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Biomedical subjects

E F Fuchs

Publications and source records attributed to E F Fuchs.

At least 37 records · Page 2Linked to original sources
PubMed1983

Immunologic considerations before and after vasovasostomy.

A prospective study has been completed to determine the incidence and significance of antisperm antibodies in 160 men undergoing vasovasostomy to relieve obstruction of the vas deferens due to vasectomy. Preoperatively, serum sperm-agglutinating antibody (SSAA), serum sperm-immobilizing antibody (SSIA), and seminal plasma sperm-agglutinating antibody (SPSAA) were found in 63%, 37%, and 3%, respectively. When they were postoperatively studied, 92 of the same men demonstrated no significant change in the incidence or the absolute level of SSAA or SSIA. The SPSAA was found in 7% of 120 men preoperatively; however, 16% of 51 men studied postoperatively exhibited SPSAA. Significant differences in pregnancy rates have been documented between the spouses of men with detectable levels of agglutinating and immobilizing antibody and the spouses of men with no evidence of antibody formation.

Autoantibodies↗
PubMed1983

Comparison of imported with locally retrieved kidneys preserved by intracellular electrolyte flushing followed by cold storage.

Ice-cold intracellular electrolyte flushing followed by cold storage and economy air shipment is the cheapest method to share kidneys for transplantation. This study from 1 center compares 62 primary cadaver kidney grafts imported from other centers to 128 that were retrieved locally. Cold ischemia time was 36.4 plus or minus 8.6 hours (mean plus or minus standard deviation) in the imported group and 24.2 plus or minus 8.8 hours in the locally retrieved group. The significant increase in first week dialysis (71 versus 42 per cent) and 1-month serum creatinine nadirs (2.63 plus or minus 2.73 versus 1.78 plus or minus 1.04 mg./dl.) was explained by longer cold ischemia times in the imported kidney grafts. There were no significant differences between the 2 groups with respect to actuarial kidney graft survivals and serum creatinine levels at 1, 2 and 3 years. Intracellular electrolyte flushing followed by simple cold storage and air transportation provides kidney graft survivals and long-term kidney graft function at minimal expense when the kidneys are retrieved from beating-heart cadavers and have undergone minimal warm ischemia.

Cold Temperature↗
PubMed1983

Successful human kidney preservation by intracellular electrolyte flush followed by cold storage for more than 48 hours.

Transplantation of cadaver kidneys after flushing with an ice-cold intracellular electrolyte solution is inhibited by arbitrary time limits on cold ischemia. During the 25-month interval ending March 22, 1982 we transplanted 7 kidneys preserved by this method and cold-stored for 48.2 to 61.4 hours. Of the recipients 86 per cent required dialysis within 1 week after transplantation, the mean serum creatinine nadir within 1 month was 2.1 mg./dl. and the graft survival at 1 month was 71 per cent. The 1-year actuarial cadaver graft survival was 69.2 plus or minus 18.1 per cent. Kidneys preserved by this simple method can be transplanted successfully after 48 hours of simple cold storage.

Cold Temperature↗
PubMed1983

Percutaneous vaso-occlusion for nonmalignant renal lesions.

Transarterial renal embolization has been used in the management of renal cancer. We report on 9 patients who underwent selective and superselective renal arterial embolization for nonmalignant renal lesions. Embolization was done in 5 patients for hemorrhage owing to renal angiomas, renal artery, pseudoaneurysm, percutaneous renal biopsy and adult polycystic kidney disease, and in 2 patients with end stage renal disease because of massive proteinuria. Another chronic renal failure patient with severe hypertension was treated successfully with bilateral renal embolization. A postoperative renal arteriovenous fistula was treated successfully by catheter vaso-occlusion. Renal embolization may be a suitable alternative to surgery in poor operative risk patients and for technically difficult benign lesions. Renal infection is a contraindication to embolization.

Adult↗
PubMed1982

Adjuvant chemotherapy with vinblastine and bleomycin in stage B nonseminomatous germ cell tumors of the testis.

Between 1974 and 1980, 48 lymph node dissections were done for nonseminomatous tumors. Of 23 patients with pathologic stage A disease 1 (4 per cent) suffered recurrence but is free of disease after chemotherapy and pulmonary resection. All 23 patients (100 per cent) are free of disease. Adjuvant chemotherapy with high dose vinblastine and constant infusion of bleomycin was given in 25 patients with stage stage B disease and none had maintenance chemotherapy. Of these 25 patients 2 (8 per cent) had evidence of recurrent disease after adjuvant chemotherapy and both are free of disease after further chemotherapy, which included cis-platinum. One patient died after a second primary embryonal carcinoma developed in the remaining testis 3 years after the initial tumor. Twenty-four of the 25 patients with stage B tumor (96 per cent) are free of disease 15 months to greater than 7 years after therapy.

Adolescent↗
PubMed1982

Effect of donor surgeon on first cadaver kidney transplant function.

Community urologists and general surgeons were recruited into a cadaver kidney program in 1976. This study from 1 center compares 41 primary cadaver kidney grafts retrieved by community hospital retrieval teams to 60 primary cadaver kidney grafts retrieved by a center-based transplant team. Of the kidneys 100 were preserved with Collins' C2 flushing followed by simple cold storage and 1 was preserved with pulsatile machine perfusion. Cold storage time ranged from 9 to 44.5 hours in the community hospital kidney group and from 11 to 44 hours in the university hospital group. There was no significant difference between the 2 kidney retrieval teams with respect to 1) incidence of acute tubular necrosis, 2) 1-month serum creatinine nadir of surviving grafts, 3) 1 and 2-year serum creatinine levels and 4) actuarial graft survivals up to 5 years. Community hospital retrieval teams can provide kidneys as satisfactory for transplantation as a center-based transplant team and are a valuable resource for cadaver kidney transplant programs.

Adult↗
PubMed1981

Uroepithelial carcinoma in association with cyclophosphamide ingestion.

The association of daily oral cyclophosphamide with the development of transitional cell carcinoma or squamous cell carcinoma of the bladder had been documented. We report the first 2 cases of transitional cell carcinoma of the renal pelvis and an additional 4 cases of transitional cell carcinoma of the bladder following cyclophosphamide ingestion. Patients who have been taking daily oral cyclophosphamide for a prolonged period should have excretory urography, cystoscopy and bladder mucosal biopsies performed as part of a cancer surveillance protocol.

Aged↗
PubMed1981

Initial experience with the Rosen incontinence device.

During a 25-month period, beginning in May 1977, 19 patients had Rosen incontinence devices implanted. During the 9 to 34 months of followup 26 additional operations were required for urethral compression balloon leakage, urethral compression balloon aneurysm, tubing kinks, reservoir malfunction and urethral erosion. Currently, 7 devices are in place, 6 of which are functioning and 3 of which have aneurysms of the urethral compression balloon. The 6-month failure rate of the first device was 44 per cent. During the 247 months that the devices were in place the patients were dry for 89 months, and required pad protection for 118 months and condom or an external urethral clamp for 40 months.

Aged↗
PubMed1980

An analysis of 100 primary cadaver kidney transplants.

A multifactorial analysis of 100 consecutive first cadaver kidney transplants was done to document the current status of this treatment for end stage renal disease and to determine the influence of the following variables on kidney losses owing to rejection: splenectomy, pre-transplant transfusions, transfusion at the transplantation, recipient sex, pre-transplant nephrectomy, donor and recipient A, B or O blood group, human leukocyte A and B antigen mismatches, kidney preservation method, donor treatment with methylprednisolone and cyclophosphamide, recipient treatment with antilymphocyte serum or antilymphoblast globulin and a low dose of steroid treatment for rejection. Pre-transplant splenectomy for leukopenia, 5 or more pre-transplant blood transfusions and pre-transplant transfusions without development of circulating cytotoxic antibodies significantly reduced kidney losses owing to rejection (p less than 0.05)., A low dose of steroid treatment for rejection resulted in a trend towards improved patient survival without sacrificing kidney graft survival. Clinical studies demonstrating decreases in kidney graft rejection should be controlled for pre-transplant blood transfusions and, possibly, for pre-transplant splenectomy for hypersplenism.

Adolescent↗
PubMed1980

Transureteroureterostomy: 25-year experience with 100 patients.

During the last 25 years 100 patients have been subjected to transureteroureterostomy. In 2 cases postoperative death was attributable to other pathologic processes. We treated 94 donor units successfully in this manner. An additional 2 units, normal for several years after transureteroureterostomy, had periureteral fibrosis and stricture owing to the inferior mesenteric artery syndrome and required another definitive surgical procedure. Ninety-seven recipient kidneys remained normal after the procedure.

Adolescent↗
PubMed1979

Synthesis and antitumor activity of sugar-ring hydroxyl analogues of daunorubicin.

Daunorubicin analogues in which the natural amino sugar, daunosamine, is replaced by neutral 2,6-dideoxy-hexopyranosyl residues have been prepared in high yields. Glycosidation of 3,4-di-O-acetyl-2,6-dideoxy-alpha-L-lyxo-hexopyranosyl chloride (13) with daunomycinone under Koenigs-Knorr conditions yielded exclusively the protected alpha-anomeric product 4, which was converted into the free glycoside 5. In contrast, the 1-chloro-D-ribo isomer 19, bearing p-nitrobenzoyl groups for hydroxyl-group protection, furnished a 5:3 mixture of the alpha (6) and beta (7) glycosides. Separation and individual deprotection afforded the target compounds 8 (from 6) and 9 (from 7). Whereas all of the D-ribo analogues (6--9) are inactive as antitumor agents in vivo against P388 lymphocytic leukemia in mice, the protected L-lyxo glycoside 4 (T/C 186) and also the free glycoside 5 (T/C 183) are highly effective in this test system; 5 is also active (T/C 146) in vivo against murine B16 melanocarcinoma.

Animals↗
PubMed1979

New daunorubicin analogs. 3-Amino-2,3,6-trideoxy-alpha- and beta-D-arabino- and 3,6-diamino-2,3,6-trideoxy- alpha-D-ribo-hexopyranosides of daunomycinone.

Glycosidation of 2,3,6-trideoxy-3-trifluoroacetamido-4-O-trifluoroacetyl-alpha-D-arabino-hexopyranosyl chloride (19) (or the corresponding 4-p-nitrobenzoate, 20) with daunomycinone under Koenigs-Knorr conditions afforded, after separation of the anomers and removal of the protecting groups, the individual target glycosides 8 (alpha anomer; major product) and 9 (beta; minor) in acceptable yields. In contrast, the title diamino sugar, suitably protected with N-trifluoroacetyl and O-acetyl (or O-p-nitrobenzoyl) groups, underwent stereospecific coupling to the anthracycline aglycon by the glycal procedure to give, after deprotection, the alpha glycoside 12. All three analogs were assayed in vivo against P388 lymphocytic leukemia. They showed little (T/C 125 for 8; T/C 115 for 9) or no (compound 12) activity, but were essentially devoid of toxicity at the dose-levels tested.

Animals↗