Thomas L. Marchioro

Renal Transplantation for Childhood Cystinosis

Abstract Four cystinotic children with renal failure received a renal allograft from a parent. The follow-up durations for the four patients were eight, 14, 16 and 32 months; final creatinine clear...

Monoclonal Immunoglobulin Deposition Disease in a Renal Allograft: Probable Recurrent Disease in a Patient Without Myeloma

A case in which monoclonal IgG-kappa deposition in the glomeruli of a renal allograft apparently resulted in graft failure is described. Review of biopsy material obtained from the patients native kidney biopsy indicates a high probability that this glomerulopathy represents recurrent disease in the allograft. The reported transplantation experience with this entity (monoclonal immunoglobulin deposition disease; light-chain nephropathy) is limited; this case indicates the potential for disease recurrence even in the absence of a systemic lymphoplasmacytic disorder.

The Use of Self-Retained Ureteral Stents in the Management of Urologic Complications in Renal Transplant Recipients

Nineteen self-retaining ureteral stents were used to manage postoperative ureteral obstruction and fistulas in 12 renal transplant recipients. In 3 patients with ureteral obstruction and 2 with a fistula placement of the self-retaining stents for 4 to 6 weeks allowed the complication to resolve. In 3 patients with ureteral obstruction placement of the self-retaining stents allowed for stabilization of the condition and reduction of immunosuppression therapy before an open surgical repair. In 6 patients self-retaining ureteral stents were used to protect the high risk anastomosis done at an open surgical repair of a complication. Placement of a self-retaining ureteral stent may be the best choice in the early management of ureteral obstruction and fistulas in transplant recipients.

Benign cartilaginous tumor (chondroma) of the liver

A 44-year-old woman with a large benign cartilaginous tumor (chondroma) of the liver is presented. After being followed up by computed tomography for 6 years and with imagining evidence for a recent increase in its size, this asymptomatic tumor was successfully removed at surgery. The resected tumor proved to be chondroma, a benign cartilaginous tumor. A review of the literature showed no previous reports of this type of hepatic neoplasm.

The diagnosis of hereditary pancreatitis by pancreatography

Hereditary pancreatitis is an uncommon disorder in which the diagnostic contributions of radiography have been minimal. When utilizing plain films, which show large, peripherally dense pancreatic calculi in approximately three-quarters of patients, and pancreatic ductography, which will define an elongated, dilated duct with large intraductal lithiasis, accurate and early diagnosis is possible.

Ureteroileostomy in renal transplant patients. A modified technique.

Abstract Five patients have received renal homografts with urinary drainage into ileal conduits since March 1970. The renal vessels were anastomosed end-to-side into the terminal vena cava and aorta. The ureter, in its normal dependent position, entered a short ileal segment. The only complication in the series was a parastomal hernia developing thirty-three months after the transplant. We believe this technique offers several advantages over those previously described.

Web-based education in computational science and engineering

The World Wide Web can be used both well and badly as an educational tool. When used well, it is especially suited to the needs of teaching computational science. It is argued that a growing body of good teaching materials for CSE are available, on the Web and otherwise.

Acquired immunodeficiency syndrome-related lymphoma of the lung presenting as empyema thoracis

B-cell lymphoma in patients infected with the human immunodeficiency virus is usually a disseminated process that occasionally involves the lungs. Surgical diagnosis is often necessary to distinguish this from other neoplasms or opportunistic infections of the lung. We report a case of pulmonary B-cell lymphoma in a patient infected with human immunodeficiency virus who presented with a left empyema thoracis and an associated left lower lobe abscess secondary to bronchial obstruction. Resection was performed and the patient subsequently recovered from the acute process and survived an additional 6 months. This report demonstrates that surgical intervention may be necessary for both the diagnosis of pulmonary lymphoma and the definitive management of infectious complications that may arise as a result of pulmonary neoplastic disease in patients with acquired immunodeficiency syndrome.

Ureteral stent in renal transplant recipients

Abstract The Gibbons indwelling ureteral stent was used in 5 renal recipients. Early post-operative obstructions at the ureterovesical junction in 2 cases and 1 at the ureteropelvic junction were treated by placing the stent through an open cystostomy. Late strictures were treated in 2 patients by inserting the stent endoscopically. It was also used to stent a ureteroureterostomy. After removal of the stent in 2 of 3 patients, no further treatment of the obstruction was required. In the third case it provided time to allow the steroid dose to be lowered so definitive repair could be undertaken. One stent has remained patent for fourteen months. The Gibbons stent appears to be a valuable new tool in the treatment of post-transplant ureteral obstruction.

Calculi in a Meckel's Diverticulum—A Cause of Chronic Anemia

The case of a 16-year-old boy referred with chronic anemia, the etiology of which was demonstrated to be a Meckels diverticulum with chronic ulcerations secondary to radio-opaque calculi, is reported.