Biomedical subjects
Publications and source records attributed to R Gabriel.
We have analysed the causes of death in a group of patients with chronic renal failure--serum creatinine more that 225 mumol/l (2.5 mg/100 ml)--and find that there is an increased incidence of malignancy when compared with the fatality rates for cancers in England and Wales (p less than 0.0005). No patient in the series had received a transplant kidney or was therapeutically immunosuppressed for other reasons.
In order to establish the absorption of vitamin B12 in the human body at present several methods are used. When the retention of the whole body is measured nearly no restricting conditions are connected with the methodically exactest declaration. The retention of the whole body can be determined by means of simple measuring arrangements. Special attention is to be paid to the initial or reference value, the establishment of which often becomes problematically by the dynamics of metabolism. In the case of the study of the vitamin B12 metabolism by means of the measurement of the retention of the whole body the reference value should be determined at the earliest after 90 minutes; then the relative retention is to be measured after 4 days or later. The method is most agreeable to the patient and does not depend on the help of the patient.
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The internal mammary artery (IMA) was used as a graft in 298 patients undergoing coronary bypass procedures. Two patients died during the operative period and 2 others died one year later. Most of the survivors are free of angina. Of the IMAs restudied 9 to 24 months postoperatively, 95% were patent. This group included nearly all the patients having angina after operation. There are some situations in which the IMA may have inadequate flow in comparison to the vein graft. These results suggest the IMA is an excellent graft in most coronary bypass procedures.
The date of onset of 360 acute renal transplant rejection episodes from 1969 to 1973 have been compared with the prevalence of various common viral infections and infections due to Mycoplasma pnuemoniae. A positive correlation was found for influenza B infections (r=0.43, p less than 0.01) up to 5 months before transplantation and for adenovirus infections (r=0.32, p less than 0.05) at 1 month before kidney grafting.
Of 153 home visits I made when employed by an emergency call service only 21 (14 per cent) were in my opinion medically essential. Thirty two (21 per cent) patients had no symptoms when visited. A nocturnal visiting fee payable by the patient is suggested to reduce unnecessary requests.
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In experiment canine kidneys preserved in Collins' solution can be kept vital for 30 hours. Angiography after autotransplantation of these kidneys shows good circulation during the immediate postoperative period. Isotope nephrography reveals reversible damage of tubuli which disappears till the 28th day after operation. This procedure of preservation causes tubular damage but does not impair the parenchymatous blood supply. Tubular regeneration therefore is possible.
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The nephrotic syndrome is the only hypoalbuminaemic state frequently associated with hyperlipidaemia. In the presence of a negative nitrogen balance, hyperlipidaemia is metabolically inappropriate and reflects the result of persistent breakaway from free fatty acid control. This lipid abnormality may result in the premature development of ischaemic heart disease in patients in whom it is not possible to control the primary renal abnormality. The authors suggest that future work should be directed towards thyroxine and insulin metabolism in nephrotic states.
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