Renopancreatic transplant. Urologic complications

OBJECTIVE: Retrospective study of urological complications in our series of reno-pancreatic transplants. MATERIAL AND METHODS: Between February 1983 and May 1994 our group has conducted 93 RPT, 80 of which, mean age 36 +/- 6 years (24-54 years), are studied in this paper: 57 male and 23 female with an average time in dialysis of 20 +/- 15 months (0-84 months) and diabetes evolution of 21 +/- 5 years (11-37 years). RESULTS: Actuarial annual survival of patient, renal graft and pancreatic graft has been 85%, 79% and 74% respectively. Haematuria: 25% incidence, with graft pancreatitis etiology in 16 cases, rejection in 8 and urinary fistula in 6. Urinary infection: 85% incidence, symptomatic in 23 patients (29%) and asymptomatic in the remaining cases. Dysuria, urethritis and urethral stenosis: 14 patients, all male, most with both conditions associated. Reconversion of pancreatic exocrine secretion by intestinal route was performed in 7 patients. Urinary fistula: secondary to surgery in 9 cases and rejection in 4. Etiology of one case remained unknown. In 4 cases it was resolved with conservative treatment, and with surgical correction in 8. One patient required pancreatic transplantectomy and one patient died of AMI. CONCLUSIONS: Urological complication in RPT account for a significant morbidity, urinary fistula being the one with greater repercussion on the patient and pancreatic graft survival.     

NADPH-diaphorase-stained neurons after experimental epilepsy in rats

The aim of this study was to determine the neuronal participation of nitric oxide (NO) in experimental epilepsy. To reach this objective, we established the amount of cells presenting nitric oxide synthase (NOS) and the amygdaline concentrations in the L-arginine-nitric oxide synthesis pathway. A group of fully epileptic rats, induced by the kindling procedure and that had reached at least 10 generalized seizures, was studied. We evaluated behavioral stages, electroencephalographic activities, and histochemical NOS-positive cells and carried out high-pressure liquid chromatography (HPLC) determinations of arginine, citrulline, and glutamic acid. Our results showed that behavioral and electrographic frequency, and duration of epileptic activities, were increased during the kindling process. Image processing system of NOS cells showed two types of intensities in cell stains in hippocampus, caudate-putamen, and amygdala. When we independently counted the two types of NOS stain cells, a selective increase in the number and density of weak-stained cells was observed, while dark-stained cells did not change in the studied structures. Additionally, arginine, citrulline, and glutamic acid concentrations in amygdala increased in kindled animals. The differential and specific increase in the stained cells expressing the nitric oxide synthase, as well as the increase in concentrations of the L-arginine-nitric oxide pathway in amygdala, suggested a relationship with the progressive augmentation in the electrophysiological hyperactivity characteristic of generalized epilepsy.     

Comparison of morphologic assessment of hypertrophic cardiomyopathy by magnetic resonance versus echocardiographic imaging

To compare the value of echocardiography and magnetic resonance imaging (MRI) in the assessment of the amount and extent of hypertrophy in hypertrophic cardiomyopathy (HC) and, second, to correlate the degree of hypertrophy, as assessed by MRI, with clinical and electrocardiographic parameters, 30 consecutive patients (16 men and 14 women, aged 20 to 74 years) with HC were studied. Measurements of left ventricular wall thickness were performed at 11 predetermined segments (5 basal, 5 midventricular, and 1 apical) by 2-dimensional echocardiography and MRI. Two parameters derived from MRI studies were considered as indicators of the degree and extent of hypertrophy: (1) mean of the measured wall thickness at the 11 segments, and (2) the number of segments with thickness > 15 mm. Results showed that, from a total of 330 myocardial segments, thickness could be measured by echocardiography in 221 (67%), whereas MRI allowed measurement of 320 segments (97%). When compared with clinical and electrocardiographic data, no correlation was found regarding mean wall thickness and number of hypertrophied segments by MRI except for the presence of an abnormal electrocardiographic repolarization pattern. It is concluded that MRI allows a better assessment of the degree and extension of left ventricular hypertrophy than echocardiography in HC. Despite the precise information on hypertrophy provided by MRI, the amount and degree of hypertrophy bears no correlation with most of the clinical data in these patients.     

9-Benzyladenines: potent and selective cAMP phosphodiesterase inhibitors

A 6-year-old Quarter Horse gelding with acute onset of a grade-4/5 lameness of the left forelimb 21 days after an encounter with a porcupine was examined. Quills had been removed by the referring veterinarian, and the horse had been treated with antibiotics and hydrotherapy for 14 days. The horse was pyretic and had effusion in the digital synovial sheath. Signs of pain were elicited on palpation of the area. A tentative diagnosis of septic tenosynovitis caused by a porcupine quill was made. Exploratory tenoscopy revealed large amounts of fibrin in the sheath and a 1.2-cm quill. Bacteriologic culture of synovial fluid yielded a pure growth of Staphylococcus aureus. The horse improved dramatically after tenoscopic removal of the quill, debridement of fibrin, and lavage to dilute inflammatory mediators and bacteria, debridement of fibrin, discovery and removal of a quill, and complete evaluation of the sheath for prognostic purposes. Tenoscopy can provide a means for direct observation and enhance the ability of clinicians to debride a septic synovial sheath in a minimally invasive manner.     

A study of ionic defects in modified lead titanate ceramics

Pb_1–x Ca _x [(Co_0.5W_0.5)_0·05Ti_0.95]O₃ ceramics with x = 0.24, 0.30 and 0.35, are prepared by a solid state reaction of oxides. Deviations from nominal chemical compositions and formation of segregated phases different from modified lead titanate perovskites, are studied. Pyro- and non-pyroelectric currents excited in the material by a thermal wave are investigated and related to mobility of electrical charges in the materials.     

Effects of interstitial oxygen on microstructure and mechanical properties of Ti-48Al-2Cr-2Nb with fully lamellar and duplex microstructures

The effect of added oxygen in the range of 1000 to 4000 wt ppm on the microstructures of a Ti-48Al-2Cr-2Nb alloy has been investigated and compared to the microstructures for a high-purity alloy. For specimens cooled from theα phase, interstitial oxygen stabilizes the lamellar microstructure with respect toγ grains, with higher than equilibrium values for theα ₂ volume fraction. For specimens cooled from theα +γ phase field, the lamellar microstructure still tends to be favored by oxygen, but it is found that the phase volume fractions are not significantly different from equilibrium values. This suggests that interstitial O essentially reduces the kinetics of theα toα +γ transformation. Thus, interstitial oxygen will have a strong effect on microstructures obtained by continuous cooling fromα, but significantly less on those, such as the duplex microstructure, obtained by long treatment in theα +γ phase field. In general, increased O content is well correlated with reduced ductility. Finally, the role of interstitial oxygen on this phase transformation is discussed.     

The growth of ferrite in Fe-C-X alloys: The role of thermodynamics, diffusion, and interfacial conditions

The growth of allotriomorphic ferrite from austenite in Fe-C-X alloys is studied. Two systems have been selected: the Fe-C-Ni system, in which the substitutional alloying element is expected to have a weak interaction with both the C and the moving interface, and the Fe-C-Mo system, in which these interactions are expected to be non-negligible. The ferrite growth kinetics was measured using two types of experiments: classical isothermal heat treatments and decarburization experiments. All of the experimental observations can be quantitatively rationalized using a model that describes an evolution in interfacial conditions from paraequilibrium (PE) to local equilibrium with negligible partitioning (LENP) during growth. This article is based on a presentation made in the “Hillert Symposium on Thermodynamics & Kinetics of Migrating Interfaces in Steels and Other Complex Alloys,” December 2–3, 2004, organized by the The Royal Institute of Technology in Stockholm, Sweden.