Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Delayed Graft Function”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,459 records · Page 81Linked to original sources
PubMed1992

Subdivision of flexor tendon "no man's land" and different treatment methods in each sub-zone. A preliminary report.

"No man's land" of the flexor tendon system is divided into 4 subdivisions based on our anatomical study. Clinically, a total of 72 flexor tendon injuries in "no man's land" were repaired during the primary and delayed primary stages. Different treatments of flexor tendons, sheath, vincula and postoperative exercises were used according to the degree of injury and anatomical and functional characteristics of each subdivision. The multiple intratendinous suture method, autogenous sheath graft and vincular repair were designed and attempted preliminarily in clinical practice. In 80.4% of the cases, excellent or good results were achieved. Comparison of treatment results in each sub-zone reveals that the IIc sub-zone is the most difficult area for satisfactory functional recovery in "no man's land". The significance of the subdivision of Bunnell's "no man's land" is discussed, and the preoperative assessment method of noting the extent of injury and selection of the treatment method for each sub-zone are presented in this paper. We believe that primary or delayed primary repair can restore good function to the repaired tendons. The effective way of enhancing treatment results of the tendon injury is to apply comprehensive treatment according to the extent of injury to the intrinsic healing capacity of the flexor digitorum profundus tendon.

Adolescent↗
PubMed1977

Delayed (degenerate) interfascicular nerve grafting: a new concept in peripheral nerve repair.

Interfascicular nerve grafts allowed to undergo endoneurial tube emptying in situ before transfer have been compared with grafts transferred fresh in terms of structure and function. The sciatic nerve of the rat was the model and its structure and ultrastructure were superior following degenerate grafting. More importantly, electrophysiological studies showed that function in nerves repaired with degenerate grafts was significantly better than in those repaired with fresh grafts.

Animals↗
PubMed1986

Segmental pancreatic autotransplantation with pancreatic ductal occlusion after near total or total pancreatic resection for chronic pancreatitis. Results at 5- to 54-month follow-up evaluation.

Reported are eight patients with idiopathic chronic pancreatitis and two patients with alcoholic pancreatitis who had near total distal pancreatectomy for disabling pain and underwent simultaneous segmental pancreatic autotransplantation of the body and tail of the gland to the femoral area in an attempt to prevent or delay the onset of diabetes. The median follow-up period was 31 months, and follow-up study in nine patients ranged from 24 to 54 months. Patency of the grafts was determined by angiography and selected percutaneous venous assays for insulin. Islet cell function was determined by oral glucose tolerance tests, intravenous (I.V.) glucose tolerance tests, and I.V. glucagon stimulation studies. Segmental autotransplantation was technically successful in eight patients, only one of whom required insulin (at 2 years after grafting). The other seven patients with technically successful grafts have remained insulin independent, including two patients who later underwent pyloric preserving pancreatoduodenectomy for completion pancreatectomy. Variable pain relief was observed in patients who underwent near total pancreatectomy, but pain was unrelieved in those patients who underwent limited distal resection. Patients with idiopathic pancreatitis appear to have better pain relief and preservation of endocrine function than alcoholic patients. Segmental pancreatic autotransplantation prevents or delays the onset of diabetes mellitus and should be considered as an alternative for those patients who require extensive pancreatic resection for chronic pancreatitis.

Adult↗
PubMed1988

Stabilization of fractures in the hand and wrist with traumatic soft tissue and bone loss.

Open type III fractures of the hand or wrist with severe bone and soft tissue loss justify aggressive treatment to restore anatomy, assure healing, and maximize functional recovery. The techniques of modern wound excision used at initial surgery predictably result in a decompressed and surgically clean wound within a few days from injury in the vast majority of cases. This allows a safe application of delayed primary internal fixation and bone grafting for fracture restoration or joint arthrodesis as well as early wound closure or coverage. The immediate or early application of stable external devices, internal fixation, or combinations of the two along with early bone grafting restores the structural integrity of the skeleton, reduces pain, protects other repaired and reconstructed tissues, promotes the healing, and supports early and intensive functional rehabilitation of the hand and wrist. Early wound closure or coverage minimizes scar formation. Together, the early sequencing of effective wound debridement with skeletal stabilization and bone grafting and early wound closure or coverage provide the most favorable circumstances for healing and functional recovery of the seriously damaged hand and wrist.

Adult↗
PubMed2005

Functioning free-muscle transfer for brachial plexus injury.

Functioning free-muscle transfers are now an important, even essential, tool in the current management of patients with brachial plexus injury. They are indicated for the restoration of elbow flexion in patients who delay presentation(those seen after 6 to 9 mo). Double free-muscle transfers provide the possibility of simple grasp function when combined with nerve transfers or grafts for restoration of shoulder motion, hand sensation, and triceps function.

Brachial Plexus↗
PubMed2003

[Safety of the use of Celsior in kidney-pancreas transplantation].

UNLABELLED: The objective of this prospective observation study was to evaluate the safety of use of Celsior extracellular solution, initially designed for cardiac preservation, in kidney-pancreas transplantation. PATIENTS AND METHODS: From August 1999 to July 2000, 140 kidneys and 9 pancreases were harvested from 71 cadaveric donors with a mean age of 34 +/- 11 years, washed and preserved until transplantation with Celsior. One hundred and thirty one isolated renal transplantations and 9 combined kidney-pancreas transplantations were performed. The mean age of isolated kidney recipients and kidney-pancreas recipients was 42 +/- 13 years (range: 4-71 years) and 39 +/- 7 years (range: 31-52 years), respectively. The mean cold ischaemia time was 21 +/- 8 hours (range: 4-45) for kidneys and 11.43 +/- 2.9 hours (range: 6-15 hours) for pancreases. RESULTS: No cardiac or haemodynamic incidents were observed during organ revascularization. No electrolyte or haematological abnormalities were observed postoperatively. The one-year graft survival rate was 96% (range: 93%-99%) for kidneys and 89% (range: 55%-100%) for pancreases. Patient survival was 100%. Return of renal transplant function was delayed in 14% (8-20%) of patients, requiring dialysis during the first week. Mean serum creatinine at 3 months and at 1 year was 123 +/- 41 mumol/l and 118.5 +/- 33.8 mumol/l, respectively. One pancreas and one kidney were lost due to venous thrombosis on D2 and D4. Two patients in the kidney-pancreas group were reoperated.

Cadaver↗
PubMed1998

Is return of angina after coronary artery bypass grafting immutable, can it be delayed, and is it important?

BACKGROUND: Because survival after either an operation or angioplasty is similar across a wide spectrum of coronary patients, lasting symptom relief assumes high priority. OBJECTIVES: The objectives of this observational clinical study were (1) to determine whether the return of angina is immutable; (2) to identify factors that might delay its return, and (3) to evaluate whether its return is predictive of subsequent adverse events. METHODS: The return of angina of any degree of severity and morbid events subsequent to its return were studied by multivariable time-related analyses in a consecutive series of 9600 patients who were undergoing primary isolated coronary bypass operations between 1971 and 1992. RESULTS: The freedom rate from return of angina was 94%, 82%, 61% and 38% at 1, 5, 10, and 15 years. Increased modest risk of early return of angina was associated with preoperative demographic, symptom, coronary and vascular disease variables but reduced by more extensive arterial grafting. The ever-increasing risk of late return of angina was associated with demographic, symptomatic, left ventricular function, and coronary disease variables and was related strongly to comorbidity but was weakly reduced by controllable surgical variables. After the return of angina, 10-year freedom rate from infarct and survival was 71% and 68% respectively. CONCLUSIONS: (1) The risk of angina return increases relentlessly after operation, so it is likely immutable. (2) Delay of late angina return by use of arterial grafting is clinically trivial; control of noncardiac comorbidity may be more effective. (3) Fortunately, the return of angina after coronary artery bypass grafting has minimal impact on survival and is not predictive of imminent infarct.

Angina Pectoris↗
PubMedDate not supplied

Potential of aspirin to inhibit thrombotic microangiopathy in alpha1,3-galactosyltransferase gene-knockout pig hearts after transplantation in baboons.

Hearts from alpha1,3-Galactosyltransferase gene-knockout (GaIT-KO) pigs were transplanted heterotopically into 8 baboons that received an anti-CD154 monoclonal antibody (mAb)-based immunosuppressive regimen and heparin. Three baboons died or were euthanized with beating grafts on 16, 23, and 56 days, respectively, and the remaining 5 grafts functioned for 59-179 days. Hyperacute rejection did not occur, and classical features of acute humoral xenograft or acute cellular rejection were rare. However, thrombotic microangiopathy (TM) developed in all cases; its onset was delayed in 2 baboons that received aspirin. Function of a pig organ in a baboon for a period approaching 6 months has not been reported previously and lends encouragement that the barriers to xenotransplantation will be overcome, but TM requires investigation.

Animals↗
PubMed1991

Effects of time required for reperfusion (thrombolysis or angioplasty, or both) and location of acute myocardial infarction on left ventricular functional reserve capacity several months later.

The purpose of this study was to determine whether reperfusion of acute myocardial infarction (AMI) by recombinant tissue-type plasminogen activator (rt-PA) or percutaneous transluminal coronary angioplasty, or both, would improve left ventricular (LV) function when it is measured several months later at rest or maximal bicycle exercise, or both. Radionuclide angiography was performed in 44 patients 5 months (range 6 weeks to 9 months) after AMI to assess function, and tomographic myocardial thallium-201 imaging was performed at maximal exercise and delayed rest to determine whether there was any evidence of myocardial ischemia. As expected, no patient had chest pain or redistribution of a thallium defect during the exercise test, because patients had undergone angioplasty (n = 28) or coronary bypass graft surgery (n = 5) where clinically indicated for revascularization. The LV ejection fraction was plotted as a function of the time elapsed between the onset of chest pain and the time when coronary angiography confirmed patency of the infarct-related artery (achieved in 91% of 44 patients by rt-PA [n = 31] or percutaneous transluminal coronary angioplasty [n = 9] ). Functional responses differed markedly between patients with anterior (n = 20) versus inferior (n = 24) wall AMI. LV ejection fraction during exercise correlated with time to reperfusion in patients with an anterior wall AMI (r = -0.58; standard error of the estimate = 11.9%; p less than 0.02) but not in patients with an inferior AMI (r = 0.10; standard error of the estimate = 13.1%; difference not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗
PubMed2003

Efficient induction of primary and secondary T cell-dependent immune responses in vivo in the absence of functional IL-2 and IL-15 receptors.

IL-2 and IL-15 are thought to be important cytokines for T cell-dependent immune responses. Mice deficient in IL-2, IL-2Ralpha, and IL-2Rbeta are each characterized by a rapid lethal autoimmune lymphoproliferative disorder that complicates their use in studies aimed at investigating the role of these cytokines and receptors for immune responses in vivo. We have previously characterized a novel transgenic (Tg) mouse on the IL-2Rbeta-/- genetic background (Tg-/- mice) that lacks autoimmune disease but still contains peripheral T cells that are nonresponsive to IL-2 and IL-15. In the present study, these mice were used to investigate the extent by which IL-2 and IL-15 are essential for T cell immunity in vivo. Tg-/- mice generated near normal primary and secondary Ab responses to OVA, readily mounted first and second set allogeneic skin graft rejection responses, and developed primary and recall CD8 T cell responses to vaccinia virus. However, Tg-/- mice generated a slightly lower level of IgG2a Abs to OVA, exhibited a somewhat delayed first set skin graft rejection response with lower allo-specific CTL, and developed a significantly lower number of IFN-gamma-producing vaccinia-specific CD8+ T cells. Thus, although T effector function is somewhat impaired, T cell immunity is largely functional in the absence of IL-2- and IL-15-induced signaling through IL-2Rbeta.

Animals↗
PubMed1994

Bracing of stable shaft fractures of the ulna.

In the laboratory an ulnar osteotomy was performed in 10 cadaveric specimens, which included 5 distal-third junctions and 5 middle-third junctions. The interosseous membrane was left intact. Each specimen was rotated through full pronation and full supination. Displacement less than half shaft width was considered stable. The interosseous membrane was subsequently released 2 cm proximal and 2 cm distal to the osteotomy. Repeated pronation and supination range of motion documented gross displacement greater than half of the width of the shaft and was diagnosed as unstable. To evaluate this hypothesis, a clinical trial of 30 stable ulnar shaft fractures of the middle and distal thirds were treated with functional bracing between 1984 and 1990. A simple protocol was followed: A long arm cast was applied for approximately 5-7 days until the patient experienced only mild pain. At 5-7 days, a prefabricated forearm brace was fitted and the patient began physical therapy, advancing the upper extremity to full functional use. The bracing was continued until radiographic union had occurred. Twenty-nine clinical cases were evaluated to fracture union. The mean time to union was 7.3 weeks (range: 6-9 weeks). One delayed union was reported in the series. At 16 weeks surgical intervention was recommended and an open reduction and internal fixation with cancellous bone grafting was performed. Twenty-nine patients regained full range of motion, and one had limited supination/pronation due to a previous injury of the radial head. In conclusion, functional bracing of stable ulnar shaft fractures leads to a high incidence of fracture union and achieves good to excellent functional results.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Functional consequences of embryonic neocortex transplanted to rats with prefrontal cortex lesions.

In four experiments we reexamined the recent report by Labbe, Firl, Mufson, and Stein (1983) that fetal cortical tissue transplanted to an aspirative prefrontal cortical cavity in rats can ameliorate the learning impairments induced by the aspirative lesions. Healthy surviving grafts from young (E16) embryonic donors had no immediate effects on the rats' impairments in T-maze alternation, spatial navigation in the Morris swimming pool task, or locomotor activity, and they produced even greater impairments than the lesions alone when all three tests were conducted after longer (3-5 month) survival periods. Grafts taken from older (E21) donors did produce a short-lasting improvement in the T-maze alternation performance, replicating the previous report. However, this effect was not seen in the other two behavioral tests; the grafts survived poorly, and the beneficial effect was no longer apparent in the long-term tests. It is concluded that (a) functional benefits of embryonic cortical grafts are dependent on a precise combination of conditions rather than being a general phenomenon, and (b) the short-lasting recovery in delayed alternation performance is attributable to diffuse influences of the embryonic tissue on the lesioned host brain rather than to a reconnection of damaged circuitries.

Animals↗
PubMed1991

Results of our first nine intraportal islet allografts in type 1, insulin-dependent diabetic patients.

With the first demonstration of insulin independence following intraportal islet transplantation into a patient with type 1 diabetes, a new era of clinical islet transplantation will begin. This report provides our initial experience of clinical islet transplantation with a total of nine consecutive portal vein islet transplants in seven diabetic recipients. The first three transplants were done in nonrenal failure diabetics (NRFI) using 6319 +/- 2173 islets/kg body weight with islets processed from single pancreas and cultured for 7 days at 24 degrees C. Prednisone, azathioprine, and cyclosporine were initiated prior to transplant. While all three recipients demonstrated C-peptide function posttransplant, all three rejected their grafts at 2 weeks. Five days of OKT3 treatment failed to recover more than 10% of their rejecting islet grafts. The studies were then shifted to established kidney transplant recipients (EKI) maintaining their basal immunosuppression while adding 7 days of Minnesota antilymphoblast globulin (MALG) to the recipient using islets from single donor pancreas that had been cultured for 7 days at 24 degrees C. There were an average of 6161 +/- 911 islets transplanted intraportally into three EKI recipients. All three had C-peptide response from the transplant, but none achieved insulin independence. While the first patient rejected his graft at 2 weeks, two recipients demonstrated long-term islet function up to 10 months posttransplant. Sustacal challenge testing demonstrated C-peptide responsiveness, but in a delayed pattern suggesting insufficient islet mass had been transplanted. The next three kidney transplant recipients received islets from more than one donor pancreas averaging 13,916 +/- 556 islets/kg body weight. The first of these was the first to achieve insulin independence from 10 to day 25 posttransplant when she appeared to have a rejection episode. The second and third recipients were retransplanted with islets from multiple donors having achieved partial islet function from single pancreas donor. The first patient on triple immunosuppression is demonstrating long-term partial function at 184 days but is not insulin independent. The third patient on prednisone and azathioprine received one half his islets after 7-day culture and the other half after 7-day culture combined with cryopreservation. He is continuing to demonstrate insulin independence for 154 days post-transplant with a glycated hemoglobin value of 5.6%. Sustacal challenge data demonstrate a total stimulated C-peptide response of 155 rhomol/ml at 4 months post-transplant compared with 148 +/- 12 rhomol/ml for normal controls (NC) and 425 rhomol/ml for nondiabetic, established kidney transplant recipients on triple immunosuppression.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed2003

Results of treatment of infected humeral nonunions: the Mayo Clinic experience.

Between 1987 and 2001, 15 infected humeral nonunions were treated of which nine were distal, four were proximal, and two were midshaft. One patient was lost to followup. The remaining 14 patients were followed up for a mean of 37 months (range, 8-156 months). All patients were treated with debridement and intravenous antibiotics. Ten patients had surgical attempts at achieving bony union: external fixation (four patients), plating (two patients), external fixation and plating (two patients), tension band wiring (one patient), and bone grafting with shoulder spica casting (one patient). Three patients were treated definitively with a functional brace because of low functional demands and one patient had resection arthroplasty followed by delayed total elbow arthroplasty. Of the 10 nonunions treated with surgical attempts at achieving bony union, only seven healed. None of those nonunions in patients treated with a functional brace healed. At final followup, 12 of 14 patients had minimal or no pain and two patients had moderate pain, both with ununited fractures. Complications included one seroma and two cases of posttraumatic elbow stiffness for which the patients required capsular release. This study documents the challenges in achieving bony union in the infected humeral nonunion in contradistinction to the predictable union rates reported for aseptic humeral nonunions. Although pain relief was predictable in most patients, functional results generally were poor and bony union was difficult to obtain.

Adolescent↗
PubMed1987

External fixation of the upper extremity.

External fixation of forearm and arm fractures is an excellent treatment option, particularly in compound, comminuted fractures that result from high-energy trauma. Limb salvage and good function have been achieved in 75% of cases by applying the principles outlined. Problems with delayed bone union have been recognized and emphasize the importance of supplemental bone grafting. A number of external fixation systems are applicable to these upper limb fractures, and the authors have not found one system superior to the others. Open pin insertion is preferred, and pins (three proximal and three distal) are ideally placed near the fracture site for optimal stability.

Arm Injuries↗
PubMedDate not supplied

Pseduarthrosis of a tibial plateau fracture: report of a case.

In an elderly woman a tibial condylar pseudarthrosis was angulated with disabling pain, significant deformity, and progressive articular deterioration. The treatment of this non-union consisted of arthrotomy, mobilization of the ununited medial condyle, slight over-elevation of the tibial plateau, iliac bone grafting to reconstitute loci of bone loss, and rigid interfragmentary and buttress plate fixation. Postoperative management consisted of early knee motion and delayed weight-bearing to facilitate functional restoration of the extremity. Within 3 months, union occurred in anatomic position.

Aged↗
PubMed2004

Functional rehabilitation of the atrophic mandible and maxilla with fibula flaps and implant-supported prosthesis.

Historically, nonvascularized bone grafts have been the standard treatment for severe mandibular and maxillary atrophy, followed by immediate or delayed implant placement. Extreme atrophy is an unfavorable biological and mechanical location for nonvascularized autologous bone transplants. The authors present the results of a multidisciplinary treatment protocol for rehabilitation of extreme mandibular and maxillary atrophy by use of the vascularized fibular flap. This protocol includes bone augmentation, implant surgery, soft-tissue management, and prosthetic restoration. Since 1993, 18 patients with a mean age of 47.5 years presented with extreme mandibular and/or maxillary atrophy and underwent alveolar crest augmentation with vascularized fibular flaps. Bone healing was achieved in 17 of the 18 patients. Seventy-three osteointegrated implants were inserted in 12 of 17 fibular flaps. Altogether, 62 implants were loaded and 11 dental prostheses were made. Average follow-up of the loaded implants was 41 months. The success rate of loaded implants was 100 percent. The authors strongly recommend the use of the fibular bone flap when dealing with extreme atrophy of the mandible and maxilla and suggest the protocol outlined in this review.

Adult↗
PubMed1965

Role of the thymus in tolerance. I. Tolerance to bovine gamma globulin in thymectomized, irradiated rats grafted with thymus from tolerant donors.

Rats thymectomized and irradiated as adults were restored to immunologic reactivity by grafts of normal adult rat thymus and bone marrow. Reactivity of the delayed (cellular) type and formation of mercaptoethanol-sensitive (MES) and mercaptoethanol-resistant (MER) antibody returned within 3 weeks, while Arthus reactivity remained subnormal till 9 weeks after irradiation and grafting. When the thymus donor was tolerant to BGG, the recipient showed specific non-reactivity to this antigen 3 weeks and, to a much lesser extent, 6 weeks after grafting. This non-reactivity affected delayed responses and MER antibody. No effect was noted on Arthus reactivity and a slight effect on MES antibody. Controls showed that the non-reactivity was not due to transfer of free antigen at the time of grafting. It was concluded that different source organs are responsible for different immune functions and that specific immunologic tolerance may be induced within such an organ as the thymus.

Animals↗