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Biomedical subjects

B A Lucas

Publications and source records attributed to B A Lucas.

At least 55 records · Page 3Linked to original sources
PubMed1981

Surgical therapy for persistent hypertension after renal transplantation.

The presence of the original diseased native kidneys in renal allograft recipients is associated with an increased prevalence of persisting post-transplant hypertension. In 9 of 10 such transplant patients bilateral nephrectomy of these native kidneys, performed at least 1 year after successful transplantation of a renal allograft, resulted in improved blood pressure control. Although these 10 patients had higher peripheral plasma renin activity (PRA) than normotensive patients (5.9 +/- 1.3 ng/ml/hr versus 1.5 +/- 0.3 mg/ml/hr), selective renal vein renin measurements did not consistently demonstrate higher renin concentrations from the native kidneys. Removal of the original kidneys was beneficial even in some patients who had stenosis of the allograft artery demonstrated by arteriography.

Follow-Up Studies↗
PubMed1981

Acute renal failure due to seminoma metastatic to the kidneys.

A patient with seminoma presenting with bilateral symmetrical enlargement of the kidneys, massive proteinuria and acute renal failure is described. No factor other than infiltration due to seminoma was found to explain the renal failure. Renal function improved markedly along with renal size and architecture in response to radiotherapy. Renal dialysis is justified in metastatic seminoma to determine the effect of tumor therapy.

Acute Kidney Injury↗
PubMed1980

Focal and segmental glomerular sclerosis in reflux nephropathy.

Reflux nephropathy was diagnosed in 23 patients (14 per cent of all the patients who received transplants) between 1973 and 1977, and nephrectomy was performed in all. Histology and immunofluorescence revealed a glomerular sclerosis associated with the idiopathic nephrotic syndrome. No focal and segmental glomerular sclerosis was seen in kidneys removed from patients with nonglomerular renal disease. Twenty-four hour urinary protein excretion in grams was 3.1 +/- 0.3 (mean +/- SEM) and was greater than that in our patients with end-stage nonglomerular renal disease. Thirty-one renal transplants were performed in these 23 patients; thereafter, maximum protein excretion was 1.4 g. Focal and segmental glomerular sclerosis was seen in only one (chronic rejection, protein excretion less than 0.5) of the 20 kidneys available for histologic study. Thus, focal and segmental glomerular sclerosis is extremely common in reflux nephropathy, accounts for "glomerular" proteinuria and may contribute importantly to progressive renal failure but, unlike that associated with the idiopathic nephrotic syndrome, rarely recurs after renal transplantation.

Adolescent↗
PubMed1980

Does vesicoureteric reflux result in renal allograft failure?

Vesicoureteric reflux (VUR) into transplanted kidneys has been cited as an often disregarded but frequent complication of transplantation which is associated with a glomerular lesion that resembles membranoproliferative glomerulonephritis, marked proteinuria, and graft failure. To determine the prevalence of this complication in our transplant population, all of our 23 patients with marked proteinuria and 27 controls without proteinuria had voiding cystourethrograms performed approximately two years after transplantation. In our population, VUR was infrequent (8%). Moreover, in the three of the four cases detected renal function has not deteriorated and three of the four do not have marked proteinuria. We cannot confirm the suggestion that VUR is a frequent cause of late renal allograft failure.

Adolescent↗
PubMed1979

Renal transplantation for patients with type I and type II membranoproliferative glomerulonephritis: serial complement and nephritic factor measurements and the problem of recurrence of disease.

Fourteen patients with membranoproliferative glomerulonephritis as their original kidney disease received 16 renal allografts. All 14 patients are alive, 11 currently have functioning allografts, and one graft was lost to recurrence of membranoproliferative glomerulonephritis. Originally depressed serum complement (C3) concentrations returned to normal soon after transplantation in those patients with no clinical evidence of recurrence. Two patients with type II membranoproliferative glomerulonephritis had recurrence of disease. Nephritic factor (C3NeF) was high in both these patients before they received their transplants and was absent soon thereafter. However, abnormally high levels were again detected in their course. The one recurrence of type I membranoproliferative glomerulonephritis was associated with depressed C3, Clq, C4 and factor B but without C3NeF activity. Despite warnings of "high risks/ and "high mortality" associated with renal transplants in patients with membranoproliferative glomerulonephritis, we, because of these results and a review of the literature, continue to recommend renal transplants from both living related (LRD) and cadaver (CAD) donors in otherwise suitable patients who have renal failure due to membranoproliferative glomerulonephritis.

Adolescent↗
PubMed1979

Controversy in renal transplantation: antireflux versus non-antireflux ureteroneocystostomy.

A comparison of 118 consecutive nephroureteral allografts suggests that ureteroneocystostomy provides excellent results with (60 cases) or without (52 cases) an antireflex procedure. Reflux was noted in less than 10% of each group after transplantation and no morbidity could be attributed to reflux when it was found. There was no obstruction or anastomotic leakage in either group. The advantages of each procedure are discussed.

Adolescent↗
PubMed1979

Kinetic depth effect examined under conditions of unimodal versus bimodal sensory input.

To perceive the three-dimensional rotation of a shadow figure, displacement and line length change are required. Without displacement, persons perceive a line lengthening and shortening on a two-dimensional plane. The present investigation attempted to create the kinetic depth effect without displacement by including auditory input. 48 persons were randomly assigned to two groups (line-length change with tone or line-length change without tone). The tone group received sound through headphones which oscillated in amplitude in synchrony with the shadow of a rotating "T" figure. The tone group perceived a three-dimensional figure in rotation significantly more often than did the non-tone group. These results suggest that the kinetic depth effect may be created by more than one combination of sensory input.

Auditory Perception↗
PubMed1979

Diffuse metanephric adenoma after in utero aspirin intoxication. A unique case of progressive renal failure.

Diffuse persistent glomerular immaturity and focal proximal tubular ectasia were seen in bilateral open renal biopsy specimens for an infant with fluid and salt depletion and slowly progressive renal failure. Subsequently, diffuse tubulopapillary renal adenoma subtotally replaced each kidney, thereby, necessitating renal transplantation. Origin of diffuse metanephric adenoma from persistent primitive epithelium of the proximal nephron is postulated and partly substantiated. We propose that this case of persistent proximal nephronic epithelial immaturity and diffuse metanephric adenoma is a variant of nephroblastomatosis and that in this case, a first trimester suicide attempt with aspirin may have initiated the maturation defect that preceded neoplastic transformation.

Aspirin↗
PubMed1978

A possible relationship between Henoch-Schonlein syndrome and IgA nephropathy (Berger's disease). An illustrative case.

A 29-year-old white male with the Henoch-Schonlein syndrome and rapidly progressive glomerulonephritis received a kidney transplant. Postransplant, a glomerulonephritis histologically and immunologically indistinguishable from IgA nephropathy (Berger's disease) developed in the absence of any extrarenal manifestations of the Henoch-Schonlein syndrome. A possible pathogenetic interrelationship between these two diseases is discussed.

Adult↗
PubMed1977

'Hyperacute rejection' due to perfusion injury.

Two kidneys were harvested from a cadaver donor and subjected to pulsatile perfusion in an identical fashion with a perfusate which was free of cytotoxic antibody. Classical 'hyperacute rejection' occurred in the right kidney when transplanted into a male patient with no previous blood transfusion or transplants, and repeatedly negative tests for cytotoxic antibody. The left kidney was not transplanted and was examined by light, electron, and immunofluorescence microscopy as was the immediately removed, transplanted kidney. Despite the absence of any immunological pathogenetic mechanism in the non-transplanted kidney, virtually identical changes of 'hyperacute rejection' were seen in both kidneys. Thus,even technically satisfactory perfusion may cause a syndrome of 'hyperacute graft failure' secondary to non-immunologically mediated perfusion injury.

Adult↗
PubMed1976

Goodpasture's syndrome in a patient with the Nail-Patella syndrome.

A patient with the nail-patella syndrome in whom end-stage renal failuure developed as the result of Goodpasture's syndrome is described. Lesions characteristic of both rare diseases were seen on renal morphology. It is postulated that the glomerular membrane alteration of the nail-patella syndrome predisposed to the development of antiglomerular basement membrane antibody and hence Goodpasture's syndrome. A review of the incidence of renal failure in the nail-patella syndrome suggests that renal involvement can no longer be regarded as benign and that immune mechanisms may be related to progressive renal disease in some cases.

Adolescent↗
PubMed1976

Urologic manifestations of polyarteritis nodosa.

Polyarteritis nodosa is an unusual condition that infrequently presents with signs and symptoms essentially confined to the urinary system. Such a case necessitating bilateral nephrectomy owing to hemorrhage is described. The pathologic findings, pathophysiology and etiology of the condition as well as treatment by renal transplatation are discussed.

Adult↗