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H Kopsa

Publications and source records attributed to H Kopsa.

At least 109 records · Page 6Linked to original sources
PubMed1977

[Acute kidney failure in hypothermia].

Two cases with acute renal failure after prolonged hypothermia are presented. Both patients were found in come, became rapidly uremic and required hemodilaysis treatment. Although the laboratory findings were typical of severe muscle damage, e.g. elevated levels of serum creatinine phosphokinase, serum lactic dehydrogenase and serum aldolase activities, visible "crush-injuries" were not found. Acute renal failure was characterized by extreme catabolism and severe metabolic acidosis. After 4 and 10 hemodialyses respectively, the patients became polyuric and finally were discharges with normal renal and muscle function. Hypotension with diminished renal perfusion and nontraumatic rhabdomyolysis due to prolonged hypothermia are regarded as the dominant pathogenetic factors in the acute renal failure.

Acute Kidney Injury↗
PubMed1977

[Behaviour of serum and urinary lysozyme after renal transplantation (author's transl)].

The behaviour of serum and urinary lysozyme was investigated before and after renal transplantation in 20 patients. The mean postoperative observation time was 67.8 (10 to 212) days. In 11 patients with reversible olig-anuria due to prolonged preoperative ischaemia, lysozymuria lasted for a period of 17 days after surgery, whereas in 8 patients with immediate transplant function lysozymuria disappeared 7 days after transplantation. Serum lysozyme concentrations were markedly elevated before transplantation in all patients. In patients with transplant failure due to ischaemia, normalization of serum lysozyme levels was achieved 28 days after surgery; patients with immediate function showed normal serum lysozyme levels already 7 days after transplantation. Prolonged lysozymuria was also noticed in 2 cases with irreversible ischaemic transplant failure, in 1 case with recurrence of glomerulonephritis and in 1 further case with acute pyelonephritis in the transplant. In 7 cases with an acute renal rejection crisis, lysozymuria was evident 0.7 days before clinical diagnosis of rejection. Serum lysozyme levels showed a strong correlation with serum correlation with serum creatinine concentrations. Therefore, lysozymuria in renal transplant patients indicates tubular transplant damage of varied aetiology. Elevated serum lysozyme levels, on the other hand, seem to reflect a reduced glomerular filtration rate.

Creatinine↗
PubMed1977

[Clinical experiences with Nepross C-02 dialyzer].

During 50 haemodialyses procedures with the Nephross C-02 coil dialyzer in a RSP-system clearance, effectivity and ultrafiltration were investigated. With a blood flow of 200 ml per minute clearance for urea, creatinine and uric acid were 88.3, 76.1 and 69.9 ml per minute respectively. Considering these results, our findings 2 hours after starting dialysis must be taken into account that clearance values measured in the recirculation-single pass-system (RSP) are about 30% lower than the results with the use of the single pass-system. The maximal ultrafiltration rate was 600 ml per hour. Overhydration therefore, is the main indication for the use of the Nephross C-02 coil dialyzer.

Creatinine↗
PubMed1976

[Motor nerve conduction velocity in uraemic polyneuropathy: correlation with metabolic factors (author's transl)].

The following parameters have been examined in twenty-one patients suffering from chronic renal failure (creatinine level between 4.5 and 18.8 mg/100 ml serum): maximum motor nerve conduction of the peroneal nerve, amplitude of the compound muscle action potential of the extensor digitorum brevis muscle, serum creatiine, total protein, serum globulins, serum albumins, alkali reserve, time of increase of serum creatinine above 4 mg/100 ml up to time of determination of the maximum motor nerve conduction, daily urinary excretion, mean blood pressure, (p less than 0.01) was found between maximum motor nerve conduction, as well as amplitude of the compound muscle action potential, and the serum albumin level only. Decreased levels of serum albumin, is correlated with diminished nerve conduction and a lower amplitude. The relationship between the electrophysiological data and serum albumin levels maybe explained on the basis of progression of a pre-existing polyneuropathy due to additional dietary malnutrition. A different interpretation is the assumption of an inactivation of neurotoxin on binding by albumins. A decrease in the albumin level would, therefore, result in an increased amount of unbound toxic agent. The values of the maximum motor nerve conduction were between 16 m/sec and 51 m/sec (mean value 42.2 m/sec), pointing to a polyneuropathy of primary axonal type rather that to primary demyelinization. The amplitudes of the compound muscle action potentials were not greatly reduced and thus the uraemic polyneuropathy seems to be of mixed type. In uraemic polyneuropathy different aetiological factors have to assumed. According to the prevalent factor a polyneuropathy of predominantly axonal or predominantly demyelinizing type may result.

Action Potentials↗
PubMed1976

[Macrocytosis in renal transplant patients (author's transl)].

Since macrocytosis was observed in a high percentage of our renal transplant patients, a follow-up study was carried out on 36 patients with determination of the mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and haemoglobin concentration (MCHC). These parameters were determined monthly for periods of up to two years (16 cases) following transplantation. There was a rise in both MCV and MCH within one month. Macrooperative MCHC, however, remained normal. Anaemia was absent or mild. The bone marrow showed striking megaloblastic changes with nuclear-cytoplasmatic dissociation in both red and white cell precursors. Vitamin B 12 absorption tests were normal in all 8 patients investigated. Macrocytosis was not detectable in two patients with a low serum iron concentration. Macrocytosis disappeared in 4 patients with chronic rejection when progressive renal failure developed. It is concluded that azathioprine therapy induces macrocytosis in renal transplant patients provided renal function is satisfactory.

Adult↗
PubMed1976

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

58 renal transplant patients were submitted to dermatological check-up investigations at regular intervals over a mean period of 26.2 months after surgery. 98% of the case material showed dermatological complications. In an analysis of the findings in 55 patients with infectious complications, viral infections occurred in 40, bacterial in 30 and mycotic infections in 20 patients. Dermatological manifestations of non-dermatological complications were mainly due to immunosuppressive therapy. The data stress the necessity of optimum cooperation between dermatologists and the attendant physician in the case of renal transplant patients.

Adolescent↗
PubMed1976

[Oto-rhino-laryngological complications in patients receiving intermittent haemodialysis and in renal transplant recipients (author's transl)].

Patients with chronic uraemia and renal transplant recipients were examined for oto-rhino-laryngological diseases over the course of a five-year period. During dialysis treatment, 58 out of 77 chronic uraemic patients developed complications, mainly affecting the nose and the ear, on a degenerative or toxic uraemic basis. In the period under review, renal transplantations were carried out in 63 patients, in whom infectious processes had occurred mainly in the upper respiratory and digestive tracts; postoperative immuno-suppressive therapy is responsible for the morbidity in these cases. Particular reference is made to the necessity of eradicating any possible sources of infection already during the period of dialysis treatment and to the importance of cooperation between physicians and oto-rhino-laryngologists.

Adolescent↗
PubMed1976

[Neuropathology of renal transplantation (author's transl)].

The neuropathological features are presented of an autopsy series of 43 renal transplant recipients. Inflammatory CNS lesions were found in 18 cases and were attributable to secondary CNS involvement in bacterial or fungal septicaemia (8 cases) or in localized extraneural infections (5 cases). Mixed bacterial-fungal infection and bacterial-fungal-viral triple infection were seen in one case each. Isolated toxoplasmic granulomas were observed in two cases. No tissue changes typical of CNS viral infections, including cytomegaly, were found except for small glial nodules in the brain stem in 7 cases. Massive intracerebral haemorrhages were seen in 2 cases after haemodialysis; subdural haematoma occurred once. Non-specific changes including brain oedema and diffuse glial poliodystrophy were found in many cases; vascular lesions and purpura occurred only seldom. A meningocerebellar malignant lymphoma, probably of metastatic origin was found in one case. Clinico-pathological correlation was poor in 5 cases; this is considered to be due to immunosuppressive therapy, which may mask either clinical expression of severe CNS lesions or morphological expression of viral encephalitis.

Adult↗
PubMed1976

[Is there a feed-back mechanism between serum gastrin concentration and gastrin release (author's transl)].

The dialysability of gastrin heptadecapeptide was investigated in a model arrangement. The amounts of gastrin passing through the dialysis membrane during a 6-hour dialysis procedure are very small. Furthermore, the serum gastrin concentrations were measured during a 6-hour haemodialysis session with and without simultaneous pentagastrin infusion (0.003 mug/kg/h) in 8 patients on intermittent haemodialysis. There is a continuous decrease in the serum gastrin concentration during the 6-hour dialysis period with simultaneous pentagastrin infusion, while in the investigation without pentagastrin infusion phases of increase in serum gastrin levels are observed. In view of this different response of the serum gastrin curve it is suggested that a direct feed-back mechanism exists between the serum gastrin concentration and gastrin release, a mechanism which was interrupted by the pentagastrin infusion in the present investigation.

Feedback↗
PubMed1975

[Disturbances of lipid metabolism following renal transplantation (author's transl)].

The serum cholesterol and triglyceride levels and the lipoprotein electrophoretic pattern were investigated in 33 kidney transplant recipients. These patients showed elevated serum cholesterol and triglyceride levels in comparison with a group of healthy control subjects. Lipoprotein electrophoresis showed a predomination of types II a, II b and IV, according to Frederickson. The causes of the disturbances in lipid metabolism are discussed. There is a definite risk of cardiovascular disease in kidney transplant patients as a consequence of the altered lipid metabolism.

Adolescent↗
PubMed1975

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

21 of 41 patients developed clinically manifest or systemic Candida albicans infection 1-36 months after renal transplantation. Asymptomatic candiduria was diagnosed in all patients even before the onset of clinical symptoms. Fungal stomatitis was the most frequent clinical sign, followed by mycotic changes in the respiratory, genito-urinary (vaginitis) and gastro-intestinal tract. In five cases intrahepatic biliary stasis was diagnosed in the course of a Candida albicans septicaemia. In 12 patients with renal transplants it was possible, by treatment with nystatin, clotrimazole, flucytosine, miconazole and amphotericine B to control a generalized or clinically manifest Candida albicans infection. Three died of the septicaemia or meningoencephalitis, six as the result of bacterial superinfections. Inspection of the mouth is an important means of early diagnosing fungal infections. Antimycotic treatment should be started if fungal cultures from urine are repeatedly positive even if the clinical findings are still negative.

Adult↗
PubMed1975

[Haemodialysis for renal failure in a case of systemic lupus erythematosus (author's transl)].

Severe acute renal failure developed in a patient with systemic lupus erythematosus which was characterized by typical skin rash, polyserositis, haemolytic anaemia and liver damage. Serological examination revealed anti-DNA antibodies in high concentrations, positive Coombs' test, excessive elevation of serum-IgG with markedly depressed serum complement fractions (C3, C4). Acute lupus nephritis led to prolonged oliguria and anuria requiring regular dialysis over almost five months. Immuno-suppressive treatment with cortisone and azathioprine finally reversed the renal failure: BUN returned to 33 mg/ 100 ml, with a plasma creatinine of 1.8 mg per 100 ml.

Acute Kidney Injury↗
PubMed1975

[Problems of infections following renal transplantation (author's transl)].

Infections arising as a complication of immunosuppressive therapy were analyzed in more than 40 renal transplant patients. Bacterial infections were observed in 78.0%, viral in 68.3% and mycotic infections in 56.3% of cases seen during a 3-year investigation. Infection was the cause of death in 5 out of 8 cases with fatal complications. Bacterial infections of the lungs were amongst the gravest post-transplant complications. Hepatitis B, herpes simplex and cytomegalovirus were the most common viral infections. Simultaneous bacterial, viral and Candida albicans infections--so-called "triple infections"--with a very poor prognosis were diagnosed in 25% of the investigated cases. The data show that after cadaveric kidney transplantation special emphasis should be laid on careful prophylaxis of infections and diagnostic measures for the early recognition of possible infections arising as a complication of immunosuppressive therapy.

Adult↗
PubMed1975

Septic candidasis with intrahepatic cholestasis and immunoglobuline deficiency after renal transplantation.

Two renal allograft recipients with acquired immunoglobulin deficiency had a disseminated infection with candida albicans. Septic fever, intrahepatic cholestasis and pulmonary mycotic disease were the prominent clinical symptoms. Recurrence of septic fever during the clinical course was associated with increase of intrahepatic cholestasis. On the other hand there was an amelioration of cholestasis when effective antimycotic therapy was instituted. In our patients there was no evidence that intrahepatic cholestasis was drug-related. It was assumed that toxic metabolits of candida albicans were responsible for intrahepatic cholestasis.

Adult↗