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Biomedical subjects

W Koall

Publications and source records attributed to W Koall.

34 records · Page 2Linked to original sources
PubMed1979

[Differential diagnosis and therapy of nephrogenic hemorrhagic diathesis].

For the development of nephrogenic haemorrhagic diatheses in the first place a decreased function of the thrombocytes and a thrombocytopenia are responsible. An inhibition in the intrinsic system may be referred to a lesion of the thrombocytic factor 3. Up to now defects in the extrinsic system do not allow a systematic classification. The best causal therapy are an effective haemodialysis and a renal transplantation. The detection of defects in the coagulation system is of importance for the dosed heparinisation and the control of the treatment with cytostatics for the immune suppression. Among 33 patients undergoing dialysis only 3 patients the Quick-value was reduced to 50% in 9 patients the thrombocyte values were below 150,000 mm3 and in 2 patients below 100,000 mm3. Among 28 carriers with renal graft only in 1 case the Quick-value was reduced to about 50%. In 12 patients the thrombocyte values were decreased below 150,000 mm3 and in 4 patients below 100,000 mm3. A correlation between the two global tests was not to be proved.

Adult↗
PubMed1979

[Pregnancy and delivery after renal transplantation (author's transl)].

A case report is given on a 21-years-old woman who became pregnant 18 months after renal transplantation. In spite of relatively unfavourable conditions (match 0,25; hypertension) renal function showed a good adaptation throughout the gestation. In the 38. week of pregnancy the woman was successfully delivered of a 2440 g healthy female child by vacuum extraction. There were no effects of the immunsuppressive drugs on the newborn. It is the third case of a successful delivery after renal transplantation in the GDR.

Adult↗
PubMed1979

[Hemofiltration of lysozyme in dialysis patients].

With the help of the haemofiltration on the capillary dialysator CDAK 4 the behaviour of lysozyme (muramidase) was investigated in 20 dialysis patients. In 6 of 55 cases a measurable lysozyme concentration in the haemofiltrate was found. A relation to the size of the serum lysozyme level could not be established. The influence of defective capillaries is discussed. Despite the in most cases not measurable lysozyme concentrations in the haemofiltrate a decrease of the serum lysozyme level taking place parallel to creatinine could be proved during dialysis. Examinations of the influence of the renal rest function in dialysis patients with a rest diuresis resulted in a lower lysozyme concentration in the serum than in patients with complete anuria. These findings allow conclusions to the behaviour of low-molecular proteins in the kidney of dialysis patients and to their losses on the dialysis membrane.

Anuria↗
PubMed1977

[Progressive multifocal leukoencephalopathy as a complication of immunosuppression in kidney transplantation].

The progressive multifocal leukencephalopathy is mostly observed as paraneoplastic complication of malignant lymphoproliferative systemic diseases. It may develop also under the influence of a long-term immunosuppressive therapy, as it is necessary in the rejection treatment of recipients or organ transplantations. It is reported on a 44-year-old man in whom a progressive multifocal leukencephalopathy with exitus letalis developed 6 months after a kidney transplantation and following immunosuppressive therapy. In the oligodendroglia of the marginal region of leukodystrophic foci in the centrum semiovale of the right cerebral hemisphere by means of electron microscopy paracrystalline situated virions of the type Papova were proved in most cases.

Azathioprine↗
PubMed1977

[Goodpasture's syndrome and nephrocalcinosis].

In comparison with literary data is reported on 3 young men with a Goodpasture syndrome. Immunohistologically in all cases a glomerulonephritis of the type of basal membrane antibodies was proved, in one patient also still 14 months after having reached the terminal stage of the renal insufficeincy. In every case the disease led to the dialytic treatment without the necessity of nephrectomies for commanding haemmorrhages of the lungs. The longest survival time was 3 years. -- In 1 patient within metastatic calcifications a pronounced nephrocalcinosis developed. Massive depositions of calcium were found in the basal membranes of the glomeruli and tubuli. It is discussed on the genesis of nephrocalcinosis, in which case a secondary hyperparathyrodism, an elevation of the calcium-phosphate-product, an alkalotic metabolic position as well as the dystrophic renal parenchyma of the rapidly progressing glomerulonephritis of Goodpasture's syndrome are taken into consideration.

Adolescent↗
PubMed1977

[Therapy of uremic pericarditis].

An uraemic pericarditis can appear as complication of a haemodialysis in different stages. At the beginning an uraemic pericarditis is still to be referred to the uncompensated retention or to adaptation processes in the cellular mineral metabolism. An uraemic pericarditis in the later course of the dialysis nearly regularly is connected with an underdialysis syndrome which can be evoked by fistula or shunt complications or by infections of different genesis (sepsis, hepatitis, virus infections). - It is reported on own experiences in the dialytic treatment of uraemic pericarditis. In the period from 1970 to 1976 among 83 patients who were in chronic dialytic treatment an uraemic pericarditis was observed in 21 cases. In 3 patients developed haemorrhagic effusions with tamponade. The longest survival time of a patient with uraemic pericarditis and acute cardiac arrest in the early stage of the dialytic treatment is up to now 5 1/2 years after transplantation of a kidney of a corpse. - The possibilities of an operative exonneration of the heart from pericarditic changes are discussed.

Chronic Disease↗
PubMed1977

[Early symptoms of hyperparathyroidism in nephropathies].

The development of an autonomous (tertiary) hyperparathyroidism in patients with renal diseases must clinically be taken into consideration, when by therapeutic measures the causes of a compensatory overfunction of the parathyroid glands were excluded, but the symptoms of a hyperparathyroidism continue or even increase. This is of special importance in the control of patients with renal grafts. The increase of the serum calcium on more than the normal value in simultaneously increased serum phosphate level and increased activity of the alkaline bone phosphatase in connection with demineralisation of the skeleton, osteoclastic changes of the bones and estraossary calcifications may be regarded as early symptoms of a hyperparathyroidism. It is to be discussed the hypothesis, whether in every autonomous hyperparathyroidism a regulative reaction precedes. In patients with renal diseases in a limited number a prevention of the regulative overfunction of the parathyroid glands is possible by an early compensation of a calcium deficit (acquired vitamin D resistance), a hyperphosphataemia and a renal acidosis.

Adenoma↗
PubMed1977

[Penicillamine-induced glomerulonephritis].

In 6 of 24 courses of a disease a nephrotic syndrome appeared under the application of penicillamine. An acute renal failure with exitus letalis developed under the penicillamine therapy of a scleroderma. In the treatment of a mercurial poisoning by penicillamine the nephrotic syndrome increased to a proteinuria of 50 g/24 hours which receded after discontinuation of the remedy. In one group of patients with chronic pyelonephritis could be demonstrated that penicillamine in a primarily damaged kidney must not lead to a secondary glomerular lesion. These findings led to the conclusion that in the appearance of a proteinuria under penicillamine a strong observation of the renal function is necessary, if a continution of the therapy is given from vital indication.

Acute Kidney Injury↗