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Biomedical subjects

J W Jones

Publications and source records attributed to J W Jones.

At least 127 records · Page 7Linked to original sources
PubMed1996

Success and complications of pancreatic transplantation at one institution.

OBJECTIVE: The authors report the results and complications of the first 59 pancreas transplantation procedures performed at one institution. SUMMARY BACKGROUND DATA: Pancreas transplantation is performed at relatively few centers. Results have improved in the past few years. METHODS: A retrospective review was completed of the results and complications after pancreas transplantation at one institution. Pancreas transplantation was indicated for patients with insulin-dependent diabetes mellitus and who were younger than 50 years of age. The results were divided into era I (March 1987-December 1992) and era II (January 1993-October 1995). RESULTS: Fifty-nine transplants were performed since March 1987. There were 45 combined kidney/pancreas transplants and 13 pancreas transplants. Graft survival at 1 year was 57% for those in era I versus 79% in era II. Rejection occurred in 74% of the patients in era I and 48% in era II. Eighty-five percent of all rejection episodes in both eras were steroid resistant and required antibody therapy. Complications were not different from eras I and II. CONCLUSIONS: Pancreas transplantation is a successful procedure with a number of significant complications. Rejection episodes are most often steroid resistant.

Adult↗
PubMed1996

Rewarming: comparison of contemporary heat-exchangers.

Heat exchange methods must be efficient in order to minimize the patient's pump time. However, comparisons of heat exchangers have been rare. Therefore, the in vivo functions of the most popular, currently available heat exchangers, Sarns, Cobe, Medtronics Maxima, and an experimental model manufactured by Haemonetics were compared. Thirty-two pigs weighing between 63-74 kg were placed on cardiopulmonary bypass with right atrial and ascending aorta cannulation through a right thoracotomy. Thermocouples were placed in the pump tubing before and after the heat exchangers, in the water line before and after the heat exchangers, in the inlet and outlet line of the pump, and the esophagus, brain, bladder, rectum, liver, myocardium, and tympanic membranes of the pigs. They were cooled until the bladder temperature was reduced to 14 degrees C, and maintained at that temperature for 10 minutes. Rewarming was begun until the bladder temperature became 37 degrees C. The pump flow was maintained between 50-60 ml/kg/min with standard ventilation. Cobe, Sarns, Maxima, and Haemonetics heat exchangers were tested and their function determined by comparing the time necessary for rewarming. The Haemonetics heat exchanger required a significant shorter time than the others to rewarm the pigs to normal bladder temperature (Cobe 82.0 +/- 12.0, Sarns 80.3 +/- 15.4, Maxima 89.0 +/- 13.9 Haemonetics 68.7 +/- 13.4, p < 0.05). The principal advantage was seen at the lowest temperatures between the Haemonetics experimental heat exchanger and the other heat exchangers. No statistically significant superiority was seen at higher temperatures. The current heat exchangers are relatively comparable but improved performance is possible with available technology.

Animals↗
PubMed1996

Type II diabetes after combined kidney and pancreas transplantation for type I diabetes mellitus and end-stage renal disease.

We report a case of a patient who developed type II diabetes after receiving a successful combined kidney and pancreas transplant for type I diabetes and end-stage renal disease. This patient underwent a combined kidney and pancreas transplant and had no evidence of rejection with good function following the transplant for nine months. The patient developed significant post-transplant obesity with her transplant weight of 80 kg rising to 109 kg. At this level of obesity, the patient developed fasting hyperglycemia of 180 mg/dl with no change in her renal function or her pancreas exocrine function. She developed hyperinsulinemia to this fasting hyperglycemia. The clinical course of this patient demonstrates that rapid weight gain following transplantation can result in type II diabetes.

Diabetes Mellitus, Type 1↗
PubMed1996

Anterior crossbite and mobile lower central incisors in a 7-year-old patient: a case report.

Anterior crossbite, a permanent upper central or lateral incisor occluding lingually to an opposing tooth, can have serious dental health implications if left untreated. It usually becomes evident in the early mixed dentition, and all general dental practitioners should be aware of the condition and know how to manage it in order to prevent the possibly serious consequences.

Child↗
PubMed1995

Myocardial revascularization in a sickle-cell trait patient.

A 56-year-old man with confirmed sickle-cell trait AS underwent successful triple-vessel myocardial revascularization with internal mammary artery and vein conduits. Variations in routine technique included limitation in hypothermia (32 degrees C), avoidance of intraoperative autologous salvage, hypoxia, severe anemia (< 25% hematocrit), acidosis and postoperative reinfusion of mediastinal drainage.

Coronary Disease↗
PubMed1995

Microbiological investigation of polyarthralgia.

Results of serological investigations on patients with joint pain, arthralgia or polyarthritis were analysed and this information was used to develop a diagnostic algorithm to ensure optimal utilisation of laboratory resources. Accordingly, all cases are now examined for parvovirus IgM, mycoplasma IgM and streptococcal antibodies. Further tests are undertaken by following the algorithm after obtaining supplementary information from a questionnaire. This approach is put forward as a preliminary standard which other laboratories may like to evaluate and develop according to local requirements.

Algorithms↗
PubMed1995

Platelet function, coagulation tests, and cardiopulmonary bypass: lack of correlation between pre-operative and intra-operative whole blood lumiaggregometry and peri-operative blood loss in patients receiving autologous platelet-rich plasma.

Platelet function and blood coagulation were studied and correlated with the post-operative red blood cell (RBC) loss in 41 patients that underwent cardiopulmonary bypass surgery. Before and after surgery, whole blood platelet aggregation and secretion were tested with different agonists, and the platelet count, prothrombin time, and activated partial thromboplastin time measured simultaneously. Post-operatively, RBC loss in chest fluid was also calculated. Platelet aggregation and secretion with different agonists (except with ristocetin and adenosine diphosphate (ADP)) were decreased significantly after protamine and platelet-rich plasma administration. There were no significant differences in aggregation and secretion immediately after cardiopulmonary bypass compared with after platelet-rich plasma administration With ADP, adenosine triphosphate (ATP) release was decreased significantly after the platelet-rich plasma infusion compared with post-protamine. Platelet count decreased significantly during surgery and remained low after platelet-rich plasma infusion. The clotting times were increased significantly after surgery, and after platelet-rich plasma infusion, the prothrombin time decreased significantly relative to the post-protamine value, the activated partial thromboplastin time being essentially unchanged. Postoperatively, the total volume of RBC collected after 36 h was 158 +/- 13 ml and there was no significant correlation with the above parameters. We conclude that pre-operative or intra-operative whole blood lumi-aggregometry is not a predictor of post-operative blood loss in patients receiving platelet-rich plasma intra-operatively.

Adenosine Triphosphate↗
PubMed1994

Successful long-term outcome with 0-haplotype-matched living-related kidney donors.

The waiting list for cadaver kidney transplantation continues to grow. Yet there has been little increase in the number of living-donor transplants. At many centers, willing relatives are turned down as potential donors because of poor HLA ABDR matching with the recipient. It has been our policy to accept the 0-haplotype-match (0-HTM) living-related donor. We studied long-term (6-year) outcome of 0-HTM transplants compared with the outcome of transplants from 1- and 2-HTM recipients and from cadaver donors. Since 1984, 352 adults have received primary living-related renal transplants, and had a minimum of 1 year of follow-up: 92 2-HTM, 216 1-HTM, and 44 0-HTM. In the same period and with the same follow-up, 362 adults have received primary cadaver (CAD) renal transplants. Immunosuppression consisted of cyclosporine, azathioprine, and prednisone (triple therapy) for living-donor and sequential therapy for CAD recipients. ABDR match (mean +/- SD) for 0 HTM was 1.3 +/- 8; CAD, 2.0 +/- 1.6; % peak panel-reactive antibodies (PRA) for 0 HTM was 1.2 +/- 5.3; 1 HTM, 6.7 +/- 20; 2 HTM, 7.5 +/- 21; CAD, 15.5 +/- 30. The percentage of PRA at the time of transplant for 0 HTM was .7 +/- 4.4; 1 HTM, 4.1 +/- 1.6; 2 HTM, 6 +/- 18; CAD, 7.2 +/- 20. While the number of ABDR matches was significantly fewer for 0 HTM than for the other groups, the % PRA at transplant and the peak % PRA were less in the 0-HTM group. Other demographics were not significantly different. Patient survival was significantly lower in the CAD group vs. 2-HTM recipients (P < .05). The living-related grafts had significantly greater survival than the CAD grafts (P < .05), but there was no significant difference between 0-, 1-, and 2-HTM graft survival. The most common causes of graft loss in all groups were death and chronic rejection. In our experience, the long-term graft survivals of 0-HTM and 1-HTM transplants are the same, and both are superior to CAD results, using 0-HTM living-related donor transplants should be continued and encouraged.

Adult↗
PubMed1994

Early lead challenge and subsequent hypertension in Sprague-Dawley rats.

OBJECTIVE: The consequences of chronic, low grade lead (Pb) burden from earlier exposure on development of hypertension (HT) and cardiovascular disease is, at best, controversial, even though many epidemiological studies suggest the possibility. Accordingly, we examined ability of a short-term Pb challenge to cause later developing HT in rats. METHODS: We gave 12 newly weaned Sprague-Dawley rats (SD) a 1% Pb acetate solution to drink for 6 weeks, while 12 control rats drank water. The rats were further subdivided into groups consuming high and low amounts of sugar. All rats were followed for 4 months after cessation of the Pb challenge. RESULTS: Early Pb challenge caused no significant changes in body weight (BW) from controls; however, systolic blood pressures (SBP) of rats initially receiving Pb continued to rise significantly above their respective dietary controls for months after cessation of challenge. While a high sugar diet alone was associated with elevated SBP, high sugar consumers also challenged with Pb had the highest SBP. Protein excretion did not increase, suggesting, along with other evidence, a lack of significant renal damage. CONCLUSIONS: Previous exposure to Pb can cause subsequent chronic elevations in SBP.

Animals↗
PubMed1994

Nutrition and growth in pediatric renal transplant recipients.

Pediatric renal failure patients undergo similar rates of growth retardation on all forms of dialysis, but appears to be worst in the patients not dialyzed before transplant and on TF. These patients had an average age of 27 months before transplant. Table 1 shows that all groups undergo progressive decline in growth as the interval from diagnosis to transplant increases. This is not affected by the number of calories supplied. Pretransplant TF seems to improve catch up growth after transplant, but we saw no definite effect on growth in the pretransplant period. Renal transplantation uniformly improves growth in this population.

Child, Preschool↗