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Biomedical subjects

H Kopsa

Publications and source records attributed to H Kopsa.

At least 91 records · Page 5Linked to original sources
PubMed1978

[Spontaneous birth of a live healthy child during successful hemodialysis treatment of pregnancy pyelonephritis with acute oligo-anuria].

A 19-year-old nullipara developed uremia due to acute pyelonephritis in the 30th week of pregnancy, necessitating hemodialysis within one week of onset of clinical infective symptoms. Almost daily prophylactic hemodialyses (7 in all) were performed. BUN and serum creatinine levels were maintained below 75 mg/100 ml and 12 ml/100 ml respectively, and the patient's weight was kept constant until delivery in the 32nd week of pregnancy. A live healthy child of 1.7 kg was born with a length of 39 cm and a normal neurologic examination. After 10 hemodialyses, polyuria set in and the maternal BUN and serum creatinine levels were within normal ranges 3 weeks after delivery. The importance of close cooperation between gynecologist and internist is stressed.

Adult↗
PubMed1978

[Frequency of cardiovascular risk factors in renal transplant patients (author's transl)].

The incidence of cardiovascular risk factors was studied in 83 renal transplant recipients: 84.3% showed at least one cardiovascular risk factor, hyperuricaemia was found in 42.2%, hypertension in 39.7%, hypercholesterolaemia in 31.3%, hypertriglyceridaemia in 27.7%, diabetes mellitus in 19.3%, obesity in 14% and nicotine abuse in 13.2% of the patients. Patients aged from 30 to 39 and 40 to 49 showed a mean incidence of 2.7 and 2.9, respectively out of the 7 investigated cardiovascular risk factors. The results demonstrate that renal transplant patients are a high-risk group for the development of degenerative cardiovascular diseases.

Adolescent↗
PubMed1978

[Recurrence of intramembraneous glomerulonephritis in 2 consecutive kidney transplantations].

A case of dense intramembranous deposit disease, partial lipodystrophy, hypocomplementemia, and nephritic factor-like activity in the serum is presented. Recurrence of underlying renal disease was noted in two consecutive renal allografts. The first transplant was lost 7 months after implantation, chronic renal rejection being an additional cause of graft failure. A favourable clinical course, however, was observed after the second renal transplantation. 22 months after surgery, the patient was fully rehabilitated and transplant function only slightly reduced despite electron microscopic evidence of typical dense intramembranous deposit lesions. Low C3-serum complement and normal C4-serum complement levels were constant findings throughout observation time. The case supports the assumption that patients with dense intramembranous deposit disease should not be excluded from renal transplantation As shown in the literature, maintenance of satisfactory graft function is usually obtained for a long period of time despite recurrence of original disease.

Adult↗
PubMed1978

[Successful haemodialysis treatment of acute renal failure in a patient with multiple myeloma (author's transl)].

A case of multiple myeloma with severe osteolytic destructions and myeloma kidney is presented, in whom a rapidly progressive renal insufficiency because of hyponatraemia and dehydration developed. After 5 months of regular dialysis treatment diuresis increased and a sufficient global kidney function recurred. Aetiological factors and the pathomechanisms of acute renal failure in multiple myeloma are discussed. We assume that acute renal insufficiency is - in rare cases - at least partly reversible. Therefore patients with acute renal failure and multiple myeloma should not be excluded from haemodialysis treatment because even complete rehabilitation can be achieved.

Acute Kidney Injury↗
PubMed1978

[Pancreatitis after renal transplantation (author's transl)].

A renal transplant patient in whom acute pancreatitis developed 2 1/2 years after surgery is presented. Pancreatisis was accompanied by hyperlipaemia, diabetes mellitus and acute renal failure possibly due to acute tubular necrosis. Pancreatic abscesses necessitated subtotal pancreatectomy 2 months later. Because of generalized tuberculosis finally the patient succumbed 6 weeks thereafter. As aetiological factors cytomegalovirus disease, disorders in lipid metabolism and immunosuppressive therapy must be discussed. It is concluded that prophylactic measures as well as early diagnosis, intensive care and therapy are necessary for reducing the high risks of pancreatis in renal transplant recipients.

Acute Kidney Injury↗
PubMed1978

[Prolonged renal graft survival after repeated blood transfusions (author's transl)].

In order to investigate the influence of pretransplant blood transfusions on renal graft survival, the results in 43 recipients with 10 or more transfusion (group A) were compared with those in 48 recipients with less than 10 or no transfusions (group B). In both groups cadaveric kidneys with mainly 3 or more mismatched histocompatibility antigens were transplanted. The incidence of preformed cytotoxic antibodies was similar in both groups (25.6% and 22.9%, respectively). The cumulative renal graft survival rate was significantly higher in the poly-transfused group: 85.6% +/- 6.1% and 73.4 +/- 7.9% after 1 and 2 years, respectively, in group A in comparison with 73.9 +/- 6.6% and 63.3 +/- 8.1% after 1 and 2 years respectively, in group B (Wilcoxon rank sum test: p less than 0.05). Severe renal rejection with a serum creatinine above 3 mg/100 ml was more frequently observed in group B than in group A. Enhancement due to blocking antibodies must be assumed as a possible explanation for the favourable effect of repeated pretransplant transfusions on graft survival rates.

Antibodies↗
PubMed1978

[Hepatitis b infection in renal transplant recipients (author's transl)].

During a period of 4 1/2 years the incidence and clinical course of endemic hepatitis B infection was studied in 43 renal transplant recipients with an observation time of 3 to 47 (average: 26.3) months after surgery. During the investigation period 27 out of 43 patients (62.8 per cent) had hepatitis B infection. In 8 patients HBs antigenaemia persisted after chronic dialysis treatment. After surgery HBs antigenaemia was detected for the first time in 7 patients. Recurrence of HBs antigenaemia was noted in one patient. In 7 further cases with HBs antigenaemia after transplantation regular controls of HBsAg and HBsAb were not available before transplantation. In 2 patients HBs antibodies were detectable at the time of transplantation; 2 further patients developed HBs antibodies postoperatively. Hepatitis B infection showed a mild and persistent clinical course. 6 out of 7 icteric patients simultaneously had other severe mycotic and viral infections. Therefore, the conclusion was drawn that in patients with coexisting multiple infections liver damage is not necessarily attributable to HBs antigenaemia.

Azathioprine↗
PubMed1978

[Recurrence of pseudotumour cerebri (intracranial hypertension) after renal transplantation (author's transl)].

The case report is presented of a 24-year-old male who developed the clinical signs and syptoms of pseudotumour cerebri (intracranial hypertension) twice during the course of protracted rejection 1 and 4 months after renal transplantation. Clinically, headache, nausea, hypertensive crisis and, finally, severe coma with an acute mid-brain syndrome was observed. Neurologically a mild left-sided hemiparesis was found on the second occasion. Examination of the fundi revealed bilateral papilloedema. Electroencephalograms showed pathological changes of a diffuse nature, later followed by abnormal delta range activity in the right frontotemporal projection. The withdrawal of corticosteroid therapy may have been responsible for the pseudotumour cerebri in this case.

Adult↗
PubMed1978

Acquired antithrombin III deficiency in patients with glomerular proteinuria.

Antithrombin III (AT II/III) was determined immunologically and by means of a heparin cofactor assay in plasma samples and 24-hour urine of 15 patients with various degrees of proteinuria, being predominantly of glomerular origin. In urine the AT II/III concentrations were significantly correlated to the concentrations of albumin, plasminogen and IgG. One third of the patients had AT II/III plasma levels below the normal range. The plasma levels showed a significant inverse correlation to the AT II/III and albumin clearance rates. Similarily, the plasminogen concentrations in plasma were decreased in two thirds of the patients, being inversely correlated to the renal plasminogen clearance values. It is proposed that AT II/III deficiency in the nephrotic syndrome is an important pathogenetic factor in venous thrombosis.

Adolescent↗
PubMed1978

[Sonography for clarify complications after renal transplantation (author's transl)].

The diagnostic value of the ultrasound method was studied via 170 individual examinations in 75 patients. The method is particularly well suited for an accurate determination of the location and size of the transplanted kidney and for demonstrating perirenal growing and displacing processes such as cystic lymphangiomas, haematomas and abscesses. In addition, ultrasound supplies information on the area covered by lacunae. However, the use of the method for diagnosing casting-off reactions is limited on account of the great variability of the dimensional parameters. It can be used without risk in followup studies of patients with transplanted kidneys, since it is a non-invasive method. It deserves preference among the possible methods of investigation, especially when growing and displacing processes have to be identified.

Abscess↗
PubMed1977

[Serum lactate dehydrogenase activity after renal transplantation (author's transl)].

Regular 4-weekly follow-up controls of serum lactate dehydrogenase activity in 23 renal transplant recipients revealed a constant rise in serum LDH activity during the early postoperative months. During the first post-transplant month serum LDH activity increased from 150.0 +/- 48.2 mE/ml to 195.5 +/- 84.8 mE/ml, serum enzyme activity being highest (329.1 +/- 143.2 mE/ml) 6 months after surgery. Since serum creatinine levels remained relatively constant, it seems unlikely that renal rejection played a major pathogenic role in the production of increased LDH activity. Since the pattern of lactate dehydrogenase isoenzymes was ithin normal limits, the pathogenesis of increased LDH serum activity following renal transplantation is not yet clear. Possible causes such as liver damage due to hepatitis B, macrocytosis induced by immunosuppressive therapy and myopathy to steroids are discussed.

Adult↗
PubMed1977

[Long-term observation of fungal and other skin disorders after renal transplantation (author's transl)].

All of 68 renal transplant recipients (mean observation time 28.4 months after transplantation) showed skin complications. In these subjects fungal infection was found in 51, viral disease in 45 and bacterial infection in 36 cases. Of fungal manifestations candidiasis, onychomycosis, and dermatomycosis were most commonly observed. The most important viral disease was herpes simplex. The main part of bacterial infections was either caused by surgical complications or by super-infection (impetigo) of steroid acne. Non infectious dermatological disorders were usually due to immunosuppressive therapy.

Acne Vulgaris↗