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Biomedical subjects

P Pils

Publications and source records attributed to P Pils.

At least 55 records · Page 3Linked to original sources
PubMed1978

[Results of operative treatment of artial septal defect in the adult (author's transl)].

55 of 59 patients with artial septal defect, who had been operated in adult age, were examined postoperatively. The mean time interval from the operation was 43,8 months. Two patients had died immediately after the operation; there were no late deaths. The majority of the reexamined subjects was free of symptoms, in no case was there congestive heart failure. Persistence of postoperative symptoms increased with increasing age at the time of operation, but only up to the fourth decade of life. In 26 cases hemodynamics were examined. Mean pulmonary arterial pressure was normal at rest and during a slight ergometric load. In 5 patients there was moderate pulmonary hypertension. In 8 subjects there was minimal, in one patient moderate increase of pulmonary vascular resistance. Heartsize in chest roentgenogramm was increased in about 25% of cases, in more than 50% the pulmonary vessels were accentuated. Irregularities of cardiac rhythm were not more frequent postoperatively, than they had been prior to surgery. However, surgery was followed by a marked decrease of right axis deviation and of EKG signs of right ventricular hypertrophy. Pulmonary function studies revealed a slight decrease of vital capacity and of maximal breathing capacity. These results are favourable compaired to medically treated groups of patients as described in the literature. It is concluded, that even in later adult age the atrial septal defect as a rule is an indication for surgery.

Adult↗
PubMed1978

Tolerance to high ultrafiltration rates during closed batch hemodialysis.

The tolerance to high levels of ultrafiltration that has been observed when using a RP-6 dialyzer with polyacrylonitrile membrane and a closed batch dialysate delivery system has led the authors to put patients on a free sodium and fluid intake. Eight patients were put on such a diet for six months. They have been dialyzed four to five hours, three times per week, on a RP-6-Rhodial 75. The mean intersession weight gain was 4.29+/-0.18 Kg after three days for a mean predialytic body weight of 63.55+/-2.54 Kg. Mean predialytic blood pressure was 1.38+/-4 mmHg for systolic pressure and 82+/-5 mmHg for diastolic pressure. Mean ultrafiltrate volume was 4.86+/-0.36 liters which corresponds to a sodium output of 661.3+/-49.5 mEq. Total plasma protein and hematocrit increased 18.8+/-3.34% and 19.13+/-3.22%, respectively, when the pre and post-dialytic values were compared. No clinical sign of fluid overload (dyspnea, edema, etc.) was noted in these patients. Cardiothoracic index remained in the normal range. This tolerance is due, possibly, to the high sodium concentration (145 mEq/L) in the dialysate. The free sodium and water diet may contribute to a better rehabilitation.

Adult↗
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↗
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

[Acute intermittent porphyria. A case report and family study].

The course of acute intermittent porphyria is described in a patient who died during an acute exacerbation of the disease. An analysis of the urinary porphyrin precursors (delta-aminolaevulinic acid and porphobilinogen), the determination of toal porphyrin excretion and the separation of haem precursors in the urine according to the number of carboxylic groups demonstrate different degrees of biochemical severity in the individual consanuinious members of this patient's family. The detection of latent carriers is of particular importance since the avoidance of porphyrogenic substances is the most important prophylactic measure to be undertaken in all latent clinical cases. According to our experience, however, prophylactic measures must also be extended to young consanguineous family members with negative excretion patterns in view of the difference in age at which the disease manifests itself.

Acute Disease↗
PubMed1977

[Improved scintigraphic imaging of the adrenals with 6beta-131I-iodomethyl-cholesterol (author's transl)].

Scintigraphic visualization of the adrenals is greatly improved after substitution of 131I-19-I-Cholesterol by 6beta-131I-Iodomethyl-Cholesterol which was first seen as a radiochemical impurity during the synthesis of 131I-19-Iodocholesterol. The interpretation of the scintigraphic imaging is further improved by application of a cross section through the visualized adrenals. In an animal experiment the radioactivity of the adrenals and to a less degree that of different tissues was found up to four times higher after injection of 6beta-131I-Iodomethyl-Cholesterol than with the applications of 131I-19-Iodocholesterol. The high affinity of the tissue for 6beta-131I-Iodomethyl-Cholesterol results in high radiation exposure of the patients. However, since less activity of 6beta-131I-Iodomethyl-Cholesterol is necessary for visualization of the adrenals the overall radiation is also less than with the application of 131I-Iodocholesterol. Higher stability of the labelled molecule is suggested to be responsible for improved scintigraphic imaging of the adrenals.

Adrenal Glands↗
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

[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

[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↗