PubMed Health⌕ Search

Biomedical subjects

C M Kullendorff

Publications and source records attributed to C M Kullendorff.

At least 55 records · Page 3Linked to original sources
PubMed1987

Evaluation of renal parenchyma in children by DMSA scintigraphy, X-ray computed tomography and intravenous urography.

The demonstration of diminished or scarred renal parenchyma in children is often the decisive factor in determining the future management of children with urinary tract malformations. Renal scintigraphy using technetium 99m-labelled dimercaptosuccinic acid (DMSA), computed tomography (CT) and intravenous urography (IU) were used to evaluate the renal parenchyma prior to ureter re-implantation in a series of 13 children. Their ages ranged from 5 months to 3 years 8 months. The indication for operation was ureteric reflux in 8 children and distal ureteric stenosis in 5. CT was performed on a Toshiba TCT-80 scanner. Renal scintigraphy was performed 3 hours after intravenous injection of DMSA. Compared with IU, DMSA imaging gave more information about the renal parenchyma in 6 children, gave equal information in 6 and less in 1. Compared with CT, DMSA imaging gave more information in 2 children, was equally informative in 8 and less so in 3. Accordingly, DMSA imaging was judged to be more sensitive than IU and as sensitive as CT. DMSA imaging can be used both for the initial evaluation and for follow-up assessment of renal parenchymal damage.

Child, Preschool↗
PubMed1987

Transluminal balloon dilation of ureteral stricture in a child. A case report.

A 12-year-old girl complained of left flank pain 4 months after the onset of symptoms of polyarthritis nodosa with hypertension, multiple neuritis and impaired renal function. Intravenous pyelography (IVP) revealed no stone. Several months later the flank pain recurred, and IVP now showed a calcified stone midway in the left ureter. Ureterolithotomy was performed, and a 3 cm long stone embedded in the mucosa was removed. Two months postoperatively IVP showed severe ureteric obstruction due to stenosis at the level of the incision. Dilation of the stricture was accomplished with a 4 mm balloon, and further dilation 2 weeks later with a 6 mm balloon. A third dilation was performed with a 4 mm balloon. At examination 3 months later the girl was free from symptoms and IVP with forced diuresis was normal, as were the findings after 6 more months. Transluminal balloon dilation of postoperative ureteral strictures in children should be considered as an alternative to surgery.

Child↗
PubMed1986

A microsurgical method for experimental kidney denervation.

A successful microsurgical method for denervation of the kidney in the rat is presented. Unilateral kidney denervation was performed in eight animals. Ten sham-operated animals were used as controls. Under ether anaesthesia, the kidney vessels on one side were exposed. The peritoneum above the vessels was incised and the area was stained with 1% toluidine blue solution. The nerves were identified. With microsurgical technique, the nerves were carefully separated from the vessels and resected. Tissue specimens from both kidneys in all animals were removed and analysed for norepinephrine content. There was no normal difference between the kidneys in the sham-operated rats. About 1 week after denervation, the norepinephrine concentration in the denervated kidney showed a 95% reduction, indicating a complete denervation. The described microsurgical procedure was a rapid, simple, and reproducible method for kidney denervation in the rat.

Animals↗
PubMed1986

Physiotherapy to improve faecal control after Stephens' rectoplasty in high imperforate anus.

The role of physiotherapy for the achievement of faecal continence after Stephens' rectoplasty for high imperforate anus was studied. Clinical assessment and ano-rectal manometry were performed more than 7 years after surgery, both before and after one year of physiotherapy training of the perianal musculature. After the training period the faecal control improved. This effect was verified by the ano-rectal manometry findings. Faecal continence can be achieved by Stephens' rectoplasty. Furthermore, with any persisting incontinence, postoperative physiotherapy with training of the voluntary muscles in the perianal region can be valuable for the achievement of faecal continence.

Adolescent↗
PubMed1986

The diagnosis and course of antenatal urinary tract dilatation.

During 1980-1984 the ultrasound examination (US) performed in the third trimester revealed urinary tract dilatation in 18 foetuses. After delivery all the infants were reexamined within the first weeks with US, intravenous pyelography and micturition urethrocystography to confirm the malformation. Pelvic dilatation was seen in 12 foetuses, 5 bilaterally. The dilatation was caused by pelviureteric obstruction in 6 infants, 4 of which were operated on with dismembered pyeloplasty. In 6 infants the dilatation was caused by distal ureteric stenoses, and 5 of them were operated on. Two foetuses with dilated pelvis and ureter had distal ureteric stenosis and both were operated. Four infants with the diagnosis of unilateral multicystic kidney, confirmed postnatally, were nephrectomised. At the follow-up the kidney function was normal in 15 infants and slightly decreased in 3 infants with bilateral malformations. The antenatal US revealed pelvic dilatation, but the diagnosis of a dilated ureter was inaccurate. Prenatal urinary tract dilatation should be controlled via US shortly after delivery and, if persistent, evaluated further by means of x-ray examinations.

Creatinine↗
PubMed1986

Innervation of the child urinary bladder.

Muscle strips from the fundus, trigonum and distal ureters obtained from children at operations for vesico-ureteric reflux were studied using histochemical and immunohistochemical methods, and electrical nerve stimulation in an organ bath. A rich supply of cholinergic nerves was found and despite a partial atropine resistance the neurophysiological experiments indicated that the transmitter causing contraction of the detrusor muscle is acetylcholine. Imipramine, which is used in the treatment of enuresis, had no anticholinergic effect on the bladder in the doses used clinically. The adrenergic innervation was very sparse except around the ureter orifices. No contractile alpha-adrenoceptors could be detected but beta receptor mediated relaxation was found, which was neither of the beta 1 nor beta 2 type. A third type of beta receptor is postulated. Peptidergic nerves containing vasoactive intestinal peptide, VIP, were demonstrated in a few nerve terminals running along bundles of smooth muscle. No nerves containing enkephaline, somatostatine or substance P were found. VIP affected the detrusor muscle indicating a possible role as a modulator of transmitter action, while substance P had no effect. The anticholinergic and calcium antagonistic drug terodiline inhibited all muscle activity, whether it was induced by nerve stimulation, cholinergic drugs or a potassium rich solution, making it suitable for treatment of diurnal enuresis.

Adrenergic Fibers↗
PubMed1986

Effect of loperamide on faecal control after rectoplasty for high imperforate anus.

The effect of loperamide on faecal control after Stephens rectoplasty for high imperforate anus was studied in eight patients more than 8 years after surgery. Clinical assessment and anorectal manometry were performed before and after administration of loperamide for 6 to 8 weeks. Decreased faecal soiling was noted in seven of the eight cases. Obstipation forced two patients to stop the medication. The improved faecal control was verified by an increase in squeeze pressure at anorectal manometry in four patients. When incontinence persists after Stephens rectoplasty, loperamide can improve the faecal control in some cases.

Adolescent↗
PubMed1985

Hepatic lipase activity increases after liver denervation in the rat.

We have investigated the effects of hilar denervation of rat liver upon the activity of hepatic lipase determined in tissue extracts. Denervated animals had an enzyme activity of 7.89 +/- 0.37 mU/mg protein, compared to 6.45 +/- 0.43 in sham-operated controls (mean +/- S.E.; P less than 0.05). We conclude that hepatic innervation may contribute to the regulation of hepatic lipase activity.

Animals↗
PubMed1985

Malrotation in children with symptoms of gastrointestinal allergy and psychosomatic abdominal pain.

Three children with malrotation 4.5, 5 and 9 years old at operation are presented. Their preliminary diagnoses were gastrointestinal (GI) allergy, GI allergy with colon irritable and psychosomatic abdominal pain. They were treated on an outpatient basis under these diagnoses for more than two years before their malrotations were discovered. In two children radiology did not demonstrate any signs of intestinal obstruction and in one of these children repeated radiological examinations were necessary for the diagnosis of malrotation. Operative findings were chronic volvulus with compromised blood flow and obstructive duodenal bands. The third child suffered acute strangulation ileus with gangrene of the intestines before diagnosis was made. We conclude that special consideration must be given to the possibility of malrotation when treating and radiologically investigating children with GI disturbances.

Abdomen↗
PubMed1985

Preoperative ultrasonography of the undescended testis.

In a prospective study during 1981-1983 42 boys aged 3-12 (mean 6.5) years were operated on for a palpable undescended testis. Twelve boys 3-8 (mean 4) years old were operated on for an unpalpable testis and 2 boys for an ectopic testis. The day before operation an ultrasound examination was performed. Reoperations were made on 11 patients and a bilateral operation on 2. In total, 69 ultrasound examinations were made. Comparison of the position at operation and ultrasound showed accordance in 47 of the 55 cases with only a slight variation of the position in 8 cases. Of the 12 non-palpated testes the ultrasonography showed 4 testicles, 3 non-testis-like formations and no finding in 5 cases. Exploration of these 5 latter cases showed an aplasia testis in 4 and a small intraabdominal testis in 1 boy. Preoperative ultrasonography can be recommended in case of an unpalpable testis in a boy not previously operated on in the inguinal area. Ultrasonography is particularly valuable before reaching a decision on hormonal therapy.

Child↗
PubMed1985

Significant bleeding at kidney resection after experimental denervation.

The effects of microsurgical denervation of the kidney on blood loss, bleeding time, platelet count and APT time in standardized kidney resection were studied in rats. The renal nerves running alongside the blood vessels were stained, identified and resected with a microsurgical technique. One week after the denervation, the blood loss and bleeding time at kidney resection were significantly greater than in control rats (without denervation). The bleeding resulted in reduced haemoglobin and haematocrit values, but the platelet count and APT time were unchanged. Platelet aggregation was not influenced by the denervation procedure. The increased bleeding at parenchymal kidney resection in the denervated rats was regarded as a consequence of interrupted nerve supply to the kidney. The effects on bleeding may have implications for renal surgery in humans.

Animals↗
PubMed1985

Testicular torsion in children--bilateral or unilateral operation.

Between 1969 and 1984 65 children were operated on for testicular torsion. A follow-up study of 63 patients who underwent surgery for unilateral testicular torsion with fixation only on the affected side showed that no torsion occurred on the opposite nonfixated side and there was no retorsion during an observation period of an average of more than seven years. From our calculated risk for contralateral testicular torsion we suggest that bilateral fixation is not necessary in children who present with a unilateral testicular torsion.

Adolescent↗
PubMed1984

The advantage of antenatal diagnosis of intestinal and urinary tract malformations.

In a 24-month prospective screening programme 6020 pregnant women were examined with diagnostic ultrasound at 17 and 32 weeks gestation. In a total of 23 (0.38%) abnormalities, four cases of urinary tract and two of intestinal tract abnormalities were discovered. The antenatal diagnosis influenced the management of these disorders both before and after birth.

Abdominal Muscles↗
PubMed1984

A microsurgical method for denervation of the liver in the rat.

The role of the nerves in the hepato-duodenal ligament should be of special surgical interest, since these nerves are often injured in hepatic and biliary tract surgery. We have developed a microsurgical procedure for liver denervation. All visible nerves were resected after staining. Norepinephrine values in central liver tissue of denervated rats were only 18% of the corresponding values in innervated liver tissue, indicating an appreciable degree of sympathetic denervation. No detectable immunoreactivity of gastrin, cholecystokinin, vasoactive intestinal polypeptide, substance P, somatostatin or enkephalin were found within resected hepatic nerves. The described denervation procedure is simple and reproducible. It can be used to obtain additional information about the nervous regulation of various liver functions.

Animals↗
PubMed1983

Malignant ovarian teratoma in childhood.

Successful treatment of three cases of malignant ovarian teratoma is reported. The first manifestation was abdominal pain in all cases. An abdominal mass was palpated in one patient only. Ultrasonography and computerized tomography could not supply an exact preoperative diagnosis. The initial therapy was unilateral salpingo-oophorectomy. Peritoneal implants were present in all three cases. The implant was malignant in two children and peritoneal resection was performed. Further treatment consisted of combined chemotherapy with actinomycin, adriamycin, vincristin and cyclophosphamide according to a modified T2 protocol. Radiation therapy was also applied to the entire abdomen. The favourable results may be attributed to this aggressive combined treatment, which may improve prognosis.

Age Factors↗