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Biomedical subjects

A Olesen

Publications and source records attributed to A Olesen.

18 recordsLinked to original sources
PubMed1992

[Traumatic rupture of a main bronchus. Clinical and peroperative presentation, physiopathological mechanisms, treatment and late sequelae].

On the basis of a case report, the clinical and peroperative features of bronchial rupture caused by blunt thoracic trauma, theories concerning the pathophysiological mechanisms, the treatment and outcome are reviewed. Two distinct clinical presentations may occur: (a) with free communication between the bronchus and the pleura (as in the present case) and (b) with little or no communication. The suspected diagnosis is confirmed by bronchoscopy. Peroperatively, bronchial rupture is seen at places of reduced resistance (the junction between the cartilaginous and the membranous trachea or bronchus and the annular ligaments) and typically within 2.5 cm from the carina. The pathophysiological basis includes three mechanisms: decrease in the anteroposterior diameter of the thorax, sudden increase in intrabronchial pressure with a closed glottis and rapid deceleration. These mechanisms may occur independently or together. The initial treatment aims at maintaining the airway, reversing shock and relieving pneumothorax. Surgical repair should follow as soon as the condition of the patient permits. The optimal surgical technique is identical with that employed for vascular anastomoses. Surgical repair of bronchial rupture should only be omitted if extensive parenchymal pulmonary damage and/or suppuration are present. Even after years of delay, reconstruction will lead to partial recovery of pulmonary function.

Adult↗
PubMed1991

[Heart transplantation in Denmark. Therapeutic routines and preliminary results].

When the criterion of brain-death was introduced in Denmark on 1.7.1990, the possibility for heart transplantation and other interventions was opened. The first heart transplantation was carried out 3.10.1990 and, during the first year, 28 transplantations were carried out on 27 patients. The therapeutic routines in the department are reviewed and the results obtained after the first year are presented. A total of 33 donors who fulfilled the donor criteria were available. Of these, 28 came to Rigshospitalet, two were sent abroad and suitable recipients could not be found for two. The recipient group consisted of four women and 23 men with an average of 46 years. At the time of writing, on an average 169 days after operation (13-330), 23 out of 27 patients survived in good health and with normal cardiac function. Three patients are still in hospital.

Adult↗
PubMed1989

[A prospective controlled study of vagotomy in the treatment of duodenal ulcer. Results after 11-15 years].

A prospective, randomized, controlled trial was conducted to compare truncal vagotomy and drainage (TV), selective vagotomy and drainage (SV) and parietal cell vagotomy (PCV) as elective treatment for duodenal ulcer. Between 11 and 15 years post-operatively, 248 patients were available for study of the recurrent ulceration rate by a life table method and 197 patients could be studied with regard to post-vagotomy symptoms. The recurrent ulcer rates were TV 28.5%, SV 37.4% and PCV 39.3%. These differences were not statistically significant. There was no significant difference in the Visick gradings among the three groups either before or after treatment of the failures. About two-thirds of the patients in each group were finally satisfied with their operation, often after second operations or prolonged medical treatment.

Clinical Trials as Topic↗
PubMed1989

Prospective controlled vagotomy trial for duodenal ulcer. Results after 11-15 years.

A prospective, randomized, controlled trial was conducted to compare truncal vagotomy and drainage (TV), selective vagotomy and drainage (SV) and parietal cell vagotomy (PCV) as elective treatment for duodenal ulcer. Between 11 and 15 years after operation, 248 patients were available for study of the recurrent ulceration rate by a life table method, and 197 patients could be studied with regard to postvagotomy symptoms. The recurrent ulcer rates were 28.5% for TV, 37.4% for SV, and 39.3% for PCV. These differences were not statistically significant. The incidence of severe postvagotomy symptoms was as follows: dyspepsia, 18.4% for TV, 20.5% for SV, 8.6% for PCV; dumping, 5.9% for TV, 19.6% for SV, 2.2% for PCV; diarrhea, 9.8% for TV, 11.8% for SV, 4.4% for PCV. The incidence of severe dumping was significantly less frequent among the PCV patients than the SV group. The differences did not reach statistical significance in any of the other groups. There was no significant difference in the Visick gradings among the three groups either before or after treatment of the failures. About two thirds of the patients in each group were finally satisfied with their operation, often after second operations or prolonged medical treatment. It is concluded that none of the three forms of vagotomy can be recommended as the standard operative treatment of duodenal ulceration.

Clinical Trials as Topic↗
PubMed1989

Moclobemide and clomipramine in reactive depression. A placebo-controlled randomized clinical trial.

The purpose of this study was to compare moclobemide and clomipramine in reactive depression according to the Newcastle II classification. Sixty patients were allocated to either 300 mg moclobemide, 150 mg clomipramine or placebo, all divided in 3 daily doses. Improvements occurred over time, but differences between treatments and compared with placebo were never statistically significant. Dizziness, tremor and anticholinergic symptoms were significantly more frequent with clomipramine than with moclobemide and placebo.

Adjustment Disorders↗
PubMed1987

Prospective 14- to 18-year follow-up study after parietal cell vagotomy.

One hundred and thirty-five patients underwent elective parietal cell vagotomy for duodenal, pyloric or prepyloric ulcers. The patients were followed prospectively at intervals of 1-3 years in order to detect postvagotomy symptoms and recurrent ulcers; 14-18 years after surgery 106 patients were studied with regard to recurrent ulceration and 84 concerning postvagotomy symptoms. Thirty-two patients (30 per cent) had developed proven recurrent ulcers and a further 9 per cent were suspected of having recurrences. Two patients were reoperated for gastric outlet obstruction and one for bile reflux gastritis. Four patients had severe dyspeptic symptoms and four severe dyspepsia plus dumping. No patient had severe diarrhoea. Forty-three patients were regarded as failures after parietal cell vagotomy. After treatment of these failures 88 per cent of the patients available for subsequent follow-up had satisfactory results. The alternatives to parietal cell vagotomy are discussed. It is concluded that although parietal cell vagotomy has a high long-term recurrence rate, this disadvantage is outweighed by the low incidence severe postvagotomy symptoms.

Adult↗
PubMed1983

Results of surgical treatment for lung cancer.

A review is presented of 233 patients who were surgically treated for bronchial carcinoma during a five-year period. The survival time was determined in relation to operative procedure and to cell type and anatomic extent of the tumours. Staging according to the TNM classification gave five-year survival rates of 51.6% in Stage I, 12.0% in Stage II and 8.4% in Stages III-IV. Among the Stage I cases, tumours classified as T1N0M0 were associated with longer survival than were T1N1M0 or T2N0M0 tumours. It is concluded that the stage of the disease as defined by TNM classification should be regarded as the most important prognostic factor.

Adult↗