Biomedical subjects
Publications and source records attributed to L Burrows.
Scanning with technetium-99m was used as a diagnostic aid in renal transplant patients with post-transplant oliguria. It is a safe and dependable method of determining whether the renal vasculature is still intact and can often be used to differentiate acute tubular necrosis from acute rejection.
The effect of cyproheptadine, a potent platelet deaggregator, was investigated in rats bearing renal allografts. Thirty-three bilaterally nephrectomized LEW rats received orthotopic transplants of a (LEW X BN)F-1 kidney. Fourteen rats were treated with cyproheptadine, 1.5 mg/kg i.m. daily, for 60 days after transplantation; the remaining animals served as controls. The median allograft survival time in the cyproheptadine group was prolonged to 64 days compared to 12 days in the untreated group (P less than 0.005). In the cyproheptadine group the blood urea nitrogen rose to over 150 mg/100 ml 1 week after transplantation, fell to 80-120 mg/100 ml, and then rose steadily from the day after transplantation until the death of the animals. Despite prolonged survival, cyproheptadine-treated animals usually showed the histological findings of acute and chronic renal rejection. Cyproheptadine may be a useful adjunct to immunosuppression in the management of human renal allotransplantation.
A review of the experience with 66 patients on chronic hemodialysis who underwent 67 major surgical procedures is presented. There were 58 general surgical procedures, and nine major cardiovascular procedures including four emergency cardiac valve replacements. The preoperative, intraoperative and postoperative management of these patients is discussed as well as the morbidity and mortality encountered. It is concluded that patients on well-managed chronic dialysis will tolerate minor and major surgery well and renal failure should no longer be regarded as a relative contraindication for appropriate elective or emergency surgery.
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A double wall PTFE graft with a silicone rubber middle layer (PTFE-sil) shown in a canine model to be self-sealing after needle puncture, was tried in 30 dialysis patients. Thirty-five patients with PTFE grafts were controls. All patients were followed for 1 year. In the PTFE-sil group, mean time to first dialysis was 1.3 days after implantation; during first 10 treatments, 17% of punctures did not bleed, 61% bled minimally, and 4% required 10 or more minutes of compression. No bleeding complications were encountered at any time. Complications of PTFE-sil vs. PTFE were as follows: thrombosis 36.6% vs. 28.5%; infection 13.3% vs. 11.4%; seroma 3% vs. 0%; steal 3% vs. 0%; pseudoaneurysm 0% vs. 17.1%; one year primary patency 63% vs. 66%; secondary patency 75% vs. 67%. In conclusion, the PTFE-sil graft, can be used immediately after implantation, sparing patient additional access procedures for acute dialysis. This results in less morbidity, decrease in bleeding complications, considerable shortening of hospital stay and significant reduction in expenses.