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Biomedical subjects

W van der Linden

Publications and source records attributed to W van der Linden.

At least 19 recordsLinked to original sources
PubMed1995

Diseases and lesions associated with third molars. Review of 1001 cases.

This study reports on a retrospective survey of 1001 panoramic radiographs in a dental school population of persons with impacted third molars. The objective was to determine the association between pathologic conditions visible on radiographs and third molar teeth. In the series 2872 impacted third molars were examined. The most common problem seen radiolucencies. Other than caries, occurrence rates were low. Statistically significant differences in occurrences rates were seen within and between jaws for various pathologic conditions. The low rates did not offer support for the likely presence of pathologic conditions to be an indication for third molar removal.

Adolescent↗
PubMed1993

Cholescintigraphy and biochemical tests in cholecystitis--an evaluation with discriminant analysis.

The biochemical values of 76 patients with suspected cholecystitis were subjected to discriminant analysis. The final diagnoses, i.e. acute cholecystitis, chronic cholecystitis and non-biliary disease, were used as the grouping variable. Cholescintigraphy identified patients with acute cholecystitis. Routine preoperative biochemical tests were found to be of limited value. Only alkaline phosphatase was of help in predicting common-duct stones, especially in patients with acute cholecystitis. The conclusion is that many biochemical tests presently in common use could as well be dispensed with.

Acute Disease↗
PubMed1985

Bile flow before and after cholecystectomy: a study with 99mTc-HIDA.

Computer-assisted 99mTc-HIDA cholescintigraphy was performed before and after elective cholecystectomy in 24 patients. Preoperative cholecystography had shown gallstones in a well visualized gallbladder in 12 of the patients, and in 12 the gallbladder had not been visualized. Liver function tests gave normal results in all 24 patients, and peroperative cholangiography showed no common duct stones in any patient. In the series with functioning gallbladder, comparison of the preoperative and postoperative scintigrams showed that cholecystectomy was followed by significantly earlier visualization of the lower part of the common duct and of the duodenum. The number of times that passage of activity to the duodenum was observed also rose significantly. Comparison of the time-activity curves showed that after cholecystectomy the liver activity reached its maximum value significantly earlier post-injection as compared with the preoperative values. All of these changes were absent in the series with nonfunctioning gallbladder. Removal of a functioning gallbladder results in accelerated, though still irregular flow of activity to the duodenum.

Adult↗
PubMed1984

Filling of the gallbladder as studied by computer-assisted Tc-99m HIDA scintigraphy: concise communication.

Gallbladder filling was studied using computer-assisted cholescintigraphy in normal subjects who had fasted overnight. The gallbladder tended to visualize earlier than the distal part of the common bile duct. It appeared at approximately the same time regardless of whether or not there was passage of activity into the duodenum. This suggests that filling is not dependent on contraction of the sphincter of Oddi. Sequential images demonstrated that the activity entering the gallbladder rapidly reached the fundus. Time-activity curves showed a gradual buildup of activity in the bile ducts followed by sudden entrance into the gallbladder. Time-activity curves of the gallbladder's proximal and distal parts showed signs of an exchange of activity, suggesting that the gallbladder's motor function is not quiescent during fasting. Gallbladder motility could explain the periodic irregularities on the time-activity curve. These irregularities were smaller but not less frequent after morphine administration.

Adult↗
PubMed1983

The possible carcinogenic effect of cholecystectomy. No postoperative increase in the proportion of secondary bile acids.

In consecutive patients with gallstones in well-functioning gallbladders, duodenal bile was sampled before and 2 to 3 months after cholecystectomy. The preoperative and postoperative bile acid patterns were compared. Cholecystectomy resulted in a significant shift from cholic- to chenodeoxycholic acid. This shift could help to explain the low incidence of recurrent common duct stones. The percentage of secondary bile acids showed very little change. An increase of the mean preoperative value of 3.9 percentage points or more was improbable (P = 0.025). This finding refutes the hypothesis that cholecystectomy could lead to colonic cancer via an increase in the proportion of secondary bile acids. An alternative hypothesis is proposed for the reported high incidence of previous cholecystectomy in colonic cancer. Both gallstones and cancer of the colon may be associated with high levels of secondary bile acids.

Bile↗
PubMed1983

Function of liver, gallbladder and sphincter of Oddi after major surgery studied by computer-assisted cholescintigraphy and real-time ultrasonography.

Patients with normal gallbladders were subjected to computer-assisted Tc-HIDA cholescintigraphy at fixed intervals after major surgery. Hepatic time--activity curves showed that hepatic excretion of the material was first reduced and later a reduction of hepatic uptake followed. The gallbladder responded first by dilatation and reduction of motility and later by delay in or even absence of visualization. Postoperative dilatation was confirmed with real-time ultrasonography. No tracer passed into the duodenum in the early postoperative stage indicating spasm of the sphincter of Oddi. Healthy volunteers were studied with and without morphine and with and without a 24 h fast. The sphincter of Oddi closed after morphine but not after fasting. Transient non-visualization of the gallbladder after surgery makes the diagnosis of postoperative cholecystitis more difficult.

Aged↗
PubMed1983

Open tibial shaft fractures.

A change in the management of open tibial shaft fractures provided an opportunity for comparative study. One series of patients was treated nearly exclusively by conservative methods and compared with another series treated by external skeletal transfixation (EST). The latter method was found to be superior. In spite of a number of pin tract infections, EST led to a significantly shorter healing time and fewer pseudarthroses. EST had no effect on the duration of hospital stay.

Adolescent↗
PubMed1983

Jaundice in acute cholecystitis without common duct stones.

Patients with acute cholecystitis without common duct stones were studied pre- and postoperatively with 99mTc-HIDA scintigraphy. The resulting hepatic time-activity curves were analyzed. Preoperative serum bilirubin levels were closely correlated with hepatic discharge but not with hepatic uptake of the radiopharmaceutical. Cholecystectomy resulted in prompt improvement of hepatic discharge but did not affect uptake. In acute as well as in chronic cholecystitis cholangiograms taken before removal of the gallbladder were compared with those taken after. In acute cholecystitis the former view frequently showed medial displacement of the biliary tract and incomplete filling of its proximal part. Displacement of the duct was also apparent in comparisons of pre- and postoperative scintigrams. Jaundice in acute cholecystitis is due to reduced excretion which may be caused by pressure on the ducts by the distended gallbladder.

Acute Disease↗
PubMed1983

What makes the peritoneal drain work? Pressure in the subhepatic space after biliary surgery.

To determine the nature of the forces responsible for the evacuation of fluid from the peritoneal cavity via a drain we measured the pressure in the subhepatic space after biliary surgery. Pressure in that space increased with inspiration and decreased with expiration. The inspiratory increase was larger in the erect than in the supine position. Evacuation of fluid from the subhepatic space via a drain results from intermittent increase in pressure such as occurs during deep inhalation. Drainage is improved by maximal inspiration in the erect position.

Adult↗
PubMed1982

A study of bile duct dynamics using computer-assisted 99mTc-HIDA scintigraphy.

Using computer-assisted scintillation camera imaging bile duct dynamics was studied in 28 patients with a nonvisualizing gallbladder due to acute cholecystitis. Postoperative repeat studies were carried out in 8 of the 28 patients. In half of the studies three accumulations of activity were evident on the 60 added 1-min views. These three accumulations were interpreted as corresponding to the biliary tree. An explanation for the separation of the activity into three depots, is proposed. Analysis of the time-activity curves of the accumulations showed an irregular exchange of activity, suggesting intracholedochal movements of bile. Passage of bile from the common duct into the duodenum was observed 1-7 times during the 1-h studies. In most studies the bulk of the activity was caught by an antegrade peristaltic wave as soon as it left the duct. The activity was then transported rapidly in a medial direction. This finding suggests that relaxation of the sphincter occurs in phase with duodenal peristalsis.

Bile Ducts↗
PubMed1982

Transient nonvisualization of the gallbladder by Tc-99m HIDA cholescintigraphy in acute pancreatitis: concise communication.

In five of seven patients with acute pancreatitis, Tc-99m HIDA scintigraphy failed to visualize the gallbladder. In all five patients the gallbladder was later found to be normal and in three of them normal filling was obtained at a repeat examination performed after the attack had subsided. Transient nonvisualization of the gallbladder in acute pancreatitis is probably due to disturbed motility of the biliary tree.

Acute Disease↗
PubMed1981

Diagnosis of deep vein thrombosis with in vivo 99mTc-labeled red blood cells.

A comparative study of 27 patients with suspected deep vein thrombosis was carried out using 99mTc-labeled red blood cells and conventional X-ray venography. In 22 of the 27 patients with results of the two methods were in agreement; in 12 cases thrombosis was present and in 10 cases it was absent. In the remaining five cases the results of the two methods were at variance. Venography was negative in one patient who had all the clinical signs and symptoms of thrombosis. Scintigraphy was negative in four patients, in three of whom venography showed only minute thrombi. The use of Tc-labeled red blood cells is considered an acceptable alternative for the detection of deep vein thrombosis.

Adult↗
PubMed1981

Creatine kinase in tibial shaft fractures. Serum creatine kinase levels in patients with tibial shaft fractures.

The creatine kinase (CK) activity of the serum of 33 male and 24 female patients with tibial shaft fractures has been assayed. In 40 of the 57 patients the CK level surpassed the maximal normal limit of 1.7 mukat/l. Patients with fractures due to direct violence had significantly higher levels than those with fractures due to indirect violence. When the fracture was displaced the CK level was more often abnormal than when there was no displacement. Patients with extensive swelling of the injured leg had significantly higher levels than patients with minor or no swelling. CK determinations could be used to quantify muscle injury.

Adolescent↗
PubMed1981

Randomized trial of drainage after cholecystectomy. Suction vaersus static drainage through a main wound versus a stab incision.

One hundred eighty-four patients who underwent biliary surgery were randomly allocated to four groups arranaed in a 2 by 2 design. In 92 patients the drain was brought out through the wound and in the other 92 through a stab incision. In half of the patients in each group the drain was connected to a suction system and in the other half to a sterile bag. Suction was found to impair rather than enhance intraperitoneal drainage. In patients who underwent elective cholecystectomy and early operation for acute cholecystitis, the amount of discharge was more than twice as large when suction was omitted than when it was applied. After common duct operations the amount of discharge was very large and there was little difference in cases with and without suction. Prolonged drainage, static or suction, resulted in an increase in the serum haptoglobin level. Analysis of out data suggested that after a few days the drain starts to act as a traumatic stimulus. No difference was found between cases with the drain brought out through a stab incision and those with the drain brought out through the main wound. A number of studies have ascertained the superiority of closed to open drainage. The results of the present trial lead us to recommend that after biliary surgery the closed us to recommend that after biliary surgery the closed drain should not be connected to a suction apparatus and that after elective cholecystectomy the drain should preferably be removed after a few days.

Adult↗
PubMed1981

A radionuclide study on the effectiveness of drainage after elective cholecystectomy.

Passive drainage after elective cholecystectomy was studied in six patients. Their erythrocytes were labeled in vitro with technetium-99mTc and injected via the drain after operation. After one hour, we were able to recover labeled erythrocytes and free pertechnetate from peripheral blood. After 24 hours, a large part of the injected erythrocytes had been evacuated via the drain. In eight patients subjected to cholecystectomy, 99mTc-HIDA was injected intravenously after the operation. In four cases, in which the gallbladder bed was raw, the activity ratio discharge/blood rapidly reached extremely high values. In the other four cases, in which the liver surface had not been denuded, the ratio was much lower. Passive drainage is a useful device for evacuation intra-abdominal bile or hemolysed blood after cholecystectomy, especially when the gallbladder bed has been denuded.

Abdomen↗
PubMed1981

Sump drainage versus static drainage after cholecystectomy.

Sump drainage was compared with closed static drainage in a randomized trial using a restricted sequential plan. Sump drains were converted into static drains by closing the air-vent tubes and by omitting suction. Sump drains so converted evacuated more intraperitoneal fluid during the first 24 hours after cholecystectomy than did drains in which the sump was functioning. For drainage after cholecystectomy, the sump drain is inferior to the passive drain in a closed circuit.

Cholecystectomy↗