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Biomedical subjects

J Gierup

Publications and source records attributed to J Gierup.

At least 19 recordsLinked to original sources
PubMed1990

[30 years of urethral valve treatment in Sweden].

To achieve the best possible late results in valve treatment we think the following procedure would be mandatory: 1. Immediate transfer to a specialised hospital. 2. Acute diagnostics with correction of the water and electrolytes balance. 3. Suprapubic procedure is preferable over the transurethral approach if the catheter is expected to remain indwelling for a length of time. 4. The obstructing urethral valve is the primary object. 5. Resection is done only in 12 o'clock position in dorsosacral (lithotomy) position. 6. In rare cases with a severely constricted neck of the bladder it may be necessary to perform resection after Turner-Warwick. 7. In most cases it is possible to avoid surgical intervention at the upper urinary tract. 8. Regular follow-up checks are urgently recommended (sonography, x-ray, endoscopy, urodynamics).

Adolescent↗
PubMed1985

Skiing injuries in children: lower leg fractures.

A study was made of 113 children who sustained a lower leg fracture during downhill skiing. The age distribution showed a peak between 4 and 7 years in both sexes, and boys had another peak in their teens. Three of four patients were beginners. To a large extent, they had had their bindings adjusted in ski shops. Three of four bindings did not release at the time of the accident. Spiral fractures in the shaft or distal metaphysis of the tibia predominated (73%); the incidence of concomitant fibular fracture was low. The degree of malalignment was generally small. The results of treatment, which was generally conservative, were good, 7% of the patients having minor sequelae 1-3 years after the accident. To reduce the risks in children's downhill skiing, the following measures seem important: intensified training during the beginner stage; increased supervision by parents and in ski schools; development of children's release bindings and testing methods; and adequate instruction of personnel in ski shops.

Adolescent↗
PubMed1984

Skiing safety in children: adjustment and reliability of the bindings.

One-hundred children were picked at random from ski lift queues and were questioned as regards their skiing ability, experience, and ski equipment. Around 40% of the skiers had not made any adjustment and/or setting of the bindings. The lateral toe release and recentering forces were recorded. We found, irrespective of to which reference system our results were correlated, a very low percentage of bindings with acceptable setting, lower than has been reported for adults. Sixty percent of the bindings did not have any space between the sole of the boot and the slip plate. After correction of the space, the lateral toe release torque decreased significantly. Only 20% of the bindings displayed a recentering force. Our results indicate the need for several improvements regarding children's release bindings, including factors such as mechanical function, adjustment, and testing. The IAS reference system is recommended as the best of the existing reference systems.

Accident Prevention↗
PubMed1984

Early bladder training in patients with spina bifida.

A bladder training programme was applied in 43 children with myelomeningocele and complete urinary incontinence. In one group the training was commenced before the age of 3 years (mean age 1.3 years) and in another group between the ages of 3 and 13 years (mean age 5.8 years). The results as regards continence were better in the group with an early start of training, girls showing significantly better results than boys. Pharmacotherapy and cautious urethral surgery were valuable complements in selected cases. Vesico-ureteral reflux disappeared during treatment in 60% of the patients. Patients not showing significant improvement should be candidates for clean intermittent catheterization and/or cholinergic drugs, if detrusor hyperactivity is present.

Adolescent↗
PubMed1984

Urinary incontinence in children: treatment with free autogenous muscle transplantation.

Free autogenous muscle transplantation has now been carried out in 13 patients with anal incontinence and 16 patients with urinary incontinence. In anal incontinence the results have been excellent; all patients were improved and 12 out of 13 reached an acceptable level of continence. In 10 patients with urinary incontinence the results were good, with increase of functional bladder capacity and abandonment of nappies during the day. Two patients were improved and 4 were failures. Cinematographic studies in both anal and urinary incontinence clearly demonstrated the muscular activity of the transplants and confirmed the existence of a reinnervation process. The longest postoperative observation time is now 7-years in the anal patients and 6 years in the urinary patients.

Adolescent↗
PubMed1983

Skiing injuries in children and adults: a comparative study from an 8-year period.

The investigation is a retrospective analysis of 2756 skiing injuries from two centers in a Swedish skiing area during the years 1972 to, and including, 1979. The relative frequency of lower extremity injuries successively diminished, while a corresponding increase of upper extremity injuries was found. The relative frequency of ankle and foot injuries declined, while the frequency of knee injuries did not change, knee injuries still being the most common skiing injury. The relative frequency of fractures of the lower leg showed a statistically significant decrease, but, in children, constituted 16% of all injuries at the end of the investigation period. Further studies, with special regard to the children's prerequisites, seem to be necessary to define the desired characteristics of an optimally functioning safety binding for children.

Adolescent↗
PubMed1982

Piperacillin in paediatric surgery.

23 infants and children, aged 1 month - 15 years, were treated with piperacillin, a new semi-synthetic penicillin with a broad spectrum of activity. The indications were perforated appendicitis with peritonitis or abscess formation (12 patients), urinary tract infection due to congenital anomalies (3 patients), miscellaneous infections (3 patients) and peroperative prophylactic treatment (5 patients). The clinical response was good. Few adverse reactions were noted. The drug seems to be effective and safe.

Abscess↗
PubMed1982

Aspects on the treatment of omphalocele and gastroschisis. Twenty years' clinical experience.

Sixty-one patients with abdominal wall defects (omphalocele 37; gastroschisis 24) were treated during a twenty-year period according to different therapeutical principles. An analysis showed that good results were obtained by means of primary radical closure, large lesions included. The silo-technique appeared to be less successful. The use of central vessels for infusion probably contributed to a negative outcome, while total parenteral nutrition (in peripheral veins) and postoperative assisted ventilation had positive effects. With the exception of the antenatal type of gastroschisis, our experience indicates that the vast majority of cases with omphalocele or gastroschisis can be successfully treated by means of radical primary repair.

Abdominal Muscles↗
PubMed1981

Experience of the Cohen method for ureteral reimplantation in complicated cases.

Thirty-seven infants and children (41 ureters), a majority with complicating factors (low age, neurogenic bladder, duplication, reoperative surgery), were treated with ureteral reimplantation according to Cohen. The results were good in 90% of the cases. Minor deviations from the original technique, i. e. Dexon instead of chromic catgut as suturing material, catheter splinting of ureter in only 40% and short length of submucosal tunnel in some cases, did not seem to have a negative influence on the results. The method, which is easy and safe to perform, is recommended, particularly in complicated cases.

Adolescent↗
PubMed1981

Urodynamic studies in boys with disorders of the lower urinary tract. V. Posterior urethral folds. A pre- and postoperative study.

Urodynamic investigation was performed in 21 boys with posterior urethral folds. An abnormal micturition pattern characterized either by varying degree of obstruction during the course of a micturition or by constant obstruction of "stricture type" was found in nine cases. The obstruction was generally of moderate degree. No micturition pattern specific for posterior urethral folds could be shown. Ten boys had enuresis. They did not differ from the other boys in regard to urodynamic variables. On the basis of clinical indications, 16 of the boys were operated on. Postoperative urodynamic follow-up indicated definite improvement or complete normalization in most of them, though urethral resistance was slightly increased postoperatively in three cases. Patients with posterior urethral folds probably should be treated by transurethral resection only if urodynamic investigation reveals an obstruction.

Child↗
PubMed1979

Free autogenous muscle transplantation in 5 children with urinary incontinence.

Five children with urinary incontinence were operated with a new method involving free autogenous muscle transplantation. Before transplantation a skeletal muscle (extensor brevis of the foot) is denervated and, 2 weeks later, it is transplanted and placed as a U-sling around the urethra in close contact with normally innervated muscles, which act as reinnervation sources. All patients showed improvement of continence and increasing bladder capacity from about 2 months after transplantation. Postoperative cine-micturition studies clearly demonstrated the functional properties of the transplanted muscle and estimation of urinary flow rate showed no signs of infravesical obstruction.

Adolescent↗
PubMed1978

A new treatment of anal incontinence in children: free autogenous muscle transplantation.

A new method is presented for the treatment of anal incontinence in children, including free autogenous muscle transplantation. The primary step is denervation of a skeletal muscle, which 2 wk later is transplanted and placed as a U-sling around the rectum, imitating the position and function of the puborectalis muscle. The transplant is placed in close contact with innervated muscles, which act as reinnervation sources. The results in five consecutive patients are highly promising. An early sign of improvement is the occurrence of a sensation of rectal fullness. All the patients reached an acceptable degree of continence, including abandonment of the use of napkins, 4-12 mo after surgery.

Adolescent↗
PubMed1978

Urodynamic studies in boys with disorders of the lower urinary tract. IV. Congenital bladder neck obstruction. A pre- and postoperative study.

Eighteen boys with diagnose of bladder neck obstruction, based on roentgenological criteria, underwent urodynamic investigations. In the majority of patients, urodynamics clearly deviated from the normal range, substantiating that bladder neck obstruction, although rare, really exists in male infants and children. A rather uniform radiographic appearance of the bladder neck was associated with different urodynamic patterns, suggesting that various pathophysiological mechanisms may be involved.

Child↗
PubMed1977

Urodynamic studies in boys with disorders of the lower urinary tract. I. Urethral strictures. A pre-and postoperative study.

Sixteen boys with urethral strictures underwent urodynamic investigation pre- and postoperatively. The intravesical pressure preoperatively showed wide variations during micturition and was increased in only half of the patients. The urinary flow pre-operatively displayed a uniform picture with a decreased maximum flow in all the patients, plateau-formation and slow initiation of the flow curve. The maximum exit velocity of the urinary stream was decreased and the urethral energy losses were very high. After treatment, the out-flow situation was generally improved, but restored to normal only in some cases. Patients with short strictures showed the highest degree of urethral obstruction, but they also seemed to have the best prognosis, some of them even reaching supernormal flows. Flow measurement alone is recommended in the long-term follow-u, which is necessary in these patients. After-contraction was not present in any of the patients pre-operatively, blt occurred in about half of them postoperatively. This and some other findings may indicate the existence of functional changes in the bladder neck in patients with urethral stricture. On case with partial detrusor muscle insufficiency is reported.

Child↗