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Biomedical subjects

S I Cho

Publications and source records attributed to S I Cho.

At least 73 records · Page 4Linked to original sources
PubMed1982

Lethal complications associated with nonrestrictive treatment of abdominal aortic aneurysms.

Five high-risk patients received nonresective treatment of abdominal aortic aneurysms (AAAs). This treatment included ligation of the iliac arteries to induce acute thrombosis of AAA and a simultaneous axillobifemoral bypass for restoration of arterial flow to the lower extremities. Of these five patients, lethal complications associated with this procedure developed in four. The complications included rupture, infection of the thrombotic aortic aneurysm, visceral ischemia, and consumptive coagulopathy. This high incidence of lethal complications and the unacceptably high patient mortality in these five patients indicates extreme precaution in the application of nonresective treatment for AAA.

Aged↗
PubMed1981

Computed tomographic angiography.

Computed tomographic angiography performed by the intravenous administration of contrast medium was evaluated in 86 vascular patients. This experience demonstrates a new approach to the evaluation of patients with symptomatic aortic aneurysms, in whom computed tomographic angiography will aid in evaluating the need for emergency surgery. Nonoperative patients are serially evaluated by computed tomographic angiography to detect significant changes in the geometric configuration of their aneurysms. Computed tomographic angiography was beneficial in the evaluation of the patency of vascular reconstructive procedures such as femoropopliteal bypass, aortoiliac bypass and application of a vena caval device. More clinical experience and possibly a rapid sequence technique are needed to evaluate patients with portasystemic shunts.

Abdomen↗
PubMed1981

Prospective controlled trial of cryoprecipitated plasma, plasma protein fraction and serum albumin solution for kidney preservation.

A controlled prospective study was conducted to compare the results of kidney preservation and transplantation in regard to the type of perfusate used for perfusion preservation. Cryoprecipitated plasma, plasma protein fraction and serum albumin solution were used as perfusate. Between February 1979 and July 1980, 176 kidneys were preserved by one of these perfusates and transplanted. There was no statistically significant difference in the donor and recipient status, perfusion characteristics or graft and patient survival among the three groups. Synthetic perfusates are an acceptable alternative to cryoprecipitated plasma for perfusion preservation of cadaver kidneys.

Adult↗
PubMed1981

Nephrostomy drainage for renal transplant complications.

The use of temporary diverting nephrostomy drainage in the management of immunosuppressed renal transplant patients with supravesical urinary extravasation, fistulas or ureteral obstruction is reviewed. In a literature survey covering an 11-year interval and 4,307 transplants there were 204 cases (4.7 per cent) of ureteral extravasation or fistula and 113 cases (2.6 per cent) of ureteral obstruction. Attempts at urologic repair in these 317 cases resulted in 30.9 per cent failure rate (98 cases), of which 86.7 per cent (85 cases) occurred in patients without nephrostomy compared to 13.3 per cent (13 cases) in patients with nephrostomy. In our 255 consecutive renal transplant patients there were 7 (2.7 per cent) with ureteral extravasation or fistula and 14 (5.5 per cent) with ureteral obstruction. Temporary nephrostomy was done in all 21 patients to protect the urologic repair and, when necessary, to control sepsis and allow for patient stabilization before delayed urinary tract reconstruction. In our series there was no mortality and only 1 renal unit (4.7 per cent) was lost as a consequence of urologic complications. The use of nephrostomy in transplant patients with ureteral extravasation, fistulas or ureteral obstruction is encouraged strongly to optimize patient and renal unit survival.

Drainage↗
PubMed1980

Cessation of immunosuppressive therapy after successful transplantation: a national survey.

A retrospective survey of 165 United States renal transplant units identified 48 patients who had discontinued all immunosuppressive therapy (IT). Sixteen had received cadaveric and 32 had received living-related grafts. The interval from transplantation to cessation of medication was similar in both groups and did not correlate with the outcome. Of 16 cadaveric grafts, 9 failed ("delta" serum creatinine concentration of greater than or equal to 5 mg/dl) within a mean of 59 days; 3 patients maintained stable renal function for 244, 395, and 425 days, respectively. Of the 32 related grafts, 12 failed within a mean of 234 days. Of the 20 related grafts that did not fail, 5 had stable function for greater than or equal to 1 year and 6 for greater than or equal to 3 years after cessation of IT. Our data demonstrate that at no point after transplantation is it prudent to stop all IT barring serious drug toxicity. Also, in patients who stop IT surreptitiously and in whom renal function remains normal, reinstitution of therapy is indicated within 1 year and is advisable as long as 3 years after cessation; those few patients who do well without IT for greater than 3 years may not need further treatment.

Adolescent↗
PubMed1980

New arterial clamp for perfusion preservation of cadaver kidneys.

A new arterial clamp has been developed for the perfusion of kidneys with single or multiple renal arteries which significantly reduces the risk of intimal damage. The use of this clamp completely eliminates the necessity for renal artery cannulation and also minimizes several disadvantages currently encountered with en block perfusion and preservation.

Constriction↗
PubMed1979

Penile carcinoma in renal transplant recipient.

A case of squamous cell carcinoma of the penis occurring in a renal transplant recipient is presented. Despite a markedly increased incidence of epidermoid carcinoma in the transplant population, this is the first reported case of penile carcinoma occurring in a renal transplant recipient. As with other superficial epithelial tumors in this population, conventional therapeutic techniques are recommended. However, excisional biopsy is recommended for penile lesions at the time of initial presentation or if any clinical suspicion exists.

Adult↗
PubMed1978

Hematuria in renal transplant recipients.

This study is a retrospective analysis of microscopic and gross hematuria in 127 male renal transplant recipients. The incidence of hematuria was 12%. The causes of hematuria were similar to those in the general population with inflammatory conditions predominating. Urologic malignancy was not found. Hematuria heralded rejection episodes in three instances. Complete evaluation of hematuria revealed pathology of the urinary tract in every instance.

Adult↗
PubMed1978

Perfusion pressure and human kidney preservation.

From July 1972 to September 1976, 708 kidneys received through the Interhospital Organ Bank, New England were divided into two groups. Both groups were preserved by continuous pulsatile perfusion. Group 1 (308 kidneys) was maintained at a systolic pressure of 60 mm Hg throughout the preservation period. Group 2 (399 kidneys) was perfused at an initial pressure of 60 mm Hg. The pressure was adjusted to 55 mm Hg at 1 hr, then no further adjustments were made. Comparison reveals that group 2 donors were younger and that the kidneys in group 2 were preserved for longer periods that those in group 1. Both groups had an equivalent number of kidneys that were discarded and kidneys that did not function. The incidence of immediate function was higher in group 2 but this difference is not statistically significant. Compared with conventional preservation, kidneys can be preserved at lower systolic and mean pressures without loss of quality, and in fact, may suffer less damage from perfusion.

Adult↗
PubMed1977

Ascites following renal transplantation.

Idiopathic ascites has been described in patients on maintenance peritoneal dialysis and hemodialysis. The mechanism responsible for ascites formation in these patients is unknown, and therapy has been generaly unsuccessful. However, renal transplantation has been associated with resolution of this form of ascites. We describe a patient who was free of ascites during maintenance dialysis, in whom ascites developed following renal transplantation associated with transient impairment of renal function. No specific cause of the ascites was found. Resolution of ascited occurred as renal function improved. This experience extends the spectrum of idiopathic ascites in uremic patients to the transplant recipient.

Ascites↗
PubMed1976

The effect of air embolism on renal preservation.

Air embolism to the kidneys was induced in dogs during an ex vivo perfusion preservation period using cryoprecipitated plasma to demonstrate the effect of air embolism on the function of the preserved kidneys. A sharp decline in plasma flow rate was observed after air was infused, but the rate returned to the preembolism range in 60 minutes. Differences in posttransplant serum creatinine levels between the control and air embolism groups were not statistically significant. No deleterious effect was demonstrated on the final function of preserved kidneys by infusion of air. Three cadaver kidneys that accidentally sustained air embolism during the perfusion preservation period were transplanted. Although an initial period of acute tubular necrosis developed in these three kidneys, two kidneys regained good renal function and the third kidney was removed because of irreversible rejction. This study demonstrates that kidneys that sustain air embolism can be used for clinical transplantation.

Animals↗
PubMed1976

Analysis of 75 discarded cadaver kidneys.

Of 431 cadaver kidneys available for transplantation, 75 were discarded after a period of pulsatile perfusion. Kidneys were discarded because of poor flow, multiple arteries with segmental obstruction, prolonged warm ischemia time, perfusion pump malfunction, and lack of donor cells for cross-matching, among other reasons. Certain selected variables common to transplantated kidneys and kidneys discarded have been analyzed. The most significant finding was that 70% of transplanted kidneys came from donors who had recieved pretreatment with either phenoxybenzamine hydrochloride, methylprednisolone sodium succinate, or phentolaminemesylate. Only 33.3% of kidneys discarded were taken from donors who had received such pretreatment (P less than .01). Attention is focused on the need for careful consideration of the technical aspects of donor nephrectomy as well as the need for donor pretreatment, in order to decrease the number of discarded kidneys.

Cadaver↗
PubMed1976

Regional program for kidney preservation and transplantation in New England.

From July 1972 to March 1975, 431 cadaver kidneys were harvested and preserved by continuous pulsatile perfusion with cryoprecipitated human plasma. Forty-eight per cent of the transplanted kidneys were considered to have immediate function, another 48 per cent demonstrated acute tubular necrosis, and 4 per cent were classified as nonfunctioning. There was no difference in the incidence of acute tubular necrosis in relation to the total preservation time. There was a significant difference in the survival of primary cadaver grafts at six months and one year between the kidneys that demonstrated immediate function and those with acute tubular necrosis.

Cadaver↗