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Biomedical subjects

S Meijer

Publications and source records attributed to S Meijer.

At least 271 records · Page 15Linked to original sources
PubMed1980

Transplantation of contaminated organs.

In cadaveric organ transplantation there is a risk of transfer of infectious agents from donor to recipient. The consequences can be fatal for immunosuppressed recipients. This is illustrated by a case history in which an infection with the fungus Monosporium apiospermum was transferred from a donor to two cadaveric kidney recipients, of whom one died and the other survived with the loss of the graft. These events led to a review of the literature to determine methods of demonstrating possible contamination of donor organs. Analysis of the case history of potential donors, a history taken from relatives or the family doctor, autopsy and laboratory examinations are considered useful. Victims of drowning, patients with severe burns and patients who have been ventilated for a long time are high risk donors.

Abscess↗
PubMed1980

Management of rupture in allografted kidneys.

Allograft rupture is a rare but serious complication in renal transplantation, occurring in 3 to 8.5% of the transplanted kidneys. The consequences for the recipients are fatal in 6% of the cases and graft loss is the outcome in another 53%. Clinical features and treatment of renal allograft rupture are discussed and illustrated by a case history, in which successful management of this complication resulted in salvage of the graft and patient. A literature study with the purpose of determining the pathogenesis of graft rupture revealed that rejection plays a major role.

Adolescent↗
PubMed1979

Cadaveric kidney retransplantation, is it justified?

Results of 44 second cadaveric kidney transplantations are reported and compared with the results of 149 primary cadaveric transplantations. No difference in patient survival is observed. Patients with a non-immunological first graft failure (NIF) had a better two year second graft survival (60%) when compared with patients with an immunological first graft failure (IF) (20%). This difference was not due to a higher degree of presensitisation in the IF group. The use of scarce cadaveric kidneys for retransplantation in patients whose first graft was rejected is considered questionable.

Adult↗
PubMed1979

A renal function study in 30 patients on long-term lithium therapy.

30 patients on long-term lithium therapy have been studied. The results are presented of the urinary concentrating ability after water deprivation and the intranasal administration of vasopressin, of the simultaneous determination of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), of the minimal urine pH after an oral dose of ammonium chloride, and of the urinary beta-2-microglobulin excretion. Mean urine concentration (+/- SEM) after 22 hr water deprivation (= Uosm) amounted to 854 +/- 22 mOsm/kg H2O, mean GFR was 101 +/- 4 ml/min, mean ERPF 360 +/- 18 ml/min, and mean minimal urine pH 4.95 +/- 0.06. In 8 out of 30 patients there was polyuria. In these 8 patients the values were 778 +/- 51 mOsm/kg H2O, 113 +/- 6 ml/min, 415 +/- 33 ml/min and 4.99 +/- 0.08, respectively. Serum levels of beta-2-microglobulin and lysozyme and the urinary excretion of beta-2-microglobulin were normal in all patients. No correlation was established between Uosm and the serum lithium concentration during the test (0.8 +/- 0.05 mmoles/l) nor between Uosm and the average serum lithium level during treatment (0.79 +/- 0.03). GFR was only correlated with age. It was found that administration of indomethacin during the concentration test increased Uosm in these patients. The results suggest that, given proper dosage and surveillance, long-term treatment with lithium is not likely to cause disturbances in renal function.

Acid-Base Equilibrium↗
PubMed1979

Venous hypertension of the hand caused by subcutaneous arteriovenous fistulae established for hemodialysis.

Side-to-side arteriovenous fistulae established in patients on chronic intermittent hemodialysis can cause venous hypertension. This gives rise to pain, pigmentation and trophic ulcers. Four patients with these complications are described. In three patients, with a fistula between the radial artery and the cephalic vein, the thumb and the second and third fingers were affected. In the fourth patient, with a fistula between the ulnar artery and the basilic vein, the fourth and fifth fingers were involved. This finding suggests segmental venous drainage of the hand. All patients were cured by ligation of the distal vein. An end-of-vein-to-side-of-artery fistula does not cause the complication described, and for this reason is to be preferred.

Arteriovenous Shunt, Surgical↗
PubMed1978

Occlusive phlebitis, a diagnostic feature in Riedel's thyroiditis.

Five cases of Riedel's invasive fibrous thyroiditis are presented. Clinically and histopathologically all cases fulfilled the criteria for this lesion. In both small and large veins there were inflammatory changes and obliteration of the lumen, followed by sclerosis. These changes were found in each operative specimen, and seemed to be a diagnostic feature of invasive fibrous thyroiditis. We consider this change to be an occlusive phlebitis, and have noted that it occurs in association with multifocal fibrosclerosis. Three stages can be recognised: infiltrative, occlusive and sclerotic. In other thyroid lesions such as Hashimoto's thyroiditis, granulomatous thyroiditis of the Quervain type and adenomatous goitre these peculiar changes in the veins were not found.

Adult↗
PubMed1978

Curative and palliative surgical treatment of pancreaticoduodenal adenocarcinoma.

In the period 1965 to 1976 inclusive, 55 patients suffering from duodenopancreatic adenocarcinoma were surgically treated at the Free University Hospital. Twenty of these patients underwent a 'curative' Whipple pancreaticoduodenectomy for a resectable tumor. The difference in survival time makes a differentiation important between carcinomas occurring in the head of the pancreas and those of the peri-ampullary region. In our series, 11 of the former were found and 9 of the latter group. Of each group one patient died within 30 days of the operation. The average survival time of 9 patients, operated on for a tumor in the head of the pancreas, was 10.2 months, with a range from 2 to 23 months. One patient is still alive 23 months after the operation. The average survival time of 5 patients with a periampullary tumor was 22 months with a range from 6 to 52 months. Three patients are still alive, one more than 12 years and 2 more than 19 months after operation. Considering the bad results, and the fact that 30 percent of pancreatic carcinomas are multifocal, it would seem that the classical Whipple operation is a thing of the past. One can then make a plea for total pancreaticoduodenectomy or even for a regional pancreatectomy. Thirty-five patients underwent a palliative procedure, consisting of a biliary bypass combined in a number of cases with a gastroenterostomy. Five patients died within 30 days of the operation. The average survival time for the remaining patients was 9.5 months with a range of 1.5 to 30 months.

Adenocarcinoma↗
PubMed1977

Syndrome of Shwachman and leukaemia.

The syndrome of Shwachman is characterized by pancreatic insufficiency and bone marrow dysfunction, usually manifesting itself as neutropenia. The pancreas shows replacement of the exocrine glands by adipose tissue; sweat electrolytes are normal. A 23-year-old male who was known to suffer from neutropenia and pancreatic dysfunction from early childhood, presented with fever, acquired Pelger-Huet anomaly (of the polymorphonuclear granulocytes) and sideroblastic anaemia, a combination of symptoms suggestive of preleukaemia. A few months later he died of acute myeloblastic leukaemia and autopsy showed a dystrophic pancreas. Considering this case history it seems possible that the haematological anomalies of Shwachman's syndrome are signs of preleukaemia. Careful follow-up of patients suffering from Shwachman's syndrome seems warranted.

Adult↗
PubMed1976

Idiopathic retroperitoneal fibrosis in multifocal fibrosclerosis.

A case of rare combination of retroperitoneal fibrosis and Riedel's thyroiditis is presented. The term multifocal fibrosclerosis is used in the literature to denote such combination and others which include idiopathic retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, invasive (Riedel's) thyroiditis and pseudotumor of the orbit.

Humans↗
PubMed1976

Histoplasmoma of the lung.

A review of all granulomatous surgical lesions in the files of the Free University Hospital revealed four cases of histoplasmoma in which Grocott-staining procedures provided histologic confirmation of the presence of Histoplasma capsulatum bodies. The case histories have been presented briefly. A short review of the literature follows.

Adult↗