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W Pinggera

Publications and source records attributed to W Pinggera.

27 records · Page 2Linked to original sources

Corticosteroids and proliferation of smooth muscle cells in arteries of renal transplants.

In the arteries of 17 rejected renal grafts 'activated' smooth muscle cells (ASMC) were discerned from a 'resting' type. Proliferation and fibre production by ASMC resulted in a marked thickening of intima. Each of four normal Wistar rats received 20 mg prednisolone i.v./day for one week and the development of hypertension was therapeutically prevented. Changes similar to those in the graft arteries were found in the rat aortas. We assume that SMC were stimulated by several mechanisms in rejection but also by extremely high dosed corticoids.

Adrenal Cortex Hormones↗

[Immunglobulin levels after kidney transplantation and during rejection crisis (author's transl)].

In the first three weeks after kidney transplantation the patients were examined for daily changes in immunoglobulin levels. Only very seldom was a decrease of IgM detected in our patients who had undergone splenectomy. During half of the rejection crisis there were indeed short periods of increase (spikes) in immunoglobulins. These were observed always before or concomitantly with the clinical diagnosis of a rejection reaction. In order to determine the connection between immunoglobulin-spikes and an approaching rejection episode the general one-sided binominal test was used. A significant relation was established between IgM peaks and an approaching rejection crisis. No such relation could be found for the IgA peaks observed. The IgG globulins showed no consistent pattern during a transplantation rejection. A persistent fall of the IgG globulins was noted in the first ten days after renal allograft with the immunosuppressive regimen of an initial gramme of methylprednisolon and high dosage of azothioprine. A good correlation was observed with the simultaneous depression of serum albumin concentrations. As losses of protein in urine are minimal (already confirmed by other authors), it must be assumed that in the first place a high rate of catabolism and a restriction in the protein synthesis is responsible for the decrease in the IgG globulins and the serum albumins.

Azathioprine↗

[Pneumocystis carinii infections following kidney transplantation].

Four adult recipients of cadaveric renal homografts acquired Pneumocystis carinii infections from which they subsequently died. The disease in adults under immunosuppressive therapy runs a course different from the disease observed in newborns. The clinical course is rapidly progressive and early diagnosis by means of aggressive diagnostic procedures is mandatory. To prevent a fatal outcome, treatment even on suspicion is suggested. Epidemiologically, a person-to-person spread seems possible and isolation of the patient is necessary.

Adult↗

A simple test for early detection of severe renal homograft rejection.

Adding urine to a standard buffered fibrinogen solution and then coagulating it with thrombin gives reproducible coagulation times with normal urines. Coagulation of fibrinogen by thrombin is prolonged in acid solutions with a pH below six. Urines of high acidity lower the buffer pH of the fibrinogen solution below a value of six thus rendering the system uncoagulable or significantly prolonging the coagulation time. With this test system we found that out of 16 severe homograft rejections 15 were accompanied by a high acid excretion in six-hour urine specimens. Ten of these acid episodes became apparent 12 to 48 hr before clinical symptoms and before elevation of the serum creatinine could be detected.

Creatinine↗