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Biomedical subjects

G A Olthuis

Publications and source records attributed to G A Olthuis.

6 recordsLinked to original sources

Immediate versus delayed shoulder exercises after axillary lymph node dissection.

A total of 144 evaluable patients with breast cancer were enrolled in a multicenter, randomized, prospective study to establish the role of delayed shoulder exercises on wound drainage and shoulder function after axillary lymph node dissection. Patients in group 1 (n = 78) started active shoulder exercises 1 day postoperatively. Patients in group 2 (n = 66) started on the eight postoperative day, following 1 week of immobilization of the arm. Patients in group 2 had 14% less wound drainage volume than those in group 1 (600 +/- 436 mL versus 701 +/- 398 mL); this difference, however, was not significant. Also, no differences could be established between the two groups when duration and volume of wound drainage, number and volume of seroma aspirations, wound complication rates, and shoulder function were compared 6 months after surgery.

Axilla

Decreased venous outflow without venous obstruction--an analysis of three cases.

Three patients without prior thrombosis or varicosities presented with decreased venous outflow. They suffered from venous complaints, such as oedema and pain in the leg after prolonged standing. Phlebograms showed no obstruction or hypoplasia. Normal function of calf muscle pump and valves was present at venous pressure determination. The theoretical basis of venous emptying is discussed and a hypothesis is postulated that decreased emptying is due to a change in elastic properties of the venous vessel wall.

Adult

Reconstructive approach of chronic oedema of the lower limb.

The results are presented of 22 reconstructive operations in 22 patients with venous and/or lymphatic oedema of the leg, after a maximum follow-up of three years. An overall patency rate of venous anastomoses of 92% and symptomatic improvement in 75% after lymphovenous anastomoses, indicates that there is a place for reconstruction in a highly selected group of cases. Deep venous insufficiency is diagnosed by transbrachial descending phlebography and direct venous pressure determination. Mixed forms of oedema, i.e. combined venous and secondary lymphatic, frequently occur in patients who have undergone tumour resections and radiotherapy. Both non-invasive plethysmography and routine phlebography via venipuncture on the dorsum of the foot are not reliable in diagnosing mixed oedema. For adequate visualization, direct puncture of the femoral vein in the groin is recommended.

Adult