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Biomedical subjects

S K Fellner

Publications and source records attributed to S K Fellner.

28 records · Page 2Linked to original sources
PubMed1987

Recurrent reversible acute renal failure from amphotericin.

A patient with cryptogenic cirrhosis and disseminated sporotrichosis developed acute renal failure immediately following the administration of amphotericin B on four separate occasions. The abruptness of the renal failure and its reversibility within days suggests that there was a functional component to the renal dysfunction. We propose that amphotericin, in the setting of reduced effective arterial volume, may activate tubuloglomerular feedback, thereby contributing to acute renal failure.

Acute Kidney Injury↗
PubMed1984

Ocular involvement in primary hyperoxaluria.

Ocular involvement from primary hyperoxaluria developed in one infant and one teenaged patient. Autopsy procedures in the first case used special histopathologic staining techniques to demonstrate a wider deposition of calcium oxalate crystals within the eye than was previously suspected. Clinical photographs and fluorescein angiograms in the older patient demonstrated a widespread retinal distribution of crystals with a periarterial predilection. This patient also demonstrated a unique acquired black macular lesion.

Adolescent↗
PubMed1982

Lymphocyturia: an important diagnostic and prognostic marker in renal allograft rejection.

We examined the urine for lymphocytes in 60 renal allograft recipients in the immediate posttransplant period using a simple staining technique with methylene blue. 37 acute rejection episodes associated with deterioration in renal function were observed. Other causes of decreased renal function, such as acute tubular necrosis, vascular occlusion or urologic obstruction were carefully excluded. 34 (92%) of the 37 acute rejection episodes were accompanied by significant lymphocyturia. Lymphocyturia was recognized concomitantly with the rise in serum creatinine in 20 of the 34, whereas in 14 it preceded the rise in serum creatinine by a period of 3.5 +/- 2.5 days. 24 (71%) of the 34 acute rejection episodes were reversed by high dose steroid administration and only 2 of them showed persistent lymphocyturia following treatment. On the other hand, 9 of the 10 nonresponders to steroid therapy showed persistent lymphocyturia. All the nonresponders eventually required maintenance dialysis. Detection of lymphocyturia is not only of value in the diagnosis of acute allograft rejection, but is also useful in determining allograft survival in the immediate posttransplant period.

Acute Disease↗
PubMed1981

Creatine phosphokinase in long-term dialysis patients.

Of 90 patients undergoing regular dialysis, 42% had elevated levels of creatine phosphokinase (CPK). The BB isoenzyme was not detected, and only one patient had CPK MB. The elevation of CPK MM level did not correlate with values for calcium, phosphorus, calcium times phosphorus product, dry weight, or parathyroid hormone. Elevated levels of the enzyme correlated directly with muscle weakness in male patients and with hypothyroidism (depressed free thyroxin index) and inversely with treatment with vitamin D, supplements. We conclude that high CPK levels in uremia are secondary to skeletal muscle abnormalities and that hypothyroidism and vitamin D, deficiency may contribute to so-called uremic myopathy.

Adult↗
PubMed1978

Ultrasonographic evaluation of vascular access complications.

In 24 patients, sonograms were obtained of 25 vascular accesses, 16 of which were bovine grafts, 7 arteriovenous fistulae, 1 a polytetrafluoroethylene graft, and 1 an external Silastic shunt. On the sonograms, the lumen, course, and insertions of the vascular grafts and fistulae were outlined, anterior and posterior aneurysms demonstrated, hematomas differentiated from aneurysms, and intrinsic distinguished from extrinsic lesions. The authors conclude ultrasonography is a valuable adjunct to clinical evaluation in assessing certain complications of vascular access.

Adult↗
PubMed1975

Transcatheter embolization of renal arteriovenous fistula.

A patient with malignant hypertension and acute renal failure underwent percutaneous renal biopsy which resulted in the creation of an arteriovenous fistula that communicated with the renal pelvis. Successful segmental embolization with gelatin sponge (Gelfoam) was achieved via a transcatheter approach.

Adult↗