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F Perner

Publications and source records attributed to F Perner.

At least 55 records · Page 3Linked to original sources
PubMed1998

Attitudes of donors towards organ transplantation in living related kidney transplantations.

The demand for transplantation exceeds the availability of cadaveric organs, which is why the importance of living, related kidney transplantation is increasing. In our study we wanted to evaluate the experiences of living related donors (LRD). Between 1973 and 1996, 1325 kidney transplantations were performed at our Department. Of these 1247 were from cadaver donors while 78 were from LRD. We contacted each living donor by post. We carried out a physical examination, laboratory tests, ultrasound and isotope investigations and they were interviewed and completed a questionnaire. Thirty previous kidney donors came to our Department who were all blood relatives of the recipients. In the recipient group, 16 still have a functioning kidney, the average time since transplantation being 8.92 years. The longest kidney survival time is 18 years. All the donors willingly donated their kidney, none was worried about their own health and their only concern was whether the kidney would function or not. Regarding general attitudes towards living related organ transplantation, all were in favour of blood relative donor transplantation and also husband/wife transplantation. Opinions regarding non-related transplantation were more mixed; 63.3% would have given their kidneys to a friend, only 46.6% to a stranger. Almost two-thirds (63.3%) of donors were not in favour of selling and buying organs but, controversially, they would have bought an organ had one been available. All agreed that the donation did not change their general health. In conclusion, the donors of living, related kidney transplantation all agreed that it was a good thing to donate; All confirmed they would go through the same procedure again in order to help. Apart from one person, who emphasised that he is agnostic, all belonged to a Christian religion.

Adolescent↗
PubMed1997

[Follow-up on alpha-glutathione-S-transferase serum level following liver transplantation].

The authors followed up six patients after allograft liver transplantation which have been held in the Transplantation and Surgical Clinic. They routinely examined the serum samples of the patients in the post-transplantation period and made a comparison between the serum concentration of alpha-glutathione-S-transferase (alpha-SGT) and conventional liver function enzymes, like aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in association with acute liver allograft rejection. In two cases the authors found that the alpha-glutathione-S-transferase indicated the allograft liver acute rejection-proved by biopsy-2 days earlier than the transminases. In 1 case the alpha-glutathione-S-transferase serum level decrease followed the early post-transplant high level, showed the normalisation of the liver function, but on the 3, day the new elevation was detected, indicating the early acute rejection, the transminases serum levels in all early post-transplant period were elevated. The results of the follow-up-corresponding with the foreign researches-proved that the alpha-glutathione-S-transferase is a reliable marker of the allograft liver acute rejection, in some cases indicates the rejection diagnosis earlier than the conventional liver function enzymes like transaminases.

Alanine Transaminase↗
PubMed1997

Our preliminary results in application of Stoppa technique for recurrent groin hernia.

In 1994 we have started the Stoppa technique which was only used for the recurrent groin hernia repair, when Mersilene mesh was implanted in preperitoneal position from a lower midline incision. From March, 1994 to March, 1996 seventeen Stoppa procedures were performed in our department (14 men, 3 women, mean age of 66 years). Type of hernias: 13 unilaterale, 3 bilaterale recurrent groin hernias and 1 primary bilaterale groin hernia combined with a lower midline incisional hernia. Operations were performed by 7 surgeons. The mean time of the surgery was 85 min. (35-165). The mean postoperative stay in the hospital was 9 days (7-19). The Stoppa technique could be performed in all patients. Serious early postoperative complications didn't occur. The two late recurrences were observed amongst the first five patients. All implanted mesh were well tolerated by the patients. Author believe, this procedure has some advantages: the site of the incision is located in a new place from where the dissection is easier than in the previous incision, the stich fistulas from the previous operation can be avoided, furthermore this method could be applicated for combined hernias located in the lower part of abdomen and it is cheaper than the laparoscopic hernioplasty.

Aged↗
PubMed1997

Prospective randomized trial comparing Shouldice and Bassini-Kirschner operation technique in primary inguinal hernia repair.

The authors conducted a prospective randomized trial to compare the Shouldice and the Bassini-Kirschner technique between April, 1994 and December, 1995. During this period 129 adult patients, mean age 54 (17-87) years underwent operation on primary inguinal hernias in their department. 63 Shouldice and 66 Bassini-Kirschner operations were performed by 17 surgeons. The duration of surgery, the technique of anesthesia, the perioperative complications, the duration of postoperative care, then one year after the operation the recurrence rate and the patient's subjective complains were investigated. 85 patients of 129 were examined one year after the operation in spite of that all the patients were invited for control. Both operations gave almost the same results in the perioperative period and nearly identical recurrence rate (4.44% in Shouldice and 5.0% in Bassini-Kirschner group). The patient's subjective complains were also very similar one year after the operation. The authors could not find significant difference in the results of the two types of surgery although they were well experienced with the Bassini-Kirschner operation and just starting to practice the Shouldice procedure. These facts suggest that having more experience with the Shouldice operation makes available the extreme low recurrence rate published by several authors.

Adolescent↗
PubMed1997

Evaluation of urinary enzymes in renal allograft damages by histology examination.

Acute allograft rejection (ARE) is one of the most current problem in kidney transplantation. Urinary enzymes (glutathione-S-transferase /GST/. dipeptidil-dipeptidase /DPP/) are frequently used as prognostic factors of ARE. The authors compared the results of light microscopic study (by Banff scheme), and the GST, and DPP secretion in acute rejection. The correlation between the laboratory, and histology findings wasn't significant. our results suggest that both GST, and DPP are very sensitive, but less specific indicators in ARE, since their activity increases in many other damages as well.

Acute Disease↗
PubMed1997

Clinicopathologic aspects of 8 Kaposi's sarcomas among 1009 renal transplant patients.

In 8 of 1009 patients receiving renal grafts and consecutive immunosuppressive therapy during the last 20 years in Budapest, Hungary, Kaposi's sarcoma developed 6.5 months (average) after transplantation. Of 8 cutaneous cases of this disease, 5 also presented visceral manifestations. Seven patients died. Those with visceral tumors died because of the tumor itself. One patient affected by cutaneous tumor has survived for 5 years post-treatment. The relatively high incidence of Kaposi's sarcoma may be explained by a high infection rate with Herpes virus 8, which was shown to be positive in all three cases investigated.

Adult↗
PubMed1996

[Liver transplantation in Hungary].

Necessities and possibilities being in Hungary are discussed. All the requirements involving personal, organization and material (room, equipment, diagnostics) necessities are particularly listed. Possibilities of donors are satisfactory. Problem is the viral diagnostics of donors. The quality of liver transplantation to be waited in Hungary is calculated with activity number in the world. At least 70 liver transplantation are to be yearly waited in Hungary, against this only some patients are on the waiting list. The most important gate is the insufficient quantity of blood according into the selection of program of liver transplantation. The author particularly analyses the covering expenses; the Transplantation and Surgical Department is a good background for liver transplantation, this way the National Health Insurance Institute ought to assure the activity expenses.

Hepatitis, Viral, Human↗
PubMed1996

[Experience gained from the organization of the first group of patients who benefited from liver transplantation].

The authors report in this ciency in the majority of the cases was alcohol abuse or article about their experiences, how could they select a small group of patients awaiting liver transplantation since September 1994. The cause of the liver insuffiHCV infection. During 37 weeks 3 liver transplantations were performed and 5 patients died on the waiting list. (15,6% of the patients on the waiting list.)

Adult↗
PubMed1996

[Availability of livers from cadaver donors in Hungary].

The availability of cadaver livers for transplantation have been studied based on data recorded prospectively by authors. Between January 1, 1995 and August 31, 1995, 98 cadaver kidney donors were accepted in Hungary. Using well established selection criteria 52 of them could have been suitable for liver donation. Steatosis or cirrhosis of the donor livers have been considered most frequent causes of unsuitability for transplantation. Based on these data 70-75 cadaver livers could be transplanted yearly in Hungary that's enough to start a transplant program. The treatment of acute hepatic failure with transplantation seems to be uncertain because of unequal time and blood group distribution of donors. There are just few available cadaver livers for children therefore transplantation of reduced sized liver is needed.

Blood Group Incompatibility↗
PubMed1996

[Organization of liver transplantation--role of the transplantation coordinator].

The authors give a short overview about the background of the organisation of the liver transplantation and about the process of the "liver alarm". One of the most important work of the coordinator is to increase the number of organ donation. The other part of the preparation of liver transplantation is to create the recipient waiting list. The organisation of the "liver alarm" needs the work of two coordinators. The donor coordinator keeps contact with the donor hospital, harmonizes the travel of different transplant teams and organizes the organ explantation. In the same time, the recipient coordinator prepares the liver recipient for the liver transplantation and keeps contact with the donor coordinator in the donor hospital. If the donor liver macroscopically seems good for transplantation, the patient can be send to the operating room and the work of the anaesthesiologists and the surgeons starts.

Cadaver↗
PubMed1996

[Anesthesiologic and intensive care requirements in liver transplantation].

The complex anaesthesia and intensive care of liver transplantation require special instruments beside expert's knowledge. We monitorize the haemodynamics invasively during the operation and immediately afterward. In the later period of intensive care we prefer the noninvasive haemodynamic monitoring techniques. The transoesophageal echocardiography has special role in the anaesthesia of liver transplantation. One of the most important equipment during the operation is the biopump that assures the shunt between the lower and the upper body. Controlling it also belongs to the tasks of anaesthesiologist. During the anaesthesia and early period of intensive care the most serious problem can be the disfunction of blood coagulation system of the recipient. To investigate it the thrombelastography is the most suitable technique which can show the in vivo processes. To analyze the curve of the thrombelastography requires special knowledge. Similarly, the analysis of the electroencephalogram during the anaesthesia is not the everyday task of an anaesthesiologist. To reduce the blood requirements during the operation we use the autotransfusion techniques. During the anaesthesia of the liver transplantation we use other equipment that belong to the everyday work of an anaesthesiologist i.e.: rapid blood infusion and patient warming and cooling systems, rapid laboratory and blood-gas analyzing methods. The anaesthesia and intensive care of liver transplantation claim wideranging knowledge of anaesthesiologist not only theoretically but also practically.

Anesthesia↗
PubMed1996

[Endocrinologic complications of neurofibromatosis type 1].

Neurofibromatosis type 1 is the most common autosomal dominant inheritable disease, which is often associated with secondary forms of hypertension and with tumors of neuroectodermal origin. The authors present the results of evaluation of 60 members of 3 families. Of the 60 family members, 13 subjects had symptoms of neurofibromatosis type 1 disease, of which 7 subjects were evaluated. The case histories of patients are discussed: (1) An incidentally discovered adrenal tumor was proved to be a pheochromocytoma. (2) Because of complaints similar to thyrotoxicosis, thyrostatic drugs were administered for years without effect and, finally, an adrenal phaeochromocytoma was diagnosed after the presence of neurofibromatosis was established. (3) Preeclamptic pregnancy of a young primigravida complicated with severe HELLP syndrome (hemolysis-elevated liver enzymes-low platelet count) led to thorough evaluation which revealed renal artery stenosis. In this patient, percutaneous renal artery angioplasty resulted in a complete cessation of hypertension. (4) Glucocortocoid replacement therapy in a patient with neurofibromatosis type 1 resulted in a complete normalization of both secondary adrenal insufficiency and a previously unexplained iron-refractor iron-deficient anemia. The case histories of the patients demonstrate a lack of in-depth knowledge of neurofibromatosis in clinical practice. A regular follow-up of neurofibromatosis patients is suggested in specialized health centers.

Adrenal Gland Neoplasms↗
PubMed1996

[The use of teicoplanin for Gram-positive infections in patients with kidney transplantation].

Teicoplanin was used for the treatment of multiresistant Gram-positive-Staphylococcus aureus, coagulase negative Staphylococcus and Enterococcus-infections in 15 cases of kidney transplantations. The motive of the application was the once per day dosage and the spare of the transplanted kidney. Nosocomial infections were the most common. Clinical and microbiological diagnosis was the criteria in order to begin the 5-21 days treatment. These patients which were infected with Gram positive bacteria, teicoplanin was also effective in methicillin-resistant cases. In some mixed infections, after several courses of antibiotics, teicoplanin even if combined with other antibiotics could not prevent fatal sepsis.

Adolescent↗
PubMed1996

Diagnostic value of urinary enzyme determination in renal transplantation.

The measurement of enzyme activity in urine provides a sensitive assessment for renal tubular cell damage. The present study was undertaken to evaluate the clinical value of the determination of tubular brush-border-associated enzymes, alkaline phosphatase (AP), gamma-glutamyl transferase (GGT), leucine aminopeptidase (LAP), and dipeptidyl peptidase IV (DPP), of patients with normal graft function (NOR, n = 20), with acute tubular necrosis (ATN, n = 11), with an acute rejection episode (ARE, n = 17) after transplantation, and of healthy persons (n = 20). The second urine of the morning was collected daily during the patients' stay in hospital. The enzyme activities were measured at 25 degrees C and were expressed as U/mmol creatinine. The enzymuria in NOR is higher than in healthy controls, but is still in the normal range. By 5 days after transplantation the initial increased excretion declines as the graft function improves. Elevated enzymuria (DPP 0.69 +/- 0.56, AP 3.06 +/- 3.24, GGT 4.16 +/- 4.13, and LAP 1.39 +/- 1.27) was observed during the rejection episodes. Two days before clinical diagnosis of rejection, the release of DPP-IV and GGT increases to double, and the AP and LAP increases to 3 times the value on the fourth day before rejection. Successful treatment of rejection coincided with a quick return by the third day of the rejection period to the previous enzyme distribution. In ATN no decrease of enzymuria occurs and the excretion is much higher than in ARE. Our method with the every day monitoring of kidney graft function offers the possibility for the early diagnosis of acute rejection.

Adult↗
PubMed1996

The results of 1009 kidney transplantations performed in Hungary.

Kidney transplantation is a widely used method throughout the world for the treatment of end-stage renal disease. Following the pioneering work of Szeged Medical University Hospital and Miskolc District General Hospital, the first successful kidney transplantation in Hungary was performed at the Department of Transplantation and Surgery at Semmelweis Medical University on November 16, 1973. This patient is still alive with a functioning kidney graft after 21 years. We report herein our review of the global results of Hungarian kidney transplantation. Hungary is a medium-developed country with a population of over 10 million where the gross national product is about 4000 U.S. dollars per person per year. In Hungary there are 49 dialysis centers, 4 immunological laboratories, and 4 transplantation centers.

Adolescent↗
PubMed1996

Effects of joining peptide (1-18) and histamine on dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulphate (DHEAS) production of human adrenocortical cells in vitro.

Joining peptide 1-18 (JP 1-18), added alone in concentrations of 10(-13)-10(-7) M to collagenase-dispersed human adrenocortical cells, did not affect the basal production of corticosterone, cortisol, aldosterone, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulphate (DHEAS). JP 1-18 potentiated the ACTH-stimulated production of steroids. When administered in combination with histamine (10(-8)-10(-3) M), JP 1-18 (10(-8) or 10(-10) M), enhanced the synthesis of DHEA and DHEAS. JP 1-18, together with histamine, may play a role in the regulation of DHEA and DHEAS production.

Adrenal Cortex↗