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Biomedical subjects

B Klin

Publications and source records attributed to B Klin.

At least 37 records · Page 2Linked to original sources
PubMed1995

Mixed diquat/paraquat-induced burns.

BACKGROUND: Ducatalon is a bipyridylium herbicide containing a mixture of diquat and paraquat, and is used in agriculture. Adverse reactions due to contact of this compound with the skin have rarely been described. CASE REPORTS: Two men were seen for severe pain due to extensive chemical burns in the perineal and scrotal regions, caused by leaking of Ducatalon from defective equipment used for spraying the herbicide. The lesions responded well to treatment with topical silver sulfadiazine, combined with systemic antibiotics. The damaged skin healed without scarring within a few days. The lesions have not recurred after the faulty spraying apparatus was replaced. CONCLUSION: Direct contact of the skin with Ducatalon may lead to severe chemical burns. Proper precautions should be taken by the personnel handling this compound, with particular attention to the integrity of the equipment used for spraying the herbicide.

Agriculture↗
PubMed1994

[Nissen fundoplication for gastroesophageal reflux in children].

During a 5-year period 50 children, aged 2 months to 15 years, underwent Nissen fundoplication for the management of severe gastroesophageal reflux and were then followed for from 3 months to 5 years. There were no immediate postoperative deaths. 8 patients (16%) died of serious underlying medical conditions during follow-up. The operation was successful in 86.3% in relation to indications for surgery. Postoperative complications specific for fundoplication occurred in 27 (54%) and other complications in 11 (22%). Of those with complications, 71% were treated successfully. The rest developed dumping syndrome which was diagnosed 1 month to 4 years after operation. They were treated with carbohydrate restriction and a special diet, the results of which will be evaluated later. Although Nissen fundoplication is very successful in resolving the indications for surgery, the high rate of postoperative complications demands re-evaluation of the indications for the operation in children.

Adolescent↗
PubMed1994

Airway obstruction in neonates and children: surgical treatment.

OBJECTIVE: This review of 54 infants and children with airway obstruction who were treated surgically emphasizes the importance of the surgical indications with respect to various anomalies causing airway obstruction and the surgical approach to their management. PATIENTS: There were 4 etiologic groups of airway obstruction. Group A comprised 12 infants with subglottic stenosis; Group B--20 infants with tracheomalacia; 21 patients (Group C) with anatomic narrowing of the trachea; and 1 infant (Group D) with laceration of a main bronchus. METHODS: The surgical procedures performed included anterior laryngotracheal decompression in 12 infants, aortopexy in 19; 1 pulmonary arteriopexy; tracheal stenting with an autologous rib graft in 3 and with Marlex mesh in 1. Tracheal widening, using a free tibia autologous graft, was performed in 3 patients; transbronchoscopic excision in 12; anterior tracheal wedge resection in 4, and segmental tracheal resection and anastomosis in 1 patient. The lacerated bronchus was repaired with fine Dexon sutures. RESULTS: There were no operative deaths. With respect to the original indications for surgery, there were 3 failures--2 in Group A and 1 in Group C. Two patients died from causes unrelated to the procedures--one 10 days postoperatively, and the other 3 months after surgery. CONCLUSIONS: The surgical approach to tracheal obstruction in infants and children offers effective treatment, with no operative mortality, a low complication rate, and good long term survival.

Age Factors↗
PubMed1994

A new intratracheal stent made from nitinol, an alloy with "shape memory effect".

Temporary or permanent tracheal splinting in pediatric patients may be indicated in tracheomalacia or bronchomalacia, repair of congenital tracheal stenosis, and after tracheal resection. This study presents the results of the development of a new intraluminal airway stent made from titanium alloy, a metal with "shape memory effect". At low temperatures (martensitic state) the titanium alloy stent can be fashioned into a specific shape; then when heated to a higher temperature (austenitic state) the stent alters its shape, only to regain its original shape when recooled to the lower temperature. The stent, connected to a small electric power supply, was introduced into 20 young rabbits with the use of a 2.5 cm rigid bronchoscope. After implantation in the martensitic state the stent was warmed to 40 degrees C, the austenitic state, by an electric current of 1.5 to 3 ampere for 1 to 2 seconds. After a period of 8 to 10 weeks the stent was removed (in its martensitic state) through the same-sized bronchoscope after being cooled with 3 to 4 ml of 80% alcohol solution at 6 degrees C. No signs of airway obstruction developed in any of the animals after implantation or extraction of the stent. The biomechanical properties of the trachea, as shown by strain measurements with the use of incremental forces, showed significant differences between the stented and unstented segments (p < 0.005). The titanium alloy intratracheal stent adequately fulfilled the requirements of a temporary intraluminal airway splint, and because of its unique feature of shape memory effect the stent could be inserted, fixed, and removed easily, even in very small airways.

Alloys↗
PubMed1993

Chronic diffuse varioliform gastritis in a child. Total gastrectomy for acute massive bleeding.

Chronic diffuse varioliform gastritis is an uncommon, subacute, inflammatory gastric mucosal disease characterized by swollen congested rugae and disseminated mucosal erosions. The entity is exceptionally rare in children. The spectrum of reported symptoms is broad; frank hematemesis has never been reported in childhood. We present a child in whom the disease had a remarkably unusual clinical course. Because many caretakers were unaware of the existence of the disease in children, the patient had numerous hospitalizations and surgical procedures, until massive gastric bleeding resulted in unavoidable emergency total gastrectomy. Microscopical examination and immunofluorescent staining of the gastric mucosa confirmed the diagnosis of chronic diffuse varioliform gastritis.

Child↗
PubMed1993

Treatment of epidermal cysts with Solcoderm (a copper ion and acid solution).

The treatment of epidermal cysts has often posed a problem for dermatologists. Although surgical excision has been adopted as the method of choice for the removal of these lesions, complications of surgery and recurrences have warranted the search for alternate therapeutic modalities. Use of a recently introduced compound, Solcoderm, is reported in the treatment of 116 epidermal cysts in 85 patients over a 2-year period. The satisfactory cosmetic results observed, low incidence of recurrence, low cost and ease of administration, make this drug a viable alternative in the management of epidermal cysts, particularly in those cases where surgery should be avoided.

Acetates↗
PubMed1993

Familial thyroglossal duct cyst.

Thyroglossal duct cysts are common congenital abnormalities or developmental field defects, usually detected in early childhood. Despite their frequent occurrence, familial patterns are rare. We report on two new families with thyroglossal duct cysts. In the first family three siblings were involved, while in the second one, father and son were affected. This trait may be autosomal recessive or possibly multifactorial, as the first family would indicate, and also autosomal dominant, as the second family would suggest.

Adult↗
PubMed1993

Oral blast injury caused by an accident.

Blast trauma within the oropharyngeal cavity may be associated with superficial or deep injuries. Superficial injury generally needs only observation; deeper injury that violates the retropharyngeal space may produce dissecting emphysema into the neck and mediastinum followed by prevertebral soft tissue infections and mediastinitis. Injury involving the parapharyngeal space might damage vital cervical vessels. Life-threatening complications may result unless treatment is adequate. Three children who sustained oropharyngeal blast injury are presented. The direct cause was the blast effect of a new, spoiled, orange-flavor beverage just released on the market. The bottle cap of the soft drink and its effervescent liquid "exploded" into their mouths while they were trying to open the bottle with their teeth. Obviously, the failure to observe due precautions, as frequently happens among children, contributed to the occurrence of the accidents. This paper describes the diagnosis, management, and relevant educational and preventive measures of the problem.

Accidents↗
PubMed1993

False-positive ultrasonography in agenesis of the gallbladder: a pitfall in the laparoscopic cholecystectomy approach.

We report a case of agenesis of the gallbladder in a 15-year-old girl incorrectly diagnosed as cholelithiasis on preoperative sonography and suspected at laparoscopic surgery. The diagnosis of agenesis was confirmed at open surgery with intraoperative sonography, intraoperative cholangiography, and postoperative radioisotope scan. Difficulties in preoperative diagnosis and the management during laparoscopic and open surgery are discussed.

Adolescent↗
PubMed1992

Hypertonic saline treatment of uncontrolled hemorrhagic shock at different periods from bleeding.

Hypertonic saline has been recently recommended for treatment of patients in hemorrhagic shock. Infusion of hypertonic saline at different periods in cases of uncontrolled hemorrhagic shock was studied in rats. The animals were divided into six groups: in group 1 uncontrolled hemorrhagic shock was induced by tail resection and no hypertonic saline was administered; in group 2 hypertonic saline was administered 5 minutes after shock was induced; in group 3 hypertonic saline was administered 15 minutes after shock was induced; in group 4 hypertonic saline was administered 30 minutes after shock was induced; in group 5 hypertonic saline was administered 60 minutes after shock was induced; and in group 6 hypertonic saline was administered 120 minutes after shock was induced. Tail resection in rats in group 1 was followed by a mean +/- SEM bleeding of 2.7 +/- .03 mL in 5 minutes. Infusion of hypertonic saline after 5 and 15 minutes resulted in additional bleeding of 6.3 +/- 1.0 mL and 3.8 +/- 0.5 mL, respectively, and a drop in mean arterial pressure to 36 +/- 8 mm Hg and 56 +/- 9 mm Hg, respectively. Mortality was 80% in group 2 and 53% in group 3. Infusion of hypertonic saline 30 and 60 minutes after shock was induced did not alter bleeding, mean arterial pressure, or survival. Infusion of hypertonic saline within 15 minutes of hemorrhagic shock resulted in increased bleeding, hypotension, and early death. Infusion 30 minutes or later did not alter these variables. This potential danger of early hypertonic saline therapy should be considered in the treatment of patients in trauma.

Animals↗
PubMed1992

Case report: selective occipital lobe hydrocephalus and agenesis of the left lobe of the liver in congenital myotonic dystrophy.

Myotonic dystrophy (Steinert's disease) is an uncommon familial autosomal dominant disease, characterized by progressive muscular atrophy and myotonia. Mental retardation, frontal baldness, cortical lenticular opacities and testicular atrophy are other prominent features of a disease that involves predominantly striated muscle. There is little information regarding this disease in the radiological literature. The present report introduces two additional findings involving the skull and the liver.

Adolescent↗
PubMed1992

Unilateral hydroureteronephrosis caused by abdominoscrotal hydrocele.

Abdominoscrotal hydrocele is extremely rare in children. A case is presented of an unusually large abdominoscrotal hydrocele in a child, with secondary right hydroureteronephrosis due to contiguous pressure and right cryptorchidism. This entity, although unusual, should be considered in the differential diagnosis of a lower abdominal mass in children, as well as a cause of hydroureteronephrosis. Diagnosis is made with ultrasound, computerized tomography and occasionally excretory urography. Complete surgical excision through a groin incision is recommended, but optional inguinoabdominal or abdominal incisions have been reported. After surgical removal, healing is usually complete, including regression of the hydroureteronephrosis.

Abdomen↗
PubMed1992

The CO 2 laser in omphalitis.

Over a period of 18 months, from January 1988 to June 1989, 8 patients with chronic omphalitis were treated in a Multi-Specialty Military Clinic, using a CO 2 laser. A significant decrease in periumbilical pain, elimination of the disturbing chronic discharge, and vaporization of the reactive granulation tissue were achieved, suggesting this technique as an attractive option in the treatment of chronic recidivant omphalitis.

Adult↗
PubMed1991

Effect of injured vessel size on bleeding following hypertonic saline infusion in "uncontrolled" hemorrhagic shock in anesthetized rats.

Hypertonic saline (HTS) infusion in "uncontrolled" hemorrhagic shock (UCHS) leads to increased bleeding from injured vessels, fall in mean arterial pressure (MAP), and early mortality. The effect of injured vessel size on blood loss in response to HTS treatment was studied in Neurolidal Ketalar anesthetized Hebrew University strain rats. The animals were randomly assorted into 4 groups: In group I (n = 8) UCHS was induced by resection of 8% of the terminal portion of the rats' tail and the animals were untreated. In group II (n = 8) UCHS was induced as in group I and the animals were treated with 5 ml/kg NaCl 7.5% (HTS). In group III (n = 9) UCHS was induced by 50% resection of the animal's tail, and the animals were untreated. In group IV (n = 12) UCHS was induced as in group III and the animals were treated with 5 ml/kg HTS Resection of 8% of the animal's tail was followed by bleeding of 2.6 +/- 0.3 ml and fall in MAP from 107 +/- 7 to 80 +/- 10 torr (P less than .005) within 5 min. Resection of 50% of the animal's tail was followed by bleeding of 4.3 +/- 0.4 ml (P less than .01) and fall in MAP to 41 +/- 6 torr (P less than .001) after 5 min. Infusion of HTS in group II was followed by further blood loss of 4.9 +/- 07 ml within 4 hr while in untreated group I, blood loss was only 3.4 +/- 0.4 ml (P less than .05), MAP remained unchanged, and there was no mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

The use of the CO2 laser in pilonidal sinus disease: preliminary results of an ambulatory prospective study.

During a period of 18 months, from January 1988 to June 1989, 70 patients were treated for pilonidal sinus disease in a Multi-Specialty Military Clinic. There were 62 men and 8 women, with a median age of 19 years (range 18 to 35). All were managed as outpatients under local anesthesia. When an abscess was involved, the surgical procedure included incision, drainage, curettage, peroxide irrigation, and CO2 laser therapy. For the other processes, the surgical procedure included excision of sinus tissue and lateral fistulas, curettage, peroxide irrigation, and CO2 laser therapy with secondary healing. Morbidity was minimal. Healing time ranged from 14 days to 8 weeks, yet most sinuses healed in 4 weeks. The complications observed--pain, bleeding, and skin bridging--were minor. All recurrences but three were minor and healed completely after additional local treatment (4.3 percent major recurrences). Preliminary satisfactory results are reported, supporting a more conservative approach in the treatment of this often overtreated disease.

Adolescent↗