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Biomedical subjects

M D Jendrisak

Publications and source records attributed to M D Jendrisak.

27 records · Page 2Linked to original sources
PubMed1990

Vascular access in patients with arterial insufficiency. Construction of proximal bridge fistulae based on inflow from axillary branch arteries.

Patients with renal failure and underlying peripheral vascular disease pose a difficult management problem in establishing long-term angioaccess for chronic hemodialysis. This report summarizes our experience with five debilitated patients who developed acute upper extremity ischemia after forearm fistula construction corrected by fistula ligation. Successful angioaccess was achieved without ischemia recurrence by construction of proximal bridge fistulae with arterial inflow based on branch arteries of the axillary artery. The relatively small size of the branch vessel was the main factor in limiting fistula flow while permitting normal distal axillary artery flow. In four patients direct fistula flow measurements ranged from 200 mL per minute to 620 mL per minute. Axillary arterial flow distal to the fistula ranged from 120 to 200 mL per minute and did not significantly change after fistula construction or during temporary occlusion of the fistula. Four of the five patients continue to dialyze uneventfully from 4 to 8.5 months. One patient died after discontinuation of dialysis 1 month after operation.

Aged↗
PubMed1989

Concomitant immunosuppression and donor-specific transfusions prior to renal transplantation.

The induction of immunologic unresponsiveness to improve renal allograft survival was attempted in 151 patients by the pretransplant administration of donor-specific whole blood or buffy coat in conjunction with continuous Aza immunosuppression. All donor-recipient combinations were at least one-haplotype disparate and 21 were two-haplotype disparate. Presensitization was present in ten patients and attempts at desensitization were uniformly unsuccessful. Of the 151 nonpresensitized patients, transient sensitization occurred in 3% and permanent sensitization in 7%. Of 140 nonsensitized patients, 135 underwent renal transplantation from the specific blood donor and 56% have never experienced a rejection episode. The allograft survival rate at two years (93%) and seven years (87%) is significantly better (p less than .01) than our historical experience with one-haplotype living-related transplants at two years (68%) and seven years (59%). The low rate of sensitization (7%) has permitted almost all patients to undergo eventual renal transplantation from the specific blood donor. This and the low rate of early rejection (2%) argues for a modification of the immunologic response, perhaps by clonal deletion, rather than a selecting out process as the mechanism for improved allograft survival.

Azathioprine↗
PubMed1988

Eicosanoid synthesis inhibition and renal allograft function during acute rejection.

The effects of the dual cyclooxygenase-lipoxygenase inhibitor 3-amino-1-(m[trifluoromethyl]phenyl)-2-pyrazoline (BW755C) (10 mg/kg, p.o., b.i.d.) on renal blood flow, glomerular filtration rate (GFR), and eicosanoid production were examined in anesthetized dogs that had undergone unilateral renal allotransplantation. Rejecting renal allograft blood flow significantly declined over a 5-day period compared to the nonrejecting native kidney. In animals treated with BW755C, renal allograft blood flow was maintained over the postoperative 5-day period at levels comparable to blood flow to the native kidneys. While GFR and urine flow progressively declined in the rejecting kidney, treatment with BW755C prevented the fall in GFR and even augmented urine flow. Allograft renal cortical production or thromboxane B2 (TXB2) and leukotriene B4 (LTB4) in animals treated with BW755C was not significantly different than production by the native contralateral kidneys. Furthermore, BW755C reduced cellular infiltration and tissue damage in allografts compared to nontreated renal allografts. The selective cyclooxygenase inhibitor, indomethacin (5 mg/kg, p.o., b.i.d.) exerted no effect on renal allograft GFR or urine output but reduced allograft blood flow after 4 days compared to nontreated allografts. In conclusion, inhibition of arachidonate cyclooxygenase and lipoxygenase metabolism improves renal allograft function and reduces tissue damage while selective inhibition of the cyclooxygenase pathway does not improve renal allograft function. These data indicate that products of arachidonate-lipoxygenase metabolism potentiate the loss of renal function and tissue destruction associated with renal allograft rejection.

4,5-Dihydro-1-(3-(trifluoromethyl)phenyl)-1H-pyraz↗
PubMed1988

Renal allograft recipient immunomodulation by concomitant immunosuppression and donor-specific transfusions.

The induction of immunologic unresponsiveness to improve renal allograft survival was attempted in 151 patients by the pretransplant administration of donor-specific whole blood or buffy coat in conjunction with continuous Aza immunosuppression. All donor-recipient combinations were at least one-haplotype disparate and 21 were two-haplotype disparate. Presensitization was present in ten patients and attempts at desensitization were uniformly unsuccessful. Of the 151 nonpresensitized patients, transient sensitization occurred in 3% and permanent sensitization in 7%. One hundred thirty-five of 140 nonsensitized patients underwent renal transplantation from the specific blood donor and 56% have never experienced a rejection episode. The allograft survival rate at 2 years (93%) and 7 years (87%) is significantly better (P less than .01) than our historical experience with one-haplotype living-related transplants at 2 years (68%) and 7 years (59%). The low rate of sensitization (7%) has permitted almost all patients to undergo eventual renal transplantation from the specific blood donor. This and the low rate of early rejection (2%) argue for a modification of the immunologic response, perhaps by clonal deletion, rather than a selecting-out process as the mechanism for improved allograft survival.

Azathioprine↗
PubMed1987

Preoperative immunomodulation of renal allograft recipients by concomitant immunosuppression and donor-specific transfusions.

The induction of immunologic unresponsiveness to improve renal allograft survival was attempted in 113 patients by the pretransplant administration of donor-specific whole blood or buffy coat in conjunction with continuous Aza immunosuppression. All donor/recipient combinations were at least 1-haplotype disparate and 17 were 2-haplotype disparate. Presensitization, defined as a positive Amos or antiglobulin T cell CM or a positive high-titer (greater than or equal to 1:8) B cell CM was present in 10 patients and not present in 103 patients. Attempts at desensitization of the already sensitized group were uniformly unsuccessful. Treatment of the 103 nonpresensitized patients resulted in transient sensitization in 3 patients, permanent sensitization in 8, and no evidence of sensitization in 92. Ninety-one nonsensitized patients underwent renal transplantation from the specific blood donor, and only 5 have experienced renal allograft rejection loss during a mean follow-up period of 26 months (6 to 70 months). Fifty-four percent have never experienced a rejection episode. The allograft survival rate at 2 years (91%) and 5 years (89%) is significantly better (P less than .01) than our historical experience with 1-haplotype living-related transplants at 2 years (66%) and 5 years (64%). The low rate of sensitization (8%) has permitted almost all patients to undergo eventual renal transplantation from the specific blood donor. This and the low rate of rejection (5%) argues for a modification of the immunologic response rather than a selecting out process as the mechanism for improved allograft survival.

Azathioprine↗
PubMed1986

Spontaneous abdominal aortic rupture from erosion by a lumbar spine fixation device: a case report.

Spontaneous retroperitoneal hemorrhage is an uncommon event. A case of delayed postoperative aortic rupture from erosion by a spinal fixation device, heretofore not previously described, is presented to call attention to this potential catastrophe. Appropriate management includes aggressive patient resuscitation and early surgical intervention with initial proximal and distal control of the aorta, removal of the offending prosthetic appliance, and repair of the vascular injury. Prevention of this complication of vascular erosion by an implanted foreign body requires absolute avoidance of impingement on any medium or large artery.

Adult↗
PubMed1982

Properties of a surface antigen expressed on activated human thymus-derived lymphocytes.

We have identified previously a quantitatively minor membrane protein (p28) with an apparent reduced m.w. of 28,000, which is biosynthetically labeled in activated human lymphocytes. Rabbit antisera with activity directed against p28 (alpha-ATC) were prepared and p28 was identified by immunoprecipitation in NP-40 extracts of activated, extrinsically labeled lymphocytes. p28 was not expressed in appreciable amounts by unstimulated T cells, stimulated or unstimulated B cells, null cells, or adherent cells. Protein p28 was only minimally represented on resting thymocytes but was easily detected on 4-hr activated thymocytes and the T lymphoblastoid cell lines HSB2 and MOLT-4. Absorption and immunoprecipitation studies with alpha-ATC indicated that p28 was not present on erythrocytes, platelets, neutrophils, six B cell lines, six null cell lines, and seven other T lymphoblastoid cell lines. Protein p28 from HSB2 cells was absorbed by lentil lectin, concanavalin A, and wheat germ agglutinin affinity columns and was eluted with the appropriate sugars. Gel filtration column chromatography of unreduced p28 in the presence of 0.5% NP-40 or 0.1% deoxycholate gave elution characteristics consistent with a m.w. of approximately 60,000 to 100,000. In preparative isoelectric focusing (IEF) studies the isoelectric point (pI (p28) = 5.2 to 6.1) was similar or identical to that described for the reduced and denatured protein in two-dimensional polyacrylamide gels (pI = 5.5 to 6.2). Protein p28 was eluted from DEAE-cellulose (Whatman DE-52) ion exchange columns at 0.05 to 0.15 M NaCl. Experiments with monoclonal antibodies or heteroantisera specific for other T cell and B cell antigens and various lymphoblastoid cell lines and normal peripheral blood cells indicated that p28 is distinct from the human Ia-like antigens, from T3, T4, T5, T8, and from several other reported human T cell antigens that appear to correspond to Thy-1, the sheep erythrocyte receptor, and a human thymus-leukemia antigen.

Absorption↗