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Biomedical subjects

T J Fuller

Publications and source records attributed to T J Fuller.

31 records · Page 2Linked to original sources
PubMed1977

Immune-complex glomerulonephritis in a patient with mixed connective tissue disease.

Renal involvement and hypocomplementemia in mixed connective tissue disease are reported to be rare. A patient is described here with mixed connective tissue disease and persistently low serum C'3 levels in whom renal insufficiency and nephrotic syndrome developed secondary to immune-complex glomerulonephritis. Light microscopy of the renal biopsy specimen showed predominantly a membranous lesion. Immunofluorescent staining showed granular deposition along the basement membrane of immunoglobulin G, immunoglobulin M, fibrinogen and C3. Electron microscopy showed numerous electron-dense deposits along the glomerular capillary membrane and in the mesangium.

Adult↗
PubMed1977

Reversible systemic abnormalities associated with renal cell carcinoma.

A sixty-eight-year-old male was found to have renal carcinoma after seven months of constitutional symptoms. Initial study of the patient showed a puzzling array of laboratory abnormalities. These led initially to a search for gastrointestinal malignancy and then later to consideration of multiple myeloma. This case serves as a reminder of the propensity of early renal carcinoma to produce striking constitutional symptoms and marked hematologic and serum protein abnormalities. These may occur in the absence of metastases and are frequently reversible as shown in this case with resection of the primary lesion.

Adenocarcinoma↗
PubMed1977

Prognostic value of angiography in management of severe acute renal transplant rejection.

Angiograms of 34 kidney transplant patients with progressive decrease in renal function after multiple doses of intravenous methylprednisolone (MP) were evaluated retrospectively in regard to the prognostic value of angiography. The following parameters were included in evaluation: prolonged arterial washout time, large vessel vasculitis, presence of arteriovenous shunting, poor cortical perfusion as evidenced by non-filling of cortical vessels, poor definition of cortico-medullary junction, and a poor nephrogram. When 1 to 3 of these abnormalities existed in angiogram, 67% of living related donor transplants (LRD) recovered under continued MP-therapy. With 4-6 angiographic abnormalities the recovery rate was reduced to 30%. The overall recovery rate for LRD transplants was 44%. Cadaveric transplants (CAD) had a statistically significant poorer prognosis as evidenced by only 8% recovery rate under continued MP-therapy.

Acute Disease↗
PubMed1976

Papillary necrosis in kidney transplant patients.

Of 158 renal transplant recipients, 75 underwent excretory urography at some point during a six-year period, 24 hours to 7 years after transplantation. In 11 patients, renal papillary necrosis (RPN) was found. RPN was associated in 9 patients with one or more disease entities known to be the etiologic factor to RPN in nontransplanted kidneys. In 2 patients, previous rejection episodes were the probable case for RPN. Renal papillary necrosis, a rather late complication with renal allograft, was demonstrated in this population on an average of 28.1 months after transplantation.

Adult↗
PubMed1976

Reversible changes of the muscle cell in experimental phosphorus deficiency.

Both animal and human studies suggest that either phosphorus depletion or hypophosphatemia might have an adverse effect on muscle function and composition. Recently a possible deleterious effect was noted in patients with chronic alcoholism. In this unexplained disease, a variety of toxic and nutritional disturbances could affect the muscle cell, thus obscuring the precise role of phosphorus. Accordingly, we examined eight conditioned dogs for the possibility that phosphorus deficiency per se might induce an abnormally low resting transmembrane electrical potential difference (Em) and alter the composition of the muscle cell. Eight conditioned dogs were fed a synthetic phosphorus-deficient but otherwise nutritionally adequate diet plus aluminum carbonate gel for a 28-day period followed by the same diet with phosphorus supplementation for an additional 28 days. Sequential measurements of Em and muscle composition were made at 0 and 28 days during depletion and again after phosphorus repletion. Serum inorganic phosphorus concentration (mg/100 ml) fell from 4.2 +/- 0.6 on day 0 t0 1.7 +/- 0.1 on day 28. Total muscle phosphorus content (mmol/100 g fat-free dry wt [FFDW]) fell from 28.5 +/- 1.8 on day 0 to 22.4 +/- 2.1 on day 28. During phosphorus depletion, average Em (-mV) fell from 92.6 +/- 4.2 to 77.9 +/- 4.1 mV (P less than 0.001). Muscle Na+ and Cl- content (meq/100 g FFDW) rose respectively from 11.8 +/- 3.2 to 17.2 +/- 2.8 (P less than 0.01) and from 8.4 +/- 1.4 to 12.7 +/- 2.0 (P less than 0.001). Total muscle water content rose from 331 +/- 12 to 353 +/- 20 g/100 FFDW (P less than 0.05). A slight, but nevertheless, significant drop in muscle potassium content, 43.7 +/- 2.0-39.7 +/- 2.2 meq/100 g FFDW (P less than 0.05) was also noted. After 4 wk of phosphorus repletion, all of these measurements returned toward control values. We conclude that moderate phosphorus depletion can induce reversible changes in skeletal muscle composition and transmembrane potential in the dog, and it apparently occurs independently of profound hypophosphatemia.

Animals↗
PubMed1976

Reversal of intractable uremic pericarditis by triamcinolone hexacetonide.

Of 74 patients undergoing long-term hemodialysis who were observed during a 21-month period, seven developed uremic pericarditis. Five of these patients developed intractable pericarditis, unresponsive to intensive dialysis and pericardiocentesis, and were treated with prolonged pericardial drainage (16 to 60 hours) by an indwelling polyethylene catheter and instillation of triamcinolone hexacetonide. Evidence of intractability was based on either the recurrence of cardiac tamponade after pericardiocentesis (two patients) or progression in the size of the pericardial effusion despite four weeks of intensive dialysis (three patients). These five patients recovered and subsequently were observed from 1 to 15 months with no evidence of recurrent pericarditis. This procedure may be an effective alternative to the surgical management of intractable uremic pericarditis, particularly in the patient at high risk for anesthesia and major surgery.

Adult↗
PubMed1976

Staphylococcal sepsis in patients on chronic hemodialysis regimens: intravenous treatment with vancomycin given once weekly.

Five patients on chronic hemodialysis regimens were hospitalized with six episodes of Staphylococcus aureus septicemia. Three of the patents acquired the infection during home dialysis, and it was related to the hemodialysis circulatory-access site in four. Initial therapy was methicillin sodium. Vanomycin hydrochloride was given in a 1-gm, single, weekly dose as the sole antibiotic after a short interval (mean, three days). Five of the six episodes were treated successfully. Staphylococcus epidermidis grew in blood cultures obtained during one of the treatments. The advantages of this regimen included a more prompt ambulation and the discontuation of constant infusions in patients with no peripheral veins available.

Adult↗