Biomedical subjects
Publications and source records attributed to A Flatmark.
We report a case of Wilms tumor in an adult. Pictorial and descriptive pathology information is included. The tumor was stage IV with pulmonary metastasis at diagnosis. The patient was treated with surgery and combined chemotherapy according to protocols used in childhood Wilms tumor. The patient is clinically free of disease at 21 months postoperatively.
In this study of 24 uremic diabetic patients treated with combined kidney and pancreas transplantation, the one year patient, kidney and pancreas graft survival was 96, 78 and 55%, respectively. In recipients followed for three months or more, a regression of neuropathy was registered in all patients, whereas improvement in visual acuity was seen only in two patients with simplex type retinopathy. The advanced proliferative retinopathy observed in most recipients at the time of transplantation, was not significantly altered after pancreas and kidney transplantation.
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Reconstructive surgery for renal artery aneurysm requires adequate exposure and meticulous dissection. We report 9 patients with 17 aneurysms undergoing ex vivo aneurysmectomy. The reconstructions included vessel plasties, vein and arterial interponates, followed by autotransplantations to the iliac fossae. All kidneys functioned spontaneously, and all survived. Observation times of up to 7 years have now elapsed. Microsurgery and modern preservation techniques in the extracorporeal setting have extended the borders of renal artery surgery.
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In kidneys perfused hypothermically for 48 hr, both major intracellular pools of CoA (present in cytosol and mitochondria) decreased when solutions with intracellular or extracellular electrolyte composition without CoA precursors were used. The presence of substrates such as glucose or caprylic acid in the perfusate did not counteract the depletion of CoA. The addition of the CoA precursors pantethine and adenosine together with respiratory substrates to the perfusion medium counteracted the loss of CoA. The best solution in this respect among 16 different perfusates tested contained palmitic acid and L-carnitine together with CoA precursors and dibutyryl cyclic AMP. With this solution, we obtained good preservation of the cytosolic and the mitochondrial pool of CoA.
Prednisolone pharmacokinetics have been compared in 16 Cushingoid and 46 non-Cushingoid long term kidney transplant recipients. The Cushingoid patients had a significantly (p less than 0.05) higher peak concentration, a longer elimination half-time, a greater area under the time-concentration curve of total and free prednisolone, and a lower total body clearance of prednisolone. It is suggested that prednisolone pharmacodynamics may be influenced by pharmacokinetic differences, and that differences in renal function may be an important contributing factor.
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Surgical correction of unilateral renal artery stenosis was performed in 31 hypertensive patients. Preoperative renal vein renin ratios (RVRR) before and after dihydralazine stimulation were measured in all patients. Postoperative blood pressure were normal in 12, improved in 17 and unchanged in 2 patients. Six patients did not have renin lateralization, but all were cured or improved after surgery. RVRR was a poor predictor of the results of surgery in patients with unilateral renal artery stenosis.
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