Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028961 (oliguria)
 1,847 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ninety-three thromboembolic occlusions of peripheral arteries or grafts in 85 patients were treated with high-dose urokinase by direct intraarterial infusion. Urokinase was infused at 4000 IU/min until antegrade blood flow was reestablished and then at 1000 or 2000 IU/min until clot lysis was completed. Of the 93 infusions, 75 (81%) resulted in clinical improvement. The infusion therapy was incomplete in nine patients. The mean duration of the 84 completed infusions was 18 +/- 20 hr, the incidence of complete clot lysis was 83%, and the incidence of clinical improvement was 89%. Significant bleeding, requiring transfusion, occurred during or after four of the urokinase infusions (4%). Other complications included distad clot migration, thrombus formation on the catheter, revascularization phenomena, oliguria, skin rash, pseudoaneurysm, balloon rupture during angioplasty, and vascular spasm. There were no instances of drug resistance or adverse drug reactions. These results indicate that an initially high-dose urokinase regimen accomplishes more rapid recanalization, a higher incidence of total clot lysis, and produces fewer complications than the standard low-dose streptokinase regimen.
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PMID:Thrombolysis of peripheral arterial and graft occlusions: improved results using high-dose urokinase. 387 36

Postoperative renal impairment has been reported after kidney-preserving resection of retroperitoneal neuroblastomas (NB). To avoid renal damage, intraoperative procedures include monitoring of central venous pressure (CVP) and diuresis, i.v. administration of electrolyte solutions, mannitol, and furosemide, and local application of lidocaine to the renal vessels. During the first 5 postoperative (p.o.) days, CVP, diuresis, body temperature (T), and lactate dehydrogenase (LDH) levels were monitored; color Doppler ultrasound (CDUS) was also performed on the 7th p.o. day. Simultaneous increases of T (>38.5 degrees ) and LDH (>1,500 IU/l) and/or reduction of urinary flow (< 1.5 ml/kg.h) were indicative of renal damage: in these cases dopamine was administered and CDUS performed. If renal blood flow was normal on CDUS, dopamine was administered for another 2 days; if a vascular thrombosis was detected, fibrinolytic agents (urokinase 4,000 IU/kg bolus and then 4,000 IU/kg.h for 24 h) were utilized. Between May 1997 and June 2000, 29 children (9 F, 20 M, aged) 6-72 months (median 39) affected by grade II inoperable, grade III, and grade IV NB underwent these preventive procedures at the time of surgical excision of the mass after chemotherapy 23 had an uneventful p.o. course. CDUS at 7 days was normal in 22; in 1 (polar resection at operation) it demonstrated a slight reduction of blood flow in the renal cortex. For all 23 patients, the CDUS at 3, 6, and 12 months was negative. Three patients showed a single altered parameter; the CDUS p.o. and during follow-up did not show any alteration. The other 3 patients had two or more altered parameters and were treated with dopamine: in 1 the initial CDUS was normal, but it later showed moderate hypotrophy; in 2 patients a vascular thrombosis was documented. Treatment with urokinase was successful in only 1 patient who had a normalized CDUS after 3 months. The 2nd child developed renal failure and needed hemodyalisis. In our experience, elevation of serum LDH and T and/or oliguria were good indicators of renal impairment. CDUS was also useful in detecting renal blood flow reduction and artery occlusion. These preliminary results show these intra- and postoperative measures to reliably avoid renal impairment in these children. Long-term follow-up could confirm the efficacy of these methods.
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PMID:Measures to prevent renal impairment after resection of retroperitoneal neuroblastoma. 1241 62