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Biomedical subjects

V C Marshall

Publications and source records attributed to V C Marshall.

At least 55 records · Page 3Linked to original sources
PubMed1986

Cyclosporine and the ischemic rat kidney.

The effects of cyclosporine (CsA) on renal function and morphology have been studied in the rat after unilateral nephrectomy and warm renal ischemia. There is evidence of an enhanced CsA nephrotoxic effect after unilateral nephrectomy alone and of an additive or synergistic effect of CsA and renal ischemia upon renal function and morphology. These enhanced effects are most evident after longer periods of ischemia (60 min) and with higher doses of CsA (25 mg/kg/day). The findings may be relevant to clinical practice and suggest that the nephrotoxic effects of CsA upon the donor kidney may be greatest when there is coincident renal damage from other causes.

Animals↗
PubMed1984

Studies in renal preservation using a rat kidney transplant model: II. The effect of reflushing with citrate.

This study investigated the possible beneficial effects of reflushing renal grafts with isotonic citrate solution. Rat kidneys were initially flushed with isotonic citrate or with Hartmann's solutions at O C. After 2 hr, half the kidneys of each group were reflushed with isotonic citrate; 22 hr later, all kidneys were transplanted into rats of the same inbred strain. All animals receiving kidneys flushed with Hartmann's solution died, whereas reflushing such kidneys with isotonic citrate significantly ameliorated the deleterious effects of Hartmann's solution. All animals receiving citrate-flushed kidneys survived with relatively good renal function and morphology. However, reflushing itself is not a beneficial procedure and is only of value where an ineffective preserving solution has been used to flush the kidneys initially. There is evidence that some of the adverse effects of flushing develop in the renal medulla.

Animals↗
PubMed1984

Torsion of the spleen in the polysplenia syndrome.

A case of splenic torsion is presented in an adult with the polysplenia syndrome. The factors predisposing to splenic torsion are discussed. Splenic torsion may mimic acute appendicitis. The recommended treatment is splenectomy. The polysplenia syndrome may often be undiagnosed when cardiac defects are mild or absent.

Adult↗
PubMed1983

An experimental model for assessment of renal recovery from warm ischemia.

A study was made of the acute and chronic (15 days) functional and morphologic effects on the rat kidney of warm ischemia and contralateral nephrectomy, in order to define a suitable animal model for testing renal transplant preservation techniques when warm ischemia is a contributing factor. Spontaneous recovery from 30-min warm ischemia was complete, and the model was consequently unsuitable; the high mortality from 90 min was unacceptable. Warm ischemia of 60 minutes produced severe renal tubular necrosis, an acceptable mortality, residual morphologic damage, and impairment of isolated kidney perfusion parameters at 15 days. Renal function in vivo was normal in many of these animals, despite appreciable residual morphologic changes, and it is evident that functional data alone are not sufficient for assessment of preservation regimens.

Animals↗
PubMed1983

Studies of renal preservation using a rat kidney transplant model. Evaluation of citrate flushing.

Rat kidneys were flushed with isotonic citrate solution, hypertonic citrate solution, or Collins's C2 solution, and were stored hypothermically for 24 hr before transplantation into another rat of the same inbred colony. The number of animals surviving for one month was greatest with isotonic-citrate-flushed kidneys (82%), and least with Collins's C2 solution (27%). Functional and morphological damage after transplantation was consistently greater in Collins's-flushed grafts, as compared with citrate-flushed grafts. Best results were attained with the isotonic-citrate flushed grafts. Seven days after contralateral nephrectomy all surviving animals had elevated serum creatinine and urea concentrations, along with decreased creatinine clearance, and they had secreted large volumes of dilute urine. Renal function was best in animals with isotonic-citrate-flushed grafts. After one month, significant improvement in urine osmolality, creatinine clearance, and serum creatinine had occurred only in the rats with citrate-flushed grafts. There were no significant differences between the citrate groups. All surviving rats had some residual renal cortical damage, but severe interstitial nephritis (greater than 30%) was much less frequent in the citrate groups.

Animals↗
PubMed1983

Recovery of renal function after warm ischemia. I. The effect of chlorpromazine and phenoxybenzamine.

The effects of treatment with chlorpromazine (4 mg/kg) and phenoxybenzamine (1 and 5 mg/kg) on renal function and morphology after warm ischemia and contralateral nephrectomy were studied. Chlorpromazine pretreatment by intravenous injection 15 min before warm ischemia of 60 min resulted in the survival of all animals (cf. 75% in untreated group), with better renal function in the first week. Necrosis of the proximal convoluted tubule and ultimate residual cortical damage were less severe than in the untreated groups. Chlorpromazine was also beneficial after 75 min warm ischemia, although mortality was not reduced. Administration of chlorpromazine just prior to revascularization was ineffective, suggesting that sufficient concentration of the drug must be present in the kidney during the ischemic period or immediately after revascularization. Chlorpromazine probably protects the proximal tubular cells from ischemic damage. Phenoxybenzamine (1 mg/kg) was ineffective when administered 15 min before warm ischemia. A higher (5 mg/kg) dosage of the drug proved to be detrimental.

Animals↗
PubMed1982

Value of small bowel enema in incomplete intestinal obstruction.

The usefulness of small bowel enema X-ray examination was evaluated in 11 patients in whom a provisional diagnosis of incomplete small bowel obstruction was made. Dilute barium was introduced through a nasojejunal tube. In one patient intubation of the jejunum was unsuccessful. In six patients the suspected obstruction was confirmed and information obtained about the site of obstruction. The small bowel enema X-ray examination was normal in three patients and subsequent clinical outcome was uneventful. In one patient, with normal findings on small bowel enema X-ray examination, acute obstruction developed after two days, necessitating operation. Small bowel enema X-ray examination appears a worthwhile adjuvant to clinical assessment but decisions for operative intervention still need to be based on clinical evaluation of patients.

Adolescent↗
PubMed1979

Living related renal transplantation: experience in 22 cases.

Twenty-two living related renal transplant operations have been performed at Prince Henry's Hospital over the last seven years. Donors have been accepted for nephrectomy only after exhaustive examination of their health and serach for renal disease. The one and three year graft survival rates have been 85% and 64% respectively. Only two recipients have died, and recipient morbidity has been low. Donors have not suffered any serious complication from nephrectomy. It is concluded that living related renal transplantation has many advantages over cadaveric renal transplantation and is a relatively safe procedure for the donor, provided that rigid criteria are used in donor selection.

Adolescent↗
PubMed1978

Choledochoscopy: a comparison of a rigid and a flexible fibreoptic instrument.

A comparison of choledochoscopy using a Storz rigid choledochoscope and a flexible Olympus instrument has been made. After using both instruments during a 12-month period, it is felt that the rigid instrument has practical advantages for general use, while the flexible instrument offers additional benefits, but requires more skill and care in its use.

Biliary Tract Diseases↗
PubMed1977

Preservation of cadaver of renal allografts: comparison of ice storage and machine perfusion.

Preservation of cadaveric renal allografts by ice storage and by machine perfusion after a preliminary flush with a hypertonic citrate solution has been compared in a prospective clinical trial between matched pairs of kidneys from the same cadaver donor. Over a two-year period, ice storage after flushing with the new solution gave results comparable with machine perfusion. Times of warm ischaemia and total times of storage were similar in ice-stored and machine-perfused kidneys and averaged about 16 hours. In each group of recipients, more than half of the kidneys had good early function and one-year survival times were also similar.

Cadaver↗
PubMed1977

Problems in clinical organ preservation.

Effective preservation of donor organs is essential for successful renal cadaver transplantation. Three problems of direct clinical relevance are discussed: (i) agonal damage to the donor kidney; (ii) extracorporeal preservation; (iii) effects of preservation on antigenicity. Current techniques for preserving donor kidneys by continuous perfusion and by ice storage are described.

Animals↗
PubMed1977

The creation of artificial subcutaneous arteriovenous fistulas in patients with malignant haematological disease.

Creation of an artificial subcutaneous arteriovenous fistula was attempted in five patients with malignant haematological disorders (two with Hodgkin's disease, two with acute lymphatic leukaemia, and one with acute myeloid leukaemia). The average time from the start of treatment to attempted creation of the fistulae was four years. Neither direct arteriovenous anastomosis nor an interposition mandril graft was successful in any patient. Failure was attributed to impaired venous run-off secondary to previous episodes of thrombophlebitis induced by the intravenous administration of cytotoxic drugs. The use of an arteriovenous fistula early in the course of the disease might minimize these later problems.

Adult↗
PubMed1977

Preservation of cadaveric renal allografts-comparison of flushing and pumping techniques.

A prospective clinical trial comparing flushing and ice storage using a new hypertonic citrate solution, with machine preservation by continuous perfusion showed early graft function was similar with each method, and preservation times were comparable. Good early function occurred in half the grafts with preservation times up to 24 hours. Graft survival at three and 12 months was similar with each method of preservation. Graft survival at 12 months was worsened by poor early graft function, whereas patient survival at 12 months was unaffected by early function or by the method of preservation.

Cadaver↗
PubMed1976

72-hr canine kidney preservation without continuous perfusion.

A new flushing solution consisting of electrolytes and mannitol has provided successful 3 day canine kidney preservation evidenced by immediate life-supporting renal function. In our experiments the solutions described by Sacks and Collins have failed to achieve this prolonged renal storage but have been successful in storing canine kidneys for 2 days. This relatively simple new hypertonic solution does not require additives and has been successfully used in clinical renal transplantation.

Animals↗