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Hyperparathyroidism (HPT) with hypercalcemia, often deemed irreversible and detrimental to graft survival post-kidney transplantation (KT), prompts pre-transplant parathyroidectomy in hypercalcemic patients. In this retrospective analysis of 1212 kidney transplant recipients (KTRs) between 2006 and 2019, the incidence and effect of persistent HPT and hypercalcemia on graft and patient survival, and risk factors for persistence were analyzed until 60 months of follow up (FU). At KT, 5.7% (n = 69) had no HPT, 32.7% (n = 396) had HPT without hypercalcemia and 37.0% (n = 448) had HPT with hypercalcemia. At 2 years FU, 26.4% (n = 320) of patients had no HPT and 6% (n = 73) had HPT with hypercalcemia. Dialysis and dialysis duration were linked to HPT development, while dialysis, KT waiting time and donor type correlated with persisting hypercalcemia after KT. KTRs with normalized PTH and recovered hypercalcemia had improved death-censored graft survival ( p < 0.001) and overall patient survival ( p < 0.001). HPT with hypercalcemia is frequent at time of KT with normalization of PTH and calcium in a substantial proportion of patients after a KT. These findings question the routine pre-KT parathyroidectomy for suspected parathyroid autonomy. Persisting HPT, especially with hypercalcemia, adversely affects graft and patient survival, suggesting the need for more aggressive treatment of HPT, especially in cases of persisting hypercalcemia.

An exceptionally low calcium (Ca 2+ ) concentration in the inner ear endolymph ([Ca 2+ ] endolymph ) is crucial for proper auditory and vestibular function. The endolymphatic sac (ES) is believed to critically contribute to the maintenance of this low [Ca 2+ ] endolymph . Here, we investigated the immunohistochemical localization of proteins that are presumably involved in the sensing and transport of extracellular Ca 2+ in the murine ES epithelium. Light microscopic and fluorescence immunolabeling in paraffin-embedded murine ES tissue sections (male C57BL/6 mice, 6-8 weeks old) demonstrated the presence of the calcium-sensing receptor CaSR, transient receptor potential cation channel subtypes TRPV5 and TRPV6, sarco/endoplasmic reticulum Ca 2+ -ATPases SERCA1 and SERCA2, Na + /Ca 2+ exchanger NCX2, and plasma membrane Ca 2+ ATPases PMCA1 and PMCA4 in ES epithelial cells. These proteins exhibited (i) membranous (apical or basolateral) or cytoplasmic localization patterns, (ii) a proximal-to-distal labeling gradient within the ES, and (iii) different distribution patterns among ES epithelial cell types (mitochondria-rich cells (MRCs) and ribosome-rich cells (RRCs)). Notably, in the inner ear membranous labyrinth, CaSR was exclusively localized in MRCs, suggesting a unique role of the ES epithelium in CaSR-mediated sensing and control of [Ca 2+ ] endolymph . Structural loss of the distal ES, which is consistently observed in Meniere's disease, may therefore critically disturb [Ca 2+ ] endolymph and contribute to the pathogenesis of Meniere's disease.

This investigation aims at finding a scientifically based method to prevent the traumatization of children in dental treatment. Modern brain research shows that certain simple aids directly interact with the neurological fear responses of the body and memory. With these aids we have been attempting to diminish fear before treatment and to prevent relapse into fear attacks during the treatment. The procedure was surprisingly successful. More than that, it worked equally well with older fear patients. These aids generally raise the treatment to an emotionally comfortable level and lead to better patient cooperation. They put more confidence in the dentist and better relations with the patient..

Haemophilia A is an X-linked bleeding disorder caused by a deficiency of factor VIII. As an essential cofactor in the intrinsic clotting cascade, factor VIII is activated and subsequently inactivated by proteolytic cleavages involving factor IIa (thrombin), factor Xa and activated protein C (APC). Investigation of the thrombin cleavage sites at amino acids 372 and 1689 of the factor VIII protein by oligonucleotide screening, DNA amplification and direct sequencing, enabled us to identify two missense mutations in 441 unrelated haemophiliacs. A C-to-T transition, which leads to the substitution of cysteine for arginine at position 1689, was found in a severely affected patient and a previously undescribed G-to-A substitution, causing replacement of arginine1689 with histidine, was found in a patient with mild disease.

An acquired hemorrhagic disorder developed in two patients in association with postsplenectomy thrombocytosis and leukocytosis during the course of the myeloproliferative syndrome. The presence of acquired von Willebrand's disease in these individuals was demonstrated by a decrease or absence of the larger von Willebrand factor (vWF) multimers, alteration of the repeating vWF multimeric "triplet," decreased ristocetin cofactor activity (vWF:RCo), and prolonged bleeding time. The bleeding stopped in both patients after treatment with either 1-deamino-[8-D-arginine]-vasopressin (DDAVP) or Cohn fraction I. Treatment with thrombocytapheresis and azathioprine or busulfan resulted in reduction of the elevated platelet and white cell counts and was associated with partial correction of the vWF abnormalities and remission of the hemostatic abnormalities. In five additional patients with the myeloproliferative syndrome, but without bleeding symptoms, large multimers of plasma vWF were diminished also. These findings suggest that acquired von Willebrand's disease should be considered when a bleeding diathesis develops during the course of the myeloproliferative syndrome.

Triazine herbicide residues were monitored in the rivers Adour, Danube, Garonne, Herault, Loire, Marne, Oise, Rhine, and Rhône from spring 1976 to fall 1977 to determine whether the continued use of the compounds resulted in accumulations of undesirable residues in the streams. Samples were generally collected monthly or bimonthly and analyzed for the parent compounds atrazine, simazine, terbumeton, terbuthylazine, and dealkylated metabolites GS 26571 (2-amino-4-etert-butylamino-6-methoxy-1,3,5-triazine) and G 30033 (2-amino-4-chloro-6-ethylamino-1,3,5-triazine). The compounds were extracted into dichloromethane and quantitated by gas chromatography (GC) with nitrogen-specific detection. Selected results were verified by GC with mass fragmentographic detection. Limit of detection was usually 0.4 mg/m3; 80 percent of all results were below 0.4 mg/m3, 14 percent were 0.4-1 mg/m3, 6 percent were 1-10 mg/m3, and 0.3 percent were higher than 10 mg/m3. Detectable residues were mainly atrazine from the downstream sampling sites. Residues usually peaked during June.

Hemophilia A is an X-linked bleeding disorder caused by a deficiency or abnormality of factor VIII, affecting approximately 1 male in 10,000. A subgroup of the patients develops inhibitors against factor VIII during substitution therapy. Because a considerable percentage of all cases is thought to result from de novo mutations, it is likely that many different molecular lesions lead to hemophilia A. In order to understand the molecular basis of this disorder, we examined 160 patients with different clinical features using factor VIII gene probes. We could identify six different deletions and seven nonsense mutations within the factor VIII gene. Family analysis revealed that five of these mutations occurred de novo within two generations; two of them arose in the maternal grandfather and three in the mother. In one of these mothers we could identify a mitotic origin. Mapping of the deletions showed no deletion-prone region within the gene. Furthermore, we could not find any correlation between the particular gene defects and "inhibitor" phenotypes.

11.4 mg of a ceramide hexahexoside (B-I) and 16.4 mg of a ceramide octahexoside (B-II) as blood group B-active glycosphingolipids composed of glucose, galactose, N-acetylglucosamine and fucose (molar ratios 1:3:1:1 and 1:4:2:1 respectively) have been isolated from 6,400 ml of packed human B erythrocytes. This yield is greater by more than the 13-fold amount of B-I glycosphingolipid and the 20-fold amount of B-II glycosphingolipid which has hitherto been isolated from human erythrocytes. The B-active glycosphingolipids isolated represent about 0.04% of the erythrocyte membrane and in consequence must be regarded as the main representants of B properties of the erythrocytes as far as they have been investigated up to this time. This high yield was achieved by a simple and conservative erythrocyte membrane preparation without loss of serological activity and by the improvement of some chromatographical methods which permitted a high purification without the acetylation-deacetylation procedure. Purity was checked by gas-liquid chromatographical analysis of the sugars as their alditol acetates and by the hemagglutination inhibition technique. 1.7 x 10-8 g of each of these glycosphingolipids completely inhibit the agglutination of human B erythrocytes by 4 hemagglutination units of normal human anti-B sera. A ceramide tetrahexoside and a glycolipid fraction with a high H activity could also be isolated which possibly are blood group-intermediate substances. Lewis blood group-active glycosphingolipids characterized by the hemagglutination inhibition test and by passive hemagglutination are trace constituents of other glycosphingolipid fractions.

From 46 families of predominantly German origin, afflicted with haemophilia A, 178 females were tested for carrier status. Two polymorphic restriction endonuclease sites, the extragenic marker locus DXS 52 (St 14 probe) and the intragenic Bcl I RFLP were investigated in these families. In some cases the results were corroborated by identifying (i) deletions within the factor VIII:C gene and (ii) eliminating a restriction endonuclease site. Two new alleles of the DXS 52 marker locus were found. According to this strategy, 27 women were classified as carriers and 74 as non-carriers. Forty-six women were classified as carriers according to pedigree analysis. Twenty-five females of families with sporadic cases and 6 test persons, who had mothers who where homozygous for the marker alleles, were diagnosed by additional use of conventional carrier detection.

DNA of 70 unrelated hemophilia B patients, including three inhibitor patients, was analyzed by using various restriction enzymes and was hybridized with both a factor IX cDNA and 3'- and 5'-flanking probes. When the gene was mapped this way, six patients all afflicted with severe hemophilia B were shown to have a deviating hybridization pattern. One inhibitor patient showed a partial deletion of about 9 kb that removes exons a-c. A partial deletion of at least 11 kb that removed exon a and that had a maximum size of 35 kb in the 5'-flanking region could be identified in a patient of unknown status. In another three noninhibitor patients a complete deletion of the factor IX gene and two partial deletions could be observed. The partial deletions are of approximately 8 kb and approximately 1.5 kb, removing exons d and e and exon g, respectively. As detected by oligonucleotide probing, a C-to-T transition at amino acid 338 gave rise to an altered TaqI restriction pattern that could be observed in a sixth patient. The other 64 hemophilia B patients, including two inhibitor patients, showed a hybridization pattern indistinguishable from a normal one.

A social survey in 800 dwellings showed - among other results - the relation between the intensity of traffic noise and the annoyance due to this exposure.

From 81 of human plasma of blood-group A Lea nonsecretors three different Lea blood-group active ceramide pentasaccharides (a total of 4.65 mg) have been isolated, all revealing glucose, galactose, N-acetylglucosamine and fucose in molar ratios of 1 : 2 : 1 : 1 as determined by gas liquid chromatography. A fourth blood-group active fraction (0.72 mg) represents a mixture of a Lea active ceramide pentasaccharide and an A active ceramide hexasaccharide (molar ration 7.7 : 2.3 as calculated from the content of different aminosugars). Additionally, two different globosides, two different hematosides and a new N-acetylglucosamine containing ceramide tetrasaccharide were obtained. All 9 glycolipid fractions demonstrated homogeneity in analytical high performance thin layer chromatography (HPTLC) using 4 different solvent systems. 0.2 microgram of each Lea active glycolipid completely inhibited the agglutination of O Le(a+b-) erythrocytes by 50 microliter of 4 hemagglutinating units of caprine anti Lea serum. At least 0.04 microgram of each Lea antigen are sufficient for incubation to convert 9 x 10(7) O Le(a-b-) erythrocytes into Lea-positive cells. Mainly due to the relatively low content of the blood-group A glycolipid in plasma (0.17 mg/81), previously negative erythrocytes readily become agglutinable by anti Lea sera and not by anti A sera after incubation with appropriate plasma.