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Biomedical subjects

A Flatmark

Publications and source records attributed to A Flatmark.

At least 181 records · Page 10Linked to original sources
PubMed1978

Renal allograft rupture.

In the present material of 448 consecutive renal transplants the incidence of allograft rupture was 3.6%. Among 389 first transplants there were two ruptures in the living donor group (126 patients, 1.5%) and 12 ruptures in the cadaveric donor group (263 patients, 4.6%). Only one ruptured kidney (living donor) achieved long term function. Four patients with first graft rupture were retransplanted with early loss of the kidney in all, in two because of rupture. Two of these patients received a 3rd cadaveric graft, of which one is functioning well after two years. All ruptures occurred within three weeks after transplantation, 14 kidneys ruptured during the first week. The clinical course and the operative findings suggested that rejection was the cause of rupture in all cases. This was confirmed by light and immunofluorescent microscopy of specimens from 15 kidneys, while one kidney only demonstrated extensive intrarenal vessel thrombosis. It is concluded that renal allograft rupture signals a strong immunological response in the recipient with poor graft prognosis. The chance of a successful retransplantation is small.

Adult↗
PubMed1978

Plasma lipoprotein alterations and morphologic changes with lipid deposition in the kidney of patients with hepatorenal syndrome.

Four patients with advanced liver disease and progressive renal failure compatible with the diagnosis of hepatorenal syndrome have been studied. All four patients had low lecithin:cholesterol acyltransferase activity in plasma, and the concentration of cholesteryl esters was markedly reduced. The main lipoprotein classes were abnormal with an increased content of polar lipids. Electron microscopy of negatively stained lipoproteins from two of the patients (H.K. and I.A.) revealed large particles with layered membranes (700 to 2000 A in diameter) corresponding to the large molecular weight fraction of the low density lipoproteins. These structures were not present in the low density lipoproteins from the other two patients. In the renal biopsy from H.K. and in the necropsy specimen from I.A. deposition of osmophilic material was found in the glomeruli (especially located subendothelially), in the basement membrane, and in the mesangial regions. The deposits were similar to those we have previously described in patients with familial lecithin:cholesterol acyltransferase deficiency and most probably represent cholesterol and phospholipids. It is suggested that the renal deposition of lipid may be related to the large molecular weight low density lipoprotein fraction and that the mechanisms involved in this lipid deposition are similar to those occurring in familial lecithin:cholesterol acyltransferase deficiency.

Female↗
PubMed1978

Recurrent and persistent Cushing's syndrome after assumed total bilateral adrenalectomy.

Two cases of recurrent Cushing's syndrome after assumed total bilateral adrenalectomy are presented. Both cases were due to adrenal tissue left at the adrenalectomy. In the first case the lack of preoperative localization of the adrenal remnant caused severe postoperative complications. In the other patient localization of the adrenal tissue was achieved by scanning after administration of 131I-19-iodocholesterol. The reoperation was easy and the postoperative course smooth.

Adrenalectomy↗
PubMed1977

Organic acid profiles of human tissue biopsies by capillary gas chromatography-mass spectrometry.

A method is described to determine the organic acid content of tissue specimens comparable in size to those obtainable by closed biopsy. The method involves solvent extraction of tissue homogenates followed by analysis of trimethylsilyl derivatives of the organic acids by combined capillary gas chromatography-mass spectrometry. Organic acid profiles of human liver, pancreas, kidney and muscle are shown.

Acids↗
PubMed1977

Preliminary experience with extracorporeal renal surgery and autotransplantation.

31 patients with renovascular hypertension, calculous disease, short ureter or renal carcinoma (single kidney) were treated with renal autotransplantation, in 3 patients bilaterally. There were 2 deaths due to cardiac arrest and myocardial infarction. Secondary nephrectomy was performed in 2 patients, and thus 29 of 31 autotransplanted kidneys were salvaged.

Adolescent↗
PubMed1977

Renal failure in familial lecithin-cholesterol acyltransferase deficiency.

Familial lecithin-cholesterol acyltransferase deficiency is a hereditary disorder of lipid metabolism. Lipid material is deposited in the kidneys, the glomerular capillary basement membrane is irregularly thickened, detachment and even loss of endothelial cells are seen in the glomeruli. Proteinuria was present in 8 out of 9 cases studied, usually it has not been detected before the age of 15-20. After 15-30 years with symptomless proteinuria, terminal renal failure has developed in 6 of the patients. Possible pathogenetic mechanisms of the renal damage is discussed; a large-molecular-weight low-density lipoprotein is suggested to be an important factor.

Acyltransferases↗
PubMed1977

Surgical treatment of primary liver carcinoma.

Forty-five patients with primary liver carcinoma were treated between 1960 and 1975. Sixteen patients were less than 15 years of age. All patients underwent diagnostic laparotomy, while liver resection was performed in 16 (36%). Resectability was higher in children than in adults. Left lobectomy was performed in 8 patients, right lobectomy in 3, and an extended right lobectomy in 5 patients. One patient died postoperatively, i.e. mortality was 6%. Of the surviving 15 patients 4 died from metastatic tumor within 18 months after surgery. Patient survival at 2 years was 73%. The present material favors radical surgery of primary liver carcinoma whenever possible.

Adolescent↗
PubMed1977

Operative results in portal hypertension with bleeding oesophageal varices.

During a 15-year period 81 patients with bleeding oesophageal varices were admitted to our department. Nearly 90% had liver cirrhosis, 21% were alcoholics. 67 portosystemic shunts were performed in 63 patients, in 11 of these as an emergency shunt. Overall operative mortality in electively shunted patients was 10.7%. Even in those with the most severe liver insufficiency (Child's group C) operative mortality was below 20%. Operative mortality in elective cases was closely correlated to peroperative bleeding. Only 1 of 45 patients needing less than 10 units of blood peroperatively died, while mortality in the multitransfused group was 45.5%. Both patients surviving urgent shunt surgery were operated on early, i.e. before they had received 5 units of blood.

Adolescent↗
PubMed1977

Influence of HLA-A, -B, -C, and -D matching on the outcome of clinical kidney transplantation.

The influence of HLA matching has been studied in the Norwegian material of 142 living related and 311 cadaveric transplants. Graft survival corresponded closely to the degree of HLA haplotype disparity between donors and recipients. Furthermore, graft survival was less in combinations being incompatible for the serologically defined HLA-A and -B antigens as compared to compatible combinations. A weak MLC response, indicating a possible sharing of the HLA-D determinants between donor and recipient, was also associated with superior graft survival, even in the presence of HLA-A and -B disparity. Matching for HLA-C in addition to HLA-A and -B did not seem to improve graft survival.

Cadaver↗
PubMed1977

Kidney transplantation in diabetic nephropathy: four years experience.

Since 1972 65 patients with diabetic nephropathy have been evaluated for renal transplantation. Twenty one were not accepted, 6 died before transplantation and 10 are still under observation. Of 28 transplanted patients 13 are alive with functioning graft, and 3 are treated with hospital dialysis. Patient survival at one year was 65% and graft survival 50%.

Adult↗
PubMed1977

Hyperparathyroidism in uremia and after kidney transplantation.

From 1969 until the end of 1976, 376 patients have had kidney transplants in our department. Fourteen patients have had subtotal parathyroidectomy done, either in their uremic phase or after a successfull kidney transplantation. All patients, except one, who had an adenoma, had varying degrees of hyperplasia of the glands. The postoperative results were satisfying in 10 patients. 3 patients is medically substituted for hypoparathyroidism while one still is hypercalcemic. There was no operative mortality and no surgical complications.

Adult↗
PubMed1977

The influence of HLA-A, -B, -C, and -D matching on kidney graft survival.

The influence of HLA matching has been studied in a Norwegian material of 147 living related first transplants, 281 cadaveric first transplants and 48 cadaveric second transplants. Graft survival corresponded closely to HLA antigen disparity and degree of MLC response in combinations transplanted with kidneys from living related donors. In patients transplanted with cadaveric grafts. HLA identical and compatible grafts performed significantly better than imcompatible grafts. Matching for HLA-C in addition to HLA-A and -B did not seem to improve graft survival.

Cadaver↗