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Biomedical subjects

G H Bock

Publications and source records attributed to G H Bock.

30 records · Page 2Linked to original sources
PubMed1985

Accelerated recovery from immune-mediated thrombocytopenia with plasmapheresis.

Autoimmune thrombocytopenia unresponsive to corticosteroid therapy developed in a 16-year-old female with long-standing Sjögren's syndrome. Serial plasma exchange caused a linear decrease in platelet antibody titer associated with a concomitant rise in platelet count. Statistical analysis of sequential platelet counts revealed an increase with plasmapheresis and immunosuppression that was significantly greater than that achieved with immunosuppression alone (p less than 0.005).

Adolescent↗
PubMed1985

Vancomycin prevents polytetrafluoroethylene graft infections in pediatric patients receiving chronic hemodialysis.

Polytetrafluoroethylene (PTFE) grafts have been a useful addition to the pediatric hemodialysis vascular access armamentarium. In this study, 17 pediatric patients underwent 331 total months of hemodialysis via PTFE grafts. There was a statistically significant (P less than .025) decrease in the incidence of graft infections in 12 patients (235 patient-months) while receiving prophylactic parenteral vancomycin compared with 9 patients (96 patient-months) while receiving no vancomycin (0% v 44%). Vancomycin side effects were uncommon and mild. Vancomycin is a safe and effective agent for the prevention of PTFE graft infections in pediatric patients receiving chronic hemodialysis.

Adolescent↗
PubMed1983

Transplantation of the adult kidney into the very small child. Technical considerations.

Transplantation of adult kidneys into very small children is not performed in most centers because of concerns regarding the technical difficulty of the procedure. Advantages of the procedure include the possibility of living related donor transplantation and the increased availability of adult donor kidneys as compared with pediatric cadaver donor kidneys. We have transplanted adult kidneys into 12 children aged 11 months to 3.5 years who weighed 5,400 to 8,800 g. Ten children received living related donor and two cadaver donor grafts. Herein we describe in detail the pretransplant management, surgical strategies, intraoperative management, surgical techniques, and postoperative management which we use for transplantation of adult kidneys into very small children. Intraoperative and postoperative complications have been described to illustrate the evolving clinical principles in this area. Since 10 of the children are presently alive, 8 with their original grafts, 16 months to 9 years after transplantation, we advocate this approach for suitable small children with terminal renal failure.

Adolescent↗
PubMed1982

Use of continuous saralasin infusion to control hypertension.

Saralasin acetate, a competitive inhibitor of angiotensin II, was administered as a continuous infusion to two pediatric patients for 8 and 13 days, respectively, to control hypertension. Both patients had become refractory to parenterally administered antihypertensive medications and had an ileus that precluded drug treatment orally. Both patients had a reduction in blood pressure of 30% in response to intravenous infusion of saralasin as a diagnostic test. In the patient with renal failure, neither saralasin nor ultrafiltration was effective alone, but blood pressure was controlled when their use was combined. In these two patients the continuous infusion of saralasin proved to be an effective means for blood pressure control and was unassociated with any recognized adverse effects.

Angiotensin II↗
PubMed1982

Transplantation of adult kidney into the very small child: long-term outcome.

Adult kidneys were transplanted into 12 children weighing between 5,400 and 8,800 gm. Ten received parental and two received cadaver grafts. Ten of the 12 children are alive 18 months to 9 years post transplant; eight have their original grafts and two required retransplantation-their original grafts were lost at 4 and 9 years because of chronic rejection. All but these two surviving children had normal or accelerated growth rates despite growth retardation prior to transplant. All children evidenced moderate to severe delay in psychomotor development prior to transplant. Seven of the ten survivors now have normal psychomotor function. Two are behind in school, and one with a degenerative central nervous system disease prior to transplant remains profoundly retarded. We conclude that because of donor availability, capacity for good donor-recipient matching, and minimization of time on dialysis, transplantation of adult kidneys into pediatric patients is preferable to awaiting the relatively uncommon pediatric cadaver donor. We further conclude that the procedure is warranted.

Age Factors↗
PubMed1980

Immunologic kidney disease.

Immunologically mediated renal diseases include Goodpasture's syndrome, systemic lupus erythematosus, membranoproliferative glomerulonephritis, membranous nephropathy, poststreptococcal glomerulonephritis, IgA-IgG nephropathy and anaphylactoid purpura. In Goodpasture's syndrome, antibodies are directed against the glomerular capillary basement membrane. The other disorders appear to result from circulating immune complexes which deposit in glomerular capillary walls or in the glomerular mesangium. Treatment with steroids and/or immunosuppressives is effective in lupus nephritis; in other diseases, the results are less certain.

Anti-Glomerular Basement Membrane Disease↗