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Biomedical subjects

H A Lemmens

Publications and source records attributed to H A Lemmens.

17 recordsLinked to original sources
PubMed1991

Plasmapheresis in Raynaud's phenomenon in systemic sclerosis: a microcirculatory study.

Microcirculatory and haemorheological parameters were investigated before and after plasmapheresis in eighteen patients with secondary Raynaud's phenomenon based on progressive systemic sclerosis. After 4 plasmaphereses, once a week, all patients claimed explicit improvement of their complaints. Raynaud's phenomenon and especially the reaction upon cold provocation had disappeared and skin ulcers healed. Red blood cell (RBC) velocity increased significantly (p less than 0.001) after 4 weeks plasmapheresis. RBC aggregation and plasma viscosity were significantly lower (p less than 0.001) after the last plasmapheresis than before treatment. After 3 years four patients were still free of complaints, but in 14 patients the symptoms of Raynaud's phenomenon had reappeared after 6 to 9 months. The skin ulcers, however, did not return in these patients. RBC aggregation and plasma viscosity returned to the initial values after 9 months, while skin capillary blood flow remained significantly enhanced for 24 months. The finding that restoration of RBC aggregation and plasma viscosity to normal level is associated with enhanced skin capillary blood flow, indicates that disturbed haemorheology plays a role in the diminished skin blood flow, as observed in patients with secondary Raynaud's phenomenon. In these patients, plasmapheresis can be considered to treat severe ischemia of the digits.

Adult↗
PubMed1986

The high thoracic sympathetic nerve system--its anatomic variability.

Upon studying microscopically and macroscopically 18 resection preparations of upper thoracic sympathectomies it is clear that the variability in the anatomy of the sympathetic nervous system in connection with the spinal nervous system is higher than has always been described. A fine network of smaller and larger nerve bundles was found which connect the sympathetic and spinal nerve systems. Light microscopical perikarya were identified in many nerve bundles. These findings have an important impact on the concept of the effectiveness of thoracic sympathectomy.

Ganglia, Sympathetic↗
PubMed1985

Clinical and rheological studies in patients with intermittent claudication.

While the resistance to flow offered by means of arterial narrowing and the collateral arteries are the major determinants affecting peripheral flow, there may be a contribution by those elements which affect the viscosity of the blood. To evaluate these factors, haematocrit, red blood cell aggregation and plasma viscosity were measured in 100 patients with occlusive arterial disease of the lower extremities. Disturbances in these parameters were noted and appeared to be related to the severity and extent of the occlusive disease. However, whether these factors contribute to the cause of intermittent claudication remains uncertain.

Blood Pressure↗
PubMed1985

Microcirculatory changes in patients with primary Raynaud's phenomenon after treatment with buflomedil.

Eleven patients with primary Raynaud's phenomenon were treated with Buflomedil (4 dd 150 mg orally) for 3 months. Subjective changes were compared with capillary microscopy (red blood cell velocities) of nailfold capillaries, haemorheological parameters, thermography of hands and fingers, continuous wave Doppler investigations and measurements of blood pressure and heart rate. Eight out of 11 patients reported subjective improvement of their complaints, which could be confirmed by significant increased red blood cell velocities and temperatures of hands and fingers. It is concluded that Buflomedil might be of therapeutic value in patients with primary Raynaud's phenomenon, but that a double blind study, evaluated by haemorheological and microcirculatory measurements, should be performed to draw conclusions regarding the efficacy of the drug.

Adult↗
PubMed1982

Evaluation of the contribution of computed tomography to the staging of non-oat-cell primary bronchogenic carcinoma. A retrospective study.

In order to evaluate the contribution of computed tomography in the pre-operative staging of non-oat-cell primary bronchogenic carcinoma, the clinical T-classification by conventional methods only and after including CT was compared with the postsurgical T-classification in 21 patients. Furthermore, hilar or mediastinal lymph node enlargement as found by conventional methods only and after including CT was compared with the postsurgical N-classification. With conventional methods, T-classification was correctly evaluated in 15 of 21 patients (71%), 5 patients (24%) were underestimated and 1 patient (5%) was overestimated. Clinical T-classification including the results of CT, was correctly evaluated in 17 patients (80%), 2 patients (10%) were underestimated and 1 patient (5%) was overestimated. One patient (5%) was underestimated by bronchoscopy. Computed tomography demonstrated in 15 patients 31 lymph nodes in the mediastinum greater than 10 mm. and 18 lymph nodes smaller than 10 mm.; in 6 patients 9 lymph nodes smaller than 10 mm. were described. Only 4 patients with mediastinal lymph node enlargement were postoperatively classified as N2. Malignant growth was detected postoperatively in 10 lymph nodes smaller than 10 mm.

Aged↗
PubMed1980

[Results of therapy combining peritoneal lavage and local application of antibiotics in 250 patients with acute perforating appendicitis].

Since 1967, 2480 appendectomies have been performed at the St. Lucas Hospital (Amsterdam) and the St. Annadal Hospital (Maastricht), of which 250 were for perforated appendicitis. A so-called 'combined method' of treatment was used in all these cases: during the operation saline was used to lavage the peritoneal cavity with the patients in the reverse-Trendelenburg position. Antibiotics were left in the peritoneal cavity. No intraperitoneal drainage was performed, but the wound was drained for 5 days. Postoperative treatment consisted of nasogastric suction and parenteral antibiotics for 5 days in combination with anticoagulation. With thus combined approach one death was seen in 250 cases. There were 20 cases of wound infection (8%), 7 pelvic abscesses (2.8%), and 2 retroperitoneal abscesses. No thromboembolic complications were seen because of the use of routine anticoagulation. For 191 patients (77%), total hospitalization was less than 14 days. This method of treatment is compared with recent reports in literature.

Acute Disease↗