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PubMed1985

[Stenosis and reflux after surgery of the ureterovesical junction in children. Indications and results of reoperation. Apropos of 460 ureterovesical reimplantations].

Implantation of 460 ureters into bladder was performed in 278 children (68 boys, 210 girls) age range 3 months to 15 years. The operative technique used was generally that of Cohen (335 cases), more rarely that of Leadbetter-Politano (118 cases) and very exceptionally that of Lich-Gregoir (7 cases). Indications for surgery included: so-called "essential" reflux: 373 cases, reflux with Hutch's diverticulum: 20 cases, ureterocele: 14 cases, megaureter: 25 cases (including 14 "modelled" as described by Hendren), neurologic bladder: 10 cases, urethral valves: 7 cases, ectopic openings: 6 cases and multiple malformations: 3 cases. Results in antireflux ureterovesical implantations of 427 ureters were good but complications included 18 cases of stenosis and 9 with persistent reflux. Etiology of these unsuccessful cases, as described by H. Hendren, is discussed and indications and operative techniques for recovery surgery analyzed. Treatment in unsuccessful cases included nephrectomy for stenosis, skin shunt operation for neurologic bladder, a repeat Cohen operation and 8 repeat L.P. operations, with 8 successful results and one failure. Recurrence of reflux was treated in one case by interpyelic anastomosis on duplication, in 2 cases by Cohen's operation and twice by L.P.'s operation, with success in 4 cases. Five patients with stenosis and one with reflux were stabilized and recovery operation was not performed. Finally three patients with unsuccessful initial operation were lost to view.

Adolescent↗
PubMed1979

Relative merits of partial splenectomy, splenic reimplantation, and immunization in preventing postsplenectomy infection.

Partial splenectomy, splenic autotransplantation, and immunization with pneumococcal vaccine have been reported to protect patients against overwhelming postsplenectomy infection, and this study was undertaken to evaluate these therapeutic alternatives. For this purpose 136 rats were divided into experimental groups: 34 controls, 34 splenectomy, 34 partial splenectomy, and 34 splenic autotransplantation animals. Five weeks after operation, two-thirds of the animals were immunized with killed pneumococci. The effects of operation and immunization were studied by challenging the animals intravenously with pneumococci. Pneumococcal antibody titers were determined, and phagocytic uptake of pneumococci by the spleen and liver was measured. Immunization impressively increased the survival rate in all groups. At low-challenge doses autotransplantation prolonged survival. At higher-challenge doses only partial splenectomy increased survival. Partial splenectomy and control animals had higher antibody titers than did splenectomy and autotransplantation rats. Animals with the highest antibody titers had the greatest splenic and hepatic phagocytic uptake of pneumococci. Partial splenectomy was more efficient in removing pneumococci than was autotransplantation. Thus immunization is one of the most important factors contributing to survival after splenectomy. Partial splenectomy is preferable to splenic autotransplantation because it is associated with higher antibody titers after immunization, better pneumococcal splenic uptake, and improved survival rates.

Animals↗
PubMed1985

[Changes in the immunological indices after splenectomy and the reimplantation of splenic fragments in an experiment].

Splenectomized guinea-pigs underwent autotransplantation of splenic fragments into the greater omentum or mesentery of small intestine. Twenty-five to thirty days after operation the animals were infected with S. aureus and then were examined over time before and after infection at different times. Measurements were taken of T lymphocytes, B lymphocytes, lymphocytes with staphylococcal receptors, as well as of the content of neutrophils with IgG Fc-fragment and complement receptors. It was established that in guinea-pigs subjected to splenectomy followed by autotransplantation of decapsulated splenic fragments, the experimental generalized staphylococcal infection took a milder course, which was manifested by an increase in the above immunologic characteristics as compared to animals undergoing splenectomy alone.

Animals↗
PubMed1985

The development of 12th to 14th day foetuses following reimplantation of pre- and early-primitive-streak-stage mouse embryos.

This paper describes a technique for transplanting early postimplantation mouse embryos from their own implantation site to a decidua in another pregnant mouse. Evidence is provided that this procedure is compatible with their continued development. At a low frequency both 6th and 7th day embryos can re-establish themselves and continue apparently normal development and placentation for at least 6-8 days.

Animals↗