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Biomedical subjects

D N Hamilton

Publications and source records attributed to D N Hamilton.

At least 19 recordsLinked to original sources
PubMed1985

Dinitrochlorobenzene skin testing predicts response to hepatitis B vaccine in dialysis patients.

The pattern of seroconversion and anti-HBs titres after 3 doses of hepatitis B vaccine was studied in 40 haemodialysis patients who had been grouped on the basis of their cell-mediated immune (CMI) response into strong or weak reactors. CMI response was determined by means of a dinitrochlorobenzene (DNCB) skin test. Titres of anti-HBs were comparable to those in healthy controls in 13 of 14 (93%) strong reactors but in only 9 of 26 (35%) weak reactors. Strong reactors had an equally satisfactory seroconversion rate with either 20 micrograms or 40 micrograms of vaccine whereas weak reactors had a negligible seroconversion rate with the 20 micrograms dose. In terms of hepatitis B prophylaxis, haemodialysis patients with a well preserved CMI response require only 20 micrograms of vaccine, with a consequent saving in cost. In contrast, it will be necessary to devise more effective immunisation schedules for most patients with a poor CMI response.

Adult↗
PubMed1985

An experimental model of chronic renal failure in mice.

Chronic renal failure (CRF) was induced in CBA/J mice by a combination of surgery and diathermy to the right kidney followed 2 weeks later by complete removal of the left kidney. This procedure resulted in a progressive rise in blood urea nitrogen (BUN) levels accompanied by a fall in packed cell volume (PCV). In a typical group of mice BUN rose to 156.9 +/- 9.1 mg/100 ml and PCV fell to 36.4 +/- 1.9%, 8 weeks after removal of the left kidney, compared to 23.3 +/- 2.8 mg/100 ml and 51.6 +/- 2.1%, respectively, in normal mice. These changes were accompanied by other serum abnormalities in potassium, sodium, calcium, phosphate, chloride, and silicon levels. The surviving renal tissue showed histological changes, and skeletal changes were also evident on radiological examination. Mice in CRF had an increased mean survival time of tail skin allografts and a significant reduction in thymus weight, supporting the use of this model to investigate the well-documented phenomenon of immunosuppression in human patients with uremia.

Animals↗
PubMed1978

Morbidity and mortality in renal transplant patients after incidental surgery.

Sixty-five further surgical procedures were carried out in 39 renal transplant patients without mortality and with low morbidity. There was a 9 per cent incidence of clean wound infection, and minor chest infection occurred in another 9 per cent. Stay in hospital for these procedures was not prolonged. The function of the transplanted kidney showed no deterioration after these further surgical procedures. The successfully transplanted patients is thus a good candidate for further surgery despite the previous renal failure and the continuing immunosuppressive therapy.

Creatinine↗
PubMed1978

Influence of HLA matching and blood transfusion on renal allograft survival.

One hundred and seven consecutive cadaver kidney transplants have been followed for up to 6 years. The beneficial effect of HLA matching, shown in previous studies, has been confirmed. The 2-year failure rate from rejection was 29% for grafts with less than two incompatibilities, in comparison with a figure of 52% where there were two or more incompatibilities. In contrast to some reports, the presence of HLA antibodies did not have an adverse effect on the survival of first grafts. Patients not transfused prior to transplantation had a much higher 1-year graft failure rate (72%) than those given either frozen-thawed red cells (29%) or whole blood (23%). This apparently beneficial effect of blood transfusion was no greater in patients transfused with more than five units compared with those given less than five units. We believe that blood transfusion has an important influence on the outcome of renal transplantation.

Adolescent↗
PubMed1978

A new predictive factor for the outcome of renal transplantation.

The cell mediated immunity (CMI) of a group of patients on regular haemodialysis was measured using a modified dinitrochlorobenzene (DNCB) skin test. The strength of the reaction was graded from 0 to 15 on an objective scale which we called the DNCB index. This index was much reduced in the dialysis patients in comparison with a group of healthy controls. Thirty-six dialysis patients were subsequently transplanted and graft survival was assessed at six months. A significantly higher graft failure rate was observed in those with a strong skin reaction than in those with a weak or absent response (P less than 0.01). While the mean DNCB is much lower than normal in dialysis patients, there is a wide variation within this group. We have found that the DNCB index correlates well with renal allograft survival suggesting that this skin test has value in the prediction of transplant outcome.

Adolescent↗
PubMed1976

In-vitro monitoring of cell-mediated immunity to dinitrochlorobenzene.

A dinitrochlorobenzene (D.N.C.B.)/red-blood-cell conjugate inhibited migration of leucocytes which came from D.N.C.B. sensitised patients. This effect provided the basis for a rapid, sensitive, and quantitative in-vitro measure of D.N.C.B. sensitivity. Frequent serial measurement of cell-mediated immunity was possible with the test, provided D.N.C.B. sensitivity was maintained by occasional skin patch tests.

Cell Migration Inhibition↗
PubMed1976

Bilateral nephrectomy prior to renal transplantation.

Bilateral nephrectomy was performed in 53 patients on regular haemodialysis. The indications were pyelonephritis in 30, polycystic kidneys in 6, glomerulnephritis in 7, uncontrollable hypertension in 9 and horseshoe kidney in 1. In 87 per cent of cases the operation was carried out as a separate procedure prior to transplantation. The mortality was 9 per cent and the postoperative complications included hypotension, clotting of arteriovenous shunts, pneumonia and subphrenic abscess. As a result of our experience we have revised our indications for bilateral nephrectomy which now are pyelonephritis only when associated with persistent bacteriuria or ureteric reflux, polycystic kidneys and uncontrollable hypertension.

Adolescent↗
PubMed1976

The Sparks Mandril for vessel access in haemodialysis.

The Sparks Mandril, placed as a forearm loop, provides excellent access for haemodialysis. The long-term patency rate however, is less than for other access devices and hence the mandril's place at present is in patients with access problems.

Arteriovenous Shunt, Surgical↗