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Biomedical subjects

G J Clunie

Publications and source records attributed to G J Clunie.

At least 19 recordsLinked to original sources
PubMed1995

The Annual Scientific Congress of the Royal Australasian College of Surgeons.

The Royal Australasian College of Surgeons (RACS) is responsible for the training, examination, and recertification of its fellows, who make up the great majority of the practicing specialist surgeons in Australia and New Zealand. One of the 16 Objects of the College is "To bring together the surgeons of Australia and New Zealand periodically for scientific discussion and practical demonstration of surgical subjects." In the furtherance of this object, there are many local and national meetings each year, but the highlight is the Annual Scientific Congress (ASC), held in each of the major cities on rotation, traditionally in the month of May, which is late autumn in the southern hemisphere.

Australia↗
PubMed1994

Surgery in Australia.

More than 4000 surgeons in Australia provide services to 17.6 million people living in the world's driest continent, with a land mass comparable to that of the United States. The problem of distance has been overcome in large part for the 17% of the population who live in remote areas by modern communication systems and by the Flying Doctor and Flying Surgeon services. For the remaining population, largely clustered on the fertile eastern seaboard, surgical services rival the best in the world, and surgical training, under the control of The Royal Australasian College of Surgeons, has set an example for which Australia can be justifiably proud.

Air Ambulances↗
PubMed1993

Kidney transplantation from living related donors: a 19-year experience.

OBJECTIVE: To determine the outcome of patients with end-stage chronic renal failure treated by live donor renal transplantation at the Royal Melbourne Hospital and Royal Children's Hospital between 1973 and 1991, during which time two distinct immunosuppressive regimens were used. DESIGN: Data about live donor renal transplant recipients were retrieved from the Australian and New Zealand Dialysis and Transplantation Association Registry, to which we have submitted data on all transplant recipients at six monthly intervals since the commencement of our dialysis and transplant programs. PATIENTS: Seventy-two patients with chronic renal failure who received live donor renal transplants during the 19 years from February 1973 to February 1992 were included. MAIN OUTCOME MEASURES: Patient survival, transplant survival, transplant function, change in prednisolone requirements, and duration of hospital stay. RESULTS: The first 32 patients were treated with immunosuppressive regimens based on combinations of prednisolone and azathioprine ("dual therapy"), while the next 40 patients were treated with combinations of cyclosporin, prednisolone and azathioprine ("triple therapy"). Survival of patients in each group five years after transplantation was 97%. Actuarial graft survival at 5, 10 and 15 years in the dual therapy group was 58%, 52% and 47%, compared with a 5-year actuarial graft survival in the triple therapy group of 96%. There was no statistically significant difference in renal transplant function between the two groups within the first 6 years after transplantation. Twelve of 26 patients (46%) treated initially with triple therapy were able to stop treatment with prednisolone within 12 months of transplantation. Median hospital stay was 12 (range, 6-35) days during the period 1973-1985 and 8 (range, 5-20) days for the 1985-1992 period. CONCLUSION: Live donor renal transplantation has provided a highly satisfactory means of treating patients with end-stage chronic renal failure in the short and long term. Our recent experience indicates that excellent patient and graft survival and adequate renal function can be achieved by treating live donor renal transplant recipients with a triple immunosuppressive regimen of low dose cyclosporin, prednisolone and azathioprine.

Adolescent↗
PubMed1993

Influence of the timing of blood transfusion on experimental tumor growth.

Blood transfusion prior to renal transplantation improves subsequent renal allograft survival, and some experimental studies have shown that allogeneic transfusion significantly increases growth of subsequently transplanted tumors. The aim of the present study was to examine the influence of the timing of transfusion on tumor growth. Six experiments were performed, each with different intervals between blood transfusion and inoculation of mice with an immunogenic B16 melanoma cell line. Each experiment contained three groups of C57 BL/6J mice which received intravenously normal saline, syngeneic blood, or allogeneic blood. Allogeneic transfusion 7 and 10 days before, but not at the time of, tumor inoculation produced a significant increase in tumor growth. Allogeneic transfusion within the first 10 days after tumor inoculation was associated with larger and heavier tumors than those observed in animals treated with saline or syngeneic blood, although the differences were not always statistically significant. Multiple transfusions after tumor inoculation and transfusions in animals bearing well-established tumors significantly increased tumor growth. The study shows that growth of a transplantable immunogenic murine tumor can be increased by prior allogeneic transfusion and, perhaps more importantly, by allogeneic transfusions given after the tumor has become established.

Animals↗
PubMed1993

Variable rejection patterns of cultured keratinocyte allografts in the rabbit.

There are many conflicting reports on the survival of cultured keratinocyte allografts (CKAs). Studies were performed in the rabbit model to elucidate further the fate of CKAs. Of 24 CKAs, 7 were identified as technical failures, 13 displayed classical macroscopic evidence of rejection with a prolonged mean survival time of 2.8 days, compared to non-cultured allograft controls (p < 0.01), and 4 failed to display typical macroscopic evidence of rejection. Furthermore, the time to eventual wound healing of the classically rejected CKAs were delayed by 6.0 days (p < 0.0001), compared to identical non-grafted control wounds.

Animals↗
PubMed1993

Evidence that an anthracycline-anti-CD8 immunoconjugate, idarubicin-anti-Ly-2.1, prolongs heart allograft survival in mice.

To examine the potential use of immunoconjugates of drugs and antibodies as immunosuppressive agents, mice were treated with a short course (4 days) of T-cell-specific anti-Ly-2.1 monoclonal antibody, or MAB conjugated to an anthracycline, idarubicin (IDA). The anti-Ly-2.1 MAB had no significant effect on the survival of BALB/c (Ly-2.2) heart allografts in CBA (Ly-2.1) mice, but was a potent immunosuppressive agent when coupled to IDA, with most grafts surviving for > 100 days following treatment with doses ranging from 10 to 120 micrograms IDA, covalently coupled to 1-8 mg MAB. IDA-MAB treated mice with long-surviving heart grafts showed donor-specific tolerance. They did not reject donor-type skin grafts (these survived for > 50 days), but rejected third-party skin in 10-14 days. Heart allografts in these mice survived for > 100 days. Allografts placed 30 days after treatment were rejected, showing a recovery of peripheral T cell function at this time. Newly derived thymic T cells were, however, not required for this recovery since adult thymectomized, IDA-MAB treated animals also recovered T cell function and rejected heart allografts. FACScan analysis of T cells from mice treated with 80 micrograms IDA-4 mg MAB, which had received a heart allograft, showed 95% T cell depletion in the spleen compared with ungrafted, IDA-MAB treated animals, and untreated controls with or without allografts. Splenic T cell depletion was however not significant in CBA mice immunosuppressed with the lower dose of 10 micrograms IDA-MAB. Thus rapid depletion of splenic T cells was not required for immunosuppression induced by IDA-MAB conjugates. However, the minor subpopulation of Ly-2+, which was activated by alloantigen while carrying IDA-MAB, may be depleted during the T cell response to the allograft, resulting in a state of alloantigen-specific tolerance in mice with long-surviving heart allografts.

Animals↗
PubMed1993

Postgraduate medical education--comparisons between the United Kingdom and Australia.

The strength of postgraduate medical education in the United Kingdom lies in the recognition that it is a continuing process from the preregistration year through the training grades into the stage of independent practice. The continuity derives from the support given to postgraduate deans by the universities, regional health authorities and professional colleges whose various contributions and training activities can be coordinated under the umbrella of the dean's office. This contrasts with the Australian scene where the responsibility for medical postgraduate education is still largely divided between the Australian Medical Council, individual state medical boards and the various professional colleges and faculties. Australia, has, however, devised a shorter basic and higher specialist training structure that ensures an earlier and more productive entry to independent practice. Australia has also accepted the principle of recertification which would seem to be a logical sequel to the committed system of defining and maintaining high standards of delivery of health care in the United Kingdom.

Australia↗
PubMed1992

Spontaneous renal allograft rupture: a disappearing phenomenon in the cyclosporine era?

Spontaneous renal allograft rupture occurred in six patients in a series of 384 consecutive renal transplants performed between July 1983 and December 1990. All cases occurred in patients treated with Azathioprine and Prednisolone, and none occurred in patients immunosuppressed with Cyclosporine. Acute allograft rejection was the underlying cause of rupture. All patients underwent urgent operation and repair of the ruptured transplant. Four patients had good renal function 74-84 months after repair, while two returned to dialysis 3 and 65 months after repair because of irreversible rejection.

Adult↗