PubMed Health⌕ Search

Biomedical subjects

C F Barker

Publications and source records attributed to C F Barker.

At least 217 records · Page 12Linked to original sources
PubMed1977

Islet transplantation in genetically determined diabetes.

Hyperglycemia induced in animals by beta cell toxins or by pancreatectomy can be reversed by pancreatic islet transplantation. Abnormal carbohydrate metabolism in juvenile onset human diabetics has also been corrected, albeit temporarily because of graft rejection, by pancreatic transplantation. It does not necessarily follow that naturally occurring diabetes in animals or adult onset diabetes in man would respond to similar treatment. Islet transplantation was studied in mice with chemically induced or genetically determined diabetes. Streptozotocin-induced diabetic mice were permanently cured by syngeneic islets and, when immunosuppressed, were rendered normoglycemic for six weeks after receiving xenogeneic rat islets. In contrast, histocompatible islets from normoglycemic coisogenic donors were ineffective in hyperglycemic db/db recipients as were xenogeneic rat islets in immunosuppressed db/db hosts. However, when islets were isolated from db/db donors and transplated to genetically normal coisogenic mice, which had been rendered hyperglycemic with streptozotocin, they became normoglycemic. Apparently the metabolic defect in the db/db mice, which is similar in some ways to human maturity onset diabetes, does not reside in their islets as these cells can function normally if transplanted to genetically nondiabetic hosts. In two other types of genetic diabetes (ob/ob and NZO) islet transplantation was more effective. Pancreatic transplantation is unlikely to be the proper treatment for all types of diabetes even if technical and immunological problems are overcome.

Animals↗
PubMed1976

Acute colitis in the renal allograft recipient.

Four renal allograft recipients with evidence of ischemic damage to the colon are presented and compared with 11 cases from 5 major series. Similarities in the patients included: deterioration of renal function, multiple immunosuppressive and antibiotic regimens, the use of cadaver renal allografts, and diagnostic and therapeutic measures requiring frequent enemas with barium and ion-exchange resins. Two of our patients underwent surgery for the removal of segments of necrotic colon after several weeks of fever and abdominal pain initially attributed to either acute rejection, viral infection, or pancreatitis. One patient had three days of melena and responded to non-operative therapy. The fourth patient developed ischemic colonic changes 10 weeks after allograft nephrectomy and was receiving no immunosuppression at the time. Broad spectrum antibiotics were used at various times in all patients. Early aggressive evaluation of gastrointestinal complaints--including barium enema, upper gastrointestinal series with small bowel follow-through, proctosigmoidoscopy or colonoscopy, and arteriography--is indicated, in view of the lethality of the complication of colonic ulceration. The clinical pictures presented emphasize the fact that recipients of renal allografts are commonly heir to many complications which may be considered rare in the normal population.

Adult↗
PubMed1976

The antigenicity of venous allografts.

Segments of rat inferior vena cava modified by proteolytic digestion and dialdehyde starch tanning were found to retain their ability to sensitize allogeneic recipients both in the intradermal and intra-aortic positions. Furthermore, these grafts had a very high aneurysm formation (100%) and aneurysm rupture rate (63%), even when used as isografts, suggesting that the modification procedure so damages the structural integrity of the grafts that use in clinical situations may have disastrous consequences. Clinical trials must be undertaken with great caution and a mild, brief course of immunosuppression may be indicated when modified venous allografts are contemplated in potential organ transplant recipients. Furthermore, prosthetic mesh may be required for support whenever modified allogeneic veins are used for arterial substitutes. In the absence of autologous tissue, the bovine xenograft is probably the material of choice for reconstruction or bypass of small vessels.

Animals↗
PubMed1976

A twenty-two year review of elective resection of abdominal aortic aneurysms.

The clinical presentation and history of abdominal aortic aneurysm has changed little in the last 22 years. The improved results of elective resection of these lesions have occurred subsequent to advances in various aspects of treatment of this disease as well as increased experience in surgical management. The operative mortality associated with elective resection of abdominal aortic aneurysms has dropped to such a level that elective intervention is reinforced as the treatment of choice for this lesion. It is hoped that, with the continued improvement in the diagnostic phase resulting in earlier detection and surgical intervention, there may be a further reduction in the incidence of rupture of abdominal aortic aneurysms and further prolongation of life in those patients in whom such lesions develop.

Adult↗
PubMed1975

Disseminated mycobacterium kansasii infection presenting as cellulitis in a recipient of a renal homograft.

A recipient of a renal homograft developed disseminated infection caused by Mycobacterium kansaii. He initially presented with cellulitis and abscesses in one foot, and was thought to have a pyogenic bacterial infection. The daily administration of prednisone and azathioprine appears to have prevented the typical cell-mediated granulomatous reaction to mycobacterial infection and to have contributed to the patient's atypical inflammatory response. A switch to alternate-day prednisone combined with antimycobacterial medication resulted in rapid healing without rejection of the homograft.

Adult↗