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Biomedical subjects

J Kunlin

Publications and source records attributed to J Kunlin.

17 recordsLinked to original sources
PubMed1986

[47-year course of severe lymphedema of the right lower limb. 6 successive operations from 1941 to 1950. Satisfactory condition 36 years after the last operation].

Mrs. T... (born in 1920) consulted Pr R. Leriche in 1941 for severe lymphoedema of the right leg present since 1939 following fly bites. Elastic contention was insufficient. Lumbar sympathectomy performed in 1941, subcutaneous-aponeurotic resections of the lateral aspect of the leg in 1942, extended in 1946 (R. Leriche) and completed by a wide excision of the posterior aspect in 1948 (Pr Goinard, Alger) only provided temporary improvements. In 1949, five polyethylene tubes were inserted under the skin of the calf at the root of the thigh (Kunlin and Boely). Three catheters had to be removed after several months because of the risk of cutaneous perforation and secondary infection. In 1950, in view of the inadequate results, ten nylon threads were inserted into the subcutaneous tissue from the ankle to the lower abdominal wall and a very extensive resection of the subcutaneous tissue (to the level of the dermis) and the aponeurosis was performed on the medial aspect of the leg (K. and B.). A dramatic improvement was obtained, which persisted until the beginning of 1986, i. e. 36 years after this last operation. Unfortunately, oedema has gradually appeared in the other leg over the last 4 to 5 years. Despite the various treatments attempted, the volume of this leg is now greater than that of the operated leg and is associated with increasing discomfort for the patient (Table of measurements). A calcified sheath has formed around the two remaining polyethylene tubes.

Adipose Tissue↗
PubMed1985

Arteriovenous flow reversal, experimental investigations. I. Complete flow reversal of the small intestine and of the rear extremity of the dog.

Segments of the small intestine and hind extremities of dogs were perfused under the condition of complete arterio-venous flow reversal (AVFR). In the intestinal segments, the peripheral resistance under AVFR conditions was 4.4 times higher than under orthograde perfusion. Petechiae and hemorhagic infarction were observed. The average flow resistance of the hind extremities was 2.4 times higher than the resistance in control extremities. The pO2 and the O2 saturation in the blood, outflowing from the AVFR extremity was lower than in the control extremity, however, the pO2 was higher. The oxygen consumption was somewhat lower than in the control extremity. It is concluded that by complete AVFR an extremity may be supplied sufficiently with oxygen at least temporarily.

Animals↗
PubMed1985

Arteriovenous flow reversal, experimental investigations. II. Hemodynamic and blood gas analyses in incomplete arteriovenous flow reversal in hind extremities of dogs.

2 types of incomplete arteriovenous flow reversal were tested. When the major arteries were patent, 20% of the blood shunted into a peripheral vein was drained via the arteries whereas 80% was drained via the veins of the leg. If the pressure in the arteries was raised, the flow through the arteries was stopped when the outflow pressure reached 25% of the systemic blood pressure. Under these conditions a moderate oxygen consumption of the peripheral tissues was still observed. When the major arteries and their branches were obstructed by the injection of collagen flocculi the oxygen supply to the tissues was again reduced but not completely abolished. It is concluded that the AVFR procedure may be helpful in avoiding peripheral gangrene in very severe cases of arterial disease. In the first paper of this series (Gottlob and Kunlin, 1985) the hemodynamics of complete arteriovenous flow reversal (AVFR) were studied. In the present communication experiments with incomplete AVFR will be reported on. The animal models described resemble the clinical condition in so far as incomplete AVFR is established and as in both models the flow through the peripheral arteries was hampered.

Animals↗
PubMed1983

[New experimental documents on circulatory reversal by arteriovenous fistula in ischemia of the extremities].

The beneficial effects of circulatory reversal by lateral a.-v. fistula was confirmed in 20 hind limbs of dogs made ischaemic by Collagen embolisation. Although not done in the experiments presented here, rupture of the distal venous valves is advisable. The peripheral circulation was studied by measurement of venous pressures and by angiography. Retrograde infusions, with proximal tourniquet, confirmed reversal of flow veins to arteries. Return routes to the heart remain unknown.

Animals↗
PubMed1980

[Plea for better terminology in surgery of the profunda femoris artery (author's transl)].

Surgical publications on the profunda femoris artery rarely give information on the site of the operation and the technic used. Experience of 356 operations carried out from 1949 to 1978 by the authors and anatomical dissection of 100 profunda femoris arteries is reported. They suggest the elimination of all imprecise terms at present attached to these operations and their replacement by a more lengthy but more understandable vocabulary, together with an attempt to classify the profunda femoris artery in two groups and its nomenclature in 4 segments, more adaptable to surgery of this artery.

Aged↗
PubMedDate not supplied

Arterialization of the venous network of the foot through a bypass in severe arteriopathic ischemia.

With the object of saving a very ischemic extremity, when the classic procedures have been unsuccessful or impossible, the authors are using a modification of San Martin's operation. At present, we are making an A-V fistula with a graft interposed between the femoral or popliteal artery and the peripheral long saphenous vein at the foot or near to it. The distal valves are ruptured. In order to prevent the noxious venous overloading resulting from the distal end-to-end anastomosis, it is important to replace it by an end-to-side anastomosis. Eight patients with intense continuous rest pain and necrotic lesions of the toes and heel have been operated on: 3 failures in spite of well functioning A-V fistula; 2 temporary improvements lasted 7 and 16 months when distal thrombosis of the A-V fistula occurred; 3 good results, maintained during 5 months, 4 3/4 years and 9 1/2 years respectively. Postoperative angiography and scintillography reveal a satisfactory retrograde distribution of blood in the fore foot except in the necrotic tissues.

Aged↗