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Biomedical subjects

C Olin

Publications and source records attributed to C Olin.

At least 73 records · Page 4Linked to original sources

Traumatic rupture of the diaphragm. Report of eleven cases.

Rupture of the diaphragm is an unusual injury following blunt abdominal trauma. Due to its rather discrete initial symptoms, the diaphragmatic rupture is frequently overlooked in the acute stage. Of 11 patients operated on, only four ruptures were detected in association with the accident. The clinical picture was dominated by the patient's other injuries. Symptoms referable to the diaphragmatic rupture were pain in the upper abdomen and dyspnoea, especially in the recumbent position. The diagnosis was usually established by serial chest roentgenography, in a few cases supplemented by barium contrast studies, angiography or air insufflation in the abdomen (pneumoperitoneum). In the initial phase, an elevated and paradoxically moving diaphragm was usually seen on the injured side. Later, hermiation of viscera into the chest ensued, causeing respiratory impairment and, in about half of the cases, also gastro-intestinal disturbances. Early operation is advised in all cases of diaphragmatic rupture. Late complications are then avoided and the repair is technically easier to perform. In the presence of associated intra-abdominal injuries, e.g. rupture of the spleen, an abdominal incision is preferred. In isolated diaphragmatic ruptures, particularly in the late phase, the operation is more easily carried out through a low thoracotomy. The diaphragmatic rupture should be repaired with interrupted non-absorbable sutures--otherwise a risk of recurrence exists.

Abdominal Injuries↗

Myocardial injury and CK-MB release during aortic valve surgery with selective coronary perfusion.

The postoperative serum activity of creatine kinase MB isoenzyme (CK-MB) was studied in 25 patients undergoing isolated aortic valve replacement (Björk-Shiley prosthesis). Hypothermia at 30 degrees C and selective coronary perfusion (CP) were used for myocardial protection. Repeated electrocardiograms revealed no signs of perioperative myocardial infarction. In all patients, CK-MB was detected in the serum. The CK-MB as a percentage of total CK at peak CK-MB [12 +/- 1 (mean +/- SEM)] was of the same magnitude as that found in acute myocardial infarction (AMI). Peak CK-MB occurred 2 +/- 0 h after the end of surgery. Peak total CK occurred after 17 +/- 3 h, and the plasma half-life for total CK was three times that of CK-MB. Thus, the kinetics of serum CK differed from those in AMI, but were similar to those reported after coronary bypass operations. The release of CK-MB, as well as of asparatate aminotransferase and thermostable lactate dehydrogenase, was related to the duration of aortic cross-clamping (AC), with a marked increase after 90 min. In two subgroups with similar AC time, postoperative CK-MB activity was higher in the subgroup with longer CP, indicating that CP as a method of myocardial protection may be entirely beneficial.

Adult↗

A new method for autotransfusion of shed blood.

A new autotransfusion device for collection and retransfusion of whole blood is described. The construction, function and possible advantages of the system compared with currently available systems are discussed. The system is built up around a hollow fibre haemoconcentrator (dialysis filter), a cardiotomy reservoir and a large volume infusion bag. To prevent clotting, citrate (ACD-solution) is added in the suction tubing as well as locally. The blood is driven through the system by a roller pump.

Blood↗