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Biomedical subjects

A Korzets

Publications and source records attributed to A Korzets.

At least 55 records · Page 3Linked to original sources
PubMed1995

Decreased uroporphyrinogen decarboxylase activity in patients with end-stage renal disease undergoing hemodialysis.

Raised plasma uroporphyrin levels were found in all the 14 patients with end-stage renal disease studied, 7 of whom were on continuous ambulatory peritoneal dialysis (CAPD) and 7 on hemodialysis (HD). The elevation observed in the HD group was higher than that noted in the CAPD group; 18-fold in the former and 13-fold in the latter. The difference in uroporphyrin plasma levels between the two dialysis populations might be explained, at least partially, by the reduced activity of uroporphyrinogen decarboxylase (UROD), the enzyme which converts uroporphyrinogen to coproporphyrinogen. A decrease of 48% was noted in the HD group, whereas no change was observed in the CAPD group. A significant negative correlation (r = -0.37, p < 0.01) was found between the concentration of uroporphyrin in plasma and the activity of UROD. In view of the data shown, it is suggested that erythrocyte UROD activity should be interpreted with caution in HD patients suspected of having porphyria cutanea tarda.

Chromatography, High Pressure Liquid↗
PubMed1995

Effect of nifedipine on the renal functional reserve in cyclosporine-treated renal-transplant recipients.

Cyclosporine decreases renal perfusion and impairs the renal hemodynamic response to a protein load. High-dose nifedipine has been shown to elevate renal plasma flow (RPF). We measured the renal functional reserve of 6 cyclosporine-treated renal-transplant recipients following intravenous administration of an amino acid solution, before and 2 weeks after therapy with high-dose nifedipine (up to 120 mg/day). Pretreatment renal functional reserve was nil Following administration of nifedipine, RPF increased by 22% (p < 0.01), filtration fraction decreased by 14% (p < 0.005) and renal vascular resistance declined by 39% (p < 0.005). Renal functional reserve remained unchanged. High-dose nifedipine increases renal perfusion but does not restore renal functional reserve in cyclosporine-treated renal-transplant recipients.

Adult↗
PubMed1995

Surgery in chronic dialysis patients.

During recent years there has been a continuous increase in the number of patients with end-stage renal failure who require long-term dialysis. The purpose of this retrospective work was to look at the number and type of operations performed and the postoperative outcome and complications that may be typical for these patients. This report details our experience with surgery in chronic dialysis patients, focusing mainly on major surgical procedures. During 21 years (1972-93) 22 patients on long-term hemodialysis or peritoneal dialysis underwent 44 operations. All access operations and parathyroidectomies were excluded. Each patient underwent between 1 and 6 operations; 27 (61.4%) operations were elective and 17 (38.6%) were emergencies. The most common type of operation performed was abdominal surgery and hernia repair; the others, in decreasing order, were urological operations, amputations, and vascular surgery. Postoperative complications occurred in 54% of the operations, the most common being hyperkalemia in 32%, infectious complications in 16%, and bleeding in 11%. One patient (2%) died postoperatively; the cause was most probably secondary to hyperkalemia and a fatal arrhythmia. From a review of the literature and from the results of our study it appears that surgery in uremic patients can be performed with acceptable results in terms of morbidity and mortality rates. Complications, such as hyperkalemia, a fall in blood pressure, and bleeding, are expected and preventive measures should therefore be taken. Perioperative measures are recommended to minimize complications.

Adult↗
PubMed1995

Adenocarcinoma at ureterosigmoidostomy junction in a renal transplant recipient 15 years after conversion to ileal conduit.

In recent years, adenocarcinoma of the colon mucosa has become a recognized complication of ureterosigmoidostomy and in most cases the tumor arises at the site of ureterocolonic anastomosis. We report a case of a 29-year-old renal transplant recipient who developed two colonic carcinomas at the site of ureterosigmoidostomy 25 years after the urinary diversion and 15 years after conversion to an ileal conduit. This case emphasizes the need for a careful life-long follow-up of all patients who undergo ureterosigmoidostomy.

Adenocarcinoma↗
PubMed1994

Uninephrectomy aggravates tubulointerstitial injury in rats with adriamycin nephrosis.

The effects of uninephrectomy on the function and structure of the remnant kidney were assessed in rats with Adriamycin-induced nephrosis, 12 weeks after the injection of Adriamycin. The kidney volume of Adriamycin-treated uninephrectomized rats (NX-AD) was 2.3 times that of sham-operated, Adriamycin-treated animals (SH-AD; p < 0.001). The marked renal enlargement in NX-AD animals was due to the development of large tubular cysts. Following uninephrectomy, the fractional volume of tubular lumen almost doubled (NX-AD, 0.33 +/- 0.02; SH-AD, 0.17 +/- 0.02; p < 0.001) and the absolute volume of tubular lumen increased more than fourfold (NX-AD, 0.51 +/- 0.08 ml; SH-AD, 0.12 +/- 0.02 ml; p < 0.001). The frequency of tubular lumen with a large cross-sectional area (> or = 40,000 microns 2) was 5.8 +/- 1.1% in NX-AD and 0.7 +/- 0.2% in SH-AD groups (p < 0.001). The fractional volume of interstitial fibrosis in NX-AD animals was larger than in SH-AD (0.09 +/- 0.02 versus 0.04 +/- 0.01%, p < 0.05). As opposed to the worsening of tubulointerstitial disease, single-kidney glomerular filtration rate, fractional protein clearance, glomerular volume and the extent of glomerular sclerosis did not differ significantly in NX-AD as compared to SH-AD groups. This study shows that uninephrectomy in rats with Adriamycin nephrosis worsens interstitial nephrosis and aggravates the formation of tubular cysts, leading to a macrocystic kidney disease. These changes are not associated with an increase in glomerular sclerosis.

Animals↗
PubMed1994

Effects of erythropoietin on glucose tolerance in hemodialysis patients.

Erythropoietin (EPO) therapy is widely used to correct the anemia of end-stage renal disease. It has been reported that this treatment affects various hormonal systems. The aim of the present study was to evaluate the effects of EPO therapy on glucose tolerance. Anemia was corrected with EPO in 10 patients on chronic hemodialysis therapy. Oral glucose tolerance tests (OGTT) were performed before and after correction of anemia. The following measurements were made: the areas under the glucose curves (AUCglue), the areas over basal glucose values (OABVglue), the areas under the insulin curves (AUCins) and the areas over basal insulin values (AOBVins). Hemoglobin concentration increased from 70 +/- 1.4 milligrams to 111 +/- 1 milligram. Fasting plasma glucose, insulin and glucagon levels were were not affected by correction of the anemia. Following administration of EPO, AOBVglue increased by 19%, from 2101 +/- 243 to 2508 +/- 230 mmol.min/l (p < 0.02), while AOBVins remained unchanged. AUCins and AUCglue remained unchanged. These data show that correction of anemia with EPO in hemodialyzed patients causes an increase in the glycemic response to an oral glucose load while not affecting the insulin response.

Anemia↗
PubMed1994

Systemic distribution of beta 2-microglobulin-derived amyloidosis in patients who undergo long-term hemodialysis. Report of seven cases and review of the literature.

A search for visceral amyloid deposits was performed on autopsy material from 20 patients who had been receiving long-term hemodialysis treatment for 4 to 21 years. Visceral amyloid was found in seven patients who had undergone hemodialysis for more than 10 years. Histochemically, the amyloid was permanganate sensitive, and immunohistochemically, it stained positively for beta 2-microglobulin. The amyloid was found mainly in the wall of blood vessels, in the form of subendothelial nodules, bulging into the vessel's lumen. The amount of amyloid increased with increasing years of hemodialysis treatment. The organs most frequently involved were the heart, gastrointestinal tract, and lungs. Smaller deposits were seen in medium blood vessels of all other visceral organs. Only the spleen was "resistant" to amyloid deposition; the reason for this splenic resistance is unknown. A similar organ distribution was found in the 19 previously reported autopsy cases. Clinically, one patient experienced a perforation of the small intestine, probably related to the narrowing of the intestinal blood vessels by amyloid deposits, and this patient died of peritonitis.

Adult↗
PubMed1994

Effect of enalapril on the microvascular albumin leakage in patients with diabetic microangiopathy and normal or mildly elevated blood pressure.

The transcapillary escape rate of albumin (TERalb) is often elevated in patients with diabetic microangiopathy. The objective of this study was to examine the effect of enalapril on the TERalb of diabetic patients with albuminuria and normal or mildly elevated blood pressure. Seventeen diabetic patients with diabetic retinopathy, albuminuria, a diastolic blood pressure below 100 mmHg and increased TERalb participated in the study. Blood pressure and TERalb were measured before and after 14 days of therapy with enalapril, 20 mg daily for 14 days. Systolic and diastolic blood pressure fell from 168 +/- 6 to 155 +/- 6 (p < 0.001) and from 87 +/- 2 to 81 +/- 2 mmHg (p < 0.005) respectively. Mean arterial pressure declined from 114 +/- 3 to 105 +/- 3 mmHg (p < 0.0001). The elevated TERalb decreased from 9.5 +/- 0.5 to 7.2 +/- 0.5%/hr (p < 0.005). In the hypertensive subset, systolic, diastolic and mean arterial pressure decreased significantly by 15, 7 and 10 mmHg (p < 0.005, p < 0.005 and p < 0.005 respectively); TERalb decreased from 9.5 +/- 0.6 to 7.3 +/- 0.6 (p < 0.03). In the normotensive subset, arterial pressure remained unchanged and TERalb decreased from 9.0 +/- 0.8 to 6.8 +/- 1.0%/hr (p < 0.03). Plasma fructosamine decreased from 373 +/- 23 to 347 +/- 20 (p < 0.05) in the hypertensive group and remained unchanged in the normotensive patients. No correlation could be demonstrated between variation in TERalb and changes in blood pressure. In conclusion, enalapril decreases microvascular albumin leakage in patients with diabetic microangiopathy and normal or mildly elevated blood pressure.

Blood Pressure↗
PubMed1993

Deteriorating renal function with acetazolamide in a renal transplant patient with pseudotumor cerebri.

Treatment with acetazolamide for pseudotumor cerebri (PTC) in a renal transplant patient led to an acute, but reversible deterioration in renal function. Possible pathogenetic mechanisms behind acute renal failure and acetazolamide are detailed. In summary, caution should be exercised in all patients with chronic renal failure who require acetazolamide. It should be avoided if possible, used in reduced doses when necessary, and coupled with a high fluid intake to avoid dehydration and/or intraluminal obstruction.

Acetazolamide↗
PubMed1993

Angiotensin-converting enzyme inhibition and anaemia in renal patients.

A 35-year-old renal transplant patient with stable renal function developed an unexplained anaemia. Appropriate investigations proved non-diagnostic. Only when enalapril therapy was stopped did the anaemia reverse and haemoglobin levels returned to pre-treatment levels. An association between angiotensin-converting enzyme inhibitors and anaemia in patients with renal failure is becoming more evident. A literature review of this problem and its possible pathogenesis in patients with renal failure is given.

Adult↗
PubMed1993

Tubulointerstitial nephritis and uveitis: association with suppressed cellular immunity.

It is suggested that tubulointerstitial nephritis and uveitis (TINU) is a cell-mediated immune disease with a favourable response to treatment with steroids. However, long-term follow-up has not been described and data on immunological studies are limited. The aim of this study was to evaluate the clinical features in patients with TINU who have had a long follow-up period, and in parallel to assess their cellular immunity and HLA typing. Four women with TINU were followed for 5.7 +/- 3.6 years. On remission they were studied for T-cell-mediated immunity by skin tests, T-cell subpopulations, and lymphokine secretion in vitro. The lymphokines included interleukin-2, gamma-interferon, tumour necrosis factor, and colony-stimulating factor. The in vitro response to AS101, a previously described immunomodulator, was evaluated. HLA-typing was also performed. The nephritis, which occurred once, was resolved in all patients and did not recur. In contrast, numerous relapses of uveitis occurred despite topical or systemic steroid treatment. The patients' T-cell subpopulations did not differ from controls, but they revealed anergy to skin tests and a very low secretion rate of lymphokines. AS101 corrected the suppressed secretion in vitro. A high frequency of HLA-DR6 antigen was found in the TINU patients. TINU is probably a systemic disease with a chronic relapsing course of the uveitis but with complete clinical recovery of the nephritis. Both in vivo and in vitro T-cell functions are suppressed during remission.

Adolescent↗
PubMed1992

Reflex sympathetic dystrophy of the stump in below-knee amputees.

OBJECTIVE: To document the occurrence of reflex sympathetic dystrophy of the stump in two patients with below-knee amputation. DESIGN: A retrospective survey emphasising two clinical case reports. SETTING: Department of orthopaedic rehabilitation at a teaching rehabilitation hospital. PATIENTS: Lower limb amputees (n = 164) were accepted for prosthetic rehabilitation. Twenty-one amputees were regarded as rehabilitation failures; in two below-knee amputees intractable pain was the major problem. RESULTS: Clinical manifestations, radiological, and scintigraphic findings in the two amputees with intractable pain met the criteria for diagnosis of reflex sympathetic dystrophy. CONCLUSIONS: Reflex sympathetic dystrophy of the stump should be suspected in below-knee amputees whenever severe pain persists over a period of 3 to 4 months following amputation.

Amputation Stumps↗