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Biomedical subjects

W P Geis

Publications and source records attributed to W P Geis.

At least 55 records · Page 3Linked to original sources
PubMed1978

Pseudolymphoma in renal allograft recipients.

Five renal transplant recipients exhibited giant systemic lymphadenopathy shortly after transplantation. Biopsy specimens did not show Hodgkin's lymphoma. Immunosuppression was continued in all patients. In contrast to the rapidly fatal course of malignant lymphoma in transplant recipients, adenopathy in these five patients has uniformly resolved. Patients have been observed for 6 to 15 months with no evidence of residual disease. Interval biopsy specimens are not malignant. Each patient received antithymocyte globulin from a single lot for 10 to 21 days after transplantation. During administration, T cell lymphocytes were suppressed to 5% of control values. When lymphadenopathy occurred, T cell values rebounded to 371% of control values. Toxoplasmosis titers as well as viral cultures of lymph node biopsy specimens were negative. These data indicate a benign course of this histologically malignant disease and suggest a lymphoblastic rebound phenomenon to antithymocyte globulin.

Herpesviridae Infections↗
PubMed1978

Antibody responses to influenza vaccination in patients with chronic renal failure.

A bivalent type A inactivated influenza virus vaccine containing both sets of H3N2 and Hsw1N1 antigens was given to patients with chronic renal failure and to control subjects. The patients were divided into an azotemic group in whom dialysis was not yet required and a hemodialyzed group. Hemagglutination-inhibition (HI) antibody responses were measured at time intervals of 1,3, and 4 weeks after vaccination. We found that the mean postvaccination HI titers against both sets of antigens in the patients as a group did not differ significantly from those found in the control subjects as a group. The proportion of responders showing a fourfold or greater increase in post-vaccination antibody responses over prevaccination antibody values for either set of antigens was similar in both groups of patients and the group of control subjects. In general, an inverse correlation was found between prevaccination antibody levels and postvaccination antibody responses in both patients and control subjects. The only exception to this trend was the response of two of the azotemic patients to the H3N2 antigens who failed to respond despite low prevaccination antibody levels. These were the patients with the highest serum creatinine values.

Adult↗
PubMed1978

Intraperitoneal infusion of a nonabsorbable steroid in hemodialysis-associated ascites.

Ascites occurring in long-term hemodialysis patients continues to be a difficult management problem. Several modalities have been employed with varying success. Because of the similarities between uremic pericardial effusion and hemodialysis-associated ascites, infusion of the nonabsorbable steroid, triamcinolone hexacetonide, was attempted in five patients with the latter ailment which had become intractable. None of the patients responded and in two there were adverse effects. We conclude that for the management of this variety of ascites, intraperitoneal administration of a nonabsorbable steroid is ineffective and may be accompanied by undesirable reactions.

Ascites↗
PubMed1977

Hepatic complications.

Hepatic dysfunction is one of the most common complications following major surgical intervention, and it presents a wide spectrum of clinical manifestations as discussed. Recent progress in hepatology has provided better knowledge in etiology and pathophysiology of hepatic dysfunction and its sequelae. In addition, modern medical technology has made the diagnosis of liver disease easier and more precise. Underlying liver disease should be disclosed precisely prior to surgery and surgical complication minimized for patients with hepatic impairment. If hepatic complications occur following surgical intervention, the most logical etiology and pathophysiologic explanation should be found, utilizing all the clinical and laboratory data and diagnostic procedures in order to institute proper treatment. Specific complications in hepatic surgery are also discussed. A good understanding of pathophysiologic alterations following hepatic surgery is mandatory together with detailed anatomic knowledge and surgical skill in order to prevent and to treat serious complications.

Acute Kidney Injury↗
PubMed1977

Chronology and mode of reinnervation of the surgically denervated canine heart: functional and chemical correlates.

This study was undertaken to evaluate functionally the time and pattern of inotropic and chronotropic efferent cardiac reinnervation of the deneravated canine heart and to correlate functional data with regional myocardial catecholamine content and supersensitivity to norepinephrine. Our data indicate that efferent autonomic reinnervation takes place first in the atria, followed by a base-to-apex sequence in the ventricles, and that such reinnervation is functionally effective 9-12 mo after denervation. The return of neural function parallels the return of measurable quantities of myocardial norepinephrine and is accompanied by a decrease in supersensitivity to exogenous norepinephrine. The return to apparently complete functional reinnervation, however, cannot be quantitatively related to myocardial levels of catecholamine. Segmental myocardial supersensitivity to norepinephrine is sequentially reversed during progressive adrenergic reinnervation.

Adrenergic Fibers↗
PubMed1977

The intrinsic innervation of the canine heart: a functional study.

The intrinsic innervation of the heart has been described anatomically but seldom, functionally. These experiments were designed to verify and to evaluate the influence of intrinsic neural activation on the contractility of the atria and ventricles. Nine mongrel dogs underwent total cardiac denervation using the Geis two-stage technique. Following recovery, they were placed on total cardiopulmonary bypass. Balloons were inserted into each cardiac chamber, filled with saline, and used to record atrial and ventricular isovolumic pressures in response to intracoronary drug injections. The hearts were paced to avoid rate changes. Acetylcholine (ACh) (0.05-1.0 mug) was given to assess direct effects on the myocardium; nicotine (NIC) (25-200 mug) was used to produce indirect inotropic effects. d-Tubocurare (dTC) (1.0-2.5 mg) and tetrodotoxin (TTX) (10-30 mug) were used to differentiate the direct and the indirect effects. Both ACh and NIC produced qualitatively similar negative inotropic responses in both atria and ventricles. dTC usually produced a significantly greater blockade of responses to NIC than toACh. TTX administered to 12 other denervated dogs to differentiate direct and neurally mediated responses, completely blocked NIC-induced negative inotropy but did not change responses to ACh. The data show that (1) the intrinsic cardiac innervation can exert significant negative inotropic effects on atria and ventricles (10 to greater than 30%); (2) there is no functional evidence of participation by chromaffin cells in the inotropic responses to intrinsic nerve activation; (3) the negative inotropy produced by NIC is sensitive to dTC and, especially, TTX blockade. This is consistent with the mechanism of action being intrinsic neural stimulation.

Acetylcholine↗
PubMed1977

Prognostic significance of the active thymus derived rosette forming cells in renal allograft survival: a preliminary report.

The prognostic significance of hemodialysis, blood transfusions, total T (T-T) and active T (A-T) lymphocytes, as they relate to renal allograft survival, were evaluated in 36 renal transplant recipients. The A-T cell is thought to be a surveillance cell responsible for cellular immunity and the only prognostic factor for graft survival observed in this study. An 83% graft survival rate occurred in patients having a lower percentage of A-Ts (fewer surveillance cells) prior to renal transplantation, as compared to 50% graft survival in patients with a higher percentage of A-T cells. Evaluation of pretransplant T-T cells, phytohemagglutinin (PHA) response, and number of transfusions was not prognostic for graft survival. Similarly, there was no difference in graft survival rates in patients hemodialyzed for more vs less than 1 year. Patients hemodialyzed for more than a year received twice as many blood transfusions. There were no differences in the number of T-T or A-T lymphocytes in either group. However, lymphocytes from patients hemodialyzed less than a year were more responsive to PHA stimulation. These data suggest that pretransplant determination of A-T cell values may be prognostic for graft survival and may delineate patients, by an immunological parameter, who may be at high risk for allograft rejection.

Adolescent↗
PubMed1977

The reverse fistula for vascular access.

A new technique for vascualr access in the patient requiring chronic hemodialysis and who has had multiple failures of forearm fistulas involves the formation of a side-to-side anastomosis between the brachial artery and the basilic vein and creates reverse flow into the antecubital venous system. Attention to technical considerations will prevent edema of the arm and allow for future use of graft procedures, if necessary.

Adult↗
PubMed1976

Technical considerations in elderly renal allograft recipients.

Atherosclerosis in renal allograft recipients necessitated modification of vascular anastomoses in 62 per cent of patients older than forty years in contrast with 10 per cent in younger patients. Three forms of vascular disease occurred: atherosclerotic occlusion, tortuosity of vessels, and disruption of plaques by vascular clamps. Successful modifications of the procedure and avoidance of ischemic graft injury are described including relocation of the transplanted ureter.

Adolescent↗