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  • Renal transplantation  (4)
  • Chronic renal failure  (3)
  • 33.80.Eh  (2)
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  • 1
    Digitale Medien
    Digitale Medien
    Acute pancreatitis in six non-transplanted uraemic children (1988)
    Springer
    Pediatric nephrology 2 (1988), S. 431-435 
    Details
    ISSN: 1432-198X
    Schlagwort(e): Chronic renal failure ; End-stage kidney disease ; Children ; Pancreatitis ; Haemodialysis ; Peritoneal dialysis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Ten clinical episodes of acute pancreatitis (AP) occurred in six patients (mean age 10 years, range 3–15 years) with chronic renal failure (CRF) during a 9-year period (1977–1986). The underlying cause of CRF was vesicoureteral reflux (2); urethral valves (1); ureterohydronephrosis (1); nephronopthisis (1) and a haemolytic uraemic syndrome which occurred 12 years before (1). In all patients a diagnosis of AP was established both on clinical grounds and with a serum amylase level of 〉600 IU/1. In 3 patients laparotomy was performed because of suspected appendicitis. All patients required exclusive parentenral feeding (mean duration 25 days) and 2 patients had a partial pancreatectomy. No patient developed pancreatic pseudocysts, 2 patients experienced one relapse (3 and 21 months later) and 1 patient had two relapses and died. Mean duration of follow up was 3 years (range 1–10 years). Possible aetiological factors were: choledochal cyst (1); parotitis without a rise in mumps antibodies (1); familial dyslipidaemia but without AP in other family members (1), and aluminium intoxication with hypercalcaemia and convulsive encephalopathy treated with valproic acid in 1 patient. Severe hyperparathyroidism with radiological signs was absent in all patients. Transplantation had been performed either before AP in 2 patients (1 and 3 years before AP) or had followed AP in 1 patient (7 years after) without occurrence or relapse of AP.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00853437
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  • 2
    Digitale Medien
    Digitale Medien
    Plasma growth hormone-binding activity is low in uraemic children (1991)
    Springer
    Pediatric nephrology 5 (1991), S. 545-547 
    Details
    ISSN: 1432-198X
    Schlagwort(e): Growth hormone ; Growth hormone-binding protein ; Chronic renal failure
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Plasma growth hormone-binding protein (GH-BP) activity was evaluated in two groups of prepubertal children with chronic renal failure (CRF) who had been treated with recombinant human GH (rhGH). Group 1 consisted of eight children (mean chronological age 10.8 years) with advanced renal failure; group 2 consisted of nine children (mean chronological age 6 years) presenting with end-stage renal disease, who were on dialysis. Before treatment the specific binding of (125I)hGH to highaffinity GH-BP was low in the two groups (group 1, 17.3±1.6% of radioactivity; group 2, 14.2±1.4%) compared with the mean value obtained in normal prepubertal children (24.8±1.7%). No significant changes in GH-BP activity were found during the 1st year of GH therapy, although growth velocity and plasma levels of insulin-like growth factor-I increased significantly in both groups. The low GH-binding activity found in children with CRF supports the state of GH resistance. The reason for the absence of a GH-BP response to GH therapy has to be clarified.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01453698
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  • 3
    Digitale Medien
    Digitale Medien
    Diabetes mellitus in patients with infantile cystinosis after renal transplantation (1999)
    Springer
    Pediatric nephrology 13 (1999), S. 524-529 
    Details
    ISSN: 1432-198X
    Schlagwort(e): Key words Infantile cystinosis ; Renal transplantation ; Diabetes mellitus ; Impaired glucose tolerance
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Diabetes mellitus is a frequent long-term complication of infantile nephropathic cystinosis. We studied 44 cystinotic patients, aged 22.1±5.4 years, transplanted at a mean age of 11.3±2.5 years; 25% were treated with insulin at 20 years of age or 10 years after transplantation, and over half required insulin at latest follow-up. In comparison, diabetes mellitus occurred in only 1% of non-cystinotic transplanted patients. Sequential oral glucose tolerance tests (OGTTs) in these patients showed the progressive deterioration of glucose metabolism. All but 2 patients had an abnormal response at latest follow-up. The high doses of corticosteroid given after transplantation or during rejection episodes were responsible for transient insulin dependency. However, the development of impaired glucose tolerance and diabetes mellitus depended mainly on the cystinotic process, which developed slowly with time. The deterioration of glucose tolerance was correlated with a decreased early phase of insulin secretion, estimated from the plasma insulin level at 30 min of the OGTT, while there was no evidence of insulin resistance. The occurrence of diabetes mellitus correlated with a worsening of the vital prognosis.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s004670050651
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  • 4
    Digitale Medien
    Digitale Medien
    Effects of growth hormone in short children after renal transplantation (1998)
    Springer
    Pediatric nephrology 12 (1998), S. 437-446 
    Details
    ISSN: 1432-198X
    Schlagwort(e): Key words: Human recombinant growth hormone ; Renal transplantation ; Rejection
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. From 1991 to 1993, 90 children having received a kidney graft with a post-transplantation period of at least 12 months were included in a prospective study carried out in 18 French pediatric centers. After informed consent and randomization, children received recombinant human growth hormone (rhGH) (Genotonorm, Pharmacia peptide hormones) 30 U/m2 per week, either immediately on enrollment, for the treated group, or after 1 year of follow-up for the group serving as a control. After 1 year both groups were treated and we analyzed data during the subsequent years. Eighty-five children completed the 1-year study. Growth velocity was significantly increased by rhGH: 7.7 cm with a gain of +0.3 standard deviation score in the treated group versus 4.6 cm in the control group (P〈0.0001) during the 1st year. Four factors predicted response to therapy: growth velocity prior to GH therapy, glomerular filtration rate (GFR) at the start, mode of corticosteroid administration, and degree of insulin resistance. After 1 year we observed a moderate, significant decrease in GFR in both groups. Biopsy-proven acute rejection episodes were not significantly more frequent during the 1st year in the group of patients who received rhGH: 9 in 44 versus 4 in 46 patients. The patients who rejected did not differ in terms of age, renal function at the start, and type of immunosuppression, but history of rejection before GH treatment was discriminatory: 6 of 17 children with two or more episodes had a new rejection versus 1 of 22 who had no or only one episode (P=0.01). Glucose tolerance was not modified after 1 year of GH therapy. During the subsequent years of treatment a decrease in growth velocity was noted: 5.9 cm at 2 years, 5.5 at 3 years, and 5.2 cm at 4 years. In conclusion, GH is efficient for improving growth velocity in short transplanted children, inducing clear-cut but limited catch-up growth. The risk of rejection was shown only in patients with a prior history of more than one rejection episode.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s004670050483
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  • 5
    Digitale Medien
    Digitale Medien
    Growth after renal transplantation: Correlation with immunosuppressive therapy (1991)
    Springer
    Pediatric nephrology 5 (1991), S. 143-146 
    Details
    ISSN: 1432-198X
    Schlagwort(e): Renal transplantation ; Growth ; Immunosuppression
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The growth data for children transplanted between 1973 and 1987 were analysed according to their immunosuppressive regimen. All patients treated before 1985 received conventional treatment (prednisone, azathioprine); 37% of the prepubertal children with a follow-up of longer than 2 years showed catch-up growth, and 30% of the pubertal children exhibited a normal adolescent growth spurt. Reduced renal function and corticosteroid treatment are the two main causes of growth delay. The children transplanted between January 1985 and September 1987 were given either triple therapy [cyclosporine (CsA), prednisone, azathioprine] or conventional treatment after randomisation. Growth data were significantly better with CsA. The mean height gain for prepubertal children was +0.24 SD/year on triple therapy and +0.14 SD/year on conventional therapy during the 1st year after transplantation; and 0.4 SD/year and 0 SD/year during the 2nd year (P〈0.05). The mean height gain for pubertal children was 5.6 cm/year on triple therapy and 3.6 cm/year on conventional therapy (P〈0.005). The patients on triple therapy also received a significantly lower cumulative dose of prednisone. Some selected patients on triple therapy were taken off prednisone 12 months after transplantation. All patients showed catch-up growth (+0.83 SD/year in prepubertal children, 7.2 cm/year in pubertal children). In conclusion, protocols including CsA and the lowest cumulative dose of steroid (with alternate-day or even steroid withdrawal) allow the best restoration of growth.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00852872
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  • 6
    Digitale Medien
    Digitale Medien
    Pretransplant blood transfusions with cyclosporine in pediatric renal transplantation (2000)
    Springer
    Pediatric nephrology 14 (2000), S. 451-456 
    Details
    ISSN: 1432-198X
    Schlagwort(e): Key words Blood transfusion ; Cyclosporine ; Renal transplantation ; Cytotoxic antibodies
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Pretransplant transfusions were repeatedly shown to be associated with improved graft survival in the ”pre-cyclosporine era,” and have recently been shown to be beneficial in patients on modern immunosuppressive regimes. In an attempt to improve this transfusion effect and minimize the potential development of cytotoxic antibodies, we have given these transfusions, with concomitant cyclosporine cover, prior to transplantation. Ninety-two renal transplantations were performed in 91 children in the study group (group 1) and all received pretransplant transfusions with cyclosporine cover. Results were compared with a preceding group of 102 children (104 transplantations) who had received pretransplant transfusions without cyclosporine cover (group 2). There were 70 cadaver and 22 living-related donor (LRD) transplants in group 1, and 88 cadaver and 16 LRD transplants in group 2. Graft survival rates (1- and 5-year) for cadaver transplantation were 96% and 90% in group 1 compared with 78% and 64% in group 2 (P=0.001). For LRD transplantation, these figures were 95% and 87% in group 1 and 81% and 69% in group 2. There was no difference between the two groups in terms of age at transplantation, sex, donor age, HLA-A, -B, -DR mismatches, or cold and warm ischemia times. All cadaver graft recipients received quadruple, sequential immunosuppression post transplant. However, 9 patients in group 1 were changed to tacrolimus for recurrent rejection episodes. No patient developed persistent lymphocytotoxic antibodies post transfusion or side effects of cyclosporine. Cyclosporine can be safely given with whole blood prior to transplantation with no adverse effect and no sensitization. Graft survival was significantly improved in this group of patients and graft loss due to rejection was exceptional. This effect should be further evaluated in prospective studies.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s004670050791
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  • 7
    Digitale Medien
    Digitale Medien
    A study of recombinant human erythropoietin in the treatment of anaemia of chronic renal failure in children on haemodialysis (1994)
    Springer
    Pediatric nephrology 8 (1994), S. 338-342 
    Details
    ISSN: 1432-198X
    Schlagwort(e): Anaemia ; Chronic renal failure ; Haemodialysis ; Haemoglobin ; Recombinant human erythropoietin
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract This was an open-label multicentre study of recombinant human erythropoietin (r-HuEPO) in 116 children aged 6 months to 20 years with anaemia of chronic renal failure undergoing haemodialysis. Haemoglobin concentration at entry ranged from 3.4 to 9.5 g/dl. r-HuEPO was given intravenously two or three times per week, the starting dose being 75 U/kg per week. This was subsequently titrated in steps of 75 U/kg per week with the goal of increasing haemoglobin concentration at the rate of 1 g/dl per 4 weeks into the range 9.6–11.2 g/dl (6–7 mmol/l), with treatment then continued for up to 1 year with the aim of maintaining the haemoglobin concentration within the target range. Of the 115 children in whom efficacy could be evaluated, 93 (81%) achieved the target haemoglobin and a further 6 had a rise in haemoglobin concentration of at least 2 g/dl. At 52 weeks, the median maintenance dose for children〈30 kg was 225 U/kg per week, compared with 107 U/kg per week for children ≥30 kg. Analysis suggested that 150 U/kg per week would have been a more appropriate starting dose. The mean transfusion requirement fell from 8.9 to 0.7 units/patient per year. Of the 22 patients who failed to reach the target, 15 went on to transplantation and left the study prematurely. Sub-group analysis showed that similar doses lead to similar rates of rise in haemoglobin regardless of the severity of the original anaemia. Assessment of quality of life suggested that this may have improved with r-HuEPO. Twenty-four children needed initiation or increase of anti-hypertensive medication, suggesting that successful r-HuEPO therapy was associated with a tendency towards increased blood pressure. However, there were no significant mean changes in blood pressure, suggesting that the problem was successfully addressed by the changes in treatment. No child developed anti-r-HuEPO antibodies. The overall safety profile was excellent and no new r-HuEPO toxicities were identified in children.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00866354
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  • 8
    Digitale Medien
    Digitale Medien
    Shell effects in large AlN clusters (1993)
    Springer
    The European physical journal 26 (1993), S. 92-94 
    Details
    ISSN: 1434-6079
    Schlagwort(e): 36.40.+d ; 03.65.Sq ; 33.80.Eh ; 35.20.Vf
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Physik
    Notizen: Abstract Neutral aluminum clusters have been produced by laser vaporization technique, ionized by a low-power near-threshold laser light and detected using standard TOF spectrometric methods. Ionization potentials have been deduced in the low size range. In the large size range 250〈N〈1400 the patterns of the mass spectra exhibit a regular and continuous oscillation, originating from size-dependent ionization threshold effects. The period, constant on a Ne 1/3 scale (Ne=3N is the number of valence electrons), is approximately two times shorter than the one observed in alkali experiments. This feature is analyzed in terms of shell structure.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01425628
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  • 9
    Digitale Medien
    Digitale Medien
    Shell effects in photoionization spectra of heavy trivalent metal clusters (1993)
    Springer
    The European physical journal 26 (1993), S. 137-139 
    Details
    ISSN: 1434-6079
    Schlagwort(e): 36.40.+d ; 35.20.Vf ; 33.80.Eh
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Physik
    Notizen: Abstract Laser photoionization experiments have been performed on a large size range of indium and thallium clusters. The metal clusters were produced by laser vaporization technique and analyzed after laser ionization by standard time-of-flight mass spectrometry. For the indium clusters, individual ionization potentials (IP) are deduced for N≤132. Abrupt decreases in the IP values are observed, which correspond to the openings of new electronic shell as predicted by the spherical jellium model. For larger indium clusters, the unresolved mass spectra present small but reproducible oscillations. Interpretations in terms of either electronic shell structure or cluster geometry remain undecided for the moment. Our results on thallium clusters are less abundant and only qualitative. Nevertheless, they show that thallium behaves more like a monovalent element than like a trivalent one.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01425643
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