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Biomedical subjects

K E Klaaborg

Publications and source records attributed to K E Klaaborg.

15 recordsLinked to original sources
PubMed1996

[Esophageal perforations].

An oesophageal perforation is a serious condition with high morbidity and mortality. During the latest decades an increased number of traumatic perforations as well as wide use of endoscopic procedures have increased the incidence of oesophageal perforation. An early diagnosis and treatment is important for the prognosis. Cervical and selected thoracic perforations can be treated conservatively although the majority should be operated. Primary closure can be performed if done before 24 hours have elapsed, while later treatment is controversial. Drainage of the mediastinum and pleural space, as well as diversion of saliva and gastric content is important. The literature is reviewed in relation to etiology, diagnosis, treatment and prognosis.

Esophageal Perforation↗
PubMed1993

Intra-aortic balloon counterpulsation in Denmark 1988-1991. Early results and complications.

During the years 1988-1991 6319 patients underwent cardiac surgical procedures in Denmark. In 183 patients (2.9%) with left ventricular failure intra-aortic balloon counterpulsation (IABP) was used. Four percent of the IABP were placed preoperatively, 86% intraoperatively and 10% postoperatively. Severe complications occurred in 16 patients (8.7%) and were mainly vascular due to limb ischemia. The incidence of complications was independent of the duration of balloon pumping. Sixty percent of the patients were weaned from IABP. The 30-day mortality rate was 54%. During the observation period we found a gradual decrease in the use of IABP as well as a reduction in mortality.

Cardiac Surgical Procedures↗
PubMed1991

[A centrifugal pump used as a support of left ventricular pumping function after extracorporeal circulation].

The first Danish employment of a centrifugal pump for relief of the left ventricle after open heart surgery is presented. A man aged 72 years with three-vessel coronary arteriosclerosis was submitted to a coronary by-pass operation. At the conclusion of the operation, the pumping capacity of the heart was found to be so reduced that it was not possible to maintain an adequate minute-volume without support from a mechanical pump. The circulation in this patient was supported for four hours by means of an outflow catheter from the left atrium and an inflow catheter in the ascending aorta. After this, the patient's own heart could achieve the necessary minute-volume. The remainder of the postoperative course was uncomplicated.

Aged↗
PubMed1991

Magnesium content of the human heart.

Although changes in the body's magnesium status have been linked to ischemic heart disease, sudden death and arrhythmia, there is as yet no recommended, established procedure for evaluation of magnesium homeostasis. We therefore explored the relationship between the magnesium content of the heart and that of serum, lymphocytes and skeletal muscle in 50 men undergoing cardiac surgery, using biopsies from the right auricula, right atrium and skeletal muscle and simultaneously drawn venous blood for measurement of lymphocyte and serum electrolyte concentration. Median magnesium values (mumol/g wet weight) were 7.42 (3.98-8.89) in skeletal muscle, 5.49 (3.44-7.66) in right auricula and 5.80 (2.60-7.53) in right atrium. The magnesium concentration in skeletal muscle was found to correlate with that in right auricula (r = 0.46, p less than 0.01) and right atrium (r = 0.43, p less than 0.01), whereas values in serum and lymphocytes showed no correlation with the heart's magnesium content. When myocardial biopsy is not available, skeletal muscle magnesium concentration seems to be the best predictor of the human myocardium's magnesium status.

Chlorides↗
PubMed1989

Pancreaticogastrostomy for chronic pancreatitis.

Forty-five patients with painful chronic pancreatitis underwent side-to-side pancreaticogastrostomy. Correct diagnosis was ensured by endoscopic retrograde cholangiopancreatography, decreased exocrine pancreatic secretion, abdominal calcifications, and histologic verification. A main etiologic factor was alcohol abuse (84 percent of patients). At a median follow-up period of 3.8 years, good, fair, and poor results were achieved in 56, 23, and 21 percent of patients, respectively. The operative mortality rate was 4.4 percent. At follow-up, 16 of the patients were employed, weight was increased by a mean of 2.5 kg, and the use of opiates was significantly reduced. Poor results were significantly related to preoperative use of tranquilizers and postoperative alcohol consumption. Neither patency of the anastomosis nor the time of observation were related to the operative result. The 8-year cumulative survival rate was 83 percent.

Adolescent↗
PubMed1987

Single or multiple doses of metronidazole and ampicillin in elective colorectal surgery. A randomized trial.

A randomized trial including 294 patients was performed to evaluate the prophylactic effect of single vs. multiple doses of antibiotics in elective colorectal surgery. All patients received 1.5 g metronidazole and 3.0 g ampicillin peroperatively and were randomized to: no further prophylactic antibiotic treatment, or ampicillin 1 g X 3 and metronidazole 0.5 g X 3 given intravenously during the second and third postoperative days. Deep wound infection was seen in 9/149 (6 percent) receiving a single dose and in 8/145 (6 percent) receiving multiple doses. No differences were found in the two groups between frequencies of anastomotic dehiscences, intra-abdominal abscesses, sepsis, and pulmonary infections. The two groups were similar according to distribution of sex, age, diagnosis, and type of surgery. A single peroperative dose of metronidazole and ampicillin is a simple and satisfactory antibiotic prophylaxis in elective colorectal surgery.

Adolescent↗
PubMed1986

Suprapubic bladder drainage in elective colorectal surgery.

Suprapubic bladder drainage was assessed in 399 patients, following surgery of the rectum and sigmoid colon. An Argyle-Ingram catheter no. 16 French was inserted after the laparotomy incision had been made. The bladder was drained continuously for 24 hours, after which the catheter was closed and reopened every 6 hours for 10 minutes. The catheter was removed when the postvoided volume became less than 50 ml on each of two subsequent measurements. Abdominoperineal excision required the longest drainage period. Urethral catheterization became necessary in 13 men and six women because of persistent or recurrent urinary retention. Failures of suprapubic drainage made urethral catheterization necessary in 17 of 31 patients. Uroperitoneum, due to leakage from the bladder after removal of the suprapubic catheter, was seen in one patient with infravesical obstruction and bladder diverticula. The patient recovered after relaparotomy and suture of the bladder. Suprapubic drainage is recommended because it permits spontaneous voiding. Urethral instrumentation is avoided in most cases. Residual volume can be measured without urethral catheterization. Complications are few, and discomfort to the patient is seen in no more than 1 percent.

Adolescent↗
PubMed1986

Rectal prolapse in infancy: conservative versus operative treatment.

In infancy there are two types of rectal prolapse. One type is less pronounced and intermittent. This type occurred in 9 out of 17 children referred for rectal prolapse and ceased after a few weeks' conservative treatment. The other type is a more pronounced prolapse occurring at nearly each defecation and lasting several weeks or months. These patients may need an operation, especially when ulceration of the mucosa occurs. In our patients, a Lockhart-Mummery operation was used successfully in all but one patient. No complications were observed. Though less extensive treatment, such as submucosal injection of sclerosing agents, is recommended to be the first method of choice because pathoanatomically the prolapse in infancy is frequently a prolapse of the mucosa, in patients where this therapy does not succeed, a Lockhart-Mummery operation may be an alternative.

Child, Preschool↗
PubMed1985

Enterocutaneous fistulization due to Actinomyces odontolyticus. Report of a case.

A case of abdominal actinomycosis originating from the sigmoid colon is presented. Actinomyces odontolyticus was isolated; it is a rarity, but should be suspected in the case of a palpable mass and several fistulas developing after a latent period of weeks to months following surgical or inflammatory trauma. The diagnosis is made by anaerobic cultivation. Primary treatment with large doses of penicillin for several weeks may be supplemented by surgery. The strain isolated in the present case was only moderately sensitive to penicillin and was successfully treated with erythromycin.

Actinomycosis↗
PubMed1985

Rectal prolapse and anal incontinence treated with a modified Roscoe Graham operation.

The results of abdominal mobilization of the rectum and repair of the pelvic floor behind the anorectal junction are reported in 23 patients with rectal prolapse, being accompanied by some form of anal incontinence in 12. Within 20 months, on the average, three patients had recurrent prolapse. Two thirds of the patients with incontinence for solid and/or fluid feces were cured for prolapse as well as incontinence. Seven became constipated, while 14 were fully satisfied. Seven of eight patients with a highly reduced tone of the external sphincter before surgery had a marked improvement after surgery. The results do not differ greatly from those after the suspension operation or repair of the pelvic floor in front of the rectum, despite being more physiologic, but suggest that simultaneous suspension and abdominal repair of the pelvic floor may avoid the need for a secondary postanal repair from below in patients with persistent incontinence after suspension surgery. A controlled, randomized trial is advocated.

Adult↗
PubMed1985

Two cases of malakoplakia of the prostate.

2 further cases of malakoplakia of the prostate are reported, so that a total of 23 cases have now been described. The histological picture, as well as the methods of staining for the demonstration of the pathognomonic Michealis-Gutmann bodies are reviewed. The presence of Escherichia coli as a possible factor in the etiology is discussed. A description is given of the symptoms and physical findings in cases of prostatic malakoplakia, and the differential diagnosis, with particular reference to cancer of the prostate, is reviewed. Histology alone can provide the correct diagnosis. Finally it is emphasized that malakoplakia can be treated with long-term antibiotic therapy.

Aged↗