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Biomedical subjects

K Butt

Publications and source records attributed to K Butt.

17 recordsLinked to original sources
PubMed1991

Excessive follicular recruitment and growth in mothers of spontaneous dizygotic twins.

We wished to establish the frequency, regularity and laterality of multiple ovulation in mothers of dizygotic (DZ) twins and controls. Subjects had regular menses and were not using oral contraceptives. Ovarian ultrasound scans were taken over a number of cycles in 21 mothers of DZ twins and 18 controls (including 13 mothers of monozygotic [MZ] twins). Multiple large follicles (greater than or equal to 12 mm diameter) were seen significantly more frequently in mothers of DZ twins (13/21 mothers, 24/77 cycles, average +/- SE follicles/cycle 1.34 +/- 0.11) than controls (2/18 mothers, 3/31 cycles, average 1.10 +/- 0.08). Both ipsilateral and contralateral multiple follicles were observed. In one case a mother of DZ twins showed multiple large follicles in 7 out of 10 cycles in which she was scanned, including both ipsi- and contralateral patterns of occurrence.

Adult↗
PubMed1991

Renal transplantation from elderly living donors.

A worldwide shortage of cadaveric donors has led to the increased utilization of elderly living donors, with controversial results. In an attempt to assess the effect of donor age on graft survival and subsequent renal function, we analyzed our clinical results in 276 consecutive recipients of living related renal transplants spanning both the cyclosporine and the azathioprine eras, of whom a total of 44 recipients received kidneys from donors over 55 years old. All recipients were otherwise similar in age, race, haplotype mismatch, number of retransplants, and number of pretransplant transfusions, apart from an increased number of diabetics among the CsA-treated recipients of elderly kidneys (38% vs. 14%). The cumulative patient and graft survival rates at 1 and 5 years were independent of donor age whether CsA or AZA was utilized. Nor was the incidence of rejection or infection significantly different in the older donor group when compared with the younger cohort. Short-term and intermediate-term renal function, as assessed by serum creatinine, was however poorer but stable in the older donor group when compared with the younger one. The mean serum creatinine levels at 1 year in the CsA- and AZA-treated recipients of kidneys from older donors were 2.4 and 2.0 mg/dl, respectively, compared with 1.6 and 1.4 mg/dl, respectively, when the donor age was less than 55 years (P less than 0.001). Since renal function at the end of the first posttransplant year is considered a determinant of long-term graft survival, this is a cause for concern, but in view of the universal shortage of organs and the negligible morbidity to donors, renal transplantation from elderly living donors remains an acceptable practice.

Age Factors↗
PubMed1978

Portacaval shunt with arterialization of the portal vein by means of a low flow arteriovenous fistula.

A new operative technique was designed combining an end-to-side portacaval shunt with arterialization of the intrahepatic portal vein by means of a saphenous vein graft between the right gastroepiploic artery and the stump of the portal vein. The objective of this operation is to perfuse the hepatic portion of the portal vein with a low volume of arterial blood to ameliorate the adverse metabolic consequences of portosystemic decompression. The procedure was performed upon 18 patients with one operative mortality. The mean follow-up period is 15.4 months. The benefits of this operation are evident in the prevention of hepatic decompensation and avoidance of encephalophy, thus permiting unrestricted protein intake. The operation is well tolerated, and the operative mortality appears to be less than that following conventional shunting procedures.

Adult↗
PubMed1977

Renal transplantation in children.

23 children aged 1--16 years of age have received renal transplantation during the years 1972-1975 at the Downstate Medical Center. Of 9 children transplanted from related donors, I died and 3 lost their kidney-2 were retransplanted; 1 lost the second graft. Of 14 children transplanted from cadaver donors, 2 died, and 3 lost their kidney. 3 were retransplanted; 2 of them lost the second and 1 the third kidney as wll. Hypertension is the most frequent early and late posttransplant complication. 65% of the original 25 patients now have functioning grafts and they are rehabilitated. The success of renal transplantation in children is similar to that in adults.

Adolescent↗
PubMed1977

Prognostic significance of portal pressure in patients with bleeding esophageal varices.

Portal pressure was determined in 76 patients during acute bleeding varices, and the degree of portal hypertension was related to the cessation or noncessation of hemorrhage with nonoperative management. A direct relationship between the severity of hemorrhage and the degree of portal hypertension was established. It is suggested that portal pressure be determined as soon as feasible when bleeding varices are suspected and that other causes of hemorrhage be carefully excluded. The obtained data are of great prognostic significance and might be helpful in planning the course of therapy in these individuals.

Adult↗
PubMed1976

Clinical study of second kidney transplantation.

During the period from November 1972 to February 1975, 39 patients received second renal grafts in our institution. The clinical course of the patients was analyzed and compared with 121 patients who received only one graft during the same period. The graft survival either from living related or cadaveric sources was inferior in the second graft group. However, mortality was not increased by re-transplantation. Major differences were noted in the occurrence of hyperacute or accelerated type rejections. There was a high incidence of this type of rejection in the second graft group, especially in the simultaneous retransplant group.

Adult↗
PubMed1976

Urologic complications in renal primary and retransplantation. Experience with 202 consecutive transplants.

In a period of two years, 202 kidneys were transplanted in 162 patients at the Downstate Medical Center. On hundred twenty-nine patients had primary transplantations, twenty-nine second transplantations, and five third transplantations. Urologic complications occurred in twenty-four of the patients (12%). There were eight complications involving the urinary bladder and fifteen ureteric complications. In twenty-one patients the complications appeared within six weeks after surgery. Surgical correction immediately upon diagnosis of the urinary complications resulted in a high degree of early restoration of the urinary tract continuity and preservation of renal function. Leakage from the bladder was frequently associated with previous surgery. In five of eight patients, bladder leakage occurred after the second or third transplantations. Complications of the urinary bladder in general had a significantly favorable prognosis as compared with ureteric complications. Although all the patients with bladder complications fully recovered and maintained good renal function, four patients with ureteric complications either died or lost the graft.

Adult↗
PubMed1976

Transplant nephrectomy and simultaneous second graft retransplantation.

Tranplant nephrectomy and retransplantation has become an established modality in treating patients with rejected kidney allografts. Experience with 29 patients who underwent simultaneous transplant nephrectomy and retransplantation is presented. This procedure did not involve a considerably greater risk than a primary transplant and had an almost equal rate of success. There was no significant correlation between survival or failure of the second graft and the time the patient had been on dialysis prior to the first transplant, the duration of first graft survival, or the source of the first or second kidney. Seventy-five percent of the failures in the second transplant group were due to hyperacute or accelerated rejection, and only 25% were rejected in an acute or chronic fashion. The high frequency of hyperacute and accelerated rejections is presumably a result of presensitization by the first transplant. An inadequate supply of cadaver kidneys prevented performance of the simultaneous procedure in all patients that required it.

Adolescent↗
PubMed1975

Continuous single pass perfusion of the isolated kidney.

The use of continuous single pass perfusion to study the metabolism of isolated kidneys reveals that active metabolic processes continue in the hypothermically preserved kidney. These preliminary experiments described demonstrated a rapid uptake of substrates from the perfusion media in the first 24 hrs of storage, followed by a release of organic acids in the subsequent 24 to 72 hrs. Urea was found to be easily eliminated from the kidney. This technique may be useful for studying events related to loss of renal function by pinpointing specific residual biochemical activity and lesions that occur during prolonged preservations. An eventual correction or prevention of such lesions might be feasible in order to improve preservation techniques.

Animals↗
PubMed1975

Arterialization of the liver in combination with a portacaval shunt in the dog.

A dog preparation has been developed combining an end-to-side portacaval shunt with arterialization of the hepatic portion of the portal vein through an anastomosis between the inferior branch of the splenic artery and the stump of the portal vein. In this dog preparation, total hepatic blood flow, perfusion of the intrahepatic portal vein, and sinusoidal pressure remained within the preoperative range in the majority of the dogs. The data presented indicate that arterialization of the liver, under those conditions, resulted in no histologic damage or atrophy of the parenchyma of the liver and was effective in achieving significant prolongation of life and prevention of most of the adverse metabolic sequelae that follow a portacaval shunt in dogs. The indocyanine green extraction was restored to normal. The extraction of ammonia was impaired in all dogs with shunts; however, a significantly better ammonia extraction was seen in dogs with arterialization of the liver. It is being postulated that the dual perfusion of the liver through the hepatic artery and the portal vein is essential for the maintenance of the normal morphologic and functional states of the liver in dogs. The avoidance of hyperfusion of the sinusoidal bed with arterial blood is the most critical factor in preventing morphologic damage of the liver if arterialization of the portal vein is used.

Ammonia↗