During a 33-month interval 106 consecutive renal transplants were performed. Prophylactic parenteral antibiotics, local wound irrigation with antibiotic solutions and drains were used. The over-all incidence of wound infection was 11.3 per cent. The true incidence in primary wounds was 8.4 per cent and in reopened wounds it was 21.7 per cent. Graft loss owing to infection was 33.3 per cent. Sepsis occurred in 25 per cent and death in 16.6 per cent of the patients with wound infection. The incidence of infections in hematomas was 27.5 per cent. The use of prophylactic measures contributed to a lower incidence of wound infection, while the use of drains and the occurrence of hematomas increased the incidence of infections.
Adrenal cortical carcinoma may present solely with a syndrome of mineralocorticoid excess. Primary aldosteronism, resulting from adrenal carcinoma, is unusual and has only been reported rarely. A review of the literature revealed 19 cases with marked hypertension and hypokalemia, resulting from mineralocorticoid excess produced by adrenal cortical carcinoma. We report an additional case that supports the hypothesis that adrenal carcinoma may mimic hyperaldosteronism. Extensive assay of adrenal function will demonstrate the presence of biologically inactive steroids, suggesting the presence of adrenal cortical carcinoma.
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