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Biomedical subjects

P Kinnaert

Publications and source records attributed to P Kinnaert.

At least 109 records · Page 6Linked to original sources
PubMed1986

Subclavian vein thrombosis: a frequent complication of subclavian vein cannulation for hemodialysis.

Subclavian vein cannulation was suggested as a temporary vascular access for hemodialysis since one of its advantages was considered to be no damage to blood vessels. As we observed six patients with symptomatic subclavian vein thrombosis among 148 patients having received subclavian vein cannulation for hemodialysis, we systematically performed subclavian venogram in 42 asymptomatic patients selected on the basis of a history of previous subclavian vein cannulation. Venograms were performed 15.7 +/- 8.9 months after the removal of the last catheter. Eight patients (19%) had complete thrombosis or severe stenosis of the subclavian vein while six patients (14%) had minimal luminal defects. Considering together the 48 patients, the group with thrombosis or severe stenosis (group 1, n = 14) was compared with the group with minimal defects or normal venograms (group 2, n = 34). In group 1, as compared with group 2, there were more female (64% vs 32%, p = 0.02), more cannulations per vein (1.87 +/- 0.35 vs 1.32 +/- 0.08, p less than 0.05) and more cumulative days of cannulation per vein (35.1 +/- 7.9 vs 24.4 +/- 1.1, p less than 0.001). No difference between the two groups was seen for the number of catheter infections, the number of catheters with poor flow or obstruction, the coagulation screening of the patients or the time-length between the removal of the last catheter and the venogram study. Two of the initially asymptomatic patients developed later on clinical problems related to the subclavian vein thrombosis. We conclude that the subclavian vein cannulation leads to significant damages of the vessels, excluding a whole arm, for future vascular access in some patients.

Catheterization↗
PubMed1986

Partially reversible osteopenia after surgery for primary hyperparathyroidism.

Bone mineral content of the radius in 30 patients with primary hyperparathyroidism was determined by single-photon absorptiometry before and one year after the removal of a parathyroid adenoma. When compared with normal age- and sex-matched subjects, preoperative bone mineral content was decreased by more than 1 SD in 24 patients 3 cm from the styloid apophysis (distal site) and in 23 patients 8 cm from the styloid apophysis (proximal site). The decrease at the distal site, where there is more trabecular bone, was significantly greater than at the proximal site (74% +/- 13% of the normal mean vs 79% +/- 13%). Bone mineral content values were not different in the female and male populations. One year after surgery, the bone mineral content was significantly increased but was still lower than normal at both sites (81% and 84% of the normal mean, respectively). In some patients, seen up to three years after surgery, the bone mineral content remained lower than normal. We conclude that primary hyperparathyroidism causes an osteopenia that affects both cortical and trabecular bone and that is only partially reversible, even in the long term.

Adenoma↗
PubMed1985

Lithiasic complications of renal transplantation: the donor graft lithiasis concept.

Lithiasis is usually a late complication of renal transplantation reported in approximately 1% of all renal allografts. Underlying predisposing conditions for the formation of calculi are present in almost all cases. Preexisting stones in the donor kidney have been reported once previously. The authors have observed 2 such cases, detected by routine sonography. In 1 case, stone migration into the ureter led to acute postoperative transplant failure; this complication has been reported previously.

Adult↗
PubMed1985

Ureteral stenosis after kidney transplantation: true incidence and long-term followup after surgical correction.

Between March 1965 and December 31, 1982, 421 kidney transplantations were performed in our department. The over-all incidence of ureteral stenosis was 5.5 per cent. However, when the number of patients at risk at various times after transplantation was considered the probability for ureteral stenosis to develop was 4.6 per cent at 1 year, 7.7 per cent at 2 years and 9.7 per cent at 5 years. Preoperative and postoperative complications were frequent. The wound infection rate was 21.9 per cent and 2 of the 24 patients died of septic shock. Graft survival rate after definitive surgical correction of ureteral stenosis was 71 per cent at 1 and 2 years, and 65 per cent at 3 years. Late results justify the efforts to re-establish correct urinary drainage of the graft.

Follow-Up Studies↗
PubMed1985

Usefulness of 99mTc pyrophosphate bone scintigraphy in the survey of dialysis osteodystrophy.

Fogelman's score (FS) was used to determine the usefulness of 99mTc pyrophosphate (Tc-PP) bone scintigraphy in the evaluation of dialysis osteodystrophy. FS correlated well with bone 47Ca accretion rate. It remained stable after six months in patients treated with 1 alpha (OH)D3 and increased significantly in a randomised group of untreated patients. It decreased after two years of 1 alpha (OH)D3 therapy while serum calcium increased and iPTH and alkaline phosphatases decreased. Patients with low FS, treated by 1 alpha (OH)D3, rapidly developed hypercalcaemia. In cases of spontaneous hypercalcaemia, parathyroidectomy did not normalise serum calcium in patients with low FS despite a significant decrease in serum iPTH. Lower FS were associated with a higher increase in serum aluminium after desferrioxamine (DFO) administration and in two cases of proven aluminium osteomalacia, DFO therapy was followed by a dramatic increase in FS.

Bone and Bones↗
PubMed1985

Effect of dexamethasone on the mean plaque size of bovine herpesvirus 1.

The effect of dexamethasone on infectious bovine rhinotracheitis virus (Bovine herpesvirus 1: BHV 1) was studied by measuring the mean plaque size produced by eight virus strains under two concentrations of dexamethasone phosphate (0.1 and 1 mM). Dexamethasone induced a significant reduction of the mean plaque size, whatever the strain used. Some differences were noted between the BHV 1 strains studied, depending on the dexamethasone concentration.

Animals↗
PubMed1984

Effect of surgical trauma on various aspects of the immune response in rats.

The effects of a standard laparotomy on different aspects of the immune response were studied in Wistar R/A rats. When the antigen was administered at the time of operation, antibody synthesis against sheep red blood cells (SRBC), a thymo-dependent antigen was significantly stimulated. The same phenomenon was observed when a soluble antigen extracted from SRBC was injected during the surgical procedure. On the contrary, late antibody production induced by formalinized Salmonella enteritidis or Escherichia coli lipopolysaccharide, two thymo-independent antigens, was reduced in operated animals. Cell-mediated immunity against SRBC was investigated by the radiometric ear index test described by Kostiala in 1977. Surgery did not alter the induction phase but suppressed the expression of the cellular immune response. Carrageenin-induced edema was inhibited in operated rats. These results show that surgical trauma acts differently on the various aspects of the immune response.

Animals↗
PubMed1983

[Aseptic osteonecrosis after renal transplantation].

In a series of 388 kidney transplantations performed in 328 patients, aseptic bone necrosis was diagnosed in 27 patients. Forty seven lesions were detected. The femoral head was most often involved (33 cases) followed by the femoral condyle (10 cases), the head of the humerus (3 cases) and the carpal navicular bone (1 case). Sixteen patients had multiple lesions. The first symptoms occurred between the fifth month and the sixth year post-transplantation. With our immunosuppressive protocol, the probability of developing aseptic bone necrosis is 5.2% at one year, 11.3% at two years and 16.3% at six years. The incidence of steroid diabetes is higher in patients with aseptic bone necrosis (26%) than in patients without bone lesions (11%). Conservative treatment was successful in 60% of the cases.

Adrenal Cortex Hormones↗
PubMed1983

Effect of surgical trauma on delayed type hypersensitivity.

There is no general agreement in the literature concerning the effects of surgery on delayed type hypersensitivity (DTH). Therefore, the effect of a standard laparotomy on DTH was studied in rats and measured by the ear index method of Kostiala. Surgery depresses significantly the ear index in animals challenged at the time of operation (2.35 +/- 0.24 vs 6.30 +/- 1.26) or 24 hr later (2.69 +/- 0.21 vs 4.34 +/- 0.64). There is no late rebound of the immune response. The reduction of ear index is not due to a delayed response of operated rats but is really a decrease of the peak response. Surgery seems to act on the early phase of the immune response.

Animals↗
PubMed1983

Elbow arteriovenous fistula (EAVF) for chronic hemodialysis in small children.

Elbow arteriovenous fistulae (EAVF) were constructed in 10 children aged 27 mo to 10 yr. There were no operative failures. Follow-up ranged from 5 to 22 mo. Three episodes of thrombosis occurred in a single child. The fistula was recanalized each time. The creation of an EAVF is a simple surgical procedure. Children weighing as little as 10 kg were efficiently dialysed for prolonged periods of time with this vascular access device.

Arteriovenous Shunt, Surgical↗
PubMed1983

Prevalence and causes of hypertension late after renal transplantation.

We analysed the prevalence and causes of hypertension in 77 patients followed greater than or equal to 7 years after renal transplantation. Prevalence of hypertension remains stable, around 55 per cent, up to 11 years post-transplant. Age, sex, type of original nephropathy, graft source or prednisolone dosage are not related to hypertension; body weight is greater in hypertensive patients. Presence of native kidneys is responsible for hypertension in about one-quarter of non-nephrectomised patients. No renal artery stenosis was observed in this group. At seven years, serum creatinine is greater in hypertensive patients, suggesting that graft dysfunction is an important cause of hypertension in long term survivors.

Adolescent↗
PubMed1983

[Factors influencing the survival of the patient and the graft in kidney transplants].

The influence of several prognostic factors in kidney transplantation was studied by the actuarial method from the data collected on 332 grafts performed at one center from 1971 to 1982. Taking into account the various interactions between these factors, 3 survival parameters were calculated: patient's survival, immunologic tolerance of the graft and overall graft survival. The relevant prognostic factors, ranked in decreasing order, are: origin of the graft, immunosuppressive therapy, recipient's age, recipient's HBs status and number of blood transfusions administered prior to transplantation, HLA presensitization and HLA-A,B matching. Integration of these factors leads to a precise estimation of the risk of transplantation from the characteristics of the graft and those of the potential recipients, thereby allowing to select the best candidate.

Adult↗