Shaul M. Shasha

Successful Pregnancy in a Patient with Polycystic Kidney Disease and Advanced Renal Failure without Prophylactic Dialysis

Pregnancies in women suffering from advanced chronic renal failure are frequently associated with deterioration of maternal renal function, premature births and low birth weights. Prophylactic dialysis is sometimes instituted since this intervention ameliorates the uremic milieu and improves maternal status and fetal uterine environment. This report describes a successful pregnancy and delivery in a hypertensive woman with advanced chronic renal failure due to polycystic kidney disease without accelerating the natural deterioration of renal function and without instituting prophylactic dialysis. The infant was delivered at full term with a normal birth weight. Thirty months after delivery, growth and development of the child were normal and the rate of deterioration of maternal renal function, assessed by 1/creatinine, was unaffected by pregnancy. Conservative management and effective control of blood pressure may be sufficient to achieve successful pregnancy outcome when women with advanced chronic renal failure become pregnant.

Tubal anastomosis in the rat using the tissue adhesive cyanoacrylate (Histoacryl

n-Butyl-2-cyanoacrylate (Histoacryl) is said to be as effective as microsurgery for tubal anastomosis. In a prospective controlled study at the regional teaching hospital research laboratories, 40 female laboratory rats underwent laparotomy, with ligation of the uterine horns, and reanastomosis by microsurgery or cyanoacrylate tissue adhesive. Main outcome measures were patency of uterine horns following anastomosis, histologic examination of anastomotic sites and pregnancy rate following anastomosis by each of the two methods. Patency rates were 100% with both methods of anastomosis, although foreign-body granulomas were more prominent in horns anastomosed by microsurgery. When cyanoacrylate was used on one horn and the contralateral horn ligated, a 90% pregnancy rate was achieved; when microsurgery was used, the pregnancy rate was 80%. In microsurgically anastomosed tubes there was a longer narrow segment, resulting in a lower number of embryos per rat. Cyanoacrylate tissue adhesive is successful in tubal reanastomosis and has certain advantages over classical microsurgical techniques: fewer foreign-body granulomas occur; there is less narrowing of the uterine horn; less skill is required in its use.

Jewish Medicine and the University of Padua: Contribution of the Padua Graduate Toviah Cohen to Nephrology

During the period of the 11th to 17th century, the access of Jews to European universities was restricted and even those who were fortunate enough to be admitted to a university were not awarded a degree at the end of their studies. An exception to this situation was the University of Padua that allowed Jewish students to study and awarded them degrees; indeed 229 physicians graduated from this university between 1409 and 1721. Among these physicians there were many luminaries such as Joseph Del Medigo, Salmon Congeliano and Toviah Cohen. The latter made many contributions to the field of nephrology. In this treatise Maaseh Toviah he discussed uroscopy, kidney function, body fluid homeostasis and obstructive uropathy.

On the Continued Reconstruction of the History of Nephrology

Accessible online at: www.karger.com/journals/ajn The Third Congress of the International Association for the History of Nephrology (IAHN) was originally scheduled to be held on October 29 to November 1, 2000, in Jerusalem. Unfortunately, the disturbing events that began to unfold in Israel in the fall of that year necessitated the cancellation of the Congress the week before the anticipated meeting. While the initial intent was to reschedule the meeting in Jerusalem in the spring of 2001, the continuous and accelerating local turmoil soon made it evident that this would be an unlikely possibility in the immediate future. It was only then that another venue was sought in the summer of 2001. Professors Guido Bellinghieri and Vincenzo Savica of the Faculty of Medicine of the University of Messina were kind enough to volunteer to host the Congress in Taormina, Sicily, on November 15–18, 2001. Regrettably, the short lead time available did not permit public announcements of the Congress and the limited available resources allowed only the presenters of the original program to be notified and invited. The Congress was held under the auspices of the President of Sicily Region, the Italian Society of Nephrology, the Minister of Health of Sicily Region, the University of Messina and its Faculty of Medicine, the President of the Province of Messina, the Mayor of Messina, the Order of Medical Doctors of Messina, AAPIT of the City of Messina and the Opera of the University of Messina. All were represented at the opening ceremony of the Congress. During the opening ceremony Honorary Membership Medals were presented to Professors Ori S. Better, Charles Kleeman, Silvana Favaro and Taddeus Orlowski. The meetings were held in the bucolic Hotel San Domenico in Taormina, Sicily. Appropriately, the hotel was once a Dominican monastery and center of learning for the preservation and reproduction of manuscripts, with its scriptorium and appropriate accoutrements. The sessions were held in what used to be the church of the monastery, and what used to be the altar served as the podium of the session chairs. The program of the congress, with a few exceptions, was the one developed for presentation in Jerusalem by the Program Committee of that meeting, consisting of Shaul Shasha, Shaul G. Massry, Ori S. Better, Natale G. De Santo, Garabed Eknoyan and Shmel Kotek. The IAHN was founded in 1994, in response to interest expressed at an International Conference on the History of Nephrology organized by Natale G. De Santo and held in Naples, Italy, on October 14–16, 1993. Subsequent congresses were held under the banner of the IAHN in Kos, Greece, on October 14–16, 1996, and in Padua, Italy, on October 4–7, 1998. The proceedings of those meetings have been published as the History of Nephrology 1, 2, and 3. The proceedings of the meeting in Taormina are now presented as the History of Nephrology 4, published as a bound volume as well as a special issue of the American Journal of Nephrology.