effects is more favourable for Trimethoprim alone; the cost of therapy is almost 50% lower than that of Cotrimoxazole.

[Cyclosporin A as a diabetogenic cofactor]. / Cyclosporin A als diabetogener Kofaktor.

Two kidney transplanted patients are reported, who developed an insulin dependent diabetes mellitus after crossing therapeutic Cyclosporine A levels. After stabilisation of the Cyclosporine A levels the insulin dependent diabetes mellitus was completely reversible. The results are indicating Cyclosporine A as the insulin dependent diabetes mellitus initiator.

Phosphorus kinetics during haemodialysis and haemofiltration.

Phosphorus excretion during haemodialysis positively correlates with the plasma inorganic phosphorus (Pi) concentration and the dialyser Pi clearance. Therefore, by using highly efficient dialysers or haemofilters, disciplined patients may achieve a well regulated P-balance. The plasma Pi concentration time curve during haemodialysis or haemofiltration must be seen as the result of passive diffusion combined with an active mobilisation of Pi from a rapidly exchangeable P-pool. The plasma Pi concentration hardly falls below the normal range in dialysis patients, regardless of the quantity of Pi removed by haemodialysis or haemofiltration. The stability of plasma Pi demonstrates the existence of a mechanism for phosphate regulation in body fluids, independent of the calcium homeostasis.

[A new microglossary for biopsy pathology]. / Ein neues Mikroglossar für die Biopsiepathologie.

The documentation of surgical biopsy reports involves the ordering, processing and retrieval of their informative content. Large amounts of data require computerization, which in turn demands a hierarchical code for optimal exploitation. The best coded nomenclature at present is the Systematized Nomenclature of Medicine (SNOMED), which was developed from the Systematized Nomenclature of Pathology (1965) after a 10-year trial and systematic evaluation. This system is based on the principle of facet classification and was conceived especially for computerized data processing. A microglossary is a strict subset of diagnostic terms for one particular field, which has been chosen from the entire set of medical terms available. The microglossary for computerized processing of biopsy data, which is currently being developed at the Department of Pathology of Graz University, is presented in this paper.