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Biomedical subjects

J M Barry

Publications and source records attributed to J M Barry.

At least 19 recordsLinked to original sources
PubMed1992

Immunosuppressive drugs in renal transplantation. A review of the regimens.

Currently, expected 10-year first graft survival rates for kidneys from HLA-identical sibling, 1-haplotype-matched relative, and cadaver donors are 74, 51, and 40%, respectively. Histocompatibility, immunological conditioning with blood products, and immunosuppression with glucocorticoids, azathioprine, cyclosporin, and the antithymocyte (antilymphocyte) antibody preparations have been significant factors in the gradual improvement of kidney graft survival rates. Nearly all immunosuppression regimens are cyclosporin-based. Antithymocyte antibody induction therapy with delayed administration of cyclosporin is widely practised to avoid cyclosporin nephrotoxicity while the kidney graft is recovering from preservation injury. Late cyclosporin withdrawal results in inferior cadaver kidney transplant survival rates. Rejection crises usually respond to high dose glucocorticoid therapy. Glucocorticoid-resistant rejection usually responds to treatment with antithymocyte antibody. FK-506 is a promising new immunosuppressant that has properties similar to cyclosporin. Prophylaxis against viral, bacterial and fungal infections is necessary to reduce the morbidity of immunosuppression. The incidence of malignant conditions associated with viral infections is significantly increased with immunosuppression. New immunopharmacological agents and advances in genetic procedures may allow the induction of specific transplantation tolerance and successful xenotransplantation within the next decade.

Antilymphocyte Serum↗
PubMed1979

Hemangiopericytomas in male pelvis.

All cases of hemangiopericytomas involving the male pelvis which have been reported in the English literature with clinical data have been reviewed. Their clinical features, roentgenographic findings, pathologic features, and treatment are presented with an illustrative case. The tumor is an aggressive neoplasm which characteristically produces late local recurrences or metastases. Since the clinical behavior cannot be reliably predicted from its histologic appearance, all must be regarded as malignant. Primary treatment should be en bloc excision since a high recurrence rate results when simple enucleation or excision is performed. Long-term follow-up is mandatory, and local recurrences or metastases should be resected whenever feasible. Radiation and chemotherapy may convert a nonresectable lesion into a resectable one and provide significant palliation.

Adult↗
PubMed1978

Human kidney preservation by flushing with intracellular solution and cold storage.

Simple flushing and cold storage of human kidneys for transplantation has not been accepted for preservation times exceeding 24 hours. A prospective study of 25 primary cadaver kidney transplants was performed to evaluate Collins C2 solution for human kidney preservation. Cold storage time was 10 to 23 hours in 14 cases and 26 to 44.5 hours in 11 cases. Seventeen (68%) of the kidneys had immediate, sustained function. The one-month function rate was 88%. There were no significant differences between the 10- to 23-hour and the 26- to 44.5-hour groups with respect to the incidence of first-week dialysis, one-month graft function, or mean lowest serum creatinine value. Human kidney preservation time can be safely extended beyond 24 hours with Collins C2 flushing followed by simple cold storage.

Cadaver↗
PubMed1978

Revascularization of totally occluded renal arteries.

Two cases of total renal artery occlusion are presented. The clinical durations of occlusion were 10 days and 6 months. Revascularization procedures were successful in both patients, resulting in return of renal function and alleviation of hypertension. Our 2 cases and a review of 30 other cases demonstrate that the maximum duration of main renal artery occlusion with subsequent return of renal function is unknown.

Aged↗
PubMed1978

Impotence: a diagnostic approach.

A diagnostic approach to erectile impotence using a sexual function questionnaire, nocturnal penile plethysmography, penile blood pressure measurement, cavernosograms, cystometrograms and plasma testosterone levels is presented. Case examples demonstrate the clinical value of these diagnostic tools. Psychogenic impotence should be diagnosed only after nocturnal penile plethysmography has demonstrated the presence of complete erections.

Adult↗
PubMed1978

The influence of retrograde contrast medium on urinary cytodiagnosis: a preliminary report.

It has been recommended that before retrograde brushing of upper urinary tract lesions to diagnose malignancy the contrast medium should be washed away with saline because of possible cellular distortion. There were 21 paired specimens from 19 patients submitted for urinary cytodiagnosis. One specimen was a contrast medium wash, similar in pH and osmolality to urine, and the other a saline wash. Cellular detail was adequate for cytodiagnosis in 20 of the 21 contrast medium specimens. Of 7 specimens from patients with malignancy 3 were diagnosed correctly as malignant, 1 was classified as suspicious and 3 were falsely negative in the contrast wash group. Of the 3 falsely negative diagnoses 2 were changed to malignant when the paired saline wash specimens were examined. Urologists should not discard the contrast medium specimen prior to retrograde brushing but should send it along with a saline wash specimen for cytodiagnosis because the discarded contrast material and irrigant may have diagnostic cells.

Contrast Media↗
PubMed1978

Genitourinary malignancy and pseudohyperparathyroidism.

Genitourinary tumors account for half of all documented cases of pseudohyperparathyroidism. The treatment of hypercalcemia is directed toward immediate correction of the electrolyte imbalance and long-term control. These goals are accomplished with volume repletion, calcium normalization and removal of the tumor. Effective therapy includes saline infusion and furosemide. Additional control is obtained with phosphates and/or indomethachin. In refractory cases actinomycin-D or mithramycin is helpful. The first reported case of urethral cancer and second reported case of testicular seminoma producing this syndrome are added to the literature.

Carcinoma, Squamous Cell↗
PubMed1978

Primary cadaver kidney transplantation in older patients: survival equal to dialysis.

In our experience, primary cadaver kidney transplantation is a reasonable alternative to dialysis in the older patient with ESRD. The probability for a transplant success is no different from that of other age groups receiving their first grafts from cadaver donors and the quality of life after transplantation is equal to or exceeds that obtained with chronic dialysis.

Aging↗
PubMed1977

The morbidity of radical prostatectomy for multifocal stage I prostatic adenocarcinoma.

During a 25-year period 33 patients with stage I multifocal prostatic adenocarcinoma underwent radical prostatectomy. Carcinoma was present in 81 per cent of the specimens. The operative mortality was 3 per cent. Pelvic recurrence, rectal injury and urethrovesical stricture each occurred in 9 per cent of the cases. Fifteen per cent of the patients were totally incontinent and 42 per cent had stress incontinence. One patient required combined retropubic and perineal approaches to remove the specimen. The safest interval between the first and the radical procedure was 6 weeks or more. The 5 and 10-year relative survival rates were 100 per cent. The best candidate for a radical prostatectomy after transurethral prostatic resection or suprapubic enucleation prostatectomy is one with a thick surgical capsule in whom the first procedure procedes the radical procedure by at least 6 weeks.

Adenocarcinoma↗
PubMed1977

Ureterocolostomy. An antireflux technique.

A new antireflux ureterocolonic urinary conduit was developed and evaluated in sheep. It combined the principles of the Wallace conjoined ureterointestinal conduit with the Lich extravesical ureteroneocystostomy. The procedure accomplished the following with a single anastomotic technique: (i) joined both ureters to the intestinal stump; (ii) provided constant ureteral orifice position in the antimesenteric butt of the intestinal segment; (iii) eliminated the blind intestinal stump; (iv) prevented intestinoureteral reflux; and (v) allowed an average of 12 times the normal urinary flow rate before exceeding mean human midureteral peristaltic pressure. The projected long term animal experiments and the sound urologic surgery principles involved indicate that the procedure may soon have clinical application.

Animals↗