Search PubMed⌕ Search

Biomedical subjects

H K Johnson

Publications and source records attributed to H K Johnson.

At least 55 records · Page 3Linked to original sources
PubMed1982

Partial splenic embolization for hypersplenism in renal transplantation.

Immunosuppressive therapy is necessary in the treatment and prevention of rejection in renal transplant recipients. Unfortunately, these patients may become intolerant to this therapy when it is complicated by hypersplenism with leukopenia and/or thrombocytopenia. The therapy must then be either decreased or stopped, thus preventing adequate treatment or prevention or rejection. Splenectomy has been used to treat the hypersplenism to break this cycle. It requires operative intervention with general anesthesia and prolonged hospitalization, and has been associated with fulminant bacterial septicemia. For these reasons, partial splenic embolization was offered to our patients as an alternative to splenectomy in the treatment of their immunosuppressive therapy intolerance due to hypersplenism. Six patients with acute rejection episodes and one patient on dialysis awaiting transplantation underwent partial splenic embolization. It corrected the hypersplenism in each case without significant complications allowing control of the rejection episode with adequate immunosuppressive therapy in six patients. Strict aseptic technique, pain control, and antibiotic prophylaxis are advised to prevent the complications of splenic abscess, rupture, or septicemia when this technique is used.

Adolescent↗
PubMed1981

Cryptococcal septicemia associated with urologic instrumentation in a renal allograft recipient.

A case is presented of a renal allograft recipient with 2 episodes of cryptococcal septicemia temporally related to genitourinary manipulation, which preceded the usual signs of meningeal or cutaneous infection. A review of the literature suggests that cryptococcal disease may, occasionally, manifest itself initially in the genitourinary tract. Therefore, we suggest that cryptococcal infection be suspected in the compromised host who has symptoms of cystitis or bladder outlet obstruction during a short period.

Cadaver↗
PubMed1981

Three simple solutions for renal flush and preservation.

The harvesting of kidneys at small hospitals where standard flush solutions are not available has led to the use of several flush solutions that can be made from readily available materials. Mongrel dogs (15) had bilateral nephrectomy after receiving intravenously a mixture of Ringer's lactate, furosemide (Lasix), mannitol, and chlorpromazine (Thorazine). One kidney was perfused with iced Collins' solution and stored for 24 hours, submerged in the perfusate at 4 C. Five dogs each had the contralateral kidney perfused with a solution of either (1) Ringer's lactate, salt-poor albumin, and heparin; (2) 6% dextran 70 and Fenwall buffered heparin solution; or (3) Ringer's lactate, mannitol, and heparin, and were stored in their respective perfusate. After 24 hours' storage the kidneys were transplanted into the neck, and creatinine clearance (Crcl) was determined on days 1, 2, 3, 5, and 7. The dogs were sacrificed on day 7 and biopsy specimens were obtained from each kidney for pathologic examination. The kidneys perfused with Collins' solution had immediate function after transplantation with an average Crcl of 10.5 at 25 hours and 20.2 at seven days. The kidneys perfused with Ringer's lactate and albumin had minimal function immediately after transplantation and were anuric within 24 hours. The kidneys perfused with dextran solution and Ringer's lactate and mannitol solution had immediate function but output remained low, and by seven days the average Crcl was only 3.0 and 4.5 respectively. All solutions except the Ringer's lactate and albumin were hyperosmolar, thus helping to prevent the "no reflow" phenomenon. These results indicate that the solutions tested do not result in the adequate preservation to warrant clinical use.

Animals↗
PubMed1979

The role of HLA tissue matching in cadaveric kidney transplantation.

The role of HLA match in donor--recipient selection has been studied in 271 patients who received cadaver transplants during a 10-year period. This series included 36 four-antigen matches, 181 three-antigen matches and 54 two-antigen matches. Our results support the concept that better results can be expected when better matched kidneys are utilized for transplantation.

Cadaver↗
PubMed1979

Treatment of a retarded child's faeces smearing and coprophagic behaviour.

The daily rearrangement of a profoundly retarded child's routine shower was effective in eliminating his low-frequency faeces smearing and coprophagic behaviour during the late afternoon/early evening part of the day. The effects appeared to generalise such that both types of behaviour were reduced at other times of the day and night. These results are discussed in terms of a social learning framework. A model for analysing the motivations and reinforcing conditions for rectal digging, coprophagy, and smearing faeces is also presented.

Child↗
PubMed1979

Hemodialysis and renal transplantation in progressive systemic sclerosis: report of 2 cases.

Renal failure is a common cause of death in patients with progressive systemic sclerosis (PSS). The present paper describes two patients with chronic renal failure secondary to PSS whom we have treated by a combination of chronic hemodialysis and renal transplantation. Also reviewed are reports of six additional patients who have undergone renal transplantation. We conclude that chronic hemodialysis and renal transplantation are successful life-sustaining treatment modalities in some patients with end-stage renal disease due to PSS.

Adult↗
PubMed1979

The use of bactericidal concentrations of antibiotics in hypothermic pulsatile perfusion and the effects on canine renal autograft function.

Although cadaver allograft contamination occurs frequently, the potential danger to the transplant recipient varies. Usually the results of culture from the donor and kidney perfusates are not available at the time of transplantation. A positive culture result often necessitates the use of prophylactic antibiotics. The antibiotic may be potentially nephrotoxic, and in the setting of minimal or changing renal function this effect may be potentiated. If significant contamination with virulent organisms is found prior to transplantation, clinical judgment often dictates that the graft be discarded. Perfusion and storage with solutions containing broad-spectrum antibiotics would substantially reduce the incidence of contamination in perfused kidneys. This would in turn reduce the requirement for potentially nephrotoxic antimicrobial therapy in the transplant recipient. Since the antibiotics tested are effective against a wide range of contaminants and apparently cause no detrimental effects, it would seem reasonable to add them routinely to the perfusate solution.

Animals↗