Biomedical subjects
T J Buselmeier
Publications and source records attributed to T J Buselmeier.
Clearing of psoriasis after cardiac surgery requiring cardiopulmonary bypass oxygenation: a corollary to clearance after dialysis?
A 54-year-old man had severe psoriasis with associated arthritis for 10 years. Attempts at therapy with tars, topical steroids and a short course of ultraviolet light were unsuccessful. His psoriasis cleared 6 weeks after cardiac surgery requiring cadiopulmonary bypass oxygenation.
Invasive basal cell carcinoma with metaplastic bone formation associated with a long-standing dermatofibroma.
A nodule present for many years on the right leg of a 77-year-old woman was excised and studied by light microscopy. An invasive keratinizing basal cell carcinoma associated with metaplastic bone formation, arising within a dermatofibroma, was found.
Radial artery-cephalic vein shunts for hemodialysis.
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Arteriovenous shunt.
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Treatment of intractable uremic pericardial effusion. Avoidance of pericardiectomy with local steroid instillation.
Forty-five patients with uremic pericardial effusion were treated with local instillation of nonabsorbable steroid through an indwelling pericardial drainage catheter and followed up from one to 54 months. In these patients previous intensive dialysis and other attempts at control of the effusions were unsuccessful. The average hospitalization for percutaneous therapy was eight days. An asymptomatic internal mammary artery fistula developed in one patient. Another had resolution of her pericardial effusion but not of associated pericardial pain. She subsequently underwent pericardiectomy (stripping), without resolution of her pain. One patient had a recurrence of her effusion six months after therapy. Complications of this technique are rare. The relatively noninvasive drainage and local instillation of a nonabsorbable steroid is almost universally effective.
Dialysis therapy for psoriasis.
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Remission of psoriasis during haemodialysis.
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Treatment of psoriasis with dialysis.
Five patients with psoriasis were treated with haemodialysis. Dialysis therapy was initiated for subsequent development of uraemia in three cases. All of these had successful renal transplants without recurrence of psoriasis while being maintained on post-transplant anti-rejection regimens. Two other cases were haemodialysed, not for uraemia but primarily for psoriasis. One case had moderate improvement of psoriasis after twice-weekly dialysis for two months while the second had no objective improvement up to one month after a single haemodialysis treatment.
The polished carbon button--privileged access to the bloodstream (through attachment to an expanded PTFE conduit or arterialised fistula vessel).
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Peripheral blood access for hyperalimentation. Use of expanding polytetrafluoroethylene arteriovenous conduit.
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Fistulisation of shunt vasculature: a unique approach to fistula development.
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Intrapericardial steroids in uraemic pericarditis.
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115 patients with first cadaver kidney transplants followed two to seven and a half years. A multifactorial analysis.
One hundred fifteen consecutive patients received first transplants from cadaver donors at the University of Minnesota between January 1, 1968, and May 31, 1973. All patients have been followed for at least two years. The two-year survival rate is 70 per cent and the two-year transplant function rate is 58 per cent. Considerable improvement in both patient survival and transplant function has been noted since 1971. The success of transplantation appears to depend to a large degree on the age of the transplant recipient, the number of HLA antigens matched between donor and recipient, and the dose of antilymphoblast globulin (ALG) administered to the recipient during the first two weeks after transplantation. Each of these factors appears to be important even when the other factors are controlled, and when patients with diabetes, suffering technical failure or hyperacute rejection, are excluded. The results utilizing well-matched cadaver kidneys plus large doses of ALG appear to be equivalent to those obtained with the use of mismatched kidneys from relatives, but further analysis will be required to draw a definite conclusion. Patients receiving poorly-matched cadaver kidneys do far less well than patients receiving mismatched related grafts, however, even when ALG is utilized.
100 sibling kidney transplants followed 2 to 7 1/2 years: a multifactorial analysis.
From January 1, 1968 to May 31, 1973, 100 patients received first kidney transplants from sibling donors. All recipients have been followed for at least two years and several as long as 7.5 years. One hundred per cent follow-up information is available. The absolute two-year patient survival is 85% and the absolute two-year kidney function survival is 76%. Patients with diabetes (especially males) have less success following transplantation than do patients without diabetes. When diabetic patients are excluded, older patients appear to do slightly less well than younger patients. Patients with phenotypically identical HL-A matches with the donor do better than patients without such matches. In the nondiabetic technically perfect transplant recepient, better than 90% long-term transplant function can be expectedwith no kidney losses after the first few months. In contrast, the less well-matched transplant demonstrated both an increased early rejection rate and a high rate of loss after the third to fifth year. Increasing doses of anti-lymphoblast globulin (ALG) had beneficial results in HL-A mismatched sibling transplants, but were slightly detrimental in phenotypically identical HL-A donor-recipient pairs because of an increased rate of infection. The results are compared with the results of transplants from other related donors and from cadavers performed during the same period.