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Biomedical subjects

F C Goetz

Publications and source records attributed to F C Goetz.

At least 127 records · Page 7Linked to original sources
PubMed1976

Fragmentation haemolysis in patients with severe diabetic angiopathy.

Haemolytic anaemia associated with prominent red cell fragmentation is described in seven patients with long-standing diabetes mellitus. A common freature in the patients was severe microangiopathy as detected by retinal examination and microscopic examination of the kidneys. Renal or pancreatic islet malfunction per se is not involved in the haemolytic syndrome, since red cell abnormalities persisted in one patient for over a year following successful renal and pancreatic transplantation--this, despite the maintenance of normal renal and carbohydrate homeostasis. The kinetics of fragmentation was sutdied by tranfusing snormal type O cells into this type A patient. With reisolation of these cells by the Ashby-technique, rapid and porgressive red cell fragmentation was demonstrated by: (a) membrane lipid loss; (b) osmotic fragility increase; and (c) increase in mean cell haemoblobin concentration. This studies indicate that a red-cell-fragmentation haemolytic anaemia may occur in long-standing diabetes mellitus, related to the angiopathy of this disease and not to insulin deficiency or renal malfunction.

Adult↗
PubMed1976

A simplified method of percutaneous allograft biopsy.

Although the renal allograft represents only a single-functioning kidney, it lends itself readily to biopsy from a percutaneous approach. Previous contraindications to percutaneous biopsy of a single normally situated kidney do not apply to the renal allograft because of its altered extraperitoneal and superficial location. The transplant operative note and palpation serve to adequately localize the kidney without the need of fluoroscopy, metal tagging or other X-ray techniques. The cortex may be safely approached through a perpendicular plane directed toward the lower pole or a tangential plane directed toward the lateral curvature of the allograft. The fibrous capsule's resistance to the neddle passage helps localize the periphery of the kidney. Hemostasis is augmented through manual pressure and subsequent pressure dressing. The technique was used in 62 renal biopsies in 62 different patients. Adequate material for microscopic and bacteriologic evaluation was obtained in all cases. There were three episodes of gross hematuria, but no prolonged bleeding, significant perirenal hematoma formation, infection or decreasing renal function after the biopsy procedure.

Biopsy↗
PubMed1976

Immunopathology of renal extracellular membranes in kidneys transplanted into patients with diabetes mellitus.

Kidneys of patients with severe diabetic nephropathy demonstrate marked linear immunofluorescent staining of extracellular membranes, including the tubular and glomerular basement membranes (TBM and GBM) and Bowman's capsule. Immunofluorescent studies were carried out on kidney tissue obtained from 12 diabetic and 17 nondiabetic patients from two to 12 years following renal transplantation. The frequency and intensity of SgG and albumin staining of these membranes were significantly greater in the diabetic than in the nondiabetic patients (P less than 0.0005). TBM, GBM, and Bowman's capsule staining did not occur in any of the seven kidneys studies at the time of their transplantation into diabetic recipients. Thus, the abnormalities leading to the deposition or trapping of proteins in renal extracellular membranes occur early after the placement of normal kidneys into the abnormal metabolic environment of the diabetic transplant recipient. The present study supports the concept that basement membrane alterations in diabetes are a consequence of the biochemical perturbations of diabetes rather than a separately inherited genetically linked disorder.

Albumins↗
PubMed1976

Hyperglycemic pseudorejection in the diabetic transplant patient.

Serum creatinine elevation in a stable transplant recipient most often suggests rejection of the transplant and requires further evaluation and management. In our series of juvenile diabetic patients who have received kidney transplants, we frequently have observed creatinine elevations in association with hyperglycemia. Correction of the hyperglycemia resulted in return of serum creatinine to normal levels and no rejection therapy was required. To better define this syndrome, 2,734 paired measurements of blood glucose and serum creatinine were obtained in 52 stable post-transplant diabetic patients. A mean increase in blood glucose of 100 mg. per 100 ml. was found to increase serum creatinine by 0.5 mg. per 100 ml. in these patients (r=0.93; p less than or equal to 0.001). Evidence strongly suggests that the pathogenesis of this phenomenon is not a result of a laboratory artifact due to the technique used to determine serum creatinine. The pathogenesis may be due to the increased serum osmolarity and resulting intracellular dehydration associated with hyperglycemia. Recognition of this syndrome is important to all centers participating in the care and management of the diabetic transplant recipient.

Acute Kidney Injury↗