Glycose aminoglycane excretion and concentration in the urine of patients with frequently recurrent calcium-oxalate lithiasis prior to and following Diclofenac-Na therapy.

Excretion and concentration of glycose aminoglycans were measured in 19 patients with frequent relapses of calcium-oxalate lithiasis, prior to and two weeks after onset of Diclofenac-Na therapy. In most patients, markedly enhanced glycose aminoglycan concentration and excretion could be demonstrated. Elevation of the high-molecular inhibitor potential in the urine results in reduced risk of calcium-oxalate lithogenesis, which may explain the therapeutic success of nonsteroidal anti-inflammatory drugs in the treatment of therapy resistant calcium-oxalate lithiasis.

Clinical results in the treatment of therapy-resistant calcium-stone formers with non-steroidal anti-inflammatory drugs.

Long-lasting success was obtained in the treatment of 8 therapy-resistant, frequently relapsing calcium-stone formers with non-steroidal anti-inflammatory drugs (NSAIDs). Over the period of treatment the rate of stone formation decreased markedly in these patients. Until now 3 test persons have exhibited only partial success with NSAID treatment. Diclofenac-Na as single-drug therapy or in combination with thiazide preparations or indomethacin is presented as a novel therapeutic possibility, the influence of NSAID on pathomechanism of calcium-stone formation is discussed.

[Diclofenac-Na--an alternative treatment possibility in therapy-resistant calcium oxalate urolithiasis?]. / Diclofenac-Na--eine alternative Behandlungsmöglichkeit beim therapieresistenten Kalzium-Oxalat-Harnsteinleiden?

In a prospective study, the influence of sole Diclofenac-Na therapy (3 X 25 mg Rewodina, Voltaren) on the calculus recurrence rate of eight frequently relapsing and therapy resistant calcium-oxalate stone patients is analysed. During a period of one year's treatment, the recurrence rate could be reduced by 73.2%, from 123 to 33 calculi. Serious side effects, changes in blood serological parameters and various urine components were not observed. The course of passages of calculi was improved by reduced pain and rapid passage. The paper summarizes all results of calcium-oxalate stone treatments with nonsteroidal antiphlogistics known so far. In the opinion of the authors, the present successful Diclofenac-Na treatment offers a novel possibility of influencing therapy resistant stone-formers over long periods.

[Possibilities and limits in the treatment of cystine calculus diathesis with high-dose ascorbic acid. Results of a combined study with 17 patients]. / Möglichkeiten und Grenzen bei der Behandlung der Zystinsteindiathese mit hochdosierter Ascorbinsäure. Ergebnisse einer Verbundstudie mit 17 Patienten.

17 cystine stone patients were treated with high doses of ascorbic acid (5 g p. d.). During the observation period, a total of only two natural passages of cystine stones could be observed. For five patients the therapeutic strategy was altered because the recurrence rate did not change and the cystine concentration in the urine was enhanced. One mixed calcium-oxalate/cystine stone had to be resected. In this case as well as on the occasion of further medical check-ups of other patients, an increased risk of calcium-oxalate stone formation was signalled by an enhanced oxalic-acid concentration in the 24-hour urine. Changes in blood serum and impairment in hepatic and renal functions were not observed. With three patients, the therapy had to be interrupted because of gastritis symptoms. The use of high-dose ascorbic acid therapy is recommended and is continued. In special cases, an additive of low do ses of alpha-mercaptopropionyl-glycine is recommended.

[Modification of the risk of urolithiasis by changes in magnesium and calcium concentrations in the urine as affected by stress conditions]. / Uber die Beeinflussung des Harnsteinbildungsrisikos durch Veränderungen der Magnesium- und Calciumkonzentration im Urin unter Stressbedingungen.

Under defined stress conditions, a slight decrease in the calcium concentration in the urine of calcium oxalate stone patients on the first and second experimental days was observed. Taking simultaneously recorded calcium concentrations into consideration, Ca/Mg quotients, were calculated, which, at least in single cases, exceed the limiting range, thus signalling an increased risk of calculus formation.

[Effect of proteolytic enzymes, electrolytes and other factors on the crystallization of calcium oxalate in the urine]. / Uber den Einfluss proteolytischer Fermente, Elektrolyte und anderer Faktoren auf die Kristallisation von Kalziumoxalat im Urin.

On the basis of 18 discriminance-analytically balanced urine parameters of patients with recidive calcium-oxalate nephrolithiasis and control subjects without urological complaints, it is shown in this article that the concentration of proteolytic activity, of enzyme inhibitors, of acid mucopolysaccharides and inhibition indices do not give better separation between the control group and recidive calcium-oxalate lithiasis patients than the usually measured urine parameters.

[Gel model for measuring crystallization inhibitor activity]. / Gelmodell zur Messung von Kristallisationsinhibitoraktivitäten.

In an attempt to develop a method with the most favourable possible relationship of information gained to expenditure of material and time a simple way of measuring crystallisation inhibitor activity was developed. Calcium and oxalate ions are diffused against each other out of two opposite start holes in a layer of gel on a microscopic slide and form a strip of calcium oxalate crystals where they meet in the middle. The substances influencing crystallisation are allowed to diffuse into this central area. The density and extent of the calcium oxalate strips vary according to the inhibitory effect of the substances used. These differences were registered by means of photometric measurement for comparison against a control without any inhibitor added and an inhibition index was computed. Some of the best-known inhibitors were tested and also show a defined effect in this model. In physiological concentrations magnesium and citrate can be said to have particular importance. The range of inhibitory activities to be expected of human urine is covered by the present model.