Urinary calculi after renal transplantation.
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Biomedical subjects
Publications and source records attributed to J Andreu.
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Surgery of the renal artery and its branches has not developed at the same rate as the progress made in arterial hypertension renovascular studies. Therefore, the percentage of cure is still low, the mortality rate high and the complications frequent. Based on the experiences in renal allo- and autotransplants, on the progress achieved in different fields, such as extracorporeal kidney surgery, on a new way of approach to the spleen's hilus, on the development of microsurgery and on a better knowledge of the biopathology of vascular grafts, new orientations for this type of surgery are supported. No matter which technique is followed, renal hypothermia by arterial perfusion, elimination of the diseased arterial segment, placement of the kidney in the continuity of another arterial system (auto-or splenorenal transplants), substitution of the transperitoneal approach by the retroperitoneal one, and, in complicated cases, the practice of ex situ arterial reconstruction surgery, is considered fundamental. Statistics, following these guidelines, are presented, which indicates that there were no deaths and that the percentage of success is higher than with classic revascularization surgery.
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Eighteen patients received CP substituting AZ after renal transplantation following evidence of hepatitis. We have compared graft evolution before and after treatment with CP. Twelve patients showed no modification in graft evolution. In four patients the renal function decreased but it did not seem attributable to the change of the drug. Two patients showed intolerance attributable to the change of the drug. In one patient who received CP instead of AZ since the data of the transplant onwards, with no evidence of hepatic lesion, renal function decreased but this did not seem attributable to the use of the drug. The dose of CP in renal transplantation is discussed. We conclude that CP is a good substitute for AZ in renal transplanted patients. Adequate doses seemed to range between 0.7 and 1 mg/kg/day.
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In cases in which renal repair through conventional in situ surgery is not possible, we have proceeded to remove the organ outside of the human body and placed in on a work bench where exsitu repair is aided by microsurgery, x-ray films, and image amplifiers. In most cases the damaged kidney has recovered its function and a grave problem has been solved. Extracorporeal surgery means a new tactical solution to extreme situations.
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A prospective study was performed on the relationship of CT findings to the clinical course of 148 patients with acute pancreatitis. The type of pancreatic inflammation seen on CT was classified into six categories based on an overall assessment of size, contour and density of the gland, and peripancreatic abnormalities. The majority (94%) of patients in whom CT showed mild pancreatic changes (grades A, B and C) had two or less positive clinical indicaters of severe pancreatitis (Ranson's signs). In contrast, 92% of patients in whom CT showed more severe changes of pancreatitis (grades D, E or F) had three or more positive signs. The nine patients who died with pancreatitis-related complications were in grades D, E or F. We wish to draw attention to a CT appearance which we have called 'fat islets' (low density intrapancreatic or peripancreatic areas, the contents of which approach fat in attenuation values); there was a strong correlation between this appearance and subsequent infection.
We report a case of right psoas abscess resulting from a carcinoma of the ascending colon. Abdominal CT examination suggested a preoperative diagnosis of neoplasm of the colon, which was confirmed on barium enema films and at surgical operation.
The CT and ultrasound findings in a case of cystic schwannoma mimicking a left adrenal tumor are reported. The differential diagnosis of cystic lesions arising in the adrenal region is discussed.
Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. In some cases, it is the predominant radiological finding. This article reviews the spectrum of entities that commonly present with thickening of the interlobular septa as the main radiological feature and establishes a practical approach for the differential diagnosis.
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This article reviews the high-resolution computed tomography imaging features of miliary pattern, a characteristic radiologic manifestation of diffuse micronodular lung disease. The most common entities with this pattern are miliary tuberculosis, pneumoconiosis, sarcoidosis, metastases, and hypersensitivity pneumonia. According to the distribution of the nodules in relation to the secondary lobule, high-resolution computed tomography findings divide miliary patterns into 3 groups: centrilobular, perilymphatic, and random presentation. The radiologic features that help in the differential diagnosis are discussed.