Interventional radiologic procedures in the renal transplant

Percutaneous interventional procedures can be valuable in the evaluation and treatment of urologic complications of renal transplantation. Thirty-three patients underwent percutaneous procedures, including relief of obstruction by catheter nephrostomy, diagnostic antegrade pyelography with Whitaker testing, aspiration of various fluid collections (lymphocele, hematoma, urinoma, and abscess), and renal artery angioplasty, during a three year period at three institutions, to provide temporizing treatment and anatomic data. Surgical intervention was sometimes avoided, but more often it could be deferred to allow the patient to stabilize prior to surgery. Complications that required surgery occurred in two patients.     

Rosette inhibitory factor: T-lymphocyte subpopulation specificity and potential immunoregulatory role in hepatitis B virus infection

We have observed the disappearance of rosette inhibitory factor (RIF) from the serum of 19 patients with acute hepatitis B virus infection. This occurred at a time coinciding with the detection of anti-HBs. In addition, levels of RIF activity were significantly greater (P less than 0.001) in 35 HBsAg carriers who lacked anti-HBs when compared to 15 carriers who regularly demonstrated this antibody. In all instances, RIF effect was partial affecting some, but not all, T-lymphocytes from healthy donors were separated into TM (helper), TG (suppressor), and T0 (null) subpopulations by an immunoglobulin-ox-cell rosette depletion method. The effect of RIF on erythrocyte rosette formation and Fc-receptor expression in these subpopulations was assessed. TG-lymphocytes were found to be refractory to RIF-mediated suppression of erythrocyte rosette formation while TM-lymphocytes demonstrated an enhanced sensitivity to RIF. Incubation of TG-lymphocytes, potential TM-percursor cells, with RIF resulted in a decreased expression of new IgM-Fc receptors. In order to determine if any functional significance could be derived from these findings, the effect of RIF on in vitro immunoglobulin secretion was tested. Using pokeweed mitogen-stimulated mononuclear cell cultures, purified RIF-low density lipoprotein was shown to suppress IgM, IgG, and IgA secretion by 75.3, 74.3, and 59.3%, respectively. These data are consistent with the hypothesis that RIF is a potential immunoregulatory protein which could contribute to the lack of anti-HBs noted during the acute phase of hepatitis B and in the majority of HBsAg carriers.     

The scaphoid compression staple: an effective form of fixation

This paper involves an overview of bone healing with its relationship to tension and compression of osteotomy sites, followed by a presentation on the use of the Richards scaphoid compression staple as an effective form of fixation for closing abductory base wedge osteotomies.