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Biomedical subjects

C M Kullendorff

Publications and source records attributed to C M Kullendorff.

69 records · Page 4Linked to original sources
PubMed1983

Value of computed tomography in traumatic pancreatitis in children.

Only a few previous reports have stressed the value of computed tomography (CT) in traumatic pancreatitis in children. Three children with blunt upper abdominal trauma are presented, two of them had operatively confirmed pancreatic injury while in the third the clinical course confirmed the early exclusion of such injury at CT examination. A meteoristic abdomen, as is frequently present in acutely injured children, limited the early usefulness of ultrasound (US) in one of the patients. In all 3 patients, CT examination yielded important information. US proved easy to perform and reliable in the follow-up of complications such as pseudocysts.

Child↗
PubMed1983

Atresia of the small bowel.

From 1969 to 1981 duodenal atresia was found in 21 patients and jejuno-ileal atresia in 15 patients. Associated anomalies were revealed in 14 neonates with duodenal atresia and in 2 with jejuno-ileal atresia. Vomiting was the predominant symptom in all patients with ileal atresia except one. Abdominal distension was seen in 2 cases with duodenal atresia and in 11 with jejuno-ileal atresia. The primary surgical procedure was a duodeno-jejunostomy in case of duodenal atresia, and bowel resection with end-to-end anastomosis in jejuno-ileal atresia. Of the 36 patients (8%) died. The cause of death was respiratory insufficiency in one child with duodenal atresia and one with ileal atresia. Another child with ileal atresia died of cardiac malformation. Anastomotic stricture was the most common postoperative complication and was seen in 3 cases with duodenal atresia and in 4 with ileal atresia. As jejuno-ileal atresia is caused by a vascular accident ample resection of the blind ends is recommended.

Abnormalities, Multiple↗
PubMed1982

A method for testicular denervation in rats.

A successful method for microsurgical denervation of the testes in rats is described. Testes were unilaterally denervated in 15 animals. Thirteen untreated and two sham-operated rats served as controls. With the animal under ether anesthesia, the spermatic vessels on either side were exposed with the aid of microsurgical technique and an operating microscope. The area was then dyed with two to three drops of 1% Toluidine blue. With utmost precaution the nerves were separated from the vessels and resected. A biopsy specimen from the epididymal fat pad of each side was removed and assayed for norepinephrine content. The denervation procedure was considered successful if the norepinephrine content of the denervated fat pad was less than 11% of that of the contralateral fat pad. The denervation procedure was successful in 13 of 15 animals. No recognizable side effects from the use of Toluidine blue were observed.

Animals↗
PubMed1982

Splenectomy in children with haematological disease.

During the years 1969-1980 elective splenectomy for haematological disease was performed in 31 children, of which 17 had haemolytic anaemia (HA), 11 thrombocytopenic purpura (TP) and 3 hypersplenism (HS). The indications for splenectomy in the HA series were haemolytic crises in 6 children, constant anaemia in 4, hyperbilirubinaemia in 5 and abdominal pain in 2 children. Among children with TP there were 8 cases of idiopathic thrombocytopenic purpura, 2 cases combined TP with haemolytic anaemia and idiopathic pancytopenia in 1 child. In all patients the indication for splenectomy was therapy-resistant thrombocytopenia. In the HS series the underlying disease was Morbus Gaucher, thyrosinosis and cysta lienalis. Indication for splenectomy was thrombocytopenia in all children. In the HA series the results of splenectomy were good in all patients. The haemoglobin value rose. The increased reticulocyte count returned to normal values. Splenectomy was considered to be still indicated in all patients with hereditary spherocytosis. In the TP series good results were obtained in 6 children, 2 were markedly improved, but 3 showed no change. Splenectomy plays an important role in the management of chronic thrombocytopenia when medical treatment is without effect. In the HS series thrombocytes reached normal values in all patients. Failure of splenectomy to relieve the haematologic process is usually due to remaining accessory spleens. Splenectomy in children increases the risk of severe infections and the polyvalent pneumococcal vaccine should therefore be administered prior to splenectomy.

Anemia, Hemolytic↗
PubMed1982

Ureteric orifice deformation causing secondary reflux.

In two boys with posterior urethral valve and dilated ureters ureteroneocystostomy according to Politano-Leadbetter was performed at 4 and 6 months of age. Postoperatively both children showed vesicoureteric reflux. Endoscopic examination revealed in both cases a mucosal bridge between the medial borders of the ureteric orifices. The bridge was transected with transurethral endoscopic diathermy whereupon the reflux disappeared permanently. The fixation and deformation of the orifices were probably part of the mechanism causing the reflux. Endoscopy is recommended in case of postoperative reflux.

Child, Preschool↗
PubMed1982

Relaxation sutures for the oesophageal end-to-end anastomosis.

Intrathoracic end-to-end anastomoses were made in 4 series of piglets with 10 animals in each. In one series (S) the anastomoses were made with interrupted 6/0 silk sutures. In another series (MR) interrupted 10/0 supramid sutures were used after standardized resection. In a third series (F) 6/0 silk sutures were utilized and the oesophageal ends fastened to fascia perivertebralis with traction sutures. In a fourth series (RF) the anastomoses were made with silk 6/0 suture material after standardized resection and including traction sutures. The results were evaluated with standardized X-ray examination with calculation of anastomotic index, histological examination and macrophotography. Statistical analysis of the anastomotic index showed a significant difference between the F and S series. The anastomoses in the F series had healed with less stricture formation. No significant differences were observed between the MR and S series, the RF and S series, and the MR and RF series. Our results encourage us to recommend traction sutures in contriving an intrathoracic end-to-end oesophageal anastomosis.

Animals↗
PubMed1982

Elective splenectomy - a comparison of management in children and adults.

Elective splenectomies were performed on 39 children and 366 adults at the same hospital from 1969 to 1979. Sex distribution, extent of operative blood loss, drainage routines and length of hospital stay were similar in both groups. However, differences were observed concerning the type of incision, early ligature of the splenic artery and postoperative complications. Subcostal and transrectal incisions were most frequently used, and can be recommended. Ligature of the splenic artery above the pancreas facilitated the extirpation of large spleens. Drainage can be omitted, provided that haemostasis is complete. The necessity of removing accessory spleens and pneumococcal vaccine administration are stressed.

Adult↗
PubMed1981

Technical considerations of experimental esophageal anastomosis.

Following transection and anastomosis of the intrathoracic esophagus, the effects of rotating the esophageal ends, lumen-widening procedures, microsurgical technique and traction sutures were studied in 8 series of 10 piglets each. The results were evaluated with contrast-medium X-ray examination and macrophotography. The different procedures were compared with single-layer end-to-end anastomosis with 6/0 silk. Anastomosis with 10/0 supramid withstood the tension in the intrathoracically stressed esophageal anastomosis, but gave no advantages. Rotating of the ends of the transected esophagus showed no significant differences. Widening the anastomotic lumen with longitudinal incisions did not result in a wider lumen. Further extension of the anastomotic circumference with a Z-shaping of the mucosa did not reduce stricture formation. Traction sutures between the esophageal wall and perivertebral fascia gave a significantly wider anastomotic lumen. There was no correlation between stricture, and the amount of granuloma, submucous leakage, or degree of histologic change.

Animals↗
PubMed1981

Diagnostic aids for benign tumors of the liver in children.

Primary benign tumour of the liver in 2 children was successfully extirpated. The tumours had appeared as a palpable abdominal mass. Laboratory examinations, pulmonary X-ray and urography were in the main normal. Abdominal plain films revealed an expansive process. Ultrasonography and computerized tomography showed in one of the cases a left-sided homogeneous tumour of the liver. These non-invasive methods of investigation are easy to perform in children and give ample information. Angiography appears to be no longer necessary in the preoperative investigation. The treatment of localized benign tumours is mainly surgical. With the exception of hemangioma, the prognosis in cases of benign hepatic tumour is good.

Female↗
PubMed1981

Two anastomotic widening procedures for the repair of oesophageal atresia. An experimental evaluation.

Three series of piglets with 10 animals in each were operated on with intrathoracic oesophageal anastomosis. In one series the ends of the oesophagus were brought together with single 6/0 silk sutures (S). In another series with the same suture material each oesophageal end was slit (C). In a third series Z-shaped procedure of the mucosa was performed with 10/0 supramid and the muscular layers were stitched with 6/0 silk sutures (P). The results were assessed with standardized X-ray examination with calculation of anastomotic index, histological examination and macrophoto. Statistically, there was no significant difference in the anastomotic index between the C and P series compared with the control series S. The values were highest in the C series, in which there were four anastomoses that were wider than the best anastomosis in the S series. The histological examination showed in general more pronounced inflammatory and fibrotic reactions in the C and P series as compared with series S. With a great luminal difference between the two organ-ends without the occurrence of a large gap the method seems advantageous. Further widening of the anastomotic circumference with Z-shaped procedure of the mucosa was technically more demanding and did not reduce the stricture formation.

Animals↗
PubMedDate not supplied

Diverticulosis in total colonic aganglionosis.

Two infants with total colonic aganglionosis (TCA) extending into the distal part of the ileum are described. Considerable diagnostic delay occurred with the correct diagnosis established first at 3 and 8 months, respectively. Radiologic findings compatible with TCA such as prolonged barium retention, reflux into ileum following barium enema, and foreshortening of colon were not clearly evident initially. Both patients demonstrated multiple acquired colon diverticula which increased both in number and size during the period of observation. These diverticula are probably a late manifestation of the spastic state of the anganglionic colon. Thus demonstration of diverticula supplies a strong evidence of TCA in infants with intestinal obstruction.

Barium Sulfate↗
PubMedDate not supplied

Ultrasonography of the undescended testis.

Sixty prospective sonographic preoperative examinations were performed on 57 boys, 3 to 12 years of age (mean 6 2/3), in order to investigate the accuracy of the method for localizing undescended or non-palpable testes in the anteperitoneal region, i.e. the inguinal canal. Sonographic results agreed with the findings at surgical exploration in 53 (88%) of the 60 examinations performed which was regarded as a satisfactory result. The method is convenient and valuable for the planning of surgery. Sonograms of patients earlier operated upon were difficult to interpret and accounted for some misinterpretations as did examinations in some patients with divergent anatomy.

Child↗
PubMedDate not supplied

The value of physiotherapy for faecal continence after correction of high anal atresia. A clinical and electromyographic study.

A follow-up study of 12 patients who had undergone Stephens rectoplasty for high imperforate anus is presented. Clinical assessment and anal electromyography were performed more than 7 years after surgery, both before and after a year's physiotherapeutic training of the perianal musculature. Electromyography showed correlation between faecal continence and tonus of the anal sphincter, the anocutaneous reflex and maximal voluntary activity in the perianal muscles. After the physiotherapeutic training there was significant improvement of faecal continence. This effect was electromyographically corroborated. The results confirmed clinical observations that postoperative physiotherapy and training of the voluntary muscles in the perianal region is of value for the achievement of faecal continence.

Adolescent↗