Biomedical subjects
Publications and source records attributed to J J Lamers.
Three cases of subcutaneous emphysema of the lower extremity due to abdominal disease are reported. These were due to (a) perforation of the sigmoid, (b) perirectal abscess, and (c) non-traumatic metastatic gas gangrene due to emphysematous cholecystitis. The mechanisms and anatomical pathways are discussed.
Spontaneous esophageal perforation (Boerhaave syndrome) is a life-threatening emergency. It usually has misleading clinical manifestations and causes severe complications. In the presence of the clinical manifestations: vomiting, pain, emphysema, this diagnosis must be considered and confirmed by radiological evaluation of the chest and the esophagus. We report two cases and we describe the severity of this syndrome, its cause, its pathogenesis, and its characteristic clinical features and radiological signs.
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A double-blind comparison of two recently introduced cholangiocholecystographic agents was carried out in 80 patients. Both agents proved to be equally effective in opacifying the gall-bladder and the bile ducts. The visualization of the bile ducts after cholecystectomy was slightly better after meglumine iotroxate administration. Both agents showed evidence of hepatic toxicity in mild or moderate degree. However, there were 3 cases in which adverse hepatotoxic reactions t meglumine iodoxamate have been observed. Careful observation of patients receiving this drug is advised.
In the acute form of pigeon breeder's lung, chest X-rays often reveal micronodular changes, but 7 of the 16 patients examined showed no changes. In the subacute form, chest X-ray changes are exceedingly rare: they occurred in only 1 of the 17 patients. Pigeon breeder's lung differs from the condition known as bird breeder's lung in that it turns much less often into a chronic condition (pulmonary fibrosis and emphysema).
In enteroclysis the flow rate of the barium is important but not easily controlled with an infusion bag system. To improve the technique, an electric flow inducer was used in 156 consecutive examinations to infuse the barium suspension at a constant rate of 75 ml/min. Detailed demonstration of mucosal folds was achieved in 90 per cent. The examinations were of moderate quality in 8 per cent and of poor quality in 2 per cent. The maximum transit time was 20 minutes and the total examination time never exceeded 35 minutes. Sensitivity and specificity were 94 and 97 per cent, respectively. Examinations indicated by specific small bowel symptoms had a positive yield of 49 versus 13 per cent with non-specific indications. Both examination performance and patient tolerance were improved.