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Biomedical subjects

O J Russe

Publications and source records attributed to O J Russe.

12 recordsLinked to original sources
PubMed2006

[Surgical management of spondylodiscitis. An analysis of 78 cases].

Spondylodiscitis is a rare bacterial infection of the spine with an inflammatory, destructive course. To obtain further information on the therapeutic management and clinical course of spondylodiscitis, we retrospectively investigated 78 patients after surgical intervention. Mean age was 64 years (+/-4.6 years; range 21-80 years), the mean length of stay 49 days (+/-8.2 days; 3-121 days) including 24 days (+/-4.7 days; 0-112 days) in ICU. In hospital mortality was 9%. The cervical spine was affected in 10%, the thoracic spine in 35% and the lumbar/sacral spine in 55% of patients. Abscess formation occurred in 65% and destruction of the vertebral body in 74%. A total of 75% of patients presented with neurological deficits which could be improved by surgical intervention in 82% of cases. 24 patients were treated by ventral debridement and stabilization alone, 20 patients with a combined dorsoventral method. Most patients (n=34) were stabilized via dorsal bridging instrumentation without ventral debridement of the focus. Of this group, 23 patients were initially scheduled for secondary ventral debridement but complete healing was achieved prior to this, so further surgical therapy was unnecessary. Successful cure was obtained in 92% of cases. Based on our findings, we favor a split surgical approach: initially with dorsal internal fixation only. Abscesses can be drained percutaneously. Ventral debridement and stabilization is only recommended if insufficient stability can be obtained by dorsal fixation alone, as shown by the persistence of infection or pain.

Adult↗
PubMed2004

[Osteomyelitis of the spine].

Spinal infections are rare, occurring most often in elderly patients with urinary tract infections or diabetes. With the increasing number of patients with immune suppression, and also the increasing number of immigrants in the population, spinal infections are seen more frequently, especially in young adults. Typically spinal infections are monomicrobial, Staphylococcus aureus being the most common organism. Hematogenous spread of bacteria through the arterial paravertebral collateral vessels into the subchondral bone marrow of the vertebral bodies is the most common source of infection. Clinical presentation is often nonspecific. Important diagnostic measurements are laboratory studies, radiological evaluation including MR image scans, and CT-guided percutaneous biopsy of the lesion for microbiological studies. The management of spinal infections consists of antimicrobial therapy over 6-8 weeks. Surgical intervention is indicated in neurologically compromised patients for spinal instability and abscesses.

Anti-Bacterial Agents↗
PubMed2000

[Anterior screw fixation for odontoid fractures].

The results of anterior screw fixation of odontoid fractures in 28 patients are presented. There were 27 type II- and 1 type III-injuries. Non-union with persistent instability had to be notified in one patient (3.6 %), secondary posterior C1/2 fusion had to be performed. Incorrect positioning of the screws in the odontoid with penetration of the postero-lateral cortex occurred in 3 patients (10.7 %). Malpositioning of the odontoid after screw fixation was documented in 5 cases (17.9 %). Cardiopulmonary complications had to be treated in 5 patients (17.9 %), 4 patients (14.3 %) died in the postoperative period. 17 patients could be followed up. Only 3 patients (17.8 %) were free of symptoms. A significant limitation in ROM of axial rotation was seen in 44 % of the patients. With anterior screw fixation of the odontoid high fusion rates can be achieved, however the procedure is technically demanding. Regarding the functional outcome, there is no significant difference to other established treatment methods.

Adolescent↗
PubMed1980

Chronic vascular disease of the upper extremity: radiologic and clinical features.

The major chronic vascular diseases of the upper extremity are (1) subclavian artery occlusions, (2) thoracic outlet syndrome, and (3) angiospastic disease of the hand. Central subclavian artery lesions ease of the hand. Central subclavian artery lesions can have either hemodynamic consequences (subclavian steal syndrome) or, by peripheral embolization, can provoke ischemic symptoms of the hand. Costoclavicular narrowing can cause functional or fixed stenosis of the subclavian artery and can also involve the vein or brachial plexus. Symptoms due to pressure on the brachial plexus are most frequent, but embolization to the peripheral vessels may also occur. Angiospastic disease, the most frequent lesion of upper extremity vessels, comprises three types: Raynaud's disease, in which there are intermittent attacks of coldness and discoloration without evidence of occlusion on the angiogram; asphyxia manus et digitorum in which the attacks are also intermittent but there is morphologic evidence of occlusion; and digitus moriens or mortuus, in which there is a painful, permanent discoloration. All investigations of chronic vascular disease of the upper extremity should begin with arch aortography and then proceed to a selective catheterization of the vessels that are presumed to be involved.

Adolescent↗
PubMed1980

[Aneurysmal dilatation of the bulb of the azygos vein. Radiological and clinical value].

An aneurysm of the vena azygos should be taken into consideration when establishing the differential diagnosis of a tumor in the area of the right tracheobronchial angle or of an enlargement of the right upper mediastinum. Bilateral pelvic phlebography with demonstration of the retroperitoneal venous system and the azygos venous system is the only purposeful examination. Tentative diagnosis is made on the basis of the X-ray (radioscopy and general X-ray of the chest) and is supplemented by X-rays of the patient in a recumbent position (Valsalva- and Müller-test) and appropriate tomography. The most frequent cause of the azygos aneurysm in our patients was aplasia of the inferior vena cava. One patient presented an infrahepatic interruption of the inferior vena cava with azygos continuation. Phlebography of the inferior vena cava should always be performed in cases of azygos aneurysm. An abnormality of the inferior vena cava may be missing; in such cases the existence of a cardiac defect, abnormal emptying of pulmonary veins or hepatic cirrhosis should be taken into consideration. The enlargement of the azygotic arch may also occur during pregnancy. Thus an azygos aneurysm is frequently but not necessarily associated with enlargement of the azygotic arch. We saw one patient among our cases who presented aplasia of the inferior vena cava without any dilatation of the azygotic arch.

Adolescent↗
PubMed1979

Radiological procedures in portal hypertension.

Radiological diagnosis in portal hypertension is of paramount importance for proper treatment. The site of portal obstruction is determined preoperatively by either direct (splenoportography, transumbilical portography, epiploography, selective percutaneous transhepatic catheterization) or direct (catheterization of the celiac truncus and/or the superior mesenteric artery) methods. After a shunt procedure the examination can best be done with a balloon catheter, by direct catheterization of a shunt or by indirect splenoportography. Recently, the radiologist has started to do the treatment by percutaneous transhepatic injection of a sclerosing agent into the gastric coronary vein. For each different method the advantages and disadvantages, the indications and technical procedure are described and discussed.

Adolescent↗
PubMed1979

[Surgery of endotheracic struma].

Most cases of endothoracic struma should be considered as systemic illnesses that require thoracic surgery. Concerning cervicoendothoracic borderline cases, the same point of view is advocated, e.g., struma endothoracica falsa and vera alliata. With reference to 38 cases of true and 34 cases of false endothoracic struma, the authors summarize and discuss: 1) their experiences in diagnosis, 2) various routes of access, 3) special thoracic closure techniques, and 4) specific surgical methods on the tumor itself.

Diagnosis, Differential↗