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Biomedical subjects

R Kotzaurek

Publications and source records attributed to R Kotzaurek.

At least 19 recordsLinked to original sources
PubMed1977

[Effect of exchange transfusion on the plasma amino acid concentration in hepatic coma].

Exchange transfusion (ET) were made twice on a 22 year old patient with fulminant hepatitis and hepatic coma. The influence of the ET on the plasma amino acids (PAA) was examined. The 1. ET reduced the concentration of the total PAA from 10,023 to 7,152 mugmol/l (about 28.6%) and the 2. ET from 11,770 to 9,706 mugmol/l (about 17.5%). Three hours after the 1. ET the concentration of the total PAA has passed over the prevalue and after the 2. ET has nearly reached it. The influence of both ET on the concentration of the individual PAA was very different (- 47.9% to + 71.2% after the 1. ET and - 32.9% to + 41.8% after the 2. ET respectively). Therefor the ET seems to be not a suitable method to reduce the pathologic concentration of the PAA in the hepatic coma.

Adult↗
PubMed1977

[The disseminated intravascular coagulation. Diagnosis and therapy on a medical intensive care unit (author's transl)].

Disseminated intravascular coagulation (DIC) is a frequent acquired disorder of haemostasis in the patients at the medical intensive care unit. The pathogenesis, the different possible clinical manifestations and the obligatory laboratory tests are reviewed. In addition to the treatment of the underlying disease, the importance of adequate restoration of fluid volume and early administration of heparin is stressed.

Adolescent↗
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

[Haemodynamic changes in acute myocardial infarction following high doses of furosemide (author's transl)].

Haemodynamic measurements were carried out after administration of furosemide to 10 patients suffering from acute myocardial infarction and congestive heart failure. It was observed that a transient deterioration in cardiac function (decreased cardiac output, increased enddiastolic pulmonary arterial pressure and increased pulmonary and systemic resistance) occured in the pre-diuretic stage in these failing hearts. After the onset of diuresis the haemodynamic parameters showed a reversal of the previous trends (increased cardiac output, decreased enddiastolic pulmonary arterial pressure and pulmonary resistance). The consistently lower enddiastolic pulmonary arterial pressure in the diuretic phase as compared with the pre-diuretic value ensured an improvement in cardiac haemodynamics. An attempt was made to interpret the haemodynamic results in the light of the Frank-Starling's curve.

Acute Disease↗
PubMed1976

[The effect of "standardized forced diuresis" (SFD) on serum and urinary electrolytes(author's transl)].

The effect of standardized forced diuresis (SFD) on the serum and urinary electrolyte levels was investigated in 10 cases of severe self-poisoning with hypnotic drugs. Diuresis was initiated by furosemide and maintained at an hourly urinary ouput of 2 litres. Fluid and electrolyte substitution was carried out with a standardized electrolyte solution. Initiation and termination of the SFD was performed abruptly. The mean values of sodium, potassium, chloride and phosphorus in the urine varied widely at the beginning of the SFD, while the calcium and magnesium values varied only slightly. During SFD, urinary stabilization occured at a particular ionogram, in correlation to the electrolyte concentrations in the infusion fluid and with only minimal individual variation. Owing to this satisfactory correlation, none of the patients developed signs of electrolyte disturbances, so that no correction of the infusion constitution was necessary. The abrupt termination of the SFD prevented electrolyte disturbances in the recovery phase.

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

[Angiotensin - a possible cause of acute renal failure (author's transl)].

The hypertensive action of angiotensin is purely brought about by peripheral vasoconstriction and may, thus, lead to reduced perfusion of vital organs, especially the kidneys. The dangers of angiotensin in triggering off acute renal failure are illustrated by a case report in which this drug was administered to a comatose patient with hypovolaemic hypotension following barbiturate self-poisoning.

Acute Kidney Injury↗
PubMed1976

[Severe intoxication with leponex (author's transl)].

The clinical picture and the therapeutic management of a severe case of self-poisoning with Leponex (clozapin) are presented. In particular, the grave complications, their possible aetiology and the value of the administration of cortisone are discussed. Forced diuresis or haemodialysis are ineffective measures on account of the low serum concentrations of Leponex.

Adult↗
PubMed1976

[Clinical results with dopamine in acute renal failure (author's transl)].

Dopamine possesses specific pharmacological actions which distinguish it from the other catecholamines. Apart from its positive inotropic effect, dopamine exerts a favourable influence on renal function with an increase in renal blood flow and alterations in intrarenal haemodynamics. The use of dopamine in the early stages of acute oliguric failure is recommended on the basis of the good therapeutic response achieved in a series of cases.

Acute Kidney Injury↗
PubMed1976

[Rejection of a kidney graft after pregnancy and delivery].

Eighteen months after cadaver kidney transplantation a 22-year-old woman was successfully delivered of a healthy female child. Onset of allograft rejection in the third trimenon was followed three weeks after delivery by progressive renal failure and resumption of regular dialysis treatment. Pregnancy risk factors after successful renal transplantation and immunosuppressive therapy are discussed.

Adult↗
PubMed1976

[Parenteral nutrition in hepatic coma (author's transl)].

A special program of parenteral nutrition was established in 16 patients with genuine hepatic coma and in 24 patients with portal encephalopathy; this program involves stepwise addition of various nutritional components. On the day of admission water and electrolyte balance is normalized, on the following morning infusions with 40% glucose solutions are started, and the patient is adapted to glucose as the source of calories within the next 48 hours. After this period total parenteral nutrition is instituted comprising all essential ingredients of nutrition. Application of amino acids was especially adjusted to the situation of hepatic coma taking into account not only the typical derangements of metabolism in hepatic coma, but the essential complications of this disease as well. Serial determinations of plasma amino acids were done in order to assess the program of nutrition. Before the beginning of parenteral nutrition plasma levels of amino acids were altered in a manner typical for liver failure; these alterations could be normalized almost completely by total parenteral nutrition.

Adult↗
PubMed1975

[Partial parenteral nutrition in acute myocardial infarction (author's transl)].

The influence of partial parenteral nutrition (PPN) was compared with the effect of a calorie-free solution in 2 groups of patients (n = 10) with acute myocardial infarction. Both groups received the same daily diet of 800 to 1000 Cal. The control group was given, in addition, a calorie-free electrolyte solution and the PPN group was given a nutritious solution consisting of 1000 Cal carbohydrate and 26.5 g 1-amino acids daily by means of a subclavian catheter. The exact monitoring of the water balance indicated that patients with acute myocardial infarction can safely be given parenteral nutrition. Neither haemodynamic nor metabolic complications occurred in the group with PPN due to the small infusion volume and the continuous administration of the infusion volume and the continuous administration of the infusion. The control group was in negative nitrogen, potassium and phosphorus balance in comparison with the PPN group. This demonstrates that a hypocaloric diet is insufficient in the acute phase of myocardial infarction and causes catabolism, which can be prevented by PPN. Stimulation of healing of the myocardial infarct can be expected through the improvement of protein metabolism by PPN.

Diet↗