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Biomedical subjects

S N Chatterjee

Publications and source records attributed to S N Chatterjee.

At least 109 records · Page 6Linked to original sources
PubMed1978

Urologic complications in renal transplantation.

The current overall reported incidence of major urologic complications following renal transplantation is 5 per cent. The presence of such a complication increases the likelihood of patient mortality by a factor of three. Standard utilization of postoperative radionuclide scanning is very useful in early diagnosis. Vesical fistulas generally result from improper bladder closure. The incidence of bladder complications increases with secondary and tertiary grafts. Ureteral complications result when the blood supply of the ureter is impaired. These include fistula formation, necrosis, and obstruction. Immediate surgical correction is indicated in almost all serious urologic complications following transplantation; otherwise there is marked increase in morbidity and mortality. Complications appearing early in the postoperative period carry a poor prognosis for both graft and recipient survival. The presence of urinary tract infection early in the postoperative period also correlates negatively with graft survival. The presence of multiple renal arteries in the donor has been associated with an increased rate of urologic complications. Ureteral fistulas can be avoided by meticulous dissection of the donor at the time or organ harvesting. Great care must be taken to preserve the arterial and venous blood supply to the ureter by avoiding any dissection into the renal hilum. Aberrant renal arteries must be preserved or repaired if damaged. Ureteroneocystostomy is the preferred method for re-establishing urinary tract continuity following transplantation. The immediate surgical correction of urologic complications is mandatory, and the techniques involved are highly specialized and must be individualized with each patient.

Erectile Dysfunction↗
PubMed1978

Cytomegalovirus retinitis: two cases occurring after renal transplantation.

Cytomegalovirus (CMV) retinitis is reported in 2 patients who received immunosuppressive medication after cadaveric renal transplantation. The clinical features of this disease as well as the differential diagnosis are presented. Reduction in the amount of immunosuppressive drugs given postoperatively is suggested as the definitive treatment of this disease. Available specific antiviral chemotherapeutic agents were ineffective against CMV retinitis. This finding may be modified at a later date, with the introduction and use of new effective and safe antiviral drugs.

Adult↗
PubMed1978

Fulminant pulmonary infections in renal transplant recipients.

Opportunistic pulmonary infections often appear in patients requiring immunosuppressive therapy following renal transplantation. Fungal protozoal, viral and bacterial infections demand an immediate definitive diagnosis, since the outcome is related to the rapidity in establishing a diagnosis and the institution of appropriate therapy. Of 200 consecutive renal transplants during a seven year period, severe pulmonary infections developed in 21 patients. In 17 patients, a specific infectious agent was identified, using the flexible fiberoptic bronchoscope. Pathogenic specimens were obtained by bronchial washing, brushing or transbronchoscopic biopsy of the lung through the inner channel of the flexible bronchoscope. Bronchoscopy for localized lesions of the lung was aided by fluoroscopic guidance; for diffuse lesions, a roentgenogram of the chest was used to obtain bronchoscopic specimens from areas of maximum infiltration. Specimens were immediately dispatched and processed by the pathology laboratory. Except for one patient, all the others with fungal, protozoal and viral infections survived with functioning kidneys. Three deaths resulted from bacterial infections. Antemortem diagnoses were confirmed in all four patients who died.

Bacterial Infections↗
PubMed1977

Cytomegalovirus retinitis secondary to chronic viremia in phagocytic leukocytes.

We studied the relationship between the duration and intensity of cytomegalovirus viremia, cytomegalovirus complement fixing antibody, and cytomegalovirus retinitis in 61 renal transplant recipients. Five (8%) patients had chronic viremia which lasted more than six months. Two of the five developed typical cytomegalovirus retinitis and a severe fungal infection after intensive viremia of more than 11 months' duration. Retinitis did not develop in 22 patients with short-term viremia. Infectious cytomegalovirus was largely associated with polymorphonuclear leukocytes, but the virus was associated with monocytes during the immature granulocytic response accompanying one patient's terminal illness.

Adult↗
PubMed1977

Effect of cytosine arabinoside on Herpes virus infection in renal allograft recipients.

Cytosine arabinoside (Ara-C) was used for treatment of severe symptomatic cytomegalovirus (CMV)-herpes infections that were seen in nineteen of 174 renal allograft recipients. Ara-C was administered by continuous intravenous infusion at a mean dose of 35 mg/m2 daily for three to four days. Side effects were few and minor in nature. All cases of herpes simplex and herpes zoster, which usually have a prolonged and sometimes unfavorable course in immunosuppressed patients, cleared promptly with no recurrence. All nine patients, except one who had CMV infection with the symptom complex of fever and retinitis or pneumonitis, responded satisfactorily. In the three patients in whom the CMV titers were available, there was a significant decrease in titer within two weeks after treatment. This pilot study of Ara-C in treatment of CMV-herpes infections in immunosuppressed renal allograft recipients suggests a degree of efficacy and safety in the drug that would justify a carefully designed, controlled study.

Adult↗
PubMed1977

Sensitivity of the vibrios to ultraviolet-radiation.

The ultraviolet-inactivation kinetics of a number of strains of Vibrio cholerae (classical), Vibrio cholerae (el tor), NAG vibrios and Vibrio parahaemolyticus were investigated. Statistical analyses revealed significant differences between any two of the four types of vibrio in respect to their sensitivity to U.V.

Cell Survival↗
PubMed1977

Pharmacologic agents of potential value in protecting kidneys from ischemic damage.

Use of metabolic inhibitors has been proven useful in hypothermic anoxic storage. The data are sparse about its effects in machine preservation when the hypothermic organ is oxygenated and metabolizing, although at a slow rate. Concentration of a particular drug is also important. They can, in fact, be injurious at wrong concentrations. Various drugs have been proven to be beneficial in protecting kidneys from ischemic injury. At present, methylprednisolone seems to be the best agent, offering a predictable and complete protection, thereby justifying its use in all donors where there is reasonable suspicion of warm ischemic damage.

Adrenal Cortex Hormones↗
PubMed1977

Pretreatment of cadaver donors with methylprednisolone in human renal allografts.

Fifty cadaveric kidney donors were randomly allocated to two groups. Group 1 received 5 grams of intravenously administered methylprednisolone two to four hours prior to organ harvesting after the pronouncement of brain death. Group 2, which served as the control group, received no pretreatment. Of 100 kidneys harvested, 16 were discarded for various reasons, and 84 were transplanted and were available for evaluation, 40 from the pretreatment group and 44 from the control group. The transplant centers using these kidneys were unaware of the status of the kidney they received, that is, whether it was from a pretreated or a control group. The two groups of kidneys, pretreated and control, did not differ according to the length of warm or cold ischemia time or presence of preformed cytotoxic antibodies. The difference in graft failure between the two groups at three months was insignificant, even when the two groups were compared according to the method of preservation used.

Antibody Formation↗
PubMed1977

Abnormal serum lipid patterns in primary renal allograft recipients.

The blood lipids profile was determined in 59 patients with successful primary renal allografts, who were followed for an average period of 31.8 months (range, 6 to 80 months). Elevated levels of cholesterol (greater than 250 mg/100 ml) were found in 51% of the patients, elevated levels of triglycerides were found in 56%, and elevated levels of phospholipids in all but one of the patients who were studied (45 of 46). Correlation analysis revealed significant relationships among the systolic blood pressure with total cholesterol (r equals 0.36, P less than 0.01), triglycerides (r equals 0.56, p is less than 0.001), and phospholipids (r equals 0.40, P is less than 0.001). No significant correlations were found between the lipid levels and daily prednisone dosage or with the duration of the period following transplantation. The most significant finding in our study was an elevation of serum phospholipid level--a pattern unreported previously in transplant recipients but which has been reported to be associated with hepatic derangement in nontransplant population. Of 32 patients who had elevated levels of serum phospholipids, the liver function tests were abnormal in 22 patients (69%).

ABO Blood-Group System↗