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Biomedical subjects

P Schmidt

Publications and source records attributed to P Schmidt.

At least 37 records · Page 2Linked to original sources
PubMed1979

Use of thermography in kidney transplantation: two year follow up study in 75 cases.

During a period of 24 months 75 renal transplant recipients were examined by thermography according to Tricoire. Thermography is a non-invasive, quickly available and reproducible method. Because of the 92% incidence of exact diagnosis this investigation is a helpful additional test in kidney transplantation for evaluation of graft function as well as for diagnosis of pathological intrarenal or perirenal disorders. Thermography is especially recommended for patients if postoperative haemodialysis is necessary. In these cases information can easily be achieved whether postoperative oligo-anuria is caused by acute tubular necrosis or by primary vascular insufficiency of the transplant.

Abscess↗
PubMed1979

Cadaveric renal graft acceptance without azathioprine.

After azathioprine withdrawal serum creatinine concentrations at the end of an observation period of up to 26 months were not significantly different from the previous values in five out of seven patients with good transplant function. Patients with chronic rejection showed a constant rate of loss of transplant function, assessed by a straight line relationship between the logarithm of serum creatinine and time. After stopping azathioprine, however, there was no break in the slope of the curve in five out of six patients. Azathioprine withdrawal may be compatible with good long-term graft acceptance. Azathioprine seems to be of little value in the management of chronic renal rejection.

Azathioprine↗
PubMed1979

[Hemolysis after combined azathioprine and allopurinol therapy].

In a 37 year old renal transplant woman haemolytic anaemia was observed in the course of a combined azathioprine-allopurinol therapy. Azathioprine is converted to 6-mercaptopurine, which then catalyzed by xanthine oxidase is oxidized to 6-thiouric acid. When allopurinol and azathioprine are administered simultaneously, high 6-mercaptopurine concentrations in plasma may be expected because of inhibition of xanthine oxidase activity by allopurinol. We assume that elevated plasma 6-mercaptopurine concentration could possibly be responsible for haemolytic anaemia in this renal transplant patient.

Adult↗
PubMed1979

Recovery of kidney function following prolonged acute renal failure.

Twenty-two patients with prolonged acute renal failure (ARF), successfully treated by haemodialysis, were analysed. The clinical course was oliguric in 16 and non-oliguric in 6 cases. Twenty-seven haemodialyses on average (15-54) during a mean duration of 66.9 (30-172) days were needed for recovery of kidney function. Overall, maximum improvement of renal function was achieved within 116.4 (51-259) days, in oligo-anuric cases within 80.1 (51-208) days, in non-oliguric cases within 160.3 (90-259) days. In the latter group pre-existing renal damage was probably the cause of the more extended duration of acute renal failure.

Acute Kidney Injury↗
PubMed1978

[Long-term ophthalmologic follow-up after kidney transplantation].

16 renal transplant recipients underwent ophthalmological examination 11.4, 19.4 and 61.3 months after renal transplantation. The most common side effects of immunosuppressive therapy were steroid-induced cataract formation, steroid glaucoma, and recurrent subconjunctival haemorrhages. Posterior sub-capsular cataracts may develop as early as 2 months after surgery, reach their highest incidence within 2 years and may be reversible under low dosage steroid therapy. 75.5% of 57 ophthalmologically examined patients showed ocular complications or changes, but visual function was not severely disturbed. Despite hypertension in 23 cases, no hypertensive retinopathy was observed. In the light of these findings we assume that kidney transplantation has a positive influence on ocular functions, and especially on fundus changes dating from the time of regular dialysis treatment.

Adolescent↗
PubMed1978

[Intractable renal and enteral loss of potassium in a case of Turner's syndrome (author's transl)].

A case of Turner's syndrome is presented; many congenital defects were detected. Predominant clinical findings were cheilognatoschisis, respiratory distress, caused by congenital bronchiektasis and chronic hypokalemia with paroxysmal attacks of paralysis and tetania. Hypokalemia was mainly due to gastrointestinal losses as a consequence of permanent vomiting in the presence of stomach atonia and hiatus insufficiency or because of "third space losses", while a subileus persisted chronically. Furthermore also a renal loss of serum potassium was evident in the patient's predialytic time. Basic renal diseases were pyelonephritis, renal damage from phenacetine abuse, or probably even a nephropathy due to potassium depletion. Uraemia was controlled by dialysis treatment and by a dialysate consisting of 7 and 6 mmol/l potassium respectively. The result of this intense therapy was physical rehabilitation and the patient finally could resume her professional work again.

Adult↗
PubMed1978

[Defibrination with the snake venom enzyme arwin in peripheral arterial obstructive disease. Possibilities and limitations (author's transl)].

Defibrination with the snake venom enzyme Arwin is one of the numerous possibilities for the therapy of peripheral arterial obstructive disease. The number of complications is relatively small. In 58 patients with peripheral arterial occlusive disease stages III to IVa treated with Arwin the success rate was 50--60%. The ultrasonic Doppler pressures in the arteries of the ankle can be helpful for indicating Arwin therapy. Complications were not observed in combined treatment with hemodilution, intraarterial injection or simultaneous administration of heparin.

Ancrod↗
PubMed1978

[Effector function of acute leukemias in "spontaneous" (SCMC) and antibody dependent cellular cytotoxicity-tests (ADCC) (author's transl)].

Blood lymphocytes from 13 untreated acute leukemia patients, 3 pre-leukemias 3 immunoblastic lymphadenopathias and one infectious mononucleosis showed significantly lower spontaneous (SCMC) and antibody-dependent cellular cytotoxicity (ADCC) against 51Cr-labeled allogeneic melanoma cells of the IGR3 cell line than effector lymphocytes from 20 age- and sex matched control persons. While control lymphocytes exhibited the highest cytotoxic activity after depletion of mononuclear phagocytes (Fraction FFF), followed by the "Ficoll" purified Fraction F and defibrinated whole blood, the reverse was true for acute leukemias: here, the highest cytotoxicity was found in whole blood followed by the lymphocyte fractions F and FFF. Comparatively high cytotoxicity was found with two leukemia patients who had received blood transfusions the day before testing. During the course of an acute erythroleukemia chemotherapy drastically reduced SCMC and ADCC activities. A therapeutical splenectomy, on the other hand, did not affect cellular cytotoxicity in the case of a hairy cell leukemia. The angioimmunoblastic lymphadenopathies showed strikingly high percentages of EA- and EAC-rosettes forming cells and showed a marked increase of SCMC and ADCC activities after elimination of mononuclear phagocytes from the effector cell population.

Acute Disease↗
PubMed1978

[Parathyroid hormone and 25-hydroxycholecalciferol concentrations in the serum of patients with kidney transplantations and their radiological correlation].

In 40 renal transplant patients the serum concentration of parathyroid hormone, 25-hydroxycholecalciferol, calcium and inorganic phosphate were estimated. The results of these biochemical studies were compared to X-ray soft tissue and bone pathologic findings. The serum immunoreactive parathyroid hormone (iPTH) was normal in 37 patients and increased in 3 cases. 19 (47.5%) renal transplant recipients showed decreased serum 25-hydroxycholecalciferol levels. In 23 out of 40 patients (57.5%) serum phosphate was lower than 3.0 mg/100 ml. X-ray soft tissue changes were observed in 28 (70%) and bone changes in 18 (45%) patients; both frequencies were higher when compared to occurrence during regular dialysis treatment. Features of hyperparathyroid osteopathy were frequently observed in renal transplant recipients. Femoral head necroses were predominant in men, whereas osteomalacia with Looser's zones were found mainly in women. The pathogenesis of X-ray bone changes in patients with renal transplants seems to be multifactorial and related to the duration of secondary hyperparathyroidism before renal transplantation as well as to phosphate depletion and 25-hydroxycholecalciferol deficiency.

Adult↗
PubMed1978

[Osteopathy and serum parathormone and 25-hydroxycholecalciferol levels in patients on long-term haemodialysis (author's transl)].

Skeletal radiological changes were analyzed in 22 patients treated by chronic haemodialysis. Furthermore, the serum parathormone and 25-hydroxycholecalciferol concentrations were determined. X-ray evidence of renal osteopathy was found in 13 patients (59%). Extraskeletal calcification, subperiostal erosions and cystoids were the predominant lesions. Serum iPTH concentrations were increased in 21 out of 22 haemodialyzed patients. The serum 25-hydroxycholecalciferol concentration was normal. The results of this study seem to indicate that other factors apart from secondary hyperparathyroidism have a share in the development of renal osteopathy in patients on chronic haemodialysis.

Adult↗
PubMed1978

[Spontaneous birth of a live healthy child during successful hemodialysis treatment of pregnancy pyelonephritis with acute oligo-anuria].

A 19-year-old nullipara developed uremia due to acute pyelonephritis in the 30th week of pregnancy, necessitating hemodialysis within one week of onset of clinical infective symptoms. Almost daily prophylactic hemodialyses (7 in all) were performed. BUN and serum creatinine levels were maintained below 75 mg/100 ml and 12 ml/100 ml respectively, and the patient's weight was kept constant until delivery in the 32nd week of pregnancy. A live healthy child of 1.7 kg was born with a length of 39 cm and a normal neurologic examination. After 10 hemodialyses, polyuria set in and the maternal BUN and serum creatinine levels were within normal ranges 3 weeks after delivery. The importance of close cooperation between gynecologist and internist is stressed.

Adult↗
PubMed1978

[Frequency of cardiovascular risk factors in renal transplant patients (author's transl)].

The incidence of cardiovascular risk factors was studied in 83 renal transplant recipients: 84.3% showed at least one cardiovascular risk factor, hyperuricaemia was found in 42.2%, hypertension in 39.7%, hypercholesterolaemia in 31.3%, hypertriglyceridaemia in 27.7%, diabetes mellitus in 19.3%, obesity in 14% and nicotine abuse in 13.2% of the patients. Patients aged from 30 to 39 and 40 to 49 showed a mean incidence of 2.7 and 2.9, respectively out of the 7 investigated cardiovascular risk factors. The results demonstrate that renal transplant patients are a high-risk group for the development of degenerative cardiovascular diseases.

Adolescent↗
PubMed1978

[Recurrence of intramembraneous glomerulonephritis in 2 consecutive kidney transplantations].

A case of dense intramembranous deposit disease, partial lipodystrophy, hypocomplementemia, and nephritic factor-like activity in the serum is presented. Recurrence of underlying renal disease was noted in two consecutive renal allografts. The first transplant was lost 7 months after implantation, chronic renal rejection being an additional cause of graft failure. A favourable clinical course, however, was observed after the second renal transplantation. 22 months after surgery, the patient was fully rehabilitated and transplant function only slightly reduced despite electron microscopic evidence of typical dense intramembranous deposit lesions. Low C3-serum complement and normal C4-serum complement levels were constant findings throughout observation time. The case supports the assumption that patients with dense intramembranous deposit disease should not be excluded from renal transplantation As shown in the literature, maintenance of satisfactory graft function is usually obtained for a long period of time despite recurrence of original disease.

Adult↗
PubMed1978

[Successful haemodialysis treatment of acute renal failure in a patient with multiple myeloma (author's transl)].

A case of multiple myeloma with severe osteolytic destructions and myeloma kidney is presented, in whom a rapidly progressive renal insufficiency because of hyponatraemia and dehydration developed. After 5 months of regular dialysis treatment diuresis increased and a sufficient global kidney function recurred. Aetiological factors and the pathomechanisms of acute renal failure in multiple myeloma are discussed. We assume that acute renal insufficiency is - in rare cases - at least partly reversible. Therefore patients with acute renal failure and multiple myeloma should not be excluded from haemodialysis treatment because even complete rehabilitation can be achieved.

Acute Kidney Injury↗