The limitations of insulin therapy explain the growing interest expressed by diabetologists in pancreas and islet cell transplantations. Pancreatic graft is the most used method, and its technique is now well established; the exocrine secretion can be either dried up by pancreatic duct obstruction or drained, often into the bladder. However, this method demands permanent immunosuppression and for this reason it is used in 85 percent of the cases in diabetics requiring kidney transplantation. The mortality and morbidity due to transplantation have decreased considerably. The survival rate at 1 year is 81 percent for patients and 46 percent for grafts, with return to normal glycaemia levels in most cases. The effects of pancreas transplantation on diabetic microangiopathy are difficult to evaluate in these patients who often have very advanced complications, but the first data are encouraging. The indications for this transplantation are limited, and they should not be extented to early stage diabetes unless they are part of controlled studies. Islet cell transplantation has many potential advantages, including safety and the hope of grafts without permanent immunosuppression, but the results available in man are still very preliminary.

Diabetes Mellitus, Type 1↗

PubMedDate not supplied

[Percutaneous resection of benign renal cysts].

Six patients carrying bulky renal cysts located in the kidney lower pole were treated by percutaneous resection of the cystic wall. No complications were observed during the peri and postoperational period. In all cases disappearance of symptoms was observed, and the total success rate (absence of residual cavity) recorded was 4/6, two cases presenting persistence of a small residual cavity which originated one case of relapse. The paper presents the technique used, and the indications and possible therapeutic actions for the treatment of simple kidney cysts are discussed.

Adult↗

PubMedDate not supplied

[Endourologic treatment of tumors and pseudotumors of the upper excretory system].

Thirteen patients with a benign tumor or pseudotumor of the upper urinary tract underwent endourological treatment on 17 occasions. These patients were divided into two groups according to the anatomopathological findings. Five patients comprised group I. Mean patient age, 57.3 years. These patients had a tumor in the excretory cavity. Endoscopic work up revealed 3 papillary necroses, 1 inflammatory polyp, 1 Von Brun islet. One ureterorenoscopy (biopsy + laser) and four percutaneous (tumor resection) procedures were performed. Eight patients comprised group II. Mean patient age, 59 years. Six patients had pyelocaliceal tumors and two patients had ureteric tumors. Histologic analyses revealed a noninvasive low grade tumor on six occasions and two fibroepithelial polyps. Two ureteric tumors and 1 pelvic tumor were treated by retrograde ureterorenoscopy (2 resections and 1 Nd/Yag laser photocoagulation). Five patients were treated percutaneously (resection alone or combined with Nd/Yag laser). Four patients received local chemotherapy. Patient follow-up ranged from 1 to 3 years. Tumor recurrence was observed in 3 patients treated by percutaneous resection.

Aged↗

PubMedDate not supplied

[Renal autotransplantation in the treatment of renovascular hypertension].

Surgery plays an important role in the treatment of renovascular Hypertension (RVHT). 123 RVHT carrier patients were treated by means of 101 single autotransplants (11 double autotransplants) and 34 autotransplants preceded by extracorporeal replacement of the branches of the renal artery (1 bilateral case). Taken all round, the patients improved either totally or partly (93.5%). In lesions involving multiple branches of the renal artery, replacement of these by a hypogastric autologous arterial transplant is regularly the only technique possible to save the kidney.

Adolescent↗

PubMedDate not supplied

[Percutaneous endopyelotomy].

Endourologic treatment of the ureteropelvic junction syndrome was performed 48 times in 45 patients (1 was bilateral, and 2 required repeat treatment) via a percutaneous incision of the stenosis, and placement of a modelling double-J catheter, which was left indwelling for 4 to 6 weeks. Evaluation of the results between 6 months and 3 years revealed a success rate of 81.5% for secondary stenosis and 73.7% for congenital stenosis. If the foregoing technique fails, pyeloplasty can be performed without difficulty.

Adult↗

PubMedDate not supplied

Effects of arginine and arginine plus somatostatin infusion on insulin release in diabetic patients submitted to pancreas allotransplantation.

The present study was aimed at evaluating the role of the Autonomic Nervous System (ANS) in the insulin (IRI) response to arginine in humans. Nine patients who were recipients of simultaneous segmental pancreatic and renal grafts (6 receiving steroids and azathioprine as immuno suppression therapy, 3 treated with Cyclosporine A), 3 non-diabetic patients with kidney grafts (receiving steroid and azathioprine) and 10 normal subjects were studied. Arginine induced a clear IRI release in all subjects with no significant difference among the groups. Somatostatin (SRIF) inhibited IRI release to a similar degree in all subjects. Since the transplanted pancreas is completely denervated, these data suggest that the integrity of the ANS is not essential to the IRI response to arginine, nor for the inhibitory effect of SRIF on IRI release.

Adult↗

PubMedDate not supplied

[Anesthesia of primates (macaca and baboons) under ketamine and neuroleptanalgesia].

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Anesthesia↗