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Biomedical subjects

S C Jordan

Publications and source records attributed to S C Jordan.

154 records · Page 9Linked to original sources
PubMedDate not supplied

Successful balloon dilatation of ascending vein stenosis in obstructed supracardiac total anomalous pulmonary venous connection.

A newborn infant presenting with severe hypoxia and pulmonary edema was found to have supracardiac total anomalous pulmonary venous connection (TAPVC). There was a severe localized stenosis (gradient > 30 mmHg) of the vein ascending from the pulmonary venous confluence. Balloon dilatation of the stenosis provided immediate and effective relief of the obstruction (gradient 4 mmHg) until surgery was performed. In sick neonates with discretely obstructed anomalous pulmonary venous connection, short-term hemodynamic stability may be achieved by balloon angioplasty of the site of obstruction.

Catheterization↗
PubMedDate not supplied

Renal transplantation in infants and children.

Renal transplantation is the treatment of choice in children with end stage renal disease. Advances in organ retrieval and preservation, improved surgical techniques and postsurgical care, newer immunosuppressive drugs and prevention and treatment of infections have significantly improved survival of the renal allograft. The absolute requirements for a transplant are compatible blood group and a negative cytotoxic crossmatch. HLA identical grafts have a longer half-life than those that are less well matched. The immunosuppressive drugs most often used are cyclosporin A (or tacrolimus), azathioprine (or mycophenolate mofetil) and prednisone. Complications following transplantation include episodes of acute rejection, serious bacterial and viral infections, hypertension and recurrence of primary disease in the allograft. Each centre must have standard protocols for pre-transplant evaluation, and monitoring during surgery and in the post-operative period. Socio-economic factors should be evaluated before offering renal transplantation to children in developing countries.

Child↗
PubMedDate not supplied

Circulating immune complexes in Kawasaki syndrome.

Sera of 42 patients with Kawasaki syndrome were evaluated for the presence of circulating immune complexes (CICs) by Raji cell radioimmune and C1q solid phase assays. Overall 69% of sera tested were positive by one or both assays, 52% by Raji cell radioimmune and 48% by C1q solid phase assay. CICs were detected most frequently 2 to 4 weeks after the onset of illness, but their presence did not correlate with the clinical severity of the illness or incidence of coronary artery aneurysms. Antibody to mite antigen was found in only 2 of 30 patients tested, and only one of these had CICs. CICs are frequently associated with Kawasaki syndrome, but their role in its pathogenesis remains to be determined.

Aneurysm↗
PubMedDate not supplied

Serum interleukin-2 levels in lung transplant recipients: correlation with findings on transbronchial biopsy.

Serum interleukin-2 (IL-2) levels were examined in the serum of 17 lung transplant recipients who underwent transbronchial biopsies to diagnose reasons for allograft dysfunction. Over 60 transbronchial biopsies were performed in these 17 patients in a 22-month observation period. Mean serum IL-2 levels were significantly elevated in patients experiencing allograft rejection (p less than 0.01), cytomegalovirus pneumonia (p less than 0.0006), and bacterial/fungal pneumonia (p less than 0.01), when compared with those with normal or nondiagnostic findings on transbronchial biopsies. Serum IL-2 levels were not extraordinarily elevated as seen in other types of allograft rejection and did not differentiate between infection and rejection. In addition, overlapping values were seen in the patient groups tested. Despite these limitations, elevated serum IL-2 levels in lung allograft recipients may provide supplemental information helpful in deciding when to perform transbronchial biopsies.

Adult↗
PubMedDate not supplied

Differential soluble interleukin-2R levels in bilateral bronchoalveolar lavage after single lung transplantation.

Preliminary reports suggest that measurement of the soluble 55 kd subunit of the interleukin-2 receptor may facilitate the diagnosis of allograft rejection in solid organ transplants. Levels of soluble interleukin-2 receptor in serum or plasma have previously lacked sufficient sensitivity and specificity for the diagnosis of acute allograft rejection. Because single lung transplantation is preferentially performed for nonseptic end-stage pulmonary and cardiopulmonary maladies, we questioned whether the pattern of soluble interleukin-2 receptor recovery in bronchoalveolar lavage fluid obtained from both the native and transplanted lungs may enhance correct diagnosis. Fifty-three consecutive fiberoptic bronchoscopic procedures were performed with bilateral bronchoalveolar lavage fluid. Transbronchoscopic biopsies were histologically classified by the International Society for Heart Transplantation Working Formulation for Standardized Nomenclature. "Soluble interleukin-2 receptor index" was calculated as the quotient of soluble interleukin-2 receptor (in units per milliliter) by enzyme-linked immunosorbent assay, divided by protein (in milligrams per milliliter) to correct for differences in bronchoalveolar lavage fluid techniques and cellularity. Soluble interleukin-2 receptor indexes were significantly increased in the allograft bronchoalveolar lavage fluid during histologic grade A (acute rejection) versus normal transbronchoscopic biopsy specimens (3395 +/- 1298 U/mg versus 76 +/- 21 U/mg) associated with an increased transplanted/native lung ratio (69.9 +/- 46 versus 2 +/- 1 [mean +/- standard error of the mean]) (one-way analysis of variance, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMedDate not supplied

Serum cytokine levels in heart allograft recipients: correlation with findings on endomyocardial biopsy.

The ability to detect rejection of human cardiac allografts depends on endomyocardial biopsy diagnosis. Because cytokines are known to mediate allograft rejection events, we chose to examine serum levels of specific cytokines and receptors (interleukin-2 [IL-2], IL-2 receptor [IL-2R], and tumor necrosis factor alpha [TNF-alpha]) and to correlate those levels with findings on endomyocardial biopsy. Sequential sera samples from 23 cardiac allograft recipients were examined for the cytokine levels mentioned, and data correlated with findings on endomyocardial biopsy. Briefly, no statistically correlation of serum cytokine or receptor levels with the stage of allograft rejection was found. When sequential serum cytokine levels were determined in patients experiencing humoral and cellular allograft rejection events, the levels of TNF-alpha appeared to correlate well with endomyocardial biopsy findings. IL-2 and IL-2R levels in two patients who never experienced rejection were elevated on occasion, but TNF-alpha levels were always negative. In summary, measurement of serum cytokine (IL-2, IL-2R) levels in cardiac allograft recipients does not appear to correlate with findings on endomyocardial biopsy; however, elevated levels of TNF-alpha appear to predict more severe humoral allograft rejection episodes and may be helpful in this regard.

Adolescent↗