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Biomedical subjects

A Schramek

Publications and source records attributed to A Schramek.

At least 37 records · Page 2Linked to original sources
PubMed1980

Complete remission of Cushing's disease by total bilateral adrenalectomy and adrenal autotransplantation.

A 15-yr-old girl was diagnosed as suffering from Cushing's disease. She was treated by bilateral adrenalectomy and autotransplantation of one third of each adrenal to the corresponding thigh. The adrenal that was embedded in the right satorius muscle started functioning after about 1 yr, as proven by significant differences in cortisol levels in both femoral veins (82.5 and 17.5 micrograms/100 ml). 19-[131I]Cholesterol scanning showed adrenal tissue in the right thigh, while no adrenal remnant was demonstrated. Eleven years after surgery, the patient is symptom free and does not require replacement therapy. We find that adrenal autotransplantation, which is a simple and nonrisky procedure, should be considered whenever bilateral adrenalectomy is chosen as a treatment for Cushing's disease.

17-Ketosteroids↗
PubMed1980

Arterial combat injuries of the upper extremity.

The results of treatment of 101 combat injuries of the upper extremities are reported. There were 84 acute injuries and 17 late complications. There was a high incidence of associated fractures (35%) and nerve lesions (51%). Over half the injuries were repaired by saphenous vein graft replacement. There were seven early amputations related to a long delay before treatment, extensive tissue damage, and sepsis with delayed hemorrhage. There were no late amputations, but residual neurologic damage gave a less than perfect result in 32 extremities. Two injuries resulted in Volkmann's contracture. Fracture specific to the management of upper-extremity arterial injuries are outlined.

Amputation, Surgical↗
PubMed1979

Prolonged post-vagotomy gastric atony treated by oxytocin.

Persistent and complete post-vagotomy gastric atony was treated in 3 patients by intravenous infusion of oxytocin. Despite failure of both conventional treatment with gastric aspiration and intravenous fluids or jejunal feeding, as well as the reported trials with bethanechol chloride and metaclopramide, these patients promptly responded to oxytocin. It appears that the latter may represent a solution to this uncommon but recalcitrant complication of peptic ulcer surgery.

Chronic Disease↗
PubMed1978

Silent perforations of the stomach and duodenum by needles.

We present a series of ten patients consecutively admitted to the hospital after swallowing 12 household sewing needles. Ten of these needles, one in each patient, had perforated either the stomach or the duodenum, but in no case did the perforation cause any abdominal symptoms or signs. Immediately after arrival in the emergency ward, the diagnosis was made in most cases by means of a diatrizoate meglumine swallow, which showed the tip of the needle protruding outside the gastrointestinal tract. In the first few cases, the diagnosis was made by finding the needle in the same position after repeated plain abdominal roentgenograms. This method, however, served to delay the diagnosis of perforation. All patients were operated on immediately after the diagnosis of perforation was made, except for two who had an additional ingested needle. Operation was delayed in these patients until the second needle was spontaneously eliminated. Perforation was confirmed by operation in all cases in the present series, the operative extraction of the needle was simple, and recovery was uneventful. The fact that patients may remain asymptomatic despite perforation of their stomach or duodenum by sharp, fine foreign bodies is no cause for procrastination of surgery, as severe complications may subsequently result.

Adolescent↗
PubMed1977

Vascular injuries in the extremities in battle casualties.

A serial of 51 wounded soldiers with 54 arterial and 28 venous injuries is presented. Interposition of autogenous vein grafts was performed in 30 arterial injuries. Lateral suture or patch arterioplasty was performed in 7 arteries. End-to-end anastomosis was possible in 8 cases. Primary vein repair was performed in 14 vein injuries. Lateral suture, patch plasty, end-to-end anastomosis and interposition composite vein grafts were used. A distal temporary arteriovenous fistula to increase the flow through venous interposition grafts was performed in 4 cases. Hyperbaric oxygen treatment was used in 7 cases in which successful arterial repair did not reverse ischaemia, and it prevented major amputations. Neurovascular injuries are not always an indication for primary amputation. Six such cases are discussed.

Adult↗
PubMed1977

Hyperbaric oxygen treatment as an adjuvant to reconstructive vascular surgery in trauma.

A series of 7 young, healthy persons suffering severe vascular trauma and acute ischaemia of their limbs is presented. Standard vascular repair, although technically successful, failed to achieve satisfactory restoration of the circulation and the limbs remained severely ischaemic. Hyperbaric oxygen treatment at 2-8 atm (approximately 290 kPa) prevented the development of gangrene in all cases. This treatment is considered to be a very useful adjuvant to reconstructive vascular surgery in cases which come to repair late after injury.

Acute Disease↗
PubMed1976

Development of a valve for internal drainage of ascites into the venous system.

A valve for transfer of ascites into the inferior vena caval system, has been developed. The valve answers the specific problems of this pathological condition, namely chemical composition and quantity of fluid and pressure gradient. The valve has been used in preliminary experiments carried out on dogs. The results obtained were encouraging.

Abdomen↗
PubMed1976

Pharmacological inhibition of digestive secretions in the management of pancreaticoduodenal fistulas.

We report the pharmacological inhibition of secretions of the gastrointestinal tract for the prevention and management of pancreatic and duodenal fistulas. Nasogastric aspiration to remove gastric secretions and decrease motility and an anticholinergic drug, a carbonic anhydrase inhibitor and intravenous hyperalimentation to inhibit secretions were used to prevent pancreatic fistulas. Patients with established duodenal and/or pancreatic fistulas received local treatment consisting of lavage of the fistulous tract and skin protection in addition to the parenteral therapy. Three cases of successful prevention of pancreatic fistulas and three cases of managemtnt of duodenal fistulas are presented.

Acetazolamide↗
PubMed1976

Cephalic vein cross-over bypass for subclavian vein thrombosis: a case report.

A case of axillary vein thrombosis in a young man was treated by means of a cephalic vein cross-over bypass graft. A temporary arteriovenous fistula performed in the antecubital fossa resulted in a reasonable enlargement of the graft and prevented its occlusion in the critical postoperative period until healing of the intima resulted. The swelling disappeared and the patient, who was completely incapacitated functionally prior to the operation, resumed normal activity.

Adult↗
PubMed1975

Hypertensive crisis, erythrocytosis, and uraemia due to renal-artery stenosis of kidney transplants.

Two patients with kidney transplants had hypertensive encephalopathy and rapidly progressive kidney failure 10 weeks and 18 months postoperatively. In one patient renal failure was associated with erythrocytosis. Absence of proteinuria, despite progressive renal insufficiency in both patients, suggested that these abnormalities were not due to rejection episodes. Subsequently, angiography proved that each of these patients had renal-artery stenosis. Surgical repair of this lesion increased creatinine clearance at least threefold, and the hypertension and erythrocytosis disappeared. Apparent "rejection" episodes in which there is no proteinuria should alert clinicians to the possiblity of renal-artery stenosis of the graft. Restoration of kidney function and amelioration of hypertension may follow revascularisation, even after many months of renal ischaemia producing severe uraemia.

Adult↗