Assuntos
Transplante de Rim/fisiologia , Rim , Soluções para Preservação de Órgãos , Preservação de Órgãos/métodos , Doadores de Tecidos , Adenosina , Adolescente , Adulto , Idoso , Alopurinol , Criança , Feminino , Glutationa , Humanos , Insulina , Masculino , Pessoa de Meia-Idade , Rafinose , Fatores de TempoRESUMO
Five patients who suffered catastrophic colonic necrosis are presented. All patients were uremic and received sodium polystyrene (Kayexalate) in sorbitol enemas for the treatment of hyperkalemia shortly before the development of signs and symptoms of colonic necrosis. In all specimens extensive ischemic necrosis was present, and Kayexalate crystals were noted in the intestinal lumen. Four of the five patients eventually died. To further investigate the occurrence of colonic necrosis after the administration of Kayexalate in sorbitol enemas, a series of experiments were performed in rats. Two groups of Sprague-Dawley rats were studied. One group was made uremic by performance of bilateral nephrectomy. The other group underwent sham operation. Enemas of saline, Kayexalate alone, sorbitol alone, or Kayexalate in sorbitol were administered. In nonuremic rats, transmural necrosis was noted in seven of 10 rats receiving sorbitol enemas and in six of 10 rats receiving Kayexalate in sorbitol enemas. No significant pathologic changes were noted in the rats receiving other enemas. In uremic rats, extensive transmural necrosis was noted in all rats receiving enemas of sorbitol or Kayexalate in sorbitol. All of these 19 rats died within the period of observation compared with no deaths in 18 rats that received enemas without sorbitol (p less than 0.001).
Assuntos
Colo/patologia , Poliestirenos/efeitos adversos , Sorbitol/efeitos adversos , Uremia/tratamento farmacológico , Adolescente , Adulto , Animais , Colo/efeitos dos fármacos , Enema , Feminino , Humanos , Hiperpotassemia/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Necrose , Poliestirenos/administração & dosagem , Ratos , Sorbitol/administração & dosagemRESUMO
Sixty patients with Stage II malignant melanoma were evaluated in order to compare preoperative gallium67 total body scan, physical examination findings, and ultimate histologic findings in regard to the site of the primary lesion and status of the regional lymph nodes. Physical examination was a more efficient and a more sensitive method of evaluation compared to gallium67 scanning in these patients when assessing nodal involvement.
Assuntos
Radioisótopos de Gálio , Metástase Linfática/diagnóstico , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adolescente , Adulto , Idoso , Erros de Diagnóstico , Feminino , Humanos , Masculino , Melanoma/diagnóstico por imagem , Melanoma/cirurgia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Cintilografia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/cirurgiaRESUMO
Two patients recieving intravenous high dose methotrexate (MTX) and intracutaneous BCG injections as adjuvant treatment for osteogenic sarcoma suffered sudden cardiovascular collapse within minutes of infusion of MTX. These cases demonstrate that anaphylactic or idiosyncratic reactions to MTX and/or contaminants in these preparations do occur and that careful patient monitoring is required.
