Showing papers by "Ochsner Medical Center published in 1990"
TL;DR: Theophylline attenuates the production of erythropoietin in both normal subjects and patients with erythrocytosis after renal transplantation and may be useful in the treatment of the latter condition.
Abstract: Background. Erythrocytosis occurs in 10 to 15 percent of renal-transplant recipients, and there is in vitro evidence that the production of erythropoietin is modulated by adenosine. Methods. We prospectively evaluated the effects of theophylline, a nonselective adenosine antagonist, in eight patients with erythrocytosis after renal transplantation and in five normal controls. Results. After an eight-week course of theophylline treatment, the mean (±SEM) serum erythropoietin levels were significantly reduced in both the renal-transplant recipients (from 60±14 units per liter at base line to 9±7 units after treatment; P<0.05) and the normal subjects (from 6.9±0.8 units per liter at base line to 4.7±0.5 units per liter after treatment; P<0.05). Similarly, the hematocrits were reduced in both the transplant recipients (from 0.58±0.04 at base line to 0.46±0.03 after treatment; P<0.05) and the normal subjects (from 0.43±0.01 at base line to 0.39±0.01; P<0.05). In the renal-transplant recipients, red-ce...
117 citations
TL;DR: Perioperative assessment and surgical management are reported for three oropharyngeal teratomas, rare congenital neoplasms that distort orofacial anatomy and often cause respiratory embarrassment at birth.
24 citations
TL;DR: The experience with 71 patients who had a femorofemoral bypass for unilateral iliac artery occlusion or stenosis was reviewed, morbidity, mortality, initial relief of symptoms, early patency, and long-term primary and secondary patency; and the cause of graft failure was identified.
Abstract: We have reviewed our experience with 71 patients who had a femorofemoral bypass for unilateral iliac artery occlusion or stenosis. We analyzed morbidity, mortality, initial relief of symptoms, early patency, and long-term primary and secondary patency; and we attempted to identify the cause of graft failure. The overall hospital mortality after operative repair was 4%. One-year survival was 84% and 2-year survival was 81%. Early patency was 98.5% at 1 month, late patency was 91% at 1 year and 82% at 5 years. The major cause of graft failure was inadequate run-off and outflow disease progression.
21 citations
Journal Article•
TL;DR: A case of Wilms' tumor is reported in a 13-month-old boy who, after radical left nephrectomy, developed a left testicular mass that turned out to be metastatic Wilm's tumor.
Abstract: Wilms' tumors account for the vast majority of renal neoplasms in infants and children. Common areas for metastases include the lung, liver, and contralateral kidney. Less common sites include the bone, skin, brain, and orbit. We report a case of Wilms' tumor in a 13-month-old boy who, after radical left nephrectomy, developed a left testicular mass that turned out to be metastatic Wilms' tumor. The epidemiology, case history, review of the literature, and possible etiology of this rare site of metastatic Wilms' tumor are discussed.
14 citations
TL;DR: It is concluded that flow cytometry is not a useful guide to malignant potential or prognosis in thymomas and thymic carcinomas.
Abstract: Thymomas are the most common anterior mediastinal masses. Malignant potential and prognosis are unrelated to histologic appearance. Deoxyribonucleic acid (DNA) flow cytometry is of prognostic significance in a variety of tumors. We reviewed the records of 35 patients who on pathologic examination had a thymoma or thymic carcinoma. Flow cytometric studies, including DNA indices (ploidy) and S phase fraction, were done on paraffin block specimens from 31 patients. We believe this is the first report of DNA flow cytometric studies in thymic pathology. Mean survival was 63.5 ± 13.3 months for patients with benign thymomas, 10.5 ± 4.6 months for patients with malignant thymomas, and 19.3 ± 4.1 months for patients with thymic carcinomas. Patients with benign thymomas lived significantly longer than those with malignant thymomas (P = .001) and thymic carcinomas (P = .03). DNA flow cytometry demonstrated four aneuploid tumors (two benign thymomas and two malignant thymomas). All thymic carcinomas were diploid. There was no statistically significant difference among the groups. The mean S phase fraction was 15.22% for benign thymomas, 11.15% for malignant thymomas, and 14.31% for thymic carcinomas. No statistically significant difference was found among the groups. We conclude that flow cytometry is not a useful guide to malignant potential or prognosis in thymomas and thymic carcinomas.
8 citations
TL;DR: Electrical and histologic studies showed that Groups A and D had marked extrafascicular escape of the regenerating nerve axons, disorganizational growth of minifascicles, and loss of integrity of the donor fascicles, while Groups B and C had very minimal extrafASCicular Escape of regenerating axons.
Abstract: This experiment evaluated the electrical and histologic differences between two groups of rats, one of which underwent same-length bilateral resection of posterior tibial nerves prior to being repaired with grafts of different lengths, while the other group underwent different-length resections with same-length graft repair. In this rat model, 18 animals were used and divided into two groups. The first group of animals underwent bilateral resection of 8-mm segments of posterior tibial nerve. To repair these nerves, one leg received two 8-mm sural nerve grafts (Group A), while the other leg received two 16-mm sural nerve grafts (Group B). The second group of rats underwent posterior tibial nerve resections of 8 mm and 16 mm, respectively. The leg with the 8 mm of posterior tibial nerve resected, received two side-by-side 16-mm sural nerve grafts (Group C); the other leg with 16 mm resected, received two 16-mm sural nerve grafts (Group D). Electrophysiologic comparison of nerve conduction velocity for Groups A and B showed a significant difference (p less than 0.05), as did the same comparison for Groups C and D (p less than 0.05). Histologic studies showed that Groups A and D had marked extrafascicular escape of the regenerating nerve axons, disorganizational growth of minifascicles, and loss of integrity of the donor fascicles, while Groups B and C had very minimal extrafascicular escape of regenerating axons.(ABSTRACT TRUNCATED AT 250 WORDS)
6 citations
Journal Article•
TL;DR: Any patient who has respiratory failure after repair of CDH should be supported with ECMO when conventional techniques fail as long as no contraindications exist and any patient should be refused ECMO support when conventional measures fail.
Abstract: Respiratory distress in newborns with CDH is the result of the interaction of pulmonary hypertension and pulmonary hypoplasia. Many patients will demonstrate adequate pulmonary parenchyma after repair as evidenced by adequate oxygenation and ventilation. Patients should be classified into groups of predicted mortality using Bohn's criteria. Patients in groups A, B, and D may be managed conventionally if blood gases can be kept in the normal range. These patients should be supported with ECMO if unresponsive to conventional management. In those patients with adequate gas exchange who fall into the C group, transfer to an ECMO center should be undertaken early, since mortality with continued conventional management is predictable. Some patients never demonstrate a "honeymoon" period, and mortality can be reliably predicted in this group as well by using Bohn's criteria. Because the relative significance of pulmonary hypoplasia compared with pulmonary hypertension in an individual patient cannot be reliably determined, any patient who has respiratory failure after repair of CDH should be supported with ECMO when conventional techniques fail as long as no contraindications exist. At least one institution will withhold ECMO therapy if lung parenchyma is judged inadequate as predicted by the inability to achieve a preductal PaO2 greater than 100 mm Hg and PaCO2 less than 50 mm Hg with maximal conventional therapy. In our experience, however, some patients can survive with ECMO support when all other indicators would suggest hypoplasia incompatible with life. Therefore, we do not believe any patient should be refused ECMO support when conventional measures fail.(ABSTRACT TRUNCATED AT 250 WORDS)
3 citations
01 Dec 1990
1 citations
01 Jul 1990
TL;DR: It is concluded that this unique delivery system and the pulsed Nd-YAG laser are a safe and effect method of recanalizing arterial stenoses not amenable to conventional balloon angioplasty alone.
Abstract: We performed a clinical trial to evaluate the safety and efficacy of a unique lensed-fiber delivery
system with a pulsed Neodymium-yttrium aluminum garnet (Nd-YAG) laser in patients with
atherosclerotic peripheral vascular disease. The lensed-fiber consists of a spherical silica lens, 1 .5 mm in
diameter, mounted at the distal tip of a 300 im silica optical fiber. The Nd-YAG laser is pulsed at 10 Hz,
and we delivered 0.5 J/pulse with a pulse duration of 100 msecs in 2- to 5-second bursts. Successful
recanalization of stenoses or occlusions was obtained in 9 of 10 patients and was manifested by
improvement in blood flow as measured angiographically and with ankle-brachial blood pressure index
improvement (> 0. 15). There were no arterial perforations or dissections associated with the laser
angioplasty. All successfully recanalized patients required adjunctive balloon angioplasty to obtain a
satisfactory reduction in luminal diameter stenosis of the treated artery. We conclude that this unique
delivery system and the pulsed Nd-YAG laser are a safe and effect method of recanalizing arterial stenoses
not amenable to conventional balloon angioplasty alone.