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Biomedical subjects

P Rutten

Publications and source records attributed to P Rutten.

11 recordsLinked to original sources
PubMed2004

Reduced complement activation during cardiopulmonary bypass does not affect the postoperative acute phase response.

OBJECTIVE: In the present study the relationship was evaluated between perioperative inflammation and the postoperative acute phase response in patients undergoing elective coronary artery bypass grafting (CABG) assisted by cardiopulmonary bypass (CPB). CPB circuits contained either non-coated- (UMS), Carmeda- (BPS) or Trillium-coated oxygenators (BAS). METHODS: Prospectively, 71 CABG patients were randomly allocated to one of the oxygenator groups (UMS: n=25, BPS: n=25 and BAS: n=21). Terminal complement complexes (TCC) and elastase were determined in plasma samples collected before, during and after bypass. Secretory phospholipase A2 (sPLA2) and C-reactive protein (CRP) were determined before and after bypass. RESULTS: Demographic, CPB and clinical outcome data were similar for the three groups. TCC and elastase increased during CPB, and decreased thereafter. Significant differences between the groups were present in the levels of TCC at the end of CPB (P=0.002) and at the first (P=0.012) and second (P<0.001) postoperative days, the BPS and BAS groups having reduced levels of TCC compared to the UMS group. Also elastase concentrations differed significantly between the groups at the end of CPB (P<0.001). The postoperative sPLA2 and CRP levels increased in all three groups on the first and second postoperative days, but no significant differences were present between the groups. CONCLUSIONS: Material-induced reduction of the inflammatory response during CPB does not affect the postoperative acute phase response. Thus, in CABG patients this response seems relatively unaffected by the composition and/or biocompatibility of the modern CPB circuit and rather to be evoked by surgical trauma, anesthetics and organ perfusion.

Acute-Phase Reaction↗
PubMed1999

Surgery in Belgium.

To fully understand the present state of surgery in Belgium, it is necessary to know the structure of the Belgian State, the type of education, the statutory health insurance system, and the professional bodies representing surgeons. One of the most important problems is the excessive number of physicians, which recently led to the establishment of limits on the number of candidates receiving medical certification. Surgical training modalities are described and the results of a retrospective study concerning the quality of training are detailed. The continuing medical education and peer-review system (accreditation) is presented.

Accreditation↗
PubMed1988

A new method for analysing the geometry and timecourse of epicardial potential spreading.

A 256 unipolar electrode matrix fixed at the surface of an isolated rabbit heart was connected to a PC system via an amplifying and analog/digital converting frontend computer. This system allows measurement of 256 electrodes within 100 microseconds with a sampling rate of 0.25 ms. The data are displayed on a PC system either on-line as common ECG-recordings or off-line in projection on a two-dimensional model of the heart surface. Thereby, it is possible to visualize the epicardial potential spreading in a slow-motion presentation on a high resolution computer graphic. The samples are displayed sequentially and can be delayed by choice. This method allows the determination of the origin ("break-through-points") of the epicardial excitation and an analysis of the potential spreading. The electrodes are arranged in four grids with 64 electrodes each at an interelectrode distance of 1 mm. Thereby, it is possible to evaluate the direction of the epicardial excitation wave and the local state of epicardial activation. Furthermore, it is possible to demonstrate irregular pacemakers or re-entry circuits. The method seems to be helpful in analysis of cardiac arrhythmogenesis and mode of action of anti-arrhythmic agents.

Analog-Digital Conversion↗
PubMedDate not supplied

[Transsection of the cervical trachea secondary to a closed injury. Apropos of a case].

The successful surgical management of a case of complete blunt traumatic transection of the cervical trachea is reported. The management of this rare pathology is a real challenge for the surgeon with regard to early recognition of the lesion and proper therapeutic strategy. Except in case of respiratory distress and/or major laryngotracheal lesions, where urgent tracheotomy is recommended, diagnostic fiberoptic bronchoscopy should be performed to assess the lesions. Guided intubation can also be contemplated. It seems however more prudent to explore the trachea surgically under mask or IV (Ketalar) anesthesia with maintenance of spontaneous breathing. During this exploration intubation can be guided by the surgeon and general anesthesia be initiated. In cases of complete transection, end-to-end anastomosis using absorbable sutures, avoidance of protective tracheotomy and postoperative low-dose steroids seems to be the treatment of choice to avoid stenotic sequelae. If a postoperative stenosis occurs, it should be treated by laser before contemplating surgical correction.

Adult↗
PubMedDate not supplied

Postoperative acalculous cholecystitis. A five-case study and a literature review.

The study reports five cases of postoperative acute acalculous cholecystitis. Clinical symptoms are upper abdominal pain, fever, jaundice or an unexplained septic shock. Biology orients the diagnosis but only gallbladder ultrasonography and, to a lesser degree, hepatobiliary scintigraphy are really diagnostic. As mortality is high and increases with waiting, emergency cholecystectomy is the treatment of choice.

Acute Disease↗