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R J Corry

Publications and source records attributed to R J Corry.

At least 109 records · Page 6Linked to original sources
PubMed1985

Evaluation of techniques of controlling exocrine drainage after segmental pancreatectomy in dogs. Implications for pancreatic transplantation.

Pancreatic transplantation is hampered by difficulties in controlling exocrine drainage. Methods of controlling exocrine drainage were assessed in 30 dogs receiving right lobe pancreatectomy. In the sham group, laparotomy and dissection of the pancreas were performed. In the others, the duct was either left open, ligated, anastomosed to jejunal mucosa, or injected with 1.5 mL of either silicone rubber, Neoprene, or Prolamine. Serial serum glucose and amylase levels were obtained at regular intervals and pancreatic biopsies were performed at two and eight weeks for examination. Glucose homeostasis was maintained throughout the study period. All animals developed severe pancreatitis as shown by hyperamylasemia by the second postoperative day, which resolved in most animals by the tenth to 14th day. Animals were free of ascites, pancreatic abscesses, and pseudocysts. All methods of ductal obstruction as well as the open duct drainage led to islet and acinar fragmentation and fibrosis. Endocrine function was preserved in all groups. In three animals with patent ductal-jejunal anastomoses, the pancreas appeared normal. Duct-to-jejunum anastomosis was the preferred method to preserve pancreatic function and morphology.

Amylases↗
PubMed1985

Oxygen free radical induced damage in kidneys subjected to warm ischemia and reperfusion. Protective effect of superoxide dismutase.

Superoxide anion free radical (O2-.) has been implicated in the pathogenesis of tissue injury consequent to ischemia/reperfusion in several different organs, including heart and bowel. Superoxide dismutase (SOD), an enzyme free radical scavenger specific for O2-., has been used successfully to protect these organs from structural damage during reoxygenation of ischemic tissue. It has been suggested that the catalytic action of xanthine oxidase in injured tissue is an important source of O2-. during reoxygenation. In order to evaluate the potential of SOD to protect against kidney damage resulting from transient ischemia followed by reperfusion with oxygenated blood, a model of warm renal ischemia was studied. LBNF1 rats underwent right nephrectomy and occlusion of the left renal artery for 45 minutes. Survival in the group of ischemic untreated rats (N = 30) was 56% at 7 days and serum creatinine was greatly elevated (p less than 0.01) in rats remaining alive over the full 7-day period. In strong contrast to these results, all of the animals treated with SOD before reperfusion (N = 18) were alive after 7 days similar to sham operated control rats (N = 8). Serum creatinine in the SOD treated rats was significantly elevated only to postoperative day 3 and thereafter returned to normal. Rats treated with inactive SOD (N = 4) or SOD before ischemia (N = 4) had decreased survival rates compared to ischemic untreated animals and prolonged elevation of serum creatinine. When the ischemia time was extended to 60 minutes, only 19% of the untreated animals (N = 16) survived at 7 days whereas nearly 60% of the SOD-treated animals survived (N = 19). Serum creatinine was greatly elevated during the full 7-day observation period in all surviving rats in the untreated ischemic group, whereas serum creatinine returned to normal (p less than 0.05) after 4 days in the surviving rats treated with SOD. To test whether the action of xanthine oxidase contributed to the kidney damage after reoxygenation, 45 min. ischemic rat kidneys were treated with allopurinol. All of the animals treated with allopurinol (N = 12) were alive at 7 days. Serum creatinine values returned to normal after the episode of ischemia and reperfusion but more slowly than after SOD treatment. Histologic evaluation of kidney tissue taken from animals after ischemia alone showed extensive renal tubular damage, which was essentially absent in kidneys from SOD-treated animals.(ABSTRACT TRUNCATED AT 400 WORDS)

Allopurinol↗
PubMed1985

Failure of cyclosporine to prevent in vivo T cell priming in man. Studies in allogeneic spleen transplantation.

Cyclosporine is a potent new immunosuppressive agent utilized in clinical organ transplantation. Available evidence suggest that it interferes with the secretion of interleukin-2. However, the long term efficacy of cyclosporine in preventing allograft rejection may depend on a relative sparing of suppressor cells early in the allogeneic response, allowing them to mature and effect a state of operational tolerance. If this is the case, cyclosporine must not affect antigen priming or recognition. Two patients in our center underwent allogeneic spleen transplant in conjunction with renal and pancreatic transplant. Both patients were treated with therapeutic levels of cyclosporine during the course of transplant. Neither developed any clinical signs of renal or pancreatic transplant rejection. Both patients developed graft-versus-host disease and eventually required allogeneic (donor) splenectomy. Studies performed on the splenocytes recovered from these specimens demonstrate alloantigen-specific cytotoxic T cell precursors. These studies demonstrate that although cyclosporine can prevent allograft rejection it does not necessarily prevent or ameliorate graft-versus-host disease. Furthermore, cyclosporine does not prevent in vivo T cell priming of alloantigen recognition. The primed cytotoxic precursors can be expanded in the presence of exogenous interleukin-2 to become fully active cytoxic cells.

Cells, Cultured↗
PubMed1985

[Effects of cyclosporine and blood transfusion on cardiac xenografts in combination of rat and mouse].

Transplant surgeons have been interested in the transplantation of vasculized organ xenografts. We studied the effects of Cyclosporine and blood transfusion on rat heart xenografts in mice and in reverse combination. B6AF1 mouse recipients were transfused with C3D2F1 mouse blood, presenting H-2k/d antigen and with B10.BR mouse blood transfusion, presenting H-2D and H-9 antigen to recipients. All rejected on day 5 in control group and C3D2F1 group. Prolongation of xenograft survival occurred with MST (Mean Survival Time) of 7.0 +/- 1.7 days (p less than 0.01), when primed by B10.BR blood transfusion. The survival time (MST = 14.4 +/- 3.2 days (p less than 0.001) of rat heart xenografts was prolonged in mice recipients treated with i.m. injection of 20 mg/kg/day of Cyclosporine for 14 days (short term). When B6AF1 mouse hearts were grafted into Lewis rats, however, no significant prolongation of graft survival occurred in any of Cyclosporine-treated rats. Cyclosporine did not prove to beneficial in this combination because of rat natural antibodies or species-specific barriers to mouse.

Animals↗
PubMed1984

Ambulatory peritoneal dialysis. Exploratory laparotomy for peritonitis.

We present our experience with performing an exploratory laparotomy for peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Six of 134 patients undergoing CAPD during the study period underwent surgical intervention because of abdominal sepsis. Two patients had bacterial peritonitis without abscess formation or evidence of visceral perforation and they recovered readily and, in retrospect, may not have required an operation. Of the three patients with fungal abscesses, two died of subsequent bacterial sepsis, while one patient survived, albeit after drainage of a recurrent pelvic abscess. One patient died because of extensive intestinal gangrene that was misdiagnosed as CAPD-related peritonitis initially. Our experience with these cases suggests that fungal peritonitis is a life-threatening complication that may result in both formation of an abscess and death. Therefore, it warrants aggressive antifungal chemotherapy and surgical intervention should an abscess be discovered. In contrast, bacterial peritonitis should be treated with appropriate antibiotic regimens until adequate evidence indicating the presence of a surgical condition is obtained.

Adult↗
PubMed1984

The third kidney transplant.

To determine the feasibility of third kidney transplantation, the experience at the University of Iowa was evaluated. The success of 14 such transplantations was dependent on the outcome of both of the previous graft operations. Three successful third transplantations with graft survival of 6 years, 3 years, and 1 year have occurred in recipients with more than 1 year survival of a previous kidney. Conversely, graft loss due to rejection developed in all patients who experienced graft survival of less than 1 year for both antecedent grafts. Moreover, HLA-A and -B matching and level of presensitization were not predictive of success in this series. These data suggest that third kidney transplantation using conventional immunosuppression may not be appropriate in the subgroup of patients who have clearly lost their first two grafts to early rejection.

Adolescent↗
PubMed1984

Successful DR-incompatible cadaver kidney transplantation. Combined effect of HLA A and B matching and blood transfusion.

The purpose of this retrospective analysis of DR-incompatible cadaver renal transplantation was to evaluate the effect of HLA A and B matching and blood transfusion status on actual one-year graft survival. There were 31 2-DR, 111 1-DR, and 27 0-DR grafts at risk during the study period. First, a comparison was made between preoperative (PRE) and peroperative (PER) transfusions alone. Graft survivals were 70% vs. 92% (2 DR), 67% vs. 52% (1 DR) and 71% vs. 39% (0 DR) for the PRE and PER groups, respectively. Statistical significance was not found between the two values in each DR subgroup, although the difference approached significance in the O DR group (0.1 greater than P greater than 0.05). Matching for greater than or equal to 2 A and B antigens significantly improved graft survival in the 1 DR-matched group when compared with those matched for less than 2 antigens (76% vs. 44%, P less than 0.005). While marked differences between the greater than or equal to 2 and less than 2 A and B matched groups were observed for both the 2 DR (92% vs. 68%, P greater than 0.1) and O DR groups (59% vs. 40%, P greater than 0.3) these differences were not significant. Stratifying the data for transfusion status revealed that the positive influence of HLA A and B matching in the 1 DR group was dependent upon the presence of preoperative blood administration. Graft survival of 87% for the PRE transfused recipients of grafts matched for greater than or equal to 2 A and B antigens was significantly better (P less than 0.001) than the 42% survival observed in similarly transfused recipients of poorer matched organs. Conversely, A and B matching was not significantly beneficial in the 1 DR recipients transfused only at the time of transplant with graft survivals of 57% vs. 43% for those matched for greater than or equal to 2 or less than 2 A and B antigens, respectively (P greater than 0.3). This analysis suggests that a combined effect of both HLA A and B matching and preoperative blood transfusions may allow for highly successful first cadaver renal transplantation in the face of DR incompatibility.

Adolescent↗
PubMed1984

Suppressor cell induction in donor-specific transfused mouse heart recipients.

Administration of donor-specific blood presenting major or minor foreign histocompatibility antigens to the mouse recipient improved heart allograft survival when a single transfusion of 0.25 ml was given to the recipient prior to transplantation. Multiple transfusions did not prolong allograft survival, which suggested a presensitization effect. In addition, when the single transfusion volume was reduced to 0.025 ml, no significant effect in prolongation of graft survival was observed. Thus the amount of blood transfused seemed to be a critical factor in achieving the transfusion effect. Splenic suppressor cells after transfusion and transplantation (as determined by adoptive transfer) were present during the stable maintenance phase of graft survival in transfused recipients with long-term surviving heart allografts. Also, an intact spleen was required to achieve improved allograft survival in mice transfused with donor-specific blood. Thus a mechanism for the favorable effect of blood transfusion may be the generation of splenic suppressor cells in response to transfusion followed by transplantation.

Animals↗
PubMed1984

Fibromuscular dysplasia: an unusual cause of hypertension in the transplant recipient.

A transplant recipient developed hypertension from unsuspected fibromuscular dysplasia of the donor renal artery. We believe this is the first reported case of this disease transmitted by transplantation. Successful repair of the stenosis was obtained by resection of the stenotic area and reanastomosis to the internal iliac artery. While the diagnosis of fibromuscular hyperplasia was not suspected in our donor prior to organ retrieval, its eventual occurrence in the transplanted kidney suggests that when the donor clinical picture is appropriate the lesion should be searched for prior to use of the organs.

Adult↗