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Biomedical subjects

T S Ing

Publications and source records attributed to T S Ing.

At least 199 records · Page 11Linked to original sources

Pseudolymphoma in renal allograft recipients.

Five renal transplant recipients exhibited giant systemic lymphadenopathy shortly after transplantation. Biopsy specimens did not show Hodgkin's lymphoma. Immunosuppression was continued in all patients. In contrast to the rapidly fatal course of malignant lymphoma in transplant recipients, adenopathy in these five patients has uniformly resolved. Patients have been observed for 6 to 15 months with no evidence of residual disease. Interval biopsy specimens are not malignant. Each patient received antithymocyte globulin from a single lot for 10 to 21 days after transplantation. During administration, T cell lymphocytes were suppressed to 5% of control values. When lymphadenopathy occurred, T cell values rebounded to 371% of control values. Toxoplasmosis titers as well as viral cultures of lymph node biopsy specimens were negative. These data indicate a benign course of this histologically malignant disease and suggest a lymphoblastic rebound phenomenon to antithymocyte globulin.

Herpesviridae Infections↗

Antibody responses to influenza vaccination in patients with chronic renal failure.

A bivalent type A inactivated influenza virus vaccine containing both sets of H3N2 and Hsw1N1 antigens was given to patients with chronic renal failure and to control subjects. The patients were divided into an azotemic group in whom dialysis was not yet required and a hemodialyzed group. Hemagglutination-inhibition (HI) antibody responses were measured at time intervals of 1,3, and 4 weeks after vaccination. We found that the mean postvaccination HI titers against both sets of antigens in the patients as a group did not differ significantly from those found in the control subjects as a group. The proportion of responders showing a fourfold or greater increase in post-vaccination antibody responses over prevaccination antibody values for either set of antigens was similar in both groups of patients and the group of control subjects. In general, an inverse correlation was found between prevaccination antibody levels and postvaccination antibody responses in both patients and control subjects. The only exception to this trend was the response of two of the azotemic patients to the H3N2 antigens who failed to respond despite low prevaccination antibody levels. These were the patients with the highest serum creatinine values.

Adult↗

Intraperitoneal infusion of a nonabsorbable steroid in hemodialysis-associated ascites.

Ascites occurring in long-term hemodialysis patients continues to be a difficult management problem. Several modalities have been employed with varying success. Because of the similarities between uremic pericardial effusion and hemodialysis-associated ascites, infusion of the nonabsorbable steroid, triamcinolone hexacetonide, was attempted in five patients with the latter ailment which had become intractable. None of the patients responded and in two there were adverse effects. We conclude that for the management of this variety of ascites, intraperitoneal administration of a nonabsorbable steroid is ineffective and may be accompanied by undesirable reactions.

Ascites↗

Return of function in the thrombosed kidney after transplantation.

The incidence of intraglomerular thrombi in renal allografts and factors regulating their resolution were studied. A case report is presented in which resolution of intraglomerular thrombi is documented. In addition, 17 transplanted patients with renal biopsies were serially studied. Intraglomerular thrombi were found in 4 of 8 specimens taken 1 h after reanastamosis, all from donors with a terminal course involving prolonged hypotension. Glomerular fibrinolytic activity was markedly diminished in 4 of 11 patients' subsequent biopsy specimens; all taken during acute rejection. Resolution of thrombi was documented when signs of rejection were absent.

Adult↗

Cerebrospinal fluid changes in experimental cardiopulmonary bypass using hemodilution with glucose water.

Cardiopulmonary bypass using hemodilution with isotonic glucose water was performed on seven dogs. Intense systemic metabolic acidosis, hyponatremia, hypochloremia, and hyperglycemia were accompanied by only comparatively small changes in the corresponding cerebrospinal fluid values. The data suggested that in the present study, cardiopulmonary bypass was not associated with gross disruptions of the barriers for bicarbonate, sodium, chloride, and glucose between blood and cerebrospinal fluid.

Animals↗

Prognostic significance of the active thymus derived rosette forming cells in renal allograft survival: a preliminary report.

The prognostic significance of hemodialysis, blood transfusions, total T (T-T) and active T (A-T) lymphocytes, as they relate to renal allograft survival, were evaluated in 36 renal transplant recipients. The A-T cell is thought to be a surveillance cell responsible for cellular immunity and the only prognostic factor for graft survival observed in this study. An 83% graft survival rate occurred in patients having a lower percentage of A-Ts (fewer surveillance cells) prior to renal transplantation, as compared to 50% graft survival in patients with a higher percentage of A-T cells. Evaluation of pretransplant T-T cells, phytohemagglutinin (PHA) response, and number of transfusions was not prognostic for graft survival. Similarly, there was no difference in graft survival rates in patients hemodialyzed for more vs less than 1 year. Patients hemodialyzed for more than a year received twice as many blood transfusions. There were no differences in the number of T-T or A-T lymphocytes in either group. However, lymphocytes from patients hemodialyzed less than a year were more responsive to PHA stimulation. These data suggest that pretransplant determination of A-T cell values may be prognostic for graft survival and may delineate patients, by an immunological parameter, who may be at high risk for allograft rejection.

Adolescent↗

The reverse fistula for vascular access.

A new technique for vascualr access in the patient requiring chronic hemodialysis and who has had multiple failures of forearm fistulas involves the formation of a side-to-side anastomosis between the brachial artery and the basilic vein and creates reverse flow into the antecubital venous system. Attention to technical considerations will prevent edema of the arm and allow for future use of graft procedures, if necessary.

Adult↗

Removal of amantadine hydrochloride by dialysis in patients with renal insufficiency.

Two patients with Parkinson's disease and renal insufficiency had excessively high concentrations of amantadine hydrochloride in the blood. The amounts of the drug removed by hemodialysis and peritoneal dialysis were small. However, since extrarenal elimination is negligible in such patients, frequently repeated dialysis may be required to remove the drug.

Aged↗

[Proceedings: Hypercoagulability and compensated intravascular coagulation in chronic kidney insufficiency and after kidney transplantation].

Seven blood coagulation tests which may indicate a state of hypercoagulability or of chronic intravascular coagulation were assayed in 106 blood samples from 50 patients with chronic renal insufficiency or after renal transplantation. The following abnormal results were obtained: increased titer of fibrin(ogen) degradation products in 60%, abnormal fibrinogen immunoelectrophoresis in 49%, shortened partial thromboplastin time and whole blood clotting time in 45 and 37% respectively, prolonged thrombin time in 34%, increased cryofibrinogen level in 21% and positive protamine sulfate gelation test in 11%. The greatest number of abnormalities was found during the first week after transplantation and during transplant rejection, and the smallest in patients with stable transplant who were anticoagulated with warfarin. Partial thromboplastin times of less than 19 sec were associated in 3/4 patients with thrombosis of the renal artery or vein or with rejection. Rejections could be identified with high probability (p less than 0.001).

Anticoagulants↗

Acute renal failure complicating ruptured abdominal aortic aneurysm.

Ruptured abdominal aortic aneurysm complicated by renal failure is associated with a mortality greater than 90%. Aggressive management, which included the early use of hemodialysis, was employed. Between 1970 and 1973, a total of 43 patients had surgery for proved ruptured abdominal aortic aneurysm. Fourteen patients developed acute and fixed renal failure. Nine of these 14 patients had undergone hemodialysis with treatments beginning as early as the second postoperative day and lasting as long as ten weeks. There were six survivors, with a hospital mortality of 33%. This represents an improvement in survival compared with our earlier experience where the mortality in this type of patient was 93%. Early use of hemodialysis in the postoperative management of patients with acute renal failure complicating ruptured abdominal aortic aneurysm is recommended.

Acute Kidney Injury↗