Simultaneous bilateral simple nephrectomy.

Bilateral simultaneous nephrectomy is a rare procedure usually performed for end-stage renal disease, most often because of persistent hypertension after renal transplantation. Four trocars generally are inserted, with a lower abdominal and a subcostal port being used by the surgeon. An intra-abdominal pressure of 8 to 10 mm Hg is used during the procedure. The first kidney is left in situ while the other one is being dissected. Unless there is infection or malignancy, a retrieval sac is not used. In our series of 13 cases, the operating times ranged from 240 to 390 minutes (mean 320 minutes), and the mean 125 mL. Surgical discharges criteria usually were met on postoperative day 1 or 2. Laparoscopic bilateral nephrectomy in a single session is feasible in nearly all properly selected cases, even in patients with previous abdominal surgery or peritoneal dialysis. The operation takes longer than open surgery and may have a higher complication rate, but recovery is faster.

An epidemiological study on paramyxovirus antibody titers in multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis.

The present epidemiological study concerned and evaluation of the level of measles antibodies (hemagglutination inhibition (HI) assay) and para-influenza-1 (Sendai) antibodies (complement fixation (CF) test) in serum of 107 control individuals (38 women), 176 multiple sclerosis (MS) patients (93 women), 717 relatives to MS patients (361 women), 9 patients with systemic lupus erythematosus (SLE) (all women), 46 relatives to SLE patients (28 women), 57 patients with rheumatoid arthritis (RA) (37 women), and 143 relatives to RA patients (85 women). In MS and their relatives the HI titer value was significantly raised and the CF titer only insignificantly increased. In SLE the HI titers were insignificantly raised but the CF values significantly decreased. In RA HI values were insignificatly raised, but the CF values were significantly decreased among females lacking rheumatoid factor in serum. In the individuals under study, HI values did not correlate with CF values. In MS two groups of patients could be treated, i.e. one group with raised HI values and one with normal distribution of titers. The data obtained are discussed in light of the theory, that all three disease entities may be "Slow Virus Diseases".