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Biomedical subjects

L Gandawidjaja

Publications and source records attributed to L Gandawidjaja.

10 recordsLinked to original sources
PubMed1999

[Thoracoscopic treatment of pleural empyema].

From August 1991 to May 1997 46 patients with pleural empyema in the fibrinopurulent phase underwent thoracoscopic surgery. There were 36 men and 10 women with an average age of 47 years ranging from 18 to 84. The average operating time was 77 minutes. When only one thoracostomy drain was inserted, the drainage time was 8.5 days, if two or three drainage tubes were used it was 10.5 days. The average hospital stay was 18.1 day (range from 7 to 45). We observed ten complications. Four operations had to be converted to an open procedure because of massive thickening and fibrosis of the pleura. Three patients did not tolerate one lung ventilation, once the lung did not collapse due to technical reasons and in one patient each we observed a laceration of the parenchyma and bleeding from the parenchyma. In both cases the problem was dealt with thoracoscopically. We observed a recurrent pleural empyema in four patients which occurred between the 28th and 77th postoperative day. In summary, thoracoscopic surgery in patients with pleural empyema in the fibrinopurulent phase is an effective and well tolerated alternative to open thoracotomy.

Adolescent↗
PubMed1997

Anatomic, physiologic, bacteriologic and immunologic aspects of peritonitis.

The anatomic aspect of peritonitis describes the division of the abdominal cavity into the supracolic, infracolic and paracolic spaces, moreover the lesser sac and the cul-de-sac of the pelvis. Physiologically the peritoneum plays an important role in the passive exchange of fluid and absorption of particles. Endotoxin, which is elaborated by bacteria activates the classical as well as the alternative complement pathway. It activates also the arachidonic acid metabolism, leading to the release of prostaglandins (PG) and leukotriens (LTC). The local host defense against a bacterial invasion includes the activation of cellular and humeral immunologic defense mechanism, in which the final product of the complement pathway (C5b-9), as well as chemoattractants C3a, C5a and C567 play a key role.

Abdomen↗
PubMed1996

Thoracoscopic pulmonary surgery: indications and results.

OBJECTIVE: To report our experience of thoracoscopic pulmonary operations from May 1991 to May 1994. DESIGN: Prospective open study. SETTING: District hospital, Germany. SUBJECTS: 93 patients who underwent 120 thoracoscopic procedures. INTERVENTIONS: Wedge resection (n = 56), pleural biopsy (n = 21), early decortication (n = 16), partial pleurectomy (n = 9), pleurodesis (n = 5), pulmonary biopsy (n = 4), segmentectomy (n = 3), evacuation of haemothorax (n = 3), biopsy of mediastinal tumor (n = 2), and costal biopsy (n = 1). MAIN OUTCOME MEASURES: Morbidity, mortality, and avoidance of open thoracotomy. RESULTS: Indications for thoracoscopic intervention were: solitary pulmonary nodule (n = 37), recurrent pneumothorax (n = 17), pleural empyema (n = 14), diffuse pulmonary disease/multiple nodules (n = 10), recurrent pleural effusion (n = 11), haemothorax (n = 3), and mediastinal tumour (n = 1). In 29 of 37 patients in whom we attempted resection of a solitary pulmonary nodule we obtained enough tissue for diagnosis, and avoided thoracotomy in 18 patients. Complications included pulmonary embolus (n = 1), recurrent empyema (n = 1), haemorrhage (n = 2), infection of the drain site (n = 3), and two persistent air leaks. One was closed at a second thoracoscopy and the other required open thoracotomy after which he developed pulmonary failure and died. One patient with a haemothorax developed multiple system organ failure and died, and attempted resection of a mediastinal tumour was unsuccessful. Three thoracoscopic procedures had to be abandoned because of dense adhesions. CONCLUSIONS: Thoracoscopic surgery is a safe, well tolerated, and cost effective alternative to open thoracotomy in selected patients.

Adolescent↗
PubMed1978

[Phosphoric acid ester poisoned rats after antidote therapy. 2. Determination of serum enzyme activity].

Paraoxon in doses of one LD50 (0.426 mg/kg), eight times and eighty times LD 50 was applied s.c. to female Sprague-Dawley rats. After 3, 6, 10, 24 and 36--48 h the activities of enzymes GOT, GPT, GLDH, SDH, CPK and ChE were measured, once after i.m. antidote application of Toxogonin only, of Toxogonin + atropine and the next one after application of combination Toxogonin + atropine + Solcoseryl (low-molecular components of deproteinized blood from young calves. The values obtained showed that in spite of treatment with Toxogonin or Toxogonin + atropine the activities of the enzymes increased; this enhancement could be prevented by addition of Solcoseryl to Toxogonin + atropine. The ChE-activity after 36 h was equivalent to that of the control value. The effect of paraoxon in the initial phase of poisoning was discussed in connection with hypoxia and acidosis resulting from a respiratory insufficiency as well as the inhibition of ATPase-activity with restriction of the energy metabolism following: consequently the effect of Solcoseryl was interpreted as an activation of the disturbed energy metabolism.

Acetylcholinesterase↗
PubMed1977

[Possible combinations of antidotal therapy in rats following intoxication with phosphoric acid esters (author's transl)].

In order to improve or supplement the currently used therapy of poisoning with phosphoric acid esters, a protein free extract from calf blood containing low-molecular subtances (Actihaemyl, Solcseryl) has been tested in female Wistar rats. After poisoning with paraoxon, DFP and soman, a combination of Solcoseryl, Toxogonin and atropine sulfate prolonged the time until exitus, improved the overall rate of survival and considerably shortened the phase of regeneration of the experimental animals even when they had been intoxicated with high doses of poison.

Actihaemyl↗
PubMed1977

[Findings following antidote therapy in rats intoxicated with phosphoracetic acid. / Histochemical and biochemical lipid demonstration in liver and kidneys (author's transl)].

The fatty degeneration of the liver and kidney of Sprague-Dawley rats was observed by histochemical and biochemical means after intoxication with LD50 and 8 X LD50 O,O-diethyl-O-p-nitro-phenylphosphate (paraoxon). The degree of fatty degeneration in these organs was demonstrated alternately after antidote-treatment with bis(pyridinium-4-aldoxim-1-methyl) ether (Toxogonin) and after injection of a combination of Toxogonin, atropine and a protein-free extract from calf blood containing low-molecular substances (Actihaemyl, Solcoseryl). Under the influence of Actihaemyl the degree of fatty degeneration induced by the toxin was, in respect to both triglycerides and phospholipids, near control levels. The mode of action of Actihaemyl is discussed with regard to the activation of fatty acids.

Actihaemyl↗
PubMedDate not supplied

[Fournier's syndrome].

Fournier's syndrome, a necrotizing subcutaneous infection of the male genitalia, is characterized by an explosive onset and a rapid evolution. It is caused by a synergistic interaction of several aerobe and anaerobe bacteria. The immediate institution of an aggressive therapy with extensive drainage and supporting broad spectrum antibiotics gives the best results. Hyperbaric oxygen can be used as complementary therapy. Reconstructive surgery can be considered for very large tissue and skin defects.

Aged↗
PubMedDate not supplied

Peritonitis: pathophysiology and local defense mechanisms.

The peritoneal cavity can be divided in the supracolic infracolic and paracolic spaces, the lesser sack and the pelvis. The peritoneum is a semipermeable membrane which allows a flux of solutes into and from the peritoneal cavity. In addition, particles can be absorbed through the stomata of the diaphragmatic peritoneum. Secondary peritonitis is always a polymicrobial infection. The flora consists of aerobic enterobacteriaeceae and anaerobs mainly B. fragilis. These two groups of bacteria act synergistically. Besides unspecific defence mechanisms, i.e. the direct absorption of bacteria and the entrapment of bacteria in fibrin, the immunological defence mechanisms of the peritoneal cavity are triggered by endotoxin contained in the cell wall of the invading bacteria leading to the production of cytokines by macrophages, activation of complement and as a result the migration of granulocytes from the intervascular space into the peritoneal cavity.

Animals↗