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Biomedical subjects

P Kinnaert

Publications and source records attributed to P Kinnaert.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Differential diagnosis between secondary hyperparathyroidism and aluminum intoxication in uremic patients: usefulness of 99mTc-pyrophosphate bone scintigraphy.

Forty-one patients in chronic end-stage renal failure and 4 patients with a functioning kidney transplant presented with spontaneous hypercalcemia or intolerance to vitamin D3 sterols and/or oral calcium supplements. Bone iliac crest biopsy with aluminum staining and Tc-pyrophosphate bone scintigraphy with determination of Fogelman score were performed in all cases. Two patients had aluminum-induced osteomalacia (AL O). Thirty-eight biopsies showed renal osteodystrophy (secondary hyperparathyroidism or various combinations of osteitis fibrosa and osteomalacia): 19 with positive staining for aluminum (RO + AL) and 19 without aluminum deposits (RO). The series also comprised 2 cases of pure osteomalacia (OM), 2 cases of osteoporosis (OP), and 1 case of osteoporosis with aluminum accumulation (OP + AL). Mean Fogelman score in RO patients (9.1 +/- 0.3) was significantly higher than in all other categories (5.9 +/- 0.5 for RO + AL, and scores ranging from 0 to 8 in the last 7 patients, p less than 0.01). Patients with massive aluminum accumulation in bone (greater than 75% of the total trabecular surface) showed no or very low uptake of the isotope by the skeleton. Fogelman scores of 9 or higher were always associated with histological secondary hyperparathyroidism. 99mTc-pyrophosphate bone scintigraphy is helpful to distinguish aluminum intoxication from secondary hyperparathyroidism in uremic patients.

Adult↗
PubMedDate not supplied

Modulation of inflammatory reactions by surgical trauma: lack of relationship with corticosteroid secretion.

The effect of surgery on inflammation was studied in male Wistar R/A rats using the carrageenin-induced edema model. Swelling of the paw was measured in standardized arbitrary units 2, 4, and 6 hr after a subcutaneous injection of carrageenin iota in the subplantar region of the right hind limb. It was significantly depressed in rats submitted to laparotomy (5.0 +/- 0.4, 8.0 +/- 1.0, 13.7 +/- 1.9) when compared with controls simply anesthetized with ether (6.2 +/- 0.5, 15.5 +/- 1.2, 23.7 +/- 0.6) (p less than 0.001 at 4 and 6 hr). This inhibition lasted for at least 24 hr and was also observed after amputation, although in these experiments, the difference between operated animals and controls was not significant. Alterations of the inflammatory cellular infiltrate were studied using polyurethane sponges soaked with carrageenin lambda implanted subcutaneously in control animals and rats undergoing laparotomy or amputation. The total number of cells recovered from these sponges 5 hr after implantation was smaller in operated rats (2.9 +/- 0.4 x 10(6) cells after laparotomy, 3.1 +/- 1.0 x 10(6) cells after amputation) when compared with controls (11.1 +/- 1.9 x 10(6) cells and 10.3 +/- 1.3 x 10(6) cells) (p less than 0.001 for laparotomy and p less than 0.005 for amputation). The inhibitory effect of operative trauma was not abolished by bilateral adrenalectomy performed 12 days before laparotomy. In rats, surgical trauma induces a depression of remote inflammatory reactions. This phenomenon is not related to increased corticosterone levels.

Adrenal Glands↗
PubMedDate not supplied

Use of the Hickman catheter as permanent vascular access for hemodialysis.

Nineteen patients in whom it was impossible to create an arteriovenous (AV) fistula were hemodialyzed with adult Hickman catheters as the sole vascular access. Catheter survival was 45% at 1 year, with eight patients requiring two or three catheters for the continuation of their treatment. The probability of a patient still being dialyzed with a Hickman catheter at 1 year was 69%. The calculated risk of developing the most frequent complications was 0.07/100 catheter days for sepsis, 0.4/100 catheter days for thrombosis, and 0.06/100 catheter days for outflow obstruction. These figures seem quite acceptable, and the use of Hickman catheters as permanent vascular access is warranted in this category of difficult patient.

Adult↗
PubMedDate not supplied

Surgical anatomy of hyperparathyroidism.

The number of glands and the exact location of each normal and pathological parathyroid identified in 416 parathyroidectomies for primary and secondary hyperparathyroidism have been recorded during the last 25 years (1966-1990). Nineteen per cent of all glands were found in ectopic locations. Half of these were distant from the thyroid lobes, most frequently posteriorly alongside the oesophagus, or in the upper anterior mediastinum encapsulated in the thymic remnant. Their discovery required, in some cases, extensive dissections, but a sternotomy was necessary in two cases only. Parathyroid glands may be concealed in the thyroid or in other aberrant locations, more rarely encountered. Supernumerary parathyroids were observed in 5% of cases. They were often pathological and were often in abnormal positions. A sound knowledge of the anatomic variations and of the paths of embryologic migration of the parathyroids are the essential clues for their detection.

Adenoma↗
PubMedDate not supplied

[Evidence based surgery: ethical and methodological aspects].

Recently, it has been said that surgical clinical research was of poor quality because there are few randomized controlled trials in this area. This type of experimental protocol comes up against many difficulties in surgery and may induce a conflict between scientific requirements and ethical principles. Improving the quality of observational studies with simple measures may palliate the problem. Moreover, keeping national or international registries provides very useful informations.

Data Interpretation, Statistical↗
PubMedDate not supplied

[The enigma of the renal allografts performed in man in the early 1950s].

In the early 1950s, a few renal allografts were performed without immunosuppression in man. The paper describes these attempts and tries to explain the behavior of the medical doctors who undertook these human experimentations taking into account their personality, the knowledge at that time and the absence of treatment for end stage chronic renal failure.

Female↗
PubMedDate not supplied

[Implantation technic and maintenance of a Hickman catheter for hemodialysis].

Description of the technique of insertion of the Hickman catheter for hemodialysis based on 110 operations. Absolute prerequisites for correct functioning are: 1) Fluoroscopic control of the localization of this device in the superior vena cava and 2) Checking if adequate flow can be obtained.

Catheterization, Central Venous↗
PubMedDate not supplied

[Minimal encephalitis in patients with renal transplant. Clinicopathological study and discussion of the role of the cytomegalovirus (author's transl)].

An autopsy was performed in ten patients recipients of renal allograft who died from cytomegalovirus pulmonary infection. In six patients, encephalitis lesions disseminated in the whole brain were observed. These lesions were not symptomatic. The particular features of this entity and its relationships with the type of immunosuppression therapy are discussed.

Brain↗
PubMedDate not supplied

Granuloma of the distal extremity of the ureter in kidney transplantation.

A granuloma of the distal extremity of the transplanted ureter was diagnosed in 8 of 180 patients operated on according to the Lich-Gregoir technique. This lesion was not observed in 116 patients with Politano-Leadbetter ureterovesical anastomosis nor in 61 patients with a ureterocystostomy constructed according to the technique of De Campos Freire et al. This complication seems to be specific of the Lich-Gregoir technique.

Granuloma↗