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Biomedical subjects

Jan K Horn

Publications and source records attributed to Jan K Horn.

6 recordsLinked to original sources
PubMed2005

Endovascular repair of an actively hemorrhaging gunshot injury to the abdominal aorta.

Endovascular stents have had a limited role in the management of trauma and vascular emergencies involving active hemorrhage. We describe a patient with delayed rupture of the infrarenal aorta after intra-abdominal sepsis caused the breakdown of a primary aortic repair. A stent-graft repair was performed, as concomitant injuries did not allow anterior access to the aorta. This report describes the successful endovascular repair of an actively hemorrhaging penetrating abdominal aortic injury. Endovascular approaches to aortic injuries may be valuable in settings where a hostile abdomen precludes traditional open repair.

Abdominal Injuries↗
PubMed2003

Congenital cleft spleen with CT scan appearance of high-grade splenic laceration after blunt abdominal trauma.

The spiral computed tomography (CT) scan has made the diagnosis of traumatic injury increasingly rapid and accurate, especially in cases of solid parenchymal organ injury that follows blunt abdominal trauma. Nonetheless, this valuable method of diagnosis can be confounded when anatomical variances are encountered in the setting of concomitant associated injuries. We present here a case where a congenitally bi-lobed spleen was diagnosed by CT scan as an apparent high-grade splenic laceration, prompting emergent laparotomy.

Accidents, Traffic↗
PubMed2003

Bacterial agents used for bioterrorism.

BACKGROUND: Bacterial pathogens and their products are potential agents of biological terrorism and biological warfare. These agents can be deployed through simple aerosol delivery systems and thereby cause widespread disease and death. METHODS: This report is a review of bacterial species that have been employed for development of biological terrorism, relying on a system for classification of their threat developed by the Centers for Disease Control. RESULTS: Physicians must understand how to recognize early signs and symptoms caused by bacterial agents. Clinical findings often seen on presentation are emphasized along with a summary of therapeutic approaches. CONCLUSIONS: Initiation of immediate therapy and supportive care provides the best chance for survival from these potentially lethal and devastating infections. A high index of suspicion must be maintained, especially in the setting of a sudden influx of cases with what are often relatively nonspecific symptoms.

Animals↗
PubMed2002

Laparoscopic adrenalectomy for pheochromocytoma.

aparoscopic adrenalectomy is the standard for most surgical adrenal diseases. The aim of this study was to evaluate the safety and effectiveness of laparoscopic adrenalectomy for patients with pheochromocytoma. The medical records of 39 consecutive patients who underwent laparoscopic adrenalectomy for pheochromocytomas from 1994 to 2000 at the University of California-San Francisco were reviewed. Three groups of patients were identified. The first group comprised 17 patients with classic symptoms and signs of pheochromocytoma. The second group comprised 17 patients who had minimal symptoms and incidentally discovered pheochromocytoma (i.e., "incidentaloma"), almost half of whom inappropriately underwent fine-needle biopsies before diagnosis. The third group consisted of 5 patients who had acute hypertensive crises and required intensive preoperative preparation. The mean age of the 22 men and 17 women was 46 years (range 20-84 years), and the mean adrenal tumor size was 4.8 cm (range 2-12 cm). A total of 43 laparoscopic adrenalectomies were performed for 35 patients with unilateral tumors and 4 patients with bilateral tumors. The retroperitoneal approach was used in four patients and the lateral transabdominal approach in the remaining patients without conversion to an open operation. There were no intraoperative complications or mortality. The mean duration of hospitalization was 1.7 days. In conclusion, patients with pheochromocytoma have a wide spectrum of presentations, from minimal symptoms to hypertensive crises. When evaluating an incidentaloma, pheochromocytoma should be excluded by metabolic testing, not by needle biopsy. Laparoscopic adrenalectomy is the preferred surgical approach for patients with pheochromocytoma because it is safe and efficacious.

Adrenal Gland Neoplasms↗