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Biomedical subjects

F Kokot

Publications and source records attributed to F Kokot.

At least 19 recordsLinked to original sources
PubMed1992

Biocompatibility of extracorporeal circulation with autooxygenation.

Platelet damage, complement activation and neutropenia during cardiopulmonary bypass are the result of blood contact with artificial surfaces, mainly in the oxygenator. To evaluate biocompatibility of this kind of bypass we compared two techniques of extracorporeal circulation in 40 patients undergoing elective coronary bypass operations. In 20, a standard technique with a bubble oxygenator was used (group 1), and in the remaining 20 patients with autooxygenation, the patients' own lungs were included in the perfusion circuit (group 2). Several blood samples were taken before, during and after perfusion to estimate the corrected platelet numbers and pulmonary leucocyte sequestration in all patients, and additionally in 6 patients from each group, complement C3a and C5a anaphylatoxins were measured (radioimmunoassay). At the end of cardiopulmonary bypass, the decline of platelet number corrected to haematocrit platelet number in group 1 was significantly higher than in group 2 (P less than 0.01). There was a significant increase in circulating white blood cells when compared to pre-bypass time in both groups (P less than 0.05). However, comparison of differences between leucocyte counts in the blood of the patients' right and left atria showed enhanced leucocyte sequestration in group 1, 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x 10(3)/mm3 in group 2. The C3a rose progressively during extracorporeal circulation: in group 1 from 268 +/- 46 ng/l to 521 +/- 65 ng/l, and in group 2 from 244 +/- 46 ng/l to 418 +/- 34 ng/l (P less than 0.05). No characteristic changes in C5a activation were observed in either group.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Loss, Surgical↗
PubMed1992

Plasma erythropoietin concentrations in renal venous blood of patients with unilateral renovascular hypertension.

In 19 patients with unilateral renal artery stenosis and subsequent renovascular hypertension plasma renin activity (PRA), plasma concentrations of atrial natriuretic peptide (ANP), erythropoietin (Epo), H+ and HCO3-, as well as pO2 and pCO2 were assessed in renal venous blood of the 'ischaemic' and normally perfused kidney, both in arterial blood and in the inferior vena cava distally from the orifices of the renal veins. PRA and ANP were significantly elevated in venous blood of the ischaemic kidney as compared with the normally perfused kidney. In contrast to PRA and ANP, plasma concentrations of Epo were similar in blood withdrawn at all vascular sites. pO2 and pCO2, as well as blood H+ and HCO3- concentrations in venous blood of the ischaemic kidney were of the same magnitude as of the normally perfused kidney. From the results presented in this paper it follows that (i) in contrast to plasma renin activity and ANP, unilateral renal 'ischaemia' does not influence plasma concentrations of Epo in renal venous blood, and (ii) chronic haemodynamic alterations do not seem to influence Epo secretion by the kidneys.

Adult↗
PubMed1992

[Treatment of anemia with erythropoietin (rhuEPO) in patients with chronic kidney failure who are not yet in need of dialysis therapy].

Eleven uraemic predialysis patients have been selected for the treatment of anaemia with rhuEPO. Administration of rhuEPO was followed by a significant increase of the Hct value and haemoglobin concentration as well as an improvement of well being. The main adverse effects of rhuEPO therapy were the following: increase of blood pressure, reduction of the residual renal function and increase of serum potassium and phosphorous concentration. Monitoring of the iron status in uraemic predialysis patients on rhuEPO therapy seems to be mandatory.

Adult↗
PubMed1992

[Effect of opioid receptor blockade with naloxone on plasma renin activity and aldosterone levels in patients with kidney transplantation].

Function of the renin-angiotensin-aldosterone (RAA) system in kidney transplant patients (KTP) is often abnormal as in patients with chronic renal failure. On the other hand the importance of opioids in the regulation of function of endocrine organs is well established. These facts were the background of studies presented in this paper. They aimed to assess the role of opioid receptors in the regulation of the RAA in KTP. 12 patients with a stabilized renal graft function and on cyclosporin A + prednisone therapy and 15 healthy subjects were examined. In all subjects plasma renin activity (PRA), plasma aldosterone level (Ald) and blood pressure were assessed during a 4 hr bed-rest test. In each subject two tests were performed: the first one without naloxone administration, and the second one--after opioid receptor blockade. In KTP significantly elevated PRA and blood pressure and moderately elevated plasma Ald levels were found as compared with normals. After a 4 hr bed rest without naloxone no significant changes of the above mentioned parameters were noticed both in the patients and the controls. After opioid receptors blockade by naloxone a significant decrease of PRA and plasma Ald was observed in both examined groups. This decrease was significantly more marked in KTP than in controls. In addition only in KTP 4 hrs after naloxone administration a significant increase of systolic and diastolic blood pressure was found. Results obtained in this study suggest, that opioid receptors are involved in the regulation of the activity of the RAA system and of blood pressure more markedly in KTP than in healthy subjects.

Adult↗
PubMed1992

[The role of erythropoietin in blood pressure regulation in patients with arteritis].

Renal erythropoietin production is dependent on local oxygen content of blood which activates so called "oxygen sensors". Taking into consideration altered local renal blood supply in patients with arterial hypertension in the course of arteritis (HA) and from the other side contribution of the renin-angiotensin system in both pathogenesis of hypertension and regulation of erythropoietin production it seemed plausible to undertake this study. The aim of the study was to determine whether and in what extent patients with HA and healthy subjects differ in EPO secretion and whether EPO serum level is related in this patients to renin response to dietary sodium restriction and upright position of the body. 18 patients with HA and 12 healthy subjects were investigated. In all subjects haematocrit value, haemoglobin concentration, erythrocyte count, sodium, potassium, creatinine, iron, ferritin serum levels, total iron binding capacity, plasma renin activity (PRA), erythropoietin serum level and mean arterial blood pressure (MAP) were measured in basic conditions (normal sodium diet). Additionally PRA, EPO and MAP were measured after dietary sodium restriction to 10-20 mmol Na/24 hrs for three days and upright position of the body for three hours. Patients with HA had insignificantly lower serum EPO concentrations than healthy subjects and both studied groups did not differ in haematocrit value and determinants of iron metabolism except of significantly higher ferritin concentration in HA. After dietary sodium restriction and upright position of the body significant rise in PRA and no significant changes in EPO level were found in studied groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Efficacy of recombinant human erythropoietin (rhuEPO) in treatment of anemia in patients with myelodysplastic syndrome].

This paper summarizes results of rhuEPO--treatment obtained by different authors in 27 patients with a myelodysplastic syndrome (MDS). Only 1/3 of all patients with a MDS were responsive to rhuEPO treatment, while in 2/3 of these subjects no amelioration of anaemia was noticed, even after extremely high doses of this hormone. A detailed description of a patient with MDS, which was observed by the authors, is presented. In this patient the anaemia was refractive even after very high doses of rhuEPO administered for 10 weeks.

Anemia↗
PubMed1992

[Estimation of renal tubular function after uropoline administration in certain disease states].

24 h urinary excretion of beta-microglobulin (beta 2M) and Tamm-Horsfall protein (THP) before and after administration 40 ml of 75% Uropoline were assessed, as a specific markers of proximal and distal tubular dysfunction respectively. 22 patients without renal diseases and hypertension (C), 22 hypertensive patients (HP), 14 patients with renal stone disease (RSD) and 16 patients with pyelonephritis (PN) were examined. Administration of Uropoline did not change beta 2M and THP urinary excretion in C, but increased beta 2M excretion in HP and decreased THP urinary excretion in patients with RSD. It is concluded, that Uropoline shows a noxious effect on the proximal tubule in HP and on the distal tubule in patients with RSD.

Adult↗
PubMed1992

Do opioid receptors participate in the regulation of atrial natriuretic peptide (ANP) secretion in hypertensive patients?

Experimental and clinical studies seem to prove that both endogenous opioids and atrial natriuretic peptide (ANP) are involved in blood pressure regulation. This raised the question, whether these two factors are functionally interrelated to each other. We tried to answer this question by assessing plasma ANP levels in 15 patients with II degrees essential hypertension and in 15 healthy subjects under water immersion (WI) conditions. In all subjects two WI tests were performed--one without pretreatment with naloxone, and a second one after blockade of opioid receptors by this opioid receptor antagonist. Parallel to ANP, plasma renin activity (PRA), aldosterone (ALD) and vasopressin (AVP) were assessed. In hypertensive patients significantly higher basal plasma ANP levels were found than in control subjects. WI induced a significant increase of plasma ANP in both examined groups which became markedly reduced after blockade of opioid receptors by naloxone. Naloxone did not influence the WI induced decrease of PRA, ALD and AVP respectively. From results presented in this study we conclude, that a.) opioid receptors seem to influence regulation of ANP secretion both in healthy normotensive subjects and patients with essential hypertension, and b.) that WI induced alterations of ANP on the one side and of PRA, ALD and AVP on the other side are not interrelated.

Adult↗
PubMed1992

[Effect of opioid receptor blockade with naloxone on vasopressin secretion in patients with transplanted kidney].

The present study aimed to assess the influence of opioid receptors on vasopressin (AVP) secretion in 12 kidney transplant patients (KTP) with stable graft function, and in 15 healthy subjects (control). Significantly lower basal plasma AVP levels were found in KTP than in controls. After blockade of opioid receptors by naloxone a significant increase of plasma AVP levels were observed in both examined groups. This increase was significantly higher in KTP than in healthy subjects. From data presented in this study participation of opioid receptors in the regulation of AVP secretion is highly likely both in KTP and controls. This participation seems to be significantly greater in KTP than in healthy subjects.

Adult↗
PubMed1992

[Effect of thermal dehydration on blood levels of hormones regulating volume and electrolyte content of sweat in patients with kidney transplantation].

The thermal dehydration test was performed in 12 patients with renal transplant and in 20 healthy subjects. The study was aimed at the evaluation of the effect of volume regulating hormones on electrolyte composition of thermal sweat in patients with renal transplant. Blood plasma renin activity (PRA) as well as plasma concentrations of aldosterone (ALD), vasopressin (AVP) and atrial natriuretic peptide (ANP) were determined before and after thermal dehydration in all the subjects studied. In all the subjects sweat was also collected after 15 and 45 minutes of exposition to heat and the concentrations of sodium, potassium and chloride were determined in all sweat samples. Significantly elevated PRA and ANP concentrations and significantly lowered plasma AVP concentrations but normal ALD levels were found before thermal dehydration test in all the patients with renal transplant. After the exposition to heat lasting 1 hour the direction of changes was similar, their magnitude was, however, different in renal transplant patients than in healthy subjects. In addition, lower concentrations of sodium and chloride in thermal sweat and lower total concentration of sweat solids were found in renal transplant patients than in healthy controls. No significant correlation was found between the plasma concentrations of the hormones determined and the electrolyte concentrations of thermal sweat both in the renal transplant patients and in healthy subjects. The results suggest that the volume regulating hormones have no effect on the electrolyte composition of thermal sweat induced by short exposition to heat both in renal transplant patients and in healthy subjects.

Adult↗
PubMed1992

[Effect of thermal dehydration on blood levels of volume- regulating hormones and sweat electrolytes in patients with essential hypertension treated with propranolol].

The present study aims to answer the following questions: 1. do secretion of volume related hormones in patients with EH pre- and post treatment with propranolol differ from normotensive subjects if examined in thermal dehydration conditions; 2. is the electrolyte composition of thermal sweat related to the plasma profile of volume related hormones? and 3. does treatment by propranolol influence sweat electrolytes in EH patients. In 15 patients with EH and in 20 healthy subjects a thermal dehydration test was performed. In patients with EH this test was done twice: before treatment and after 6 weeks of propranolol therapy. In all subjects the plasma renin activity (PRA), aldosterone (Ald), AVP and ANP were measured before and after thermal dehydration. In sweat samples collected after 15' and 45' of thermal dehydration (the concentration of Na, K and Cl was assessed). In hypertensive patients before propranolol treatment significantly higher values of PRA, Ald and ANP were found, while sweat concentrations of Na and Cl were significantly lower than in controls. After propranolol treatment sweat electrolytes concentrations showed a tendency to normalize. No significant correlation was found between the plasma hormonal profile and sweat Na, K and Cl concentrations respectively both in controls and patients with EH pretreatment. A significant positive correlation was noticed only in hypertensive patients posttreatment between ANP and sweat potassium concentration respectively, and significant negative correlation between PRA and sweat sodium and chloride concentration. From results obtained in this paper it seemed, that volume related hormones (Ald, AVP, ANP) do not seem to influence markedly the electrolyte composition of thermal sweat both in healthy subjects and in hypertensive patients.

Adult↗
PubMed1992

[Erythropoietin level in the blood of patients with diabetes mellitus type 2].

UNLABELLED: 52 patients with diabetes mellitus type II (23 of them were treated by diabetic diet, 12 were on oral antidiabetic drugs and 17 were treated by insulin), and in 31 healthy subjects the serum concentrations of erythropoietin (EPO), ferritin, iron, TIBC and hematocrit value, haemoglobin concentration and erythrocytes were measured. In diabetic patients higher but in insulin treated patients significantly higher plasma erythropoietin concentrations were found than in healthy subjects. In diabetic patients the physiological negative correlation between plasma erythropoietin concentration, haematocrit value, haemoglobin concentration and erythrocytes respectively was absent. In diabetic patients plasma ferritin concentrations were significantly higher than in normals. CONCLUSION: patients with diabetes mellitus type II are characterized by elevated plasma erythropoietin and ferritin concentrations and dissociation of the physiological feedback between plasma erythropoietin and intensity of erythropoiesis.

Adult↗
PubMed1992

Influence of long-term erythropoietin therapy on endocrine abnormalities in haemodialyzed patients.

Endocrine abnormalities in patients with chronic renal failure are well documented. The present study aimed to assess the influence of long-term erythropoietin (EPO) therapy on endocrine abnormalities in haemodialyzed patients. Two groups of haemodialyzed patients, each of which comprised 17 subjects, were examined. The first one treated by EPO (EPO group) while the second one did not receive this hormone (NO-EPO group). A complete biochemical and hormonal check-up was performed before and at the 3, 6, 9 and 12 months of the study period. Normal values for the estimated parameters were obtained in appropriately selected sex and age-matched healthy subjects. After EPO therapy an increase of the haematocrit value from 21.8 +/- 0.9% to 32.6 +/- 0.9% was observed which was accompanied by a significant decline of plasma ferritin and saturation of transferrin. In patients of the NO-EPO group a significant although less marked rise of the haematocrit value (21.4 +/- 0.4% to 24.2 +/- 0.6%) was also noticed. EPO therapy did not change electrolytes (Na, K, Ca, inorganic phosphate), osteocalcin, creatinine, glucose and alkaline phosphatase plasma levels as well as plasma concentrations of calcium related hormones (PTH, calcitonin, 1.25(OH)2D3) and vasopressin (AVP). EPO treatment induced a significant decline of somatotropin (HGH), prolactin (PRO), follitropin (FSH), lutropin (LH), ACTH, cortisol, plasma renin activity, aldosterone, insulin (IRI), glucagon (IR-G), pancreatic polypeptide (PP) and gastrin plasma levels and an increase of plasma estradiol, testosterone and atrial natriuretic peptide (ANP). These EPO induced endocrine alterations were restricted mostly to the first 6 months of EPO administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1992

[Effects of furosemide, propranolol and nifedipine on urinary excretion of Tamm-Horsfall protein in patients with arterial hypertension].

UNLABELLED: In 65 hypertensive patients the influence of 10 day treatment with furosemide (24 subjects), nifedipine (21 subjects) and propranolol (20 subjects) respectively on urinary Tamm-Horsfall protein (U-THP), sodium and potassium excretion, 24 hour urinary volume and blood pressure was determined. In 23 control subjects the above mentioned parameters were assessed only under basal conditions. In hypertensive patients urinary THP excretion was not different from controls. In all examined groups a significant positive correlation was found between urine volume and urinary THP excretion under basal conditions. Such a correlation was absent after nifedipine or propranolol therapy respectively, but still existed after furosemide administration. No correlation was found between urinary THP and Na and K excretion respectively. In contrast to nifedipine and propranolol, a 10 day treatment with furosemide caused a significant increase in U-THP. CONCLUSIONS: Urinary THP excretion in hypertensive patients did not differ from U-THP in healthy subjects. In contrast to propranolol and nifedipine, treatment with furosemide caused an increase in THP urinary excretion.

Adult↗
PubMed1992

[Urinary excretion of Tamm-Horsfall protein by patients with acute renal failure].

Urinary excretion of Tamm-Horsfall protein (THP), sodium and potassium was assessed in 12 patients 5, 8, 11, 14, 17, and 22 days after the onset of acute renal failure (ARF) and in 23 control subjects. In patients with ARF at the oliguric phase urinary excretion was significantly reduced but significantly increased (when compared with controls) at the onset of the polyuric phase. In contrast to healthy subjects in patients with ARF no significant correlation was found between urine volume and urinary excretion of THP. Normalization of THP excretion was noticed prior to normalization of serum creatinine level. Results obtained in this study prove absence of the physiological relationship between urinary excretion of THP and urine volume in patients with ARF.

Acute Kidney Injury↗