PubMed Health⌕ Search

Biomedical subjects

A Munne

Publications and source records attributed to A Munne.

10 recordsLinked to original sources
PubMed2005

Recurrence of IgA nephropathy and Henoch-Schönlein purpura after kidney transplantation: risk factors and graft survival.

BACKGROUND: IgA nephropathy (IgA) is one of the most common glomerulonephritis. Renal transplantation is the treatment of choice for patients with ESRD due to any kind of glomerulopathy, including IgA and Henoch-Schönlein purpura nephritis (H-SP), but original disease recurrence is now the third most frequent cause of allograft loss. METHODS: Eighty-seven cases of glomerulonephritis as the original disease were divided in two groups: group A--37 affected with 31 IgA and 6 H-SP; and group B--50 with other glomerulopathies. We compared patient and graft survivals at 5 years. To assess the presence of IgA or H-SP recurrence in group A patients, we performed an allograft biopsy in the presence of microhematuria, proteinuria, or an increased plasma creatinine. Known risk factors influencing recurrence rate were also analyzed. RESULTS: Five-year patient (97% vs 95%) and graft survivals (81% vs 78%) were not significantly different between groups A and B. Patients with crescentic glomerulonephritis (CGN) at the moment of diagnosis of IgA or H-SP showed a 5-year graft survival of 71% in contrast with 100% graft survival among those with mesangial or focal and segmental glomerulosclerosis pattern (P = .03). Histological recurrence was diagnosed in eight patients: six IgA and two H-SP. Women (P = .013) and a good HLA match (P = .029) were significantly associated with the risk of recurrence. CONCLUSIONS: When compared with other glomerulonephritis patients, with IgA or S-HP showed similar 5-year graft and patient survivals. Nevertheless, graft survival was shorter among patients with crescentic glomerulonephritis at the moment of diagnosis. Thus, the disease prognosis after grafting may be linked to the initial histological aggressiveness. Women and those patients transplanted with a good HLA match were prone to develop disease recurrence with a tendency toward a lower 5-year graft survival.

Adult↗
PubMed2001

Multiple "slow" CT scans for incorporating lung tumor mobility in radiotherapy planning.

PURPOSE: The high local recurrence rates after radiotherapy in early-stage lung cancer may be due to geometric errors that arise when target volumes are generated using fast spiral CT scanners. A "slow" CT technique that generates more representative target volumes was evaluated. METHODS AND MATERIALS: Planning CT scans (slice thickness 3 mm, reconstruction index 2.5 mm) were performed during quiet respiration in 10 patients with peripheral lung lesions. Planning CT scans were repeated twice, followed by three slow CT scans (slice thickness 4 mm, index 3 mm, revolution time 4 s/slice). All, except the first scan, were limited to the tumor region. Three-dimensional registration of all scans was performed. The reproducibility of the imaged volumes was evaluated with each technique using (1) the common overlapping volume (COM), the component of the clinical target volume (CTV) covered by all three CT scans, and (2) the encompassing volume (SUM), which is the volume enveloped by all CTVs. RESULTS: In all patients, the target volumes generated using slow CT scans were larger than those derived using planning scans (mean ratio of planning-CTV:slow-CTV of 88.8% +/- 5.6%), and also more reproducible. The mean ratio of the respective COM:SUM volumes was 62.6% +/- 10.8% and 54.9% +/- 12.9%. CONCLUSIONS: Larger, and more reproducible, target volumes are generated for peripheral lung tumors with the use of slow CT scans, thereby indicating that slow scans can better capture tumor movement.

Humans↗
PubMed2001

Coronary angiography with multi-slice computed tomography.

BACKGROUND: A new generation of subsecond multi-slice computed tomography (MSCT) scanners, which allow complete coronary coverage, are becoming widely available. We investigated the potential value of MSCT angiography in a range of coronary disorders. METHODS: We studied 35 patients, including 11 who had undergone percutaneous transluminal coronary angioplasty and four who had had coronary-artery bypass grafts, by both MSCT and conventional coronary angiography. After intravenous injection of a non-ionic contrast medium with high iodine content, the entire heart was scanned within a single breath-hold. The total examination time was no more than 20 min. The retrospective electrocardiographically gated reconstruction source images and three-dimensional reconstructed volumes were analysed by two investigators, unaware of the results of conventional angiography. FINDINGS: In the 31 patients without previous coronary surgery, 173 (73%) of the 237 proximal and middle coronary segments were assessable. In the assessable segments, 17 of 21 significant stenoses (>50% reduction of vessel diameter) were correctly diagnosed. The non-assessable segments included four lesions. Misinterpretations were mainly the result of severe calcification of the vessel wall. Segments with implanted stents were poorly visualised, but stent patency could be assessed in all cases. Of the 17 segments of bypass grafts, 15 were assessable and four of five graft lesions were detected. Two cases of anomalous coronary anatomy could be visualised well. INTERPRETATION: These preliminary data suggest that MSCT allows non-invasive imaging of coronary-artery stenoses and has potential to develop into a reliable clinical technique.

Adult↗
PubMed1995

[Management of non-functioning renal graft].

On a series of 315 consecutive Renal Transplants (RT), the authors analyze the effects from any situation capable of causing the graft's renal failure, whether accompanied or not of oligoanuria. To begin with, the exploratory approach promoted by the ¿non-functioning kidney¿ is established recognizing three typical stages depending on the time of appearance: early, medium-term and long-term. The breakthroughs obtained in the prevention of Acute Tabular Necrosis (A.T.N.) are verified through the use of the receptor's hyperhydration, as well as the good results in the treatment of rejection since the arrival of Cyclosporin and the recent introduction of OKT3. Chronic rejection, is, today, the major cause of our transplantectomies (TX), since our attitude towards the exeresis of all irreversibly non-functioning grafts is well known. Vascular thrombotic problems have a very high percentage of losses among affected kidneys. Little can be done once the problem arises. Prevention is the best weapon available and special attention should be paid to the meticulousness of bank surgery and the suitable final positioning of the organ in the fossa iliaca, having into account the highly close relationship between this problem and the pathological and iatrogenic anomalies displayed by the organs to be transplanted in their arterial tree. The excretory tract problems are repaired in 83% cases, but the rest may even result in the loss of the kidney. In these complications, early surgery is the best way to avoid subsequent amputation surgery.

Graft Rejection↗
PubMed1992

[Leiomyoma of the renal capsule. Presentation of a case and review of the literature].

Leiomyoma of the renal capsule is rare and very difficult to diagnose preoperatively. We report on a patient in whom a solid renal mass had been incidentally detected during ultrasound evaluation for a gastroenterological condition. A CT scan confirmed the presence of a solid mass. The intraoperative biopsy showed it was a benign tumor and conservative surgery was performed. According to the literature, this tumor type has, as yet, not been diagnosed preoperatively. However, some angiographic features may indicate the presence of this condition. This is the fourth case of leiomyoma of the renal capsule reported in the literature and the second case treated by conservative surgery.

Biopsy↗
PubMed1991

[Necrotizing vasculitis with predominant kidney involvement].

We report five patients with necrotizing vasculitis with predominant renal involvement; the diagnostic and therapeutics was effected completely at regional hospital. We detach: a) the clinical presentation's forms with rapidly progressive renal failure with microscopic hematuria and minimal proteinuria; b) the biopsy of kidney with necrotizing vasculitis or necrotizing glomerulonephritis (microscopic polyarteritis). We review the necrotizing vasculitis with predominant renal involvement in its pathogenic, clinical and histological aspects, and we insist that the diagnostic and early treatment are fundamental for prognostic's improvement of these patients. We conclude that this diagnostic and treatment can be made in regional hospitals with sensible physicians by the theme.

Aged↗
PubMed1988

Association of renal xanthogranuloma and urological neoplasia.

Seven of 66 cases of renal xanthogranuloma (RXG) were associated with urinary tumors (10.6%). The diagnostic and surgical problems can be difficult because of the similarities to a neoplasm and because of the inflammatory nature of RXG. Obstruction and infection seemed to be causative factors in 5 of the 7 cases. It was not possible to demonstrate an immunological deficit in these patients. A review of the literature shows the rarity of this association: 20 cases together with our 7 cases gives a total of 27 out of the 676 cases of RXG that have been published (an incidence of 4%).

Adult↗
PubMed1977

[Blue rubber bleb nevus (author's transl)].

A case of Blue Rubber Bleb Nevus in a 11 year-old boy is reported. The patient exhibited characteristic hemangiomas of the skin and gastrointestinal tract with an iron deficiency anemia. Historical, clinical, pathological, and surgical features of the condition are discussed. Value of fibroscopic examination in delineation of the cause of persistent gastrointestinal bleeding is pointed out.

Child↗