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Biomedical subjects

J Hejnal

Publications and source records attributed to J Hejnal.

At least 55 records · Page 3Linked to original sources
PubMed1982

The effect of renal revascularization on decreased glomerular filtration rate in patients with renovascular hypertension.

The effect of revascularization on decreased glomerular filtration rate (GFR) was studied in 18 patients with renovascular hypertension (RVH) for a period of 5 to 74 months after operation. Renal artery stenosis (SRA) was present unilaterally in 3 patients, bilaterally in 13 patients, and in two patients with one kidney. Following surgical correction, the GFR increased or normalized in 6 patients, decreased in 2, and did not change in 10 patients. The blood pressure of almost 90% of the operated patients normalized or improved. The results support the assumption that severe hypertension is indicated for surgery, irrespective of the magnitude of GFR decrease. Revascularization effected a reversal of renal insufficiency only in a third of the patients.

Adult↗
PubMed1980

Contribution to the treatment of post-infarction cardiac aneurysms.

The authors discuss contemporary problems of resection of post-infarction cardiac aneurysms. In their opinion the main cause of left-sided cardiac failure is enlargement of the left ventricle which leads to increaser demands on the tension of muscle fibres and work of the heart. These mechanisms potentiate at the same time the ischaemia of the heart muscle. Reduction of the left ventricle by appropriate resection eliminates or improves markedly this adverse condition in particular when there is an opportunity of simultaneous revascularization by an aorto-coronary by-pass. Based on the results in a series of 52 operations the authors consider assessment of the stroke volume before and after the foreseen resection a suitable and reliable criterion for indication of the operation. Its application led to a substantial decline of the surgical mortality caused in particular by the postoperative low cardiac output syndrome.

Heart Aneurysm↗
PubMed1978

Renal transplantation and pregnancy.

Processing of data from 79 pregnancies (incl. 11 observed by the authors) in 64 women (incl. 6 of their own patients) after renal transplantation revealed that approximately in 20% of the pregnancies in chronological association with the pregnancy the function of the graft deteriorated or ceased and in four instances this participated indirectly in the mother's death within one year after delivery. The effect of immunosuppressive treatment of the pregnant mother on the development of the foetus and 57 evaluated infants resp. was manifested by a 50% incidence of prematurity, in seven neonates by clinical or post-mortem findings of adrenal hypofunction or hypoplasia resp. and by hypofunction or hypoplasia of the lymphatic apparatus. Only in one neonate and one foetus (observed by the authors) an inborn defect was revealed. In five neonates chromosomal aberrations were described. The above findings support our disapproval of pregnancy in women after renal transplantation with the exception of recipients of grafts from siblings with closely related tissue properties and with a renal function stabilized for a long period and with minimal immunosuppression.

Chromosome Aberrations↗
PubMed1975

Glomerulopathies in human renal allografts.

The present study discusses the light, electron and immunofluorescence microscopy as well as some clinicopathologic correlations of rejection change in human renal allograft glomeruli. It is based on examination of 126 tissue specimens from 54 grafts obtained from 50 patients (1966-1973). The most frequent and characteristic lesion was membranous transplant glomerulopathy (MG) with irregular fibrillar thickening of capillary walls but without conspicuous hypercellularity. This thickening was caused by subendothelial depositsdifferent from classical fibrinoid lesions. During further progression, widening and peripheral extension of mesangium with degenerative changes became apparent. Advanced MG was encountered most frequently in the 2nd year after transplantation (TPL) at moderate to medium proteinuria and hypertension. It was accompanied by endarteristic rejection changes, and renal insufficiency set on usually in the course of the 3rd year. Nevertheless, the course, symptoms, and graft survival exhibited considerable variations. - The morphology and manifestations of destructive segmental transplant glomerulopathy (SG) depended on the time of its development. In the early stage (within about 3 months after TPL), the lesion was characterized by areas of fibrinoid insudation and necro(bio)sis associated with severe vascular changes, most frequently obliterative arterio(lo)pathy (OA). The ultrastructure was characterized by endothelial defects with host's polynuclear reaction and focal intravascular coagulation. The grafts thus affected failed soon, their function usually subsiding within the first trimester at a moderate, but gradually increasing proteinuria and severe persistent hypertension. The late from of destructive SG presenting as fibrohyaline obliteration of the loops with foam cells always accompanied advanced MG with severe arterial lesions. - Fluorescence microscopy revealed both linear and focal fixation of antisera, which, however had no apparent correlation with the microscopical and clinical presentations.

Basement Membrane↗
PubMed1975

Cystography after kidney transplantation.

45 voiding cystographies were performed in 40 patients with renal allografts: in 30 cases diluted Verografin SPOFA (CSSR) and in 15 cases Opacist E.R. BRACCO (Italy) were used as contrast medium. The purpose of the study was to assess the frequency of vesico-ureteral reflux into the autologous ureters, into the ureter and pelvicalyceal system of the graft and the frequency of morphological and functional changes of the urinary bladder including its contraction during micturition. In three patients with urinary leakage at the site of uretero-neocystotomy voiding cystography gave false-negative results.

Abscess↗