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Biomedical subjects

G Kandel

Publications and source records attributed to G Kandel.

15 recordsLinked to original sources
PubMed1992

Comparison of hematopoietic and immune recovery after autologous bone marrow or blood stem cell transplants.

We studied hematopoietic and immune recovery in 40 subjects receiving autologous bone marrow (ABMT) or blood stem cell transplants (ABSCT). Supportive care, transplant-related morbidity, duration of hospitalization and cost were also considered. ABSCT was associated with more rapid recovery of all hematopoietic lineages than was ABMT. However, kinetics of immune recovery were similar between the groups. In the ABSCT group, there was a correlation between numbers of blood progenitor cells infused and the rate of hematopoietic recovery. The accelerated hematopoietic recovery following ABSCT correlated with less morbidity, fewer transfusions, briefer hospitalization and lower cost than ABMT.

Adolescent↗
PubMed1990

Management of nonvariceal upper GI hemorrhage.

Peptic ulcer disease remains the most common upper GI hemorrhagic diathesis, except, of course, for esophageal varices. But mucosal lesions such as vascular ectasias and superficial ulcers of Dieulafoy's disease are being increasingly recognized. Therapeutic endoscopic techniques, notably laser coagulation and injection sclerotherapy, may obviate surgery.

Endoscopy↗
PubMed1989

Pathogenesis of Shigella diarrhea. XVI. Selective targetting of Shiga toxin to villus cells of rabbit jejunum explains the effect of the toxin on intestinal electrolyte transport.

To examine the mechanism by which Shiga toxin alters intestinal water and electrolyte transport, ligated loops of rabbit jejunum were incubated in vivo with purified toxin and then studied in vivo by single pass perfusion and in vitro by the Ussing chamber voltage-clamp technique. Toxin exposure led to accumulation of water in the jejunal lumen, associated with decreased active basal NaCl absorption. Glucose- and alanine-stimulated Na absorption were also reduced, while toxin had no effect on either basal short-circuit current or the secretory response to theophylline. These observations suggest that Shiga toxin selectively inhibits NaCl absorption without significantly altering active anion secretion. To localize the cellular site of toxin action, populations of villus and crypt cells from rabbit jejunum were isolated and studied. Villus cells had a greater content of the glycolipid Shiga toxin receptor, Gb3, had more toxin binding sites than did crypt cells, and were much more sensitive than crypt cells to toxin-induced inhibition of protein synthesis. These experiments demonstrate that purified Shiga toxin inhibits jejunal fluid absorption without affecting active fluid secretion by a preferential effect on villus cells. The results suggest that this is due to the differential distribution of toxin receptors on villus compared to crypt cells.

Absorption↗
PubMed1988

Collection of circulating stem cells and their use for autograft in adults with acute lymphoblastic leukaemia.

The level of peripheral blood granulocyte-monocytic precursors (PB CFU-GM) was studied serially in 10 adult patients with acute lymphoblastic leukaemia (ALL) in early complete remission after induction chemotherapy. The patients were distributed into 2 main groups according to the morphological French-American-British classification: ALL2 and ALL3. Collection of circulating stem cells (CSC) by cytapheresis was performed in 7 of these 10 patients with satisfactory results, except in 2 ALL2 patients, both of whom had chromosome translocation, which could have been a contributing factor. It appears, moreover, that even with 2 or 3 inductions courses, the more intensive the chemotherapy regimen in previously non-treated patients, the higher the peak of PB CFU-GM and the better the collection of CSC. The measurement of CFU-GM is certainly a less effective indicator of pluripotent stem cells in blood than in bone marrow, and it is probably necessary, but sufficient, to inject 5 times more CFU-GM than normally injected in marrow transplants to allow prompt and stable engraftment. The feasibility of this new graft technique seems for the moment undeniable, the main problem in ALL is the risk of relapse.

Adult↗
PubMed1988

Duodenal perforation by a Linton-Nachlas balloon tube.

In a patient with bleeding esophageal varices, inadvertent inflation of a Linton-Nachlas balloon in the third portion of the duodenum led to bowel perforation and death. This complication emphasizes a potential problem in passing a balloon catheter as far as possible down the nares, a technique that has been suggested to prevent balloon catheter inflation in the esophagus. To the best of our knowledge, this is the first reported case of duodenal rupture from attempted balloon tamponade for variceal hemorrhage.

Balloon Occlusion↗
PubMed1987

5-ASA enemas for refractory distal ulcerative colitis. An open trial.

We conducted an open trial of 5-ASA enemas to determine the role of this drug in idiopathic distal ulcerative colitis resistant to conventional therapeutic approaches. Fifty-one such refractory patients were given 4 g 5-ASA enemas once nightly for 2 weeks, and the response was then assessed clinically and sigmoidoscopically. Overall, 29 patients (57%) had an excellent response, 11 (21%) had a satisfactory response, and a further 11 (21%) had a poor outcome. Two patients developed adverse reactions. Of the 11 patients with a poor response, nine remained dependent on oral prednisone for remission of their colitis. Although the role of 5-ASA enemas in the treatment of refractory distal ulcerative colitis remains to be determined, it appears that the drug appears to be beneficial for only a minority of patients dependent on systemic corticosteroids.

Adult↗
PubMed1986

A clinical view of recent advances in ascites.

We discuss current perspectives in ascites, focusing on newer developments of interest to clinicians and stressing the value and limitations of therapeutic paracentesis. Because there is considerable evidence to support both the "underfilled" and "overflow" hypotheses for the development of ascites, current concepts concentrate on integration of these two theories. In the management of ascites the rate of ascites mobilization is more important than the method by which excess peritoneal fluid is removed; thus salt restriction may not have to be rigid if diuretics are used judiciously. An approach to intractable ascites emphasizes the difference between unresponsive and refractory ascites, but in both situations a conservative philosophy is recommended. Nonhepatic causes of ascites are briefly reviewed since their management may require principles different from those used in cirrhosis.

Animals↗