PubMed Health⌕ Search

Biomedical subjects

R Michalik

Publications and source records attributed to R Michalik.

At least 19 recordsLinked to original sources
PubMed1986

Impaired fibrinolysis and protein C increase after cadaver kidney transplantation.

Severe rejection crises occurred in 13 out of 20 cadaver kidney recipients; removal of the graft was inevitable in 10 cases. The plasminogen levels were found to be lower (76.5 +/- 2.9%) in the 13 patients with impaired graft acceptance (group B) than in the 7 patients experiencing only moderate rejection (group A, 93.7 +/- 5.2%, p less than 0.01) or the 41 patients with chronic renal disease (group C, 88.2 +/- 2.3%, p less than 0.01). Since alpha 2-antiplasmin was found to be enhanced, the alpha 2-antiplasmin/plasminogen ratio was high (1.56 +/- 0.07) in group B as compared with group A (1.19 +/- 0.05, p less than 0.002) and group C (1.11 +/- 0.04, p less than 0.001). The fibrinolytic capacity, which was assessed by a "reversed fibrin plate" assay, declined significantly after transplantation, and was lower in group B greater than 20 days after grafting. The neoantigen alpha 2-antiplasmin-plasmin complex was not detected in any patient; thus hyperfibrinolysis is unlikely to be responsible for the plasminogen decrease. Protein C rose above preoperative values (group A 117.1 +/- 8.7%; group B 133.7 +/- 9.0%) and reached higher levels in group A (221 +/- 24.1%) than in group B (157.4 +/- 14.8%, p less than 0.05) between days 11 and 20 after transplantation. No constant alterations were found with respect to antithrombin III and fibrinogen. Fibrin deposits, which reduce perfusion, can be found in the vessels of rejected kidney grafts. An impaired fibrinolytic capacity and a subsequent inability to remove these clots may be significant for the outcome of transplantation.

Adult↗
PubMed1985

Fibronectin plasma levels after cadaver kidney transplantation.

The fibronectin plasma levels of 17 patients undergoing cadaver kidney transplantation were determined serially in the postoperative course using laser nephelometry. While 9 patients retained their grafts (group A), the grafts of 8 patients had to be removed (group B), mainly due to rejection, 3 patients had severe infections. In both groups a significant drop of the plasma fibronectin occurred after surgery. There were no significant differences between the two groups in the mean fibronectin levels. After the initial drop the group A patients exhibited rising values leading to a stable level. Progressively declining fibronectin plasma concentrations were found in 2 of 3 severely infected patients. Fluctuating values were found in 3 group B patients without a clear correlation to the rejection crises or the kidney function. The data suggest that the fibronectin plasma level does not seem to be a prognostic marker for graft rejection. But it might be useful in the important and often difficult differentiation between rejection and infection.

Adult↗
PubMed1985

Protamine induced arterial hypoxaemia: the relationship to hypoxic pulmonary vasoconstriction.

Protamine administration may induce arterial hypoxaemia in dogs and humans. However, the responsible mechanism has not been established. Protamine, as it is a pulmonary vasoactive substance, may interfere with normal hypoxic pulmonary vasoconstriction (HPV) and cause arterial hypoxaemia. This possibility was tested in dogs utilizing a one lung hypoxic model. One lung hypoxic ventilation decreased pulmonary blood flow in the hypoxic lung from 1022 +/- 96 ml X min-1 (mean +/- SEM) to 846 +/- 39 ml X min-1 (p less than 0.05) while increasing blood flow from 833 +/- 85 ml X min-1 to 1109 +/- 101 ml X min-1 (p less than 0.05) in the normoxic lung, resulting in 24 per cent effective diversion of blood flow. Protamine infusion, after heparinization, markedly elevated pulmonary vascular resistance in both lungs but preferentially in the normoxic lung (102 +/- 27 per cent increase in normoxic lung, 60 +/- 6.4 per cent increase in hypoxic lung) and significantly reversed the pulmonary blood flow shift induced by one lung hypoxic ventilation (effective diversion of blood flow was reduced to four per cent). Concurrently, arterial PO2 further decreased. Our results demonstrate that protamine interferes with effectiveness of pre-existing HPV and suggest that this mechanism, at least in part, may be responsible for arterial hypoxaemia observed after protamine infusion. The marked generalized pulmonary vasoconstriction with protamine appears to be the direct force that interferes with pre-existing auto-regulatory HPV. In addition to the well known haemodynamic effects of protamine, protamine infusion may also cause arterial hypoxaemia in those patients in whom HPV plays a significant role in maintaining arterial oxygenation.

Animals↗
PubMed1985

Impaired fibrinolysis after kidney transplantation.

Impaired fibrinolysis is associated with low plasma plasminogen (PLG) and a predominance of its inhibitor alpha 2-antiplasmin (APL). Plasma PLG and APL were determined in 10 recipients who retained their cadaveric graft (A) and 10 patients who lost it immediately after transplantation (B). In group A only five patients had a PLG less than 70 per cent and/or APL/PLG ratios exceeding 1.8, accompanied by severe albeit reversible acute rejection in three of them. In contrast nine of 10 group B patients had low PLG and/or an elevated APL/PLG ratio. Thus impaired fibrinolysis frequently appears to be associated with deterioration of cadaveric graft function.

Adult↗
PubMed1984

Myocardial infarction complicated by Boerhaave's syndrome.

Spontaneous rupture of the esophagus can simulate a variety of disease processes. Ours is the first reported case in the English literature of Boerhaave's syndrome occurring concomitantly with acute myocardial infarction.

Diagnosis, Differential↗
PubMed1975

Some immunological aspects of the long-term remission in acute lymphoblastic leukemia in children.

Nineteen children aged from 3 to 16 years with first long-term hematologic remission were studied. Cell-mediated immunity was assayed by the reaction to dinitrochlorobenzene (DNCB), nitroblue tetrazolium reduction test (NBT) and lysozyme activity. Humoral immunity was determined by immunoglobulin (IgG, IgA, IgM) levels in serum. The DNCB-reaction was positive in 50% of children treated from 12 to 36 months. Percentage and absolute counts of NBT-positive granulocytes and lysozyme/granulocyte ratio systematically increased with time of therapy. In all studied children IgG was normal, IgA and IgM were depressed to 40% and 76% of normal value (with the exception of 2 children after cessation of therapy, in which IgA was normal). It seemed that continuous control of the immunologic status during long-term cytostatic therapy is essential in clinical practice.

Adolescent↗