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Biomedical subjects

A J Pull ter Gunne

Publications and source records attributed to A J Pull ter Gunne.

11 recordsLinked to original sources
PubMed1996

[Moderate results of the treatment of femoral shaft fractures in children using intramedullary fixation].

OBJECTIVE: To evaluate the results of treatment of femoral shaft fractures in children with intramedullary nailing. DESIGN: Retrospective. SETTING: Department of Surgery, University Hospital Utrecht, Department of Paediatric Surgery, Wilhelmina Children's Hospital, Utrecht. METHOD: Between 1982 and 1993, 27 femoral shaft fractures in 27 patients under the age of 16 were treated by intramedullary nailing. The charts and radiographs of these patients were reviewed and 24 patients were seen for follow-up examination (mean 7.5 years). Leg length was measured radiographically and anteversion of the affected and normal femora was determined by a standard computed tomography (CT) study. RESULTS: The average hospital stay was 34 days. There were no postoperative complications. At follow-up 10 patients had a leg length discrepancy < 1 cm and a rotational deformity < 10 degrees. Three patients had a shortening of the injured leg > 1 cm (max. 1.7 cm), in 6 patients the injured leg was more than 1 cm longer (max. 3.5 cm). The difference in rotation between fracture side and unaffected side was > 10 degrees in 9 patients. In 6 patients this was due to increased exorotation (max. 22 degrees) and in 3 patients to increased endorotation (max. 27 degrees). Iatrogenic injury of the epiphyseal line was not seen. CONCLUSION: Regarding leg length differences and rotational deformities intramedullary nailing was not superior to the known results of conservative treatment. The indication for operation should be carefully considered and during an operation there should be perfect control of reduction.

Adolescent↗
PubMed1993

Treatment of giant omphalocele by enlargement of the abdominal cavity with a tissue expander.

Even in the absence of major associated anomalies, treatment of giant omphaloceles is difficult primarily because of the disproportion between the large volume of the omphalocele and the small volume of the intraabdominal cavity. The case of a child is presented in whom conservative treatment had to be abandoned. Reduction of the omphalocele contents and closure of the defect was successfully accomplished after a 19-day period of enlargement of the abdominal cavity by means of an intra-abdominally placed tissue expander.

Abdomen↗
PubMed1990

[Non-tuberculous mycobacterial lymphadenitis].

Twenty-two children (1-12 years old) with cervical lymphadenitis caused by non-tuberculous mycobacteria (NTM) are described. Skin tests revealed the causative agent in 20 out of 22 cases. Mycobacterium avium was cultured in 12 cases, 7 cultures remained negative. Treatment should consist of primary excision of the infected lymph node. If this is impossible puncture, incision, drainage and curettage should be applied. Antituberculous drugs should only be prescribed in case of systemic NTM infection or prolonged ulceration.

Antitubercular Agents↗
PubMed1990

Haemodynamics and 'optimal' hydration in aortic cross clamping.

The effect of optimal hydration on haemodynamics and renal function during infrarenal aortic cross clamping was studied in 26 consecutive patients operated on because of an infrarenal aortic aneurysm. The patients were randomly divided over two groups. The patients of group B (n = 13) were optimally hydrated before the operation. The Starling curve was used as standard. Patients of group A (n = 13) served as control. The pre-operative and postoperative renal functions of both groups were compared, as were the haemodynamic parameters. The haemodynamic parameters were measured at five minutes intervals during the entire procedure. During aortic clamping the heart rate was significantly lower in patients of group B, indicating a lower myocardial oxygen consumption. Neither the haemodynamic parameters nor the renal function showed other beneficial effects on optimal hydration.

Acute Kidney Injury↗
PubMed1984

Partial splenectomy for a splenic cyst.

Partial splenectomy for a large splenic cyst was performed in a seven-year-old girl referred for splenomegaly. The increased risk of sepsis in splenectomized patients induced the successful attempt at partial splenectomy. The surgical procedure described involved removal of the cyst while preserving as much of the spleen as possible. In view of the planocellular epithelial lining, the pathological diagnosis was of a rare congenital, intrasplenic cyst.

Child↗
PubMed1982

Haemodynamics and renal function in patients undergoing surgery for abdominal aortic aneurysm.

Haemodynamics and renal function were studied in patients undergoing surgery for abdominal aortic aneurysm, before, during and after infrarenal aortic clamping, in order to establish base-line criteria. The mean arterial pressure (MAP) remained practically unchanged during aortic clamping. A significant decrease in cardiac index (CI) was found. The significant decrease in pulmonary artery wedge pressure (PAWP), despite a significant rise in the systemic vascular resistance (SVRI), probably reflects relative preoperative dehydration and venous pooling in the lower part of the body. Brief suggestions are made concerning the management of this condition. No irreversible loss of renal function was seen.

Aged↗