PubMed Health⌕ Search

Biomedical subjects

R Templin

Publications and source records attributed to R Templin.

At least 19 recordsLinked to original sources
PubMed1998

Protein A immunoadsorption (i.a.) in renal transplantation patients with vascular rejection.

Vascular rejection after renal transplantation is connected with a higher frequency of allograft dysfunction or graft loss. Plasmapheresis as an adjunctive therapy in the treatment of humoral mediated acute graft rejection was compared with protein A immunoadsorption. Eleven patients with acute graft rejection and high titers of cytotoxic HLA-Ab and/or signs of vascular rejection at graft biopsy (performed in 9 patients) have been treated. Six of them have a stable graft function, the longest graft survival until now is 41 months, four are back on haemodialysis and one patient died from CMV-pneumonia with a stable graft function 9 months after transplantation. We conclude that IA is a useful adjunctive therapy in the treatment of vascular rejection after renal transplantation. Further investigations are necessary to optimize criteria for inclusion.

Endothelium, Vascular↗
PubMed1997

Radiotherapy in stage IIA and IIB testicular seminoma with reduced portals: a prospective multicenter study.

PURPOSE: A prospective multicenter study was carried out to estimate the treatment outcome of radiotherapy in Stage II seminoma after the application of modern staging and radiotherapy techniques. The lower margin of the iliac field was positioned on the upper rim of the acetabulum to reduce the amount of scattered irradiation to the remaining testicle. METHODS AND MATERIALS: The study was carried out in 25 centers in Germany. Patients with pure seminoma, negative AFP-values, and retroperitoneal lymph node metastases of less than 5 cm in diameter were entered into the study. All patients received a ventrodorsal opposed field irradiation of the para-aortic and the ipsilateral iliac lymph nodes. The fields extended from the top of the 11th thoracic vertebra to the top of the acetabulum. Patients in Stage IIA (lymph nodes <2 cm ) received 30 Gy, and patients with Stage IIB (lymph nodes between 2 and 5 cm) 36 Gy total dose. RESULTS: 39 patients in Stage IIA and 19 patients in Stage IIB were evaluated. After a median observation time of 37 months all patients are alive and disease free. Recurrence free survival in stage IIA was 100%. Two patients in Stage IIB experienced a recurrence 10 and 17 months after the end of radiotherapy. The actuarial recurrence free survival estimate in Stage IIB was 94.1% for 1 year and 87.4% for 2 years. One recurrence in Stage IIB occurred in the mediastinum, one in the mediastinum, and one the lung. Both patients could be salvaged by chemotherapy. There were no pelvic recurrences. The treatment was well tolerated, with nausea being the most common side effect (56.9% Grade 1, 15.5% Grade 2, and 8.6% Grade 3). Diarrhea occurred in 15.5% (Grade 1), 15.5% (Grade 2), and 5.2% (Grade 3) of the patients. CONCLUSIONS: The outcome of para-aortic and ipsilateral iliac irradiation in Stage IIA/B testicular seminoma is excellent with the currently available staging methods and treatment facilities. The treatment is well tolerated. The lower margin of the iliacal field can be placed at the acetabulum.

Adult↗
PubMed1995

Tandem bullet versus multiple gunshot wounds.

The differentiation of tandem bullets fired simultaneously versus multiple bullets fired separately entering through a single entrance wound may present difficulty in wound interpretation for the forensic pathologist. The authors present a case report of three separate projectiles entering through a single perforation. The differentiation of projectiles fired in tandem and multiple single projectiles is discussed.

Brain Injuries↗
PubMed1993

[The trend distribution quotient, a new tool for evaluating renal perfusion scintigraphy using 99mTc-DTPA following renal transplantation].

We developed a new quantitative concept in dynamic renal transplant imaging, the Trend Distribution Ratio, and tested its diagnostic usefulness in 137 examinations. This ratio is an expression of the distribution of blood flow velocity in different areas of the kidney. With regard to the differential diagnosis between acute tubular necrosis and the various forms of rejection we arrived at a sensitivity of 0.83 and a specificity of 0.54. A differentiation between the various histological types of rejection has not yet been possible.

Blood Flow Velocity↗
PubMed1990

[Factors influencing the result of kidney transplantation with special reference to the HLA system in conventional immunosuppression].

Among 331 recipients of cadaveric renal allografts, transplanted from 1976 to 1986 at the Rostock Transplant Center the graft survival rates have been analyzed. All patients have been treated by conventional immunosuppressive therapy using azathioprine and prednisolone. A relation between graft survival and immunological factors was found: the better the HLA match, the better the transplant results. The necessity of a restrictive transfusion regime was stressed. The higher the number of pretransplant transfusions, the higher is the panel reactivity with following lower graft survival. Cold ischemic time was without influence on graft survival. The introduction of cyclosporin may improve the graft survival rate as known of 10-20%.

Azathioprine↗
PubMed1990

[Clinical value of interleukin 1- and interleukin 2-determinations in patients after kidney transplantation].

In a retrospective study of allograft rejections in renal transplant recipients we examined the value of cytokine production monitoring. Interleukin 1 (IL 1) and interleukin 2 (IL 2) activities were determined in supernatants of mitogen-stimulated peripheral blood lymphocytes in 8 renal transplant recipients serially for a period up to 60 days after transplantation. LPS-induced IL 1 as well as PHA-induced IL 2 production in patients after renal transplantation were significantly decreased in comparison to healthy controls. Seven episodes of cellular rejection were diagnosed in renal allograft recipients during this time, only 4 rejection episodes, however, were associated with a rise in the IL 1 and simultaneous IL 2 production occurred for 2 up to 3 days before the diagnosis of rejection. Moreover there were 12 instances in which an elevation of IL 1 and IL 2 production was found independently from the rejection. In 8 cases the augmentation of IL 1 and IL 2 production could be associated with clinical infections. We conclude from these results that a cytokine monitoring for the diagnosis of allograft rejection does not seem to be useful.

Cells, Cultured↗
PubMed1989

[Pathology of the transplanted kidney and basic renal disease of the recipient].

Among 359 kidney transplantations performed from 1976 to 1986 at Rostock the 4 most frequent original renal diseases were glomerulonephritis (280 x), pyelonephritis (74 x), diabetic nephropathy (22 x) and polycystic kidney disease (14 x). From 225 transplant kidneys in 284 cases pathomorphological examinations were performed (104 biopsies, 138 removed grafts, 42 postmortem transplant examinations). The most striking finding was the earlier occurrence of rejection in grafts from recipients with glomerulonephritis compared with pyelonephritis. Therefore, a more rapid and intense immune reaction could suggested in patients with glomerulonephritis as original renal disease.

Biopsy↗
PubMed1988

Unreliability of oxygen tension-based indices in reflecting intrapulmonary shunting in critically ill patients.

Measurement of intrapulmonary shunting (Qsp/Qt), a widely used method for monitoring disturbances of pulmonary oxygen transfer in critically ill patients, involves calculation of arterial and mixed venous oxygen contents. In circumstances where mixed venous blood samples are not readily available, oxygen tension-based indices such as the alveolar to arterial oxygen tension differences (P[A-a]O2), arterial oxygen tension to alveolar oxygen tension ratio (PaO2/PAO2), PaO2 to FIO2 ratio (PaO2/FIO2) and respiratory index (RI) are widely utilized to reflect Qsp/Qt. Oxygen content-based indices such as the estimated shunt are not as widely utilized as the oxygen tension indices. In 75 critically ill patients in whom a pulmonary artery catheter was being utilized to augment clinical care, comparisons were made between Qsp/Qt and P(A-a)O2, PaO2/PAO2, PaO2/FIO2, RI, and estimated shunt to determine which index best reflected Qsp/Qt. Correlations between Qsp/Qt and estimated shunt were good (r = .94) and poor for the P(A-a)O2 (r = .62), PaO2/PAO2 (r = .72), PaO2/FIO2 (r = .71), and RI (r = .74). We conclude that there are no real substitutes for venous oxygen contents in critically ill patients. When pulmonary artery blood is not available for analysis, oxygen tension-based indices are unreliable reflectors of Qsp/Qt while the estimated shunt, an oxygen content-based index, provides a more reliable reflection of Qsp/Qt.

Aged↗
PubMed1988

[Problems of metabolic control in type I diabetic patients with chronic renal failure].

The aetiopathogenesis of the diabetic nephropathy today is still unknown. Uncontested is the contribution of chronic hyperglycemia in the pathogenesis of diabetic nephropathy. For this, there are convincing evidences from clinical and experimental experiences including transplantation surgery. The quality of the metabolic adjustment of the diabetics from the first time of diabetes manifestation is important to prevent the development of diabetic nephropathy. For this, an almost normoglycemic compensation of the glucose metabolism is mandatory. More problematically is the management of the diabetic metabolism during chronic renal insufficiency. Considerable fluctuations of the blood glucose concentration are predominately in the daily profile. The intensive conventional metabolic therapy by multiple insuline injections under self control of the blood glucose level are indicated absolutely in those patients. The therapeutic aim is a smoothing of the blood glucose fluctuation. With that it is possible--together with the elimination of hemodynamic risk factors--to delay effectively a progradient decline of the glomerulo-filtration rate and to improve the assumption to an invasive therapy.

Blood Glucose↗
PubMed1986

[Dielectric behavior of isolated dog kidneys following storage preservation and subsequent autotransplantation].

A measurement of the vitality of kidney transplants before the implantation is not yet possible, however, criteria for the proof of anoxic and hypothermic lesions on isolate kidneys are known. With the investigation means of the passive-electric behaviour over the determination of the DK-course and the dispersion of epsilon' an original evaluation of the vitality is possible. With the help of the measurement of epsilon' in frequencies between 0.5 MHz and 3 MHz we establish the proportion of intact cell membranes and mitochondria. The modul M3 explains the distribution of relaxing structures. Our hitherto performed experiments have shown that by means of the observation of the two sizes a judgment of the vitality seems to be possible. Examinations on bastard dogs of either sex were performed. For the supplementation of the dielectric measurements in certain time intervals tissue samples of the preserved kidneys were investigated electron-microscopically.

Animals↗
PubMed1985

[Preparation and implementation of kidney transplantation in patients with terminal renal failure and type I diabetes].

The newest results of transplantation in diabetic nephropathy (diabetics type I) of the world were described according to the data of the EDTA and after the symposium in The Hague. Own experience in the field of transplantation carried out in diabetics needing insulin with terminal renal failure were critically evaluated. The investigations in several centres of the GDR concerning the decompensation of diabetic nephropathy show that it is necessary to perform a three- to six-month creatinine control in long-term diabetics from the 15th year of the disease and from a serum value of 200 mumol/l to carry out in good time a common diabetological and nephrological control with test concerning the fitness for a kidney transplantation. Only by this means the conditions for an improvement of the consequence of transplantation may be achieved.

Adult↗
PubMed1984

[Microsurgical blood vessel reconstruction in kidney transplantation].

Of 214 donor kidney transplants, 14.5% exhibited multiple arterial supply, 2.8%, injuries to vessels, and 1.8%, severance of the polar vessel. Microsurgical procedures were used on 14 of these kidneys; 11 functioned immediately, so that the patients could be discharged. Techniques of anastomosis using an operating microscope or magnifying spectacles are described.

Cadaver↗
PubMed1984

[Cell electrophoresis studies of peripheral blood lymphocytes in patients following kidney transplantation].

In 111 patients (control group, dialysis patients, kidney recipients) the behaviour of T lymphocytes was observed using an automatic measuring apparatus ( Parmoquant cytopherometer ) and the spontaneous rosette test. The Parmoquant method gives no information on the process of rejection, but it helps to identify risk situations due to bacteria of viruses. In cases of rejection after the second post-operative week, the results of the two methods are reversed.

Electrophoresis↗