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Biomedical subjects

A Saenz

Publications and source records attributed to A Saenz.

At least 55 records · Page 3Linked to original sources
PubMed1994

Pheochromocytoma: laparoscopic approach with CO2 and helium pneumoperitoneum.

A number of different surgical approaches have been devised for adrenalectomy in patients with pheochromocytoma. The anterior transabdominal approach was at one time considered a source of postoperative morbidity; the advent of laparoscopy however, may result in a resurgence in its use. The laparoscopic approach was used with a CO2 pneumoperitoneum in one patient with a left pheochromocytoma, and using a helium pneumoperitoneum in another with bilateral pheochromocytoma. The left adrenalectomy took 135 minutes to perform and the total bilateral adrenalectomy 330 minutes. No transfusion was necessary. The postoperative stay was 4 days for both patients. To prevent the risk of CO2 retention during extended laparoscopic procedures, helium can serve as an alternative gas, as was documented in the patient who underwent total adrenalectomy. Unilateral or bilateral resection of pheochromocytoma can safely be performed laparoscopically and has the advantage of avoiding both the muscular trauma related to laparotomy and the rib resection necessary for the extraperitoneal approach.

Adrenal Gland Neoplasms↗
PubMed1994

Early primary tissue failure of a Labcor bioprosthesis.

A 78-year-old woman underwent re-replacement of a 19mm Labcor bioprosthesis implanted in aortic position eighteen months earlier. The rupture of the free margin of one leaflet was found at reoperation. There was no apparent cause of this rupture.

Aged↗
PubMed1993

Native and graft pancreatitis following combined pancreas-renal transplantation.

Ten patients who had undergone whole-organ pancreas transplantation and pancreatoduodenocystostomy from a total of 60 simultaneous cadaveric kidney-pancreas transplants met the criteria for graft pancreatitis. This condition is clearly different from acute rejection on the basis of marked hyperamylasaemia and significant local findings over the allograft. Graft rejection was the cause of graft loss in one of the patients; eight are alive, seven with a functioning graft 61, 30, 27, 25, 21, 18 and 14 months after transplantation. Two patients died: one from severe graft pancreatitis and the other from cytomegalovirus infection. Bladder drainage with or without antibiotics has been the most common therapy, based on the theory that damage is caused by duodenal content and infected urine reflux. To prevent graft loss, antiviral treatment should be given when pancreatitis due to cytomegalovirus is suspected or diagnosed. Two patients with native pancreatitis are also described; the disease was severe and surgery was required in both cases. The pancreas grafts have now been functioning for 2 years 7 months and 2 years 10 months respectively.

Adult↗
PubMed1993

Laparoscopic approach to the adrenal tumors.

Over the years, a number of different surgical approaches to the adrenal glands have been devised. The anterior transabdominal approach is considered to be a source of postoperative morbidity. However, this conviction can be changed. The laparoscopic approach was used in four patients. One had a right 5 cm nonfunctioning tumor, the second had a 1.8 cm right aldosterone-producing adenoma, the third patient had a 4 cm adrenocortical adenoma, and the fourth patient had a bilateral pheochromocytoma (tumor size was 3.5 cm and 4.5 cm in the right and left adrenals, respectively). Carbon dioxide pneumoperitoneum was used in three patients, but helium pneumoperitoneum was used in the patient with bilateral pheochromocytoma to prevent CO2 retention. Single right adrenalectomy lasted between 2 h and 2 h 30 min, and bilateral adrenalectomy lasted 5 h 30 min. The hospital stay was between 3 and 4 days. Unilateral or bilateral adrenalectomy through laparoscopy can be performed safely and has the advantage of avoiding the muscular trauma related to laparotomy or rib resection necessary for the extraperitoneal approach.

Adolescent↗
PubMed1992

Prospective analysis of pancreatic grafts with duplex-Doppler ultrasound: value of resistive index in the diagnosis of rejection.

The diagnosis of rejection and its differentiation from other causes of pancreatic graft dysfunction remain the basic problem in pancreas transplantation. A previous study with pulsed Doppler (PD) done at our institution demonstrated an increase of the resistive index (RI) during pancreatic graft rejection episodes. The aim of the study was to determine prospectively the utility of duplex-Doppler (DD) ultrasound (US) in identifying the cause of pancreatic graft dysfunction. The major clinical categories were graft rejection and graft pancreatitis.

Adult↗
PubMed1992

Combined whole pancreas and liver retrieval: comparison between Y-iliac graft and splenomesenteric anastomosis.

With the recent increase in the number of liver and pancreas transplants being performed in Europe, many groups have found it necessary to develop techniques for the combined harvesting of whole pancreaticoduodenal and liver grafts. To date we have carried out a total of 35 multiorgan procurements including liver, heart, pancreas, and kidneys. In ten cases we reconstructed the arterial supply of the pancreas with an end-to-end anastomosis between the proximal splenic artery and the distal end of the superior mesenteric artery (SMA), and in eight patients we used a donor Y-iliac graft. Patients were monitored postoperatively by determination of BUN, serum creatinine, blood glucose, serum and urinary amylase levels, and Doppler assessment of the graft was carried out at regular intervals. Mean ischemia/preservation time in both groups was 6 h. All simultaneous kidney and pancreas transplants functioned well initially with none of the patients requiring dialysis. All patients were insulin-free immediately after surgery. One patient in the splenomesenteric group developed venous thrombosis of the graft, requiring removal of the gland, but has subsequently been successfully retransplanted. All remaining patients have been insulin-free for 1-14 months. One patient in the Y-iliac group also developed venous thrombosis of the graft, but all remaining patients in this group have been insulin-free for 1-12 months after transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Beneficial effect of oxygen-free radical blockers in experimental kidney transplantation in rats].

UNLABELLED: The clinical potential of free radical (OFR) ablative therapy is dependent upon the proportion of the total injury caused by the reperfusion mechanism compared with the proportion resulting from ischemic injury itself. Prostaglandin cascade can both activate and be activated by OFR. AIM: to investigate the influence of different periods of cold ischemis in renal tissue (cortex and medulla) -regarding superoxide dismutase (S.O.D.) activity, the amount of erythrocyte trapping and prostaglandin synthesis. Also, to evaluate the effect of exogenous S.O.D. in the prevention of reperfusion injury. MATERIAL AND METHODS: 48 Lewis male rats (200-250 g) received renal isografts (RTx) preserved in Collins solution at 4 C for different periods: control group (8) non operated; group I (8) immediate RTx; group II (8) 12 hrs; group III (8) 18 hrs; group IV (8) 12 hrs+S.O.D. (13 mg/kg e.v.); group V (8) 18 hrs+S.O.D. (13 mg/kg e.v.). Before reperfusion all recipients received 1 ml of 51-Cr labelled erythrocytes. After 15 min. reperfusion grafts were removed and samples (cortex and medulla) obtained for measuring trapping of erythrocytes. S.O.D. activity and prostaglandins (PGe2, TxB2, 6-Keto-PGF1). RESULTS: A strong correlation was found between the duration of cold ischemia and the amount of trapping both in cortex and in medulla. S.O.D. administration induced a significant drop of trapping. In non-operated rats S.O.D. activity in cortex was two fold medulla content. However, after reperfusion, a significant decrease in cortex was found in all groups. S.O.D. administration raised S.O.D. activity in cortex similar to control values.(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗
PubMed1991

Altered levels of tissue and urinary prostacyclin in rats subjected to pancreas transplantation.

Significant increases of TXB2 and PGE2 are reported to occur in pancreas transplantation. These increases are prevented with scavengers of oxygen-free radicals. In this communication, we report on changes of prostacyclin metabolites such as tissue 6-keto prostaglandin F1 alpha and urinary 2,3-dinor 6-keto prostaglandin F1 alpha in rats subjected to pancreas transplantation after different periods of organ cold preservation ischemia as well as the effect of superoxide dismutase (SOD) on these changes. For this purpose, male Lewis rats were classified as follows: Group I, Control; Group II, syngenic pancreas transplantation after 15 min of organ preservation in Collins solution at 4 degrees C; Group III, same as II but with 12 hours of organ preservation; Group IV, same as III, but with SOD pretreatment. Results have shown significant posttransplantation increases of both tissue 6-keto PGF1 alpha and urinary 2, 3 dinor 6-keto PGF1 alpha, the latter being a useful marker to evaluate systemic prostacyclin (PGI2) production by rat pancreas. This effect was prevented when the organ had been exposed to SOD during the period of cold preservation ischemia. These results confirm the implication of oxygen-free radicals (OFR) in the ischemia-reperfusion process associated to rat pancreas transplantation leading to enhanced arachidonic acid metabolism.

6-Ketoprostaglandin F1 alpha↗
PubMed1991

Calcified constrictive pericarditis. Ultrasonic debridement.

A case of complete debridement of a calcified pericardium in a patient with constrictive pericarditis is reported. The use of an ultrasonic surgical aspirator facilitated disintegration of calcium without damaging the adherent epicardium and myocardium.

Aged↗
PubMed1991

In situ right gastroepiploic artery. A conduit for coronary revascularization.

The internal mammary artery is widely recognized as the graft of choice for coronary artery bypass grafting at present. Alternative conduits have been investigated in order to find other adequate long-term grafts. The right gastroepiploic artery has been recently used as a graft to bypass distal coronary vessels. From November 1989 to June 1990, we have implanted this artery in 46 cases. Pedicled grafts were implanted in 20 patients to the main right coronary artery, in 21 patients we grafted the right distal branches, in 3 patients the left anterior descending, and in 2 the circumflex branches. Mean grafts per patient were 3 in this series, with a mean of 2.2 arterial grafts per patient. One patient died in the early postoperative period. The remaining patients had an uncomplicated postoperative evolution. Thirteen patients underwent graft and coronary angiography. Direct or indirect graft patency was confirmed in all cases. The final important issue concerning the long-term patency of this graft will be solved in the future, but short-term patency rates of the right gastroepiploic artery can be anticipated when proper techniques are used.

Adult↗
PubMed1990

Prostaglandin E2 and thromboxane B2 levels in rats subjected to pancreas transplantation.

This work undertakes the study of changes in urinary, plasmatic and tissue levels of Thromboxane B2 (TXB2) as well as in tissue Prostaglandin E2 (PGE2) after pancreas transplantation and the effect of superoxide dismutase (SOD) on these changes. For this purpose, streptozotocine induced diabetic rats were subjected to pancreas transplantation. Experimental groups were classified as follows: Group I: Control; Group II: Animals subjected to 15 min of pancreas arterial flow occlusion followed by reperfusion; Group III: Syngenic pancreas transplantation after 12 hours of organ preservation; Group IV: Same as III, but with additional SOD (13 mg/kg) pretreatment. The results indicate that significant increases of PGE2 and TXB2 levels occur as a consequence of the surgical removal, preservation and implantation of the organ. For TXB2 these increases, immediate in plasma and tissue, are not detected in urine until 24 hours after transplantation of the pancreas. The release of TXB2 and PGE2 was effectively prevented in the SOD treated group supporting the role of oxygen free radicals and lipid peroxidation in the processes of ischemia-reperfusion associated to transplantation of the pancreas.

Animals↗
PubMed1989

[Not Available].

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Americas↗