PubMed Health⌕ Search

Biomedical subjects

D Ferluga

Publications and source records attributed to D Ferluga.

At least 55 records · Page 3Linked to original sources

Contamination of perfused donor kidneys by starch from surgical gloves.

Starch induces a variety of inflammatory reactions in humans and may contaminate surgical procedures from surgical gloves. Using polarized microscopy and electron microscopy, the authors observed starch particles in renal perfusate and in glomeruli of perfused donor kidneys. Group 1 consisted of 10 unusable kidneys handled with standard concern of glove sterility. Eight other kidneys (Group 2) were perfused with particular attention toward avoidance of starch contamination. The gloves were rinsed five times, and the cuffs were not dipped into the perfusate. Two kidneys (Group 3), deemed unsuitable for transplantation, were perfused for 24 hours with perfusate swished with unwashed sterile gloves. Group 4 consisted of five transplant biopsies performed within one week after transplantation. Perfusates alone were also circulated through the Waters Perfusion Machine continuously for 24, 72, and 188 hours with and without the use of gloves. The number of birefringent crosses were counted in each of 25 glomeruli per specimen. Group 1 displayed a mean of 1.8 birefringent crosses per glomerulus; Group 2, 0; Group 3, 5.3; and Group 4, 4.4. Groups 1 and 3 also exhibited birefringent crosses in peripheral renal vessels. Perfusate alone, handled without gloves, showed no birefringent crosses; by contrast, perfusate handled with gloves showed numerous birefringent crosses. The authors conclude that starch from surgical gloves can enter the perfusate and lodge in glomeruli and other sites of donor kidneys. Rinsing gloves five times and avoiding contact of the perfusate with the glove cuff effectively eliminates the contamination.

Birefringence↗

Nephrotic syndrome induced by D-penicillamine therapy.

The paper presents a female patient in whom the penicillamine therapy for aggressive hepatitis triggered off the development of nephrotic syndrome. Histological findings revealed membranous glomerulonephritis. After the withdrawal of penicillamine therapy, the laboratory results returned to normal. The authors concluded that penicillamine should only be administered in conditions in which other means of therapy prove inefficient (i.e. Wilson's disease, cystinuria associated with calculi).

Adult↗

[Pulmonary scar cancer and tumourlet (author's transl)].

Many investigations stress the importance of dysplastic changes of bronchial epithelium, chronic bronchitis, and chronic scar producing inflammatory processes of the lung in the development of bronchopulmonary carcinoma.--At the Institute for Lung Diseases and Tuberculosis Golnik in the period from 1964--1973 we found among 185 surgically resected lungs 20 cases (10,8%) of pulmonary scar cancer. In six patients (30,0%) we proved the tuberculous origin of the scar. Scar cancer was established in 18 patients (90,0%) in the upper parts of the lung. In half of all cases adenocarcinoma was found, squamous cell carcinoma was present in two cases and small cell anaplastic carcinoma in one case. --In the same period we found in surgically resected material two cases of tumourlets. In the first case in a 49-year old woman, the tumourlet was located in the scar surrounding an aspergillus mycetoma in the right upper pulmonary lobe. In the second case a tumourlet was found in a 42-year old woman in the region of focal fibrosis of the right upper pulmonary lobe. An 8 respectively 12 years postoperative follow-up shows no recurrence in both patients. This corresponds to the data from literature describing the tumourlet as benign process, recently reported as a minute peripheral carcinoid tumour.

Adenocarcinoma↗

Sequeale of acute viral hepatitis type B.

In 1976 we undertook to evaluate the incidence of chronic liver lesions in 161 patients treated in hospital during the years 1970-1975 for their serologically established acute viral hepatitis type B (AVH-B). At systematic control examination mode in 1976, after a period from 1-5 years since the acute onset of disease, it was established that in 133 individuals (82.6%) the antigen HBs had disappeared from blood and the BLT had become normal. Persistent HBs antigenemia was established in 20 (12.4%) individuals. In 15 (9.2%) patients persistent HBs antigenemia was accompanied by pathologic BLT, in 5 (3.1%) cases liver function became returned to normal yet with the persistent HBs antigenemia after their recovery from A VH-B. In 8 (4.9%) patients pathologic BLT persisted although HBsAg had disappeared from blood. Among 28 persons with persistent pathological BLT or with persistent HBs antigenemia out of a total of 161 patients who had had A VH-B, there were 11 (6.8%) cases with the bioptically proved CPHf, 8 (5.0%) cases with CPH, 5 (3.1%) cases with CAH, while 4 (2.5%) patients showed fatty liver metamorphosis or had by light microskopy completely normal liver. CAH was established only in cases with persistent BHs antigenemia and pathological BLT. The incidence of the chronic liver lesion and of the persistent antigenemia was among our patients who had had A VH-B in inverse ratio to the intensity of their initial infection. Our study suggests that no prodisposition for persistent HBs antigenemia is created by the prednisolone therapy.

Acute Disease↗

The significance of HB antigenemy in apparently healthy persons in the clinic for liver diseases.

The study tries to clarify the affliction of liver as a consequence of the permanent HB antigenemy in apparently healthy persons. The study proves beyond doubt that in the majority of the HB antigen carriers such histological changes of the liver can be found that can be attributed only to an infection by the hepatitis virus. The majority of the HB antigen carriers are suffering either from the chronic focal (58%) or from the diffuse (21%) persistent hepatitis. A smaller percentage is suffering from more dangerous hepatopathies (acute viral hepatitis 4,2%, hepatitis chron. aggressiva 4.2%, cirrhosis 1,4%). The kind of the illness can be determined with the histological examination only because of the absence of the clinical symptomatology and because of the liver function tests are in such cases frequently normal. Our investigations indicate that the diffuse and focal forms of persistent hepatitis can remain unchanged overlong periods and the same histological findings over a number of years. The chronic persistent hepatitis, however, may develop through clinically imperceptible changes into a chronic aggressive hepatitis, and the inapparent acute hepatitis can even pass over directly into cirrhosis. The identification of various forms of hepatitis, from light instances to the most severe cases, among the HB antigen carriers proves that the acute viral hepatitis of the type B may have in all the phases of its development a clinically asymptomatic course; it may even asymptomatically pass over into hepatopathies of the most severe kinds. The state of health of persons with HB antigenemy must be systematically followed up. For these reasons the histological examinations of the bioptic liver material that are made from time to time during the follow up of the illness have a decisive role.

Acute Disease↗

Interstitial capillary in normal and in transplanted kidneys: an ultrastructural study.

Knowledge about the normal structure and pathology of interstitial capillary is limited. Splitting and multilayering of the basal membrane (BM), as a marker of chronic rejection, has been published in association with transplant glomerulopathy. The authors investigated the ultrastructural features of the interstitial capillary basal membrane in normal (15 biopsies) and in transplanted kidneys (27 biopsies from 21 patients), expressing transplant glomerulopathy (8 biopsies from 6 patients), acute tubulo-interstitial rejection (9 biopsies from 6 patients), and recurrent or de novo glomerulonephritis (10 biopsies from 8 patients). All biopsies were fixed in 1% OsO4, embedded in Epon, and examined by electron microscope. Measurements of the interstitial capillary BM were made. The BM of interstitial capillary of intact kidney was a homogenous continuous structure, 88 nm in width on average. Thickening with diffuse multilayering of BM was most intensive in patients with transplant glomerulopathy, and much less intensive in patients with acute tubulointerstitial rejection and in patients with recurrent or de novo glomerulonephritis. These findings may provide the first information about the morphology of the normal basal lamina of interstitial capillary and support the diagnostic value of interstitial capillary changes in chronic rejection.

Adolescent↗