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M Wiesel

Publications and source records attributed to M Wiesel.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Functional MR urography in patients with kidney transplantation].

PURPOSE: To assess the value of functional magnetic resonance urology for the noninvasive postoperative evaluation of renal transplants. METHODS: A saturation inversion projection sequence allows the selective imaging of strongly T1 weighted signal from the MR contrast agent. A control slab leads to images comparable to conventional urography which can be acquired as a sequence with four images per minute. RESULTS: 15 patients with urologic questionable findings after renal transplantation were studied. FMRU revealed in 6 patients normal findings, in 6 moderate dilatation of the renal pelvis without any urodynamic relevant obstruction. 3 pathologic findings, ureteral leak, ureteropelvic-junction obstruction and ureteral stenosis were diagnosed and consequently surgically treated. The imaging quality in all studies was diagnostic and urologically relevant. CONCLUSION: FMRU can be used as a noninvasive technique for the assessment of renal transplant in cases with suspicion of complication in the excretory system.

Adult↗
PubMed1997

[The clinical significance of renal cell carcinoma in dialysis dependent patients in comparison with kidney transplant recipients].

The clinical relevance of de novo Renal Cell Cancer was compared in chronic hemodialysis patients and renal allograft recipients. Clinical course of these patients was followed for 15 years. 21 of 788 patients who underwent radical nephrectomy were suffering from renal insufficiency at the time of surgery. Evaluated data included clinical symptoms; tumor histology and clinical course. 19 patients received chronic hemodialysis treatment. 7 patients demonstrated stable function of the allograft. 92% of patients receiving hemodialysis treatment did not show metastasis and none died of renal cell carcinoma. On the contrary, 71% of patients who underwent renal transplantation showed advanced tumor disease or metastasis. 3 patients have died of RCC. Aggressive tumor growth of RCC requires close follow up in patients who received a renal allograft.

Adult↗
PubMed1997

[False increased CK-MB value after cryoablation of the prostate without myocardial infarct].

The authors report on a profound increase in creatine kinase isoenzyme MB (CK-MB) activity in three patients following uneventful cryoablation of the prostate under general anaesthesia: Just after the arrival at the recovery room CK-MB levels were 321 U/l, 245 U/l and 433 U/l, respectively. Other clinical investigations as well as additional laboratory tests ruled out myocardial infarction in all three patients. Electrophoresis of the CK-isoenzymes revealed an increase in CK-BB activity and an increase in atypical CK-BB as a cause of these findings. The presence of these isoenzymes leading to interferences with the antibody commonly used in CK-MB assays could explain the determination of a false positive CK-MB elevation in the three patients. Moreover, it is shown that this method of CK-MB activity determination may result in CK-MB levels higher than 100% of the whole CK activity. In addition, it is discussed that in patients suffering from prostatic carcinoma or other malignoma, "non-CK-M elevations" may occur. Therefore, the authors conclude that after cryoablation of the prostate additional tests like troponin T test and 12 channel ECG are required to rule out suspected myocardial infarction.

Aged↗
PubMed1996

Methicillin-resistant Staphylococcus aureus control in hospitals: the French experience. Association des Pays de la Loire pour l'Eviction des Infections Nosocomiales.

The first cases of isolation of Staphylococcus aureus resistant to methicillin in France were published in 1962. However, until recently, very few epidemiological studies or attempts to control the epidemic have been done in France. In this article, we present the results of a prospective study performed during a 3-month period in 27 hospitals of the Région des Pays de la Loire. Among the 94,605 hospitalized patients included in the study, 0.45% (427) developed methicillin-resistant Staphylococcus aureus (MRSA) infections, the incidence rate ranging from 0% to 1.2%. Thirty-four percent of MRSA-infected patients were 80 years old or older, 30% had been transferred from another service and 19% from another hospital, 56% were hospitalized at least once during the previous year, MRSA had been isolated at least once previously in 18% of MRSA-infected patients, 19% died, 16% were transferred to another service and 11% to another hospital, and only 32% were discharged to their homes. A poor compliance to contact isolation precautions was observed in all hospitals: 46% of MRSA-infected patients were hospitalized in a private room; gloves, masks, and gowns were worn for the care of 63.4%, 14%, and 42.5% of MRSA-infected patients, respectively; and handwashing was feasible in the rooms of 52% of the patients.

Cross Infection↗
PubMed1996

[Effect of HLA compatibility on the transplanted kidney in relation to recipient age].

Donor-recipient histocompatibility, as evaluated by the HLA matching results, plays an important role in the outcome of renal transplants, although much controversy surrounds the benefit of kidney allocation based on HLA typing. In this report HLA matching and survival data on 1,342 transplants performed at the University of California at San Francisco between 1984 and 1992 and treated uniformly by quadruple immunosuppression were analyzed in relation to the recipient's age. With respect to the influence of the increasing number of mismatches from 0 to 6, the analysis revealed decreasing 3-year graft survival rates as follows: 85.4%; 87.3%; 71.3%; 78.2%; 75.8%; 70.9% and 67.5%. Whereas the impact of cold ischemia time and histocompatibility was equally important during the 3-year postoperative period, the essential positive influence of good HLA matching on the long-term graft survival was demonstrated. The children aged between 5 and 18 years were identified as a high-risk group by the analysis, HLA-A incompatibility being attributed to poor graft survival in this age group. With respect to the effect of HLA-A histoincompatibility, the data provide evidence that HLA-A matching results seem to play an important role in graft survival in children, whereas transplants well matched in terms of HLA-B did well in adult recipients. No age difference in the impact of HLA-DR could be detected. In conclusion, HLA matching is still essential. It seems that there are differences in the impact of HLA loci in relation to the recipient's age.

Adolescent↗
PubMed1996

[Repetitive immuno-embolization of inoperative liver metastases of renal cell carcinoma. Method characterization and preliminary results].

Interleukin 2 (IL2)-based immunotherapy is effective in a subgroup of patients with metastatic renal cancer, but cure from liver metastases is very rare and even the selection of patients to be treated is very much limited by the toxicity of IL2. To reduce this toxicity and to augment the efficacy of intrahepatic IL2 application, a protocol of combined rIL2 (3 mg/day) and Lipiodol (2-5 ml/day according to tumour size), via a catheter inserted percutaneously into the hepatic artery, was implemented. As an adverse reaction, moderate fever (WHO) grade I and II was noted. A partial remission was seen in one patient and stable disease in four patients over a period of 2-6 years (median 32.2 month). It seems that immuno-embolisation of otherwise intractable liver metastases of renal cancer is well tolerated and its efficacy may be augmented by optimisation of the therapeutic protocol.

Adult↗
PubMed1995

Transurethral incision of the prostate following renal transplantation.

Urinary retention in male patients after renal transplantation may cause serious complications in terms of graft function and even patient survival. Only few data concerning the management and outcome of these patients are reported in the literature. Therefore, we retrospectively analyzed the outcome of patients who underwent transurethral incision of the prostate immediately after renal transplantation. Between 1990 and 1993, we performed 259 renal transplantations and 15 patients had symptoms of urinary retention postoperatively. These patients underwent a midline transurethral incision of the prostate from the bladder neck to the verumontanum. Median peak flow preoperatively was 7 ml. per second (range 0 to 11.4) and median residual urine volume was 100 ml. (range 30 to 500). Median prostate volume was 28 ml. (range 12 to 45). After transurethral incision of the prostate a significant improvement (p < 0.001) in peak flow rates (19.6 ml. per second, range 8 to 49) as well as a significant decrease in residual urine volumes (40 ml., range 20 to 80) could be achieved. After a median followup of 19 months the effect was still present.

Adult↗