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Biomedical subjects

P Nordkild

Publications and source records attributed to P Nordkild.

At least 19 recordsLinked to original sources
PubMed1989

Rectal anastomosis with application of luminal fibrin adhesive in the rectum of dogs. An experimental study.

By performing a colorectal anastomosis, the risk of a serious clinical leakage is about 10 percent. On the basis of this, the current study described a combined fibrin adhesive-sutured anastomosis in the rectum performed with interrupted seromuscular sutures externally and fibrin adhesive in the mucosa-mucosa cleft internally. Ten dogs having combined anastomosis were compared with ten dogs having a two-layer sutured anastomosis in the rectum as a control. The median bursting strength in the rectum seven days after the operation was 280 mm Hg (range, 180 to 340 mm Hg) for the combined anastomosis and 260 mm Hg (range, 170 to 405 mm Hg) for the sutured anastomosis in the control group. Two anastomoses with two-layer sutured anastomosis had a leak demonstrated radiographically, while no leakage was demonstrated in the ten dogs with combined anastomosis. In conclusion, intraluminal applied fibrin adhesive may contribute to the security of the sutured rectum-anastomosis.

Anastomosis, Surgical↗
PubMed1989

Healing of the fibrin adhesive anastomosis in the small intestine of pigs.

The healing of the fibrin adhesive small intestinal anastomosis from 1/2 to 168 hours postoperatively was evaluated by the bursting strength method in 28 pigs. There were no clinical leaks. After an initial increase in strength, from 1/2 to 48 hours postoperatively, the strength of the anastomosis dropped to a low at 96 hours postoperatively. From then on, a steady increase in strength was observed. A similar pattern of healing has been observed for the sutured intestinal anastomosis.

Animals↗
PubMed1987

The predictive value of bone scintigraphy after internal fixation of femoral neck fractures.

Persisting pain of the hip following internal fixation of fracture of the neck of the femur is often caused by capital necrosis or non-union. In a randomized trial 35 patients had 99mTc-MDP bone scintigraphy performed 6 weeks, 3, 6, and 12 months after internal fixation of their subcapital fractures with a sliding screw-plate or a sliding nail-plate. The purpose was to find out whether bone scintigraphy could predict capital necrosis or non-union before it shows up on plain radiographs, which happens later. The patients were followed up for an average of 44 months (range 12-64). Radiologically, capital necrosis occurred in five patients and non-union in six. Bone scintigraphy showed decreasing activity in the 1st year after operation in uncomplicated cases (P less than 0.03). However, it was impossible to distinguish patients with capital necrosis or non union from those with uneventful healing. There were no significant differences in the scintigraphic appearance between groups at most risk, e.g. Garden stage 3 and 4 fractures versus Garden stage 1 and 2, and fixation by sliding nail versus fixation by sliding screw-plate. In conclusion, bone scintigrams during the first 6 months after operation do not reliably predict failure of internal fixation of fractures of the neck of the femur.

Adult↗
PubMed1987

Non-sutured fibrin adhesive vs. sutured anastomosis. A comparative intra-individual study in dog colon.

In each of ten dogs the colon was subjected to a two-layered sutured anastomosis and a non-sutured fibrin adhesive anastomosis. Intra-individual comparisons showed no significant difference of in vivo bursting strength after 7 days between the colon segments with sutured and those with non-sutured anastomoses. Under experimental conditions it was thus possible to achieve a safe, sutureless anastomosis in the colon using only fibrin adhesive.

Anastomosis, Surgical↗
PubMed1986

Fibrin adhesive versus sutured anastomosis: a comparative intraindividual study in the small intestine of pigs.

The small intestine in each of ten pigs was subjected to three anastomoses: one sutured anastomosis and two non-suture fibrin adhesive anastomoses in an intra-individual controlled comparison. There was no significant difference in the in vivo bursting strength after 7 days. Thus, the two types of anastomoses were of equal strength. It is concluded that it appears possible to achieve a safe sutureless anastomosis in the small intestine, with fibrin adhesive alone.

Animals↗
PubMed1986

Traumatic fixation of the hip by a bolt fired from a bolt gun.

A 25-year-old building worker was struck in the left hip by a 12.7-cm long bolt fired from a bolt gun. The bolt penetrated deeply into the pelvis, through the acetabulum, the joint cavity and the head of the femur leading to fixation of the hip. In spite of immediate extraction of the nail, cleansing, immobilization, antibiotics and tetanus prophylaxis, the wound became infected. The tips of the modern types of nails used in nail guns may be coated with a plastic material which can constitute a troublesome foreign body if left behind, because the nail is merely extracted without opening and exploring the track.

Accidents, Occupational↗
PubMed1986

Necrosis of the femoral head following fracture of the femoral neck.

One hundred and thirty fractures of the femoral neck treated with sliding screw-plate or sliding nail-plate were followed for up to 65 months postoperatively. Throughout the observation period the yearly incidence of necrosis of the femoral head was between 5 and 10 per cent, as estimated by the life table method, and after 5 years 37 per cent of the patients with united fractures had developed necrosis of the femoral head. The cases of necrosis were all characterized radiographically by one or more areas of subchondral cortical depression, generalized subchondral fragmentation or isolated patches of sclerosis. It is concluded that estimation of the frequency of femoral head necrosis after fracture of the femoral neck requires long-term follow-up and reliable, reproducible radiographical criteria for necrosis of the head. Because of the high mortality of patients sustaining these fractures, statistical methods employing censored data should be used.

Adolescent↗
PubMed1986

Yellow nail syndrome--the triad of yellow nails, lymphedema and pleural effusions. A review of the literature and a case report.

The yellow nail syndrome, combination of yellow discoloured nails, lymphedema and pleural effusions, is a rare clinical condition. A review of the literature, including 97 patients, is presented. Most patients developed yellow nail syndrome in early middle age, and the overall male:female ratio was 1.1.6. The etiology of the syndrome is obscure, while the pathogenesis seems to involve impaired lymphatic drainage. A patient, whose recurrent pleural effusions were effectively controlled by chemical pleurodesis, is also presented.

Diagnosis, Differential↗
PubMed1986

Anaesthesia for colonoscopy. An examination of the anaesthesia as an element of risk at colonoscopy.

The importance of anaesthesia as an element of risk at colonoscopy has been examined retrospectively over a 10-year period from 1975 to 1984. The colonoscopic examinations were made by surgical gastroenterologists and anaesthesiologists working in cooperation. In 1242 cases the patients received diazepam/fentanyl anaesthesia during the colonoscopy (Group I) and in 126 cases they received general anaesthesia (Group II). The incidence of perforations of the large bowel in Group I was 0.8% (95% confidence limits: 0.4-1.5%) and in Group II 0.0% (95% confidence limits: 0.0-2.9%). Statistically the difference is not significant (P = 0.38). The groups were comparable with a view to the patients' age, weight, the duration of the colonoscopy and the number of times that polypectomy had been performed. All anaesthesia was administered by staff qualified by training and experience to administer anaesthesia, and did not cause any complications. However, four patients had vasovagal reflexes due to manipulation of the colonoscope. The dosing in the patients in Group I averaged: diazepam as premedication 9.2 mg, intravenous diazepam 12.4 mg, intravenous fentanyl 0.14 mg, and the duration of the colonoscopy was 36.5 min. The medication and the duration of the colonoscopy did not vary significantly in the patients with perforation of the large bowel. Our conclusion is that diazepam/fentanyl anaesthesia, administered by experienced staff, is harmless, and that general anaesthesia for colonoscopy did not involve an increased risk of perforation of the large bowel.

Aged↗
PubMed1986

Follow-up study after colorectal polypectomy. The predictive value of a negative double-contrast barium enema.

In this study the predictive value of a negative double-contrast barium enema for colonic polyps has been calculated as the ratio of the number of true negative radiologic examinations to the total number of negative radiologic examinations. The total number of negative double-contrast barium enemas for polyps of the colon was 357 in 228 consecutive patients with previous or suspected neoplastic colonic polyps examined in the period 1977-84. The predictive value of a negative double-contrast barium enema for all colonic polyps regardless of size was 87% (95% confidence interval, 84-91%). The corresponding predictive value of a negative result for polyps larger than 10 mm in diameter was 98% (95% confidence interval, 97-100%). Polyps that had not been detected by radiography were removed by colonoscopy, and 85% of them were available for histological examination. No cancers were found. The polyps were primarily neoplastic, but metaplastic and juvenile polyps were also ascertained.

Adolescent↗
PubMed1986

Radiation dose in investigations of the large bowel. Comparison of radiation doses in examinations of the colon with double-contrast barium enema with the Welin modification and colonoscopy.

Because of the increasing and repeated application of colonoscopy and double-contrast barium enema with the Welin modification in connection with the checking of patients who have been treated for neoplastic polyps, we have found it valuable to examine the amount of radiation that the patients are exposed to in the two kinds of examinations. The radiation dose in the examination of the colon with the Welin modification (35 examinations) and at colonoscopy (114 examinations) was, on an average, 387 and 10 mSv, respectively. Since colonoscopy gives a possibility not only of diagnosis but also of treatment and also exposes the patients to 40 times less radiation than X-ray examination with the Welin modification, we recommend colonoscopy for diagnosis and treatment of neoplastic colonic polyps.

Adolescent↗
PubMed1986

Hexcelite versus plaster of Paris: a controlled trial of the below-knee walking cast.

Hexcelite and plaster of Paris below-knee walking casts were compared in a controlled clinical trial, involving 82 patients. Fewer bandage complications, problems and better comfort was found with Hexcelite compared to plaster of Paris (P less than 0.05). If all costs relating to materials, transportation, complications and extra visits due to these, were taken into account, plaster of Paris was found more expensive than Hexcelite. Based on the above an increased use of Hexcelite is recommended.

Adolescent↗
PubMed1986

Multiple stenoses of the small intestine by metastatic spread from breast cancer.

We present a patient who had a left mastectomy for breast cancer and 3 years later developed intestinal obstruction due to metastatic spread to the small bowel. The small bowel follow through showed multiple stenoses of the small intestine leading to a variety of differential diagnostic considerations as metastatic spread from breast cancer to the small intestine has not been convincingly documented so far.

Adenocarcinoma, Mucinous↗
PubMed1986

Primary tumours of the small intestine--the diagnostic problem.

The records of 43 patients with 32 malignant and 11 benign neoplasms of the small intestine were reviewed in order to improve early diagnosis. The malignant tumours comprised of 14 carcinoids, 10 carcinomas and 8 sarcomas. The benign tumours constituted 7 different histological types. An increasing frequency of malignant tumours through the bowel was found. Thirty-three per cent of all patients had a sudden onset of symptoms leading to acute explorative laparotomy, whereas the remaining 67 per cent were characterized by a long history. The predominant symptoms were abdominal pain, nausea and vomiting, weight loss and a palpable abdominal mass. An exact preoperative diagnosis was made in 41 per cent of the cases. Upper gastrointestinal X-ray contrast examination with small bowel follow through and ultrasonography gave the greatest sensitivity. A diagnostic strategy was difficult to recommend considering the rarity of these tumours and the low sensitivity of the employed diagnostic modalities. Recently developed Japanese enteroscopes capable of exploring the entire small bowel seem to offer the most promising diagnostic method for the future.

Adult↗
PubMed1986

Tissue adhesives and intestinal anastomosis.

This article presents a review of the literature concerning the employment of tissue adhesives in the production of intestinal anastomoses. The fibrin adhesive is the tissue adhesive of choice in as much as it is physiological does not possess histotoxicity or cause allergic reactions. Fibrin adhesive sealing of a conventional sutured anastomosis might improve this anastomosis as it reduced the postoperative mortality-rate significantly in a prospective study with a retrospectively matched control group comparing sealing and no sealing, but prospective, randomized trials are lacking. Finally a cyanoacrylate intestinal anastomosis has proved obsolete as in experimental trials it has proved inferior to the conventional anastomosis.

Animals↗