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Biomedical subjects

M Kessler

Publications and source records attributed to M Kessler.

At least 541 records · Page 30Linked to original sources
PubMedDate not supplied

[Renal complications of anti-cancer treatments].

Life prolongation in cancer patients is attended by a greater frequency of renal lesions associated with chemotherapy, and in the last few years cancer patients cured or in lasting remission have begun to haunt dialysis centres. Before blaming the renal toxicity of cytotoxic drugs, it is necessary to exclude all other causes of renal dysfunction (pre-renal, obstructive, iatrogenic or cancer-related). The renal toxicity of certain drugs, such as cisplatin, cyclophosphamide, ifosfamide, streptozocin, nitrosoureas, methotrexate, mitomycin C and recombinant IL2, is of importance as it is frequent and limits their use. The dangers of anticancerous drugs combinations, concomitant administration of other nephrotoxic drugs (antibiotics, non-steroidal anti-inflammatory agents) and extracellular dehydration created by gastrointestinal disorders must be borne in mind. Careful evaluation of renal function prior to chemotherapy, application of preventive measures with proven efficacy and repeated laboratory tests in short-mid- and long-term should reduce the frequency of renal complications while preserving or even improving therapeutic effectiveness.

Acute Kidney Injury↗
PubMedDate not supplied

[Indications and results of parathyroidectomy in the treatment of hyperparathyroidism in dialyzed and kidney transplant patients. Apropos of 68 cases].

Between 1972 and 1985, 78 parathyroidectomies were performed in 60 patients under chronic haemodialysis and in 6 recipients of renal transplants. These patients had severe hyperparathyroidism and radiological evidence of fibrous osteitis. This series shows a recrudescence of tertiary hyperparathyroidism in renal transplant recipients under ciclosporin. The post-operative course was favourable in 55 cases; 13 patients had to be reoperated upon, revealing the presence of supernumerary glands in 6 of them.

Adult↗
PubMedDate not supplied

MR patterns of dialysis arthropathy.

Ten patients (average age 51 years) on long-term hemodialysis (average duration 13.5 years) were examined by magnetic resonance (MR) (all cases) and CT (five cases) for cystic radiolucencies of the wrist, shoulders, and hips. MR and CT revealed more lesions of smaller size than plain films and both showed a constant communication with the joint space. Synovial hypertrophy was generally absent or very mild even in the case of large osseous erosions. The MR analysis of the content of the lesions in the wrist was quite variable: low signal on T1- and T2-weighted images (12 of 24), low signal on T1- and high signal on T2-weighted images (10 of 24), and high signal on T1- and T2-weighted images (2 of 24). The patterns of transplanted (four cases) or ungrafted (six cases) patients were indistinguishable. These results suggest an articular origin of the lesions, but different from synovial processes such as rheumatoid arthritis, and confirm their probable multifactorial pathogenesis.

Female↗
PubMedDate not supplied

Multiparametric evaluation of brain functions in the Mongolian gerbil in vivo.

We have developed the multiprobe assembly (MPA) by which metabolic, ionic and electrical activities can be monitored from the surface of the brain. In the present study we included optical fibers for the monitoring of intracapillary hemoglobin oxygenation by use of the Erlangen Microlight Guide Spectrophotometer (EMPHO-I) from the surface of the gerbil brain. The newly developed MPA provides simultaneous information about oxygen delivery (oxydeoxy Hb), tissue pO2 level, as well as the intracellular oxygen balance (intramitochondrial redox state). The ionic homeostasis was evaluated by monitoring extracellular K+ and Ca2+ activities reflecting the permeability changes of cation channels as well as the activities of Na+,K(+)-ATPase and other ion linked transport processes. The electrical activities were monitored by a bipolar electrocortical surface probe and DC steady potential. The subjects of the present study were Mongolian gerbils (Meriones unguiculatus) anesthetized and operated according to our routine techniques. After 30 min of recovery from the operation each gerbil was exposed to a short anoxia, graded hypoxia, ischemia as well as spreading depression. The results can be summarized as follows: 1. A clear correlation was recorded between the changes in oxydeoxy Hb spectra, tissue pO2 level and oxidation-reduction state of intramitochondrial NADH under oxygen deficiency situations (hypoxia, ischemia). 2. Blood volume changes under various perturbations monitored by various probes (366 reflectance and EMPHO-I) correlated very well with each other. 3. The degree of inhibition of Na+,K(+)-ATPase induced by oxygen deficiency could be interpreted by changes in extracellular levels of K+ measured by the surface mini-electrode. 4. Brain stimulation induced by spreading depression mechanism led to transient changes in ionic homeostasis and increase in energy requirements. The major HbO2 response was an increase in oxygenation due to the large CBF increase as monitored by the laser Doppler flowmeter. 5. Changes in oxy-deoxy Hb under fast scanning of 500-600 nm during 2-3 seconds of bilateral carotid arterial occlusion provided an indirect index for tissue O2 consumption.

Animals↗
PubMedDate not supplied

Effects of ligustrazine on hepatic oxygenation in isolated perfused rat liver.

The effects of ligustrazine on hepatic oxygenation in the isolated rat liver were investigated during prolonged perfusion and following the injection of norepinephrine. After injection of erythrocytes into the perfusate, the hemoglobin spectra in the liver were measured by Erlangen microlightguide spectroscopy, and the hemoglobin oxygenation (HbO2) in the liver was calculated on the basis of the Kubelka-Munk theory. During artificial perfusion, the HbO2 value was decreased from 59.3 +/- 6.4% (after one hour's perfusion) to 25.5 +/- 19.5% (n = 441; after six hours' perfusion). However, when ligustrazine was injected into the perfusate after six hours' perfusion, the HbO2 values recovered to 56.4 +/- 9.7% (n = 441). After injection of norepinephrine, HbO2 in the liver decreased from 48.8 +/- 10.4% to 25.2 +/- 18.4% (n = 961), while subsequent administration of ligustrazine caused a recovery to 62.9 +/- 6.0% (n = 961). Our results suggested that ligustrazine is a powerful hepatic vasodilator for improving hepatic oxygenation.

Animals↗
PubMedDate not supplied

The bone-vacuum cementing technique for the fixation of the stem in total hip arthroplasty.

The bone-vacuum cementing technique is a promising method developed to obtain reliable fixation of the femoral component. Previous studies showed that intraoperative embolic complications, cardiopulmonary impairment, and deep venous thrombosis can be prevented when this technique is used. The specific aims of the present investigation were to provide additional treatment outcome information, to identify risk factors for poor results, and to define the need of surgical technique improvement by risk factor analysis. The first 118 consecutive patients (121 hips) who had primary total hip arthroplasty using the bone-vacuum cementing technique and an anatomical stem were followed-up for a mean of 2.5 years (1 to 4 years). The mean age of patients at index operation was 73 years. Current criteria were used for clinical and radiological assessment. At the time of the latest follow-up, 3 patients (3 hips, 2.5%) had been lost, and 9 patients (9 hips, 7.5%) had died. However, the status of the hip joint at the time of death could be verified in all patients. Thus, the clinical outcome of 115 patients (118 hips, 97.5%) was known. Radiographs were available for 102 patients (104 hips) who were alive for the entire follow-up period. The mean preoperative Harris Hip Score was rated 51, and it had improved to 92 at the time of follow-up. The score was good for 70 hips and excellent for 42 hips, so the rate of clinical success was 95%. Six patients (6 hips, 5%) had a fair result. Two of them had a fracture of the greater trochanter after the index operation, requiring internal fixation. Four hips with severe acetabular dysplasia had persistent limp and limited motion. The quality of the cement mantle was rated good (grade A and B) in 108 of 121 hips (89.5%). Nineteen of the 108 hips presented at least one small void in the cement mantle (grade C1). Insufficient thickness of the cement mantle (grade C2) was present in 10 hips (8%). Failure of cement to extend below the tip of the stem (grade D) was observed in the remaining 3 hips (2.5%). In the present series no femoral component required revision because of aseptic loosening, and there was no radiographic evidence of aseptic loosening at follow-up. Radiolucencies without progression were found in Gruen zone 1 in 11 of 104 hips (10.6%), and in zone 7 in 7 hips (6.7%). In one hip (0.9%) ballooning osteolysis was observed in zone 7. Seventy-five hips (72%) had either no change in femoral bone density or only patchy loss of bone density isolated to Gruen zones 1 and 7. Twenty-nine hips (28%) had some reduction of bone density isolated to zones 1 and 7. A slight cortical hypertrophy was seen in 4 hips (3.8%). Of the whole series, one hip required revision surgery because of septic loosening 2 years after the index operation. At an average of 2.5 years postoperatively, the femoral component inserted using the bone-vacuum technique functioned well overall, and patient satisfaction was high. Clinical and radiological results do not contrast with those achieved using contemporary cementing techniques.

Age Factors↗