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Biomedical subjects

J G Maxwell

Publications and source records attributed to J G Maxwell.

At least 55 records · Page 3Linked to original sources
PubMed1984

The value of magnesium in flush solutions for human cadaveric kidney preservation.

A cooperative clinical trial was conducted among 5 transplant centers in the western United States to determine the value of magnesium sulfate in intracellular electrolyte flush solutions for hypothermic, human kidney storage. Kidneys from alternate donors were flushed with either magnesium-free Euro-Collins' solution or magnesium-containing Collins' 2 solution. Donor and recipient ages, and mean preservation times were not significantly different between the 2 groups. There was a significantly lower dialysis requirement during the first week in the magnesium-containing Collins 2 group (33 per cent) versus the Euro-Collins group (54 per cent). Function rates and serum creatinine nadirs at 1 month were not significantly different. The beneficial effect of magnesium sulfate was more evident when preservation times exceeded 24 hours.

Adult↗
PubMed1983

Intraperitoneal insulin regimens and diabetic nephropathy.

Five patients with severe diabetic nephropathy (SN) and six patients with moderate diabetic nephropathy (MN) have been treated with intraperitoneal (i.p.) insulin administered by multiple injections. The five SN patients progressed to end-stage kidney disease. The six MN patients (five of whom are described) show stabilisation (and in two cases possibly some improvement) of renal function over time intervals ranging from eight to 23 months.

Blood Glucose↗
PubMed1981

Dinitrochlorobenzene skin test reactivity as a predictor of outcome in transplantation of juvenile onset diabetics.

More than 50% of patients with chronic renal failure will be suppressed in their cell-mediated immune response to 2,4-dinitrochlorobenzene (DNCB). This applies in renal failure attributable to juvenile onset diabetes as well as other types of end stage renal disease. Significantly better kidney survival of both living related and cadaver grafts is seen in diabetic patients who are non-responsive to DNCB. Twelve-month kidney survival for DNCB-negative patients receiving living related allografts is 71% compared with 25% for DNCB-positive patients. Twelve-month kidney survival in cadaver recipients is 39% in DNCB-negative compared with 9% for DNCB-positive patients. Successful second grafts were done in DNCB-negative diabetic patients, however, all second grafts in DNCB-positive patients failed in less than 3 months. DNCB skin test reactivity as a measure of cell-mediated response is a valuable predictor of immunological outcome of transplantation in patients whose renal disease results from juvenile onset diabetes. Patient survival in DNCB nonresponders is nearly twice that of DNCB responders. Differences in outcome following transplantation could not be accounted for by HLA disparity, transfusion history, or other variables known to effect transplant outcome. Kidney and patient survival in DNCB-positive diabetic patients receiving either cadaver or living related allografts is sufficiently low as to identify them as a subpopulation of renal failure patients who should be treated by dialysis, or selected for special protocols which might provide immunological manipulation prior to transplantation to improve their treatment outcome.

Diabetes Mellitus, Type 1↗
PubMed1981

Measurement of intramuscular pressure in the management of massive venous occlusion.

While controversy continues over the exact pathophysiology of and optimal therapy for phlegmasia cerulea dolens, increasing evidence favors the role of elevated interstitial pressure in the generation of extremity ischemia. We report the use of intramuscular pressure measurements in the assessment of a patient suffering massive venous occlusion of one leg. Significant elevations in pressure were found in association with symptomatic ischemia. Successful thrombectomy restored blood flow, relieved symptoms, and produced an immediate decrease in intramuscular pressure. In this disorder, measurement of compartment pressures can be useful in assessing the severity of venous insufficiency and in monitoring the response to therapy.

Adult↗
PubMed1980

Indium-111 labeled leukocytes in the evaluation of suspected abdominal abscesses.

Sixty-eight indium-111-labeled leukocyte imaging studies were performed in 53 patients with suspected abdominal abscesses. Twenty-nine studies gave abnoramal results. Nine wound infections were demonstrated, and 14 abscesses were correctly identified. Four studied demonstrated colonic accumulation, one of which remains unexplained, and two accessory spleens were identified. Indium-111 leukocyte imaging is a sensitive and specific study in evaluating patients with suspected abdominal abscess. Differentiation of abscess from other causes of inflammation has not been a problem. The exact role of leukocyte imaging compared with gallium-67 citrate imaging, ultrasound and computerized tomography remains to be determined.

Abdomen↗
PubMed1980

Neutropenia and thrombocytopenia in renal allograft recipients treated with trimethoprim-sulfamethoxazole.

Hematologic toxicity occurred when trimethoprim-sulfamethoxazole was given for prolonged periods to renal allograft subjects also treated with azathioprine. In six such patients, the incidences and duration of neutropenia and thrombocytopenia were greater than in 25 similar allograft recipients treated with azathioprine alone. In bone marrow culture, the antifolate action of trimethoprim-sulfamethoxazole enhanced the marrow-suppressive effect of 6-mercaptopurine, the active moiety cleaved from azathioprine. These studies show that in renal allograft recipients treated with azathioprine, the prolonged use of trimethoprim-sulfamethoxazole may result in life-threatening hematotoxicity.

Adult↗
PubMed1976

Ultrasonic "B" scanning in the diagnosis of complications in renal transplant patients.

B-mode ultrasonography has been used in the evaluation of complications following renal transplantations. The main indications for examining the patient are decreased renal function, clinically suspected abscesses, or suggestions of a mass in the region of the transplant. In most patients, worsening renal function is due to rejection. In 10 of 50 patients, however, lesions such as lymphoceles, postoperative hematomas, abscesses, and urine leakage were diagnosed. Ultrasonography proved to be a noninvasive and reliable method for the assessment of these complications.

Adult↗
PubMed1975

Discontinuance of immunosuprression in renal transplant patients.

Immunosuppressive therapy was discontinued in six patients for an average of 27 months. In these six patients, only two rejections have occurred. A survey of other transplant centers showed that in such patients rejection was often delayed weeks or months after therapy was stopped. Once immunosuppressive therapy has been stopped, for whatever reason, and rejection has not occurred, consideration should be given to not resuming therapy unless signs of rejection appear.

Graft Rejection↗
PubMed1975

Jaundice in patients with acute cholecystitis. Its validity as an indication for common bile duct exploration.

Our study demonstrates that (1) mild to moderate jaundice is frequently seen in patients with acute cholecystitis; (2) severe degrees of jaundice were seen in two patients without the presence of common duct stone or recognizable obstruction of the common bile duct; (3) only one of forty-one patients with acute cholecystitis had common bile duct stone; (4) jaundice does not appear to be a compelling reason for choledochotomy; and (5) less invasive technics such as intravenous and intraoperative cholangiography should suffice to exclude the possibility of common bile duct stone in patients with acute cholecystitis.

Acute Disease↗