[Cytomegalovirus infection in kidney transplantation (author's transl)].
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Biomedical subjects
Publications and source records attributed to M Liska.
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The paper deals with the incidence of infectious complications and rejection crises in patients with renal transplants. It was revealed by statistical methods that there exists a certain correlation between infections and rejections, which depends on the type of the infectious agent. In patients where infectious complications were caused only by gram-negative flora an indirect relationship was revealed, while in patients with infectious complications where gram-positive flora, viruses or fungi participated, a marked direct correlation was found. Statistical methods proved also a higher incidence of rejection crises in patients with active cytomegalic infection.
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On 35 patients with chronical relapsing urinary tact infections with different forms of the clinical course 3 localisation methods for the differentiation of infections of the upper and lower urinary tract, respectively, were evaluated. The results have shown that the bladder washout method was more reliable than the new kidney washout method. The latter method has, however, certain advantages, such as its simplicity and the catheterless accomplishment. The simplest method is the immunofluorescence investigation of the urinary sediment on the germs coated with antibodies. This method, however, still contains several unclear sources of error.
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Ten days after four-fifths nephrectomy in rats (four-fifths of the renal parenchyma removed), the total and renal elimination constants of tobramycin were lowered by one-half. The biological half-life of tobramycin doubled. These results suggest that soon after nephrectomy the residual nephrons are able to increase the rate of excretion of tobramycin. The increase in mass of the remaining renal tissue between day 10 and day 80 after nephrectomy had no effect on the biological half-life, on the total and renal elimination constants, and on the renal clearance of tobramycin. During endotoxin shock and burn shock, concentrations of tobramycin in serum decreased at a slower rate. The highest serum concentrations of tobramycin were observed in rats with shock due to burns.
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The effect of azathioprine, hydrocortisone and antihymocyte serum on the development of experimental colibacillary renal infection in rats was assessed by macroscopical findings in the kidneys, especially by determining the number of microbes in the infected organ, on day 7 after injection of the infectious agent. The greatest multiplication of bacteria and so the most pronounced macroscopical changes occurred after ALS treatment. There was statistically significant difference between ALS-treated group and the control group, whereas the differences between controls and the other experimental groups (Imuran, hydrocortisone) were non-significant.
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The model of experimental pyocyanic renal infection in rats based on direct inoculation of bacteria to the renal parenchyma is described. The authors describe in detail the procedure and evaluation of the results with respect to microbiology, histology and reproducibility. The method produced a focal supurrative inflammation with a significant bacteriologica finding in renal tissue for 8 weeks at the least. The inflammation has a tendency to form focal cicatrices not accompanied by diffuse shrinkage of the kidney. The method is well reproducible and its technique is relatively simple thus permitting to induce infection in a large series of animals within a short period of time. In the second part of the paper, the use of this method in testing the therapeutical efficacy of gentamicin, carbenicillin and their combination is reported. The results showed gentamicin to be more effective than carbenicillin and the combination of the two to have the highest therapeutical effect. Moreover, their combination made it possible to reduce the dosage of the antibiotics and thereby reduce their potential undesirable effect. Further, the results showed the described model of experimental renal infection to be well suited for testing the efficacy of chemotherapeutics and resolving some problems of the treatment of infectious diseases.
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