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Biomedical subjects

J Gardner

Publications and source records attributed to J Gardner.

At least 541 records · Page 30Linked to original sources

Cyclosporin in renal transplantation: a 9 year experience.

AIM: Review our 9 year experience using cyclosporin A (CyA) in a triple immunosuppressive regimen for renal transplantation. PATIENTS: Between 1 October 1984 and 30 June 1993 117 patients had a total of 130 renal transplants. This review was confined to 52 of these patients who had been on CyA for at least 12 months and had remained under regular surveillance in this clinic. RESULTS: Patients were given 10 mg/kg of CyA prior to transplantation then 8 mg/kg/d in two divided doses after the onset of graft function. The maintenance dose was tapered to a mean of 3.5 mg/kg/d (SD 1.4) within 9 months and thereafter ranged from 3.0-3.4 mg/kg/d. Individual patients differed significantly in the trough whole blood CyA concentrations that they produced on a certain dose. Chronic CyA nephrotoxicity occurred in 3 patients and equivocal changes in another patient, while on a CyA dose of 3.0-4.0 mg/kg/d. CONCLUSION: CyA was an effective drug as part of a triple immunosuppressive regimen for renal transplantation. Chronic CyA nephrotoxicity was an unpredictable finding and occurred with doses as low as 3.0-4.0 mg/kg/d and with drug concentrations within the recommended therapeutic range. All patients on CyA should be under regular supervision and early graft biopsy undertaken if there is evidence of graft dysfunction.

Adolescent↗

Genome-wide loss of maternal alleles in a nephrogenic rest and Wilms' tumour from a BWS patient.

A patient with Beckwith-Wiedemann syndrome (BWS) presented with Wilms' tumour. Examination of the nephrectomy specimen showed, in addition to the tumour, the presence of nephrogenic rests. Nephrogenic rests are thought to be precursor lesions from which a Wilms' tumour may develop. A molecular analysis examining the loss of constitutional heterozygosity (LOCH), initially for chromosome 11, was performed on peripheral blood, the normal kidney, nephrogenic rest and tumour material. The study was extended to include markers from all 23 chromosomes. At each informative, locus, LOCH of the maternal allele was shown in the nephrogenic rest and tumour material. In addition, the normal kidney displayed allele imbalance. It would appear from these results that either extensive LOCH across the genome was an early genetic event in the development of malignancy in this patient or that the tumour and rest developed from cells containing no maternal chromosomes. The apparent LOCH seen in the normal kidney sample implies that full reduction to homozygosity is consistent with a histologically normal appearance. Putative mechanisms to explain this phenomenon are discussed.

Alleles↗

Resuscitation skills amongst anaesthetists.

Resuscitation skills were assessed in a group of 24 anaesthetists of varying experience using 3 pre-determined scenarios. Seventy-nine percent of participants were found to be competent at resuscitation following the guidelines suggested by the Resuscitation Council (UK) in 1989. No one grade of anaesthetist was found to be consistently poor at resuscitation. Anaesthetists by the nature of their jobs may maintain the skills and knowledge of cardiopulmonary resuscitation as well as other groups in the hospital.

Anesthesiology↗