Biomedical subjects
Publications and source records attributed to C H Jensen.
A case of synovitis in the knee of a man aged 20 years is reported. The fragment measured 1 X 1 cm and proved to be material from a pair of jeans. The diagnosis was established by arthroscopy. After transarthroscopic removal of the fragment, the patient recovered.
A retrospective comparison of the results after the Bankart and the Putti-Platt procedures in the treatment of recurrent anterior dislocation of the shoulder showed no significant differences in the rate of redislocation or in the limitation of outward rotation. The dislocation recurrence rate after surgery was 13% for the Bankart procedure and 22% for the Putti-Platt procedure. Only 67% of the patients were satisfied with the operation. The poor results seem to be due to the fact that the operations were performed by 16 different surgeons who had varying approaches to the operations.
A patient with an undetectable meningocele communicating with the lower eyelid is reported. The condition was first suspected during surgical removal of xanthelasmata when liquorrhoea was observed. The diagnosis was confirmed by computer tomography.
Among 2411 consecutive arterial reconstructions performed with synthetic prosthetic material in Denmark during a 4-year period, 62 patients (2.6%) developed graft infection. Graft infection occurred only when the groin had been incised. The incidence of infection and the spread of infection along the graft did not relate to the graft material used (Dacron velour, Dacron woven, polytetrafluoroethylene, and umbilical vein). Retrospective analysis disclosed predisposing or precipitating factors in 50 of the 62 cases; the most important seemed to be unsatisfactory surgical technique. Fifty-three percent of the graft infections occurred within 30 days. Gram-positive cocci were the most common pathogen. The 62 patients had been in the hospital for a mean of 90 days and had undergone an average of 1.4 operations for graft infections. Of the patients, 25.8% died and 30.6% underwent amputations. Vascular graft infection is still one of the major problems in vascular surgery; greater care should be taken to improve antiseptics, improve surgical technique, and establish a rational prophylactic antibiotic regimen. A prophylactic antibiotic regimen of a combination of cephalosporin and ampicillin is recommended.
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Intravenous glucose tolerance tests were performed on 12 surgical patients the day before surgery and during surgery. Six patients were anesthetized with enflurane and six were operated on during an epidural lumbar blockade (Th8-S5). In the general anaesthesia group the plasma glucose concentration was significantly higher after the intraoperative glucose load than after the preoperative load. The pre- and intraoperative glucose tolerance tests were identical in the epidural group. Pre- and intraoperative glucose disappearance rates and plasma insulin responses were similar in the two groups, indicating that the observed differences in plasma glucose were caused by differences in hepatic glucose release, rather than differences in peripheral glucose utilization.
The rate of control of thyrotoxicosis during the first 2 weeks of treatment was documented in 63 patients. Twenty-three patients received carbimazole 40 mg plus lithium carbonate 750 mg daily and a comparable group of 20 patients were given carbimazole 40 mg plus potassium iodide 120 mg daily. In the lithium treated patients the mean percentage fall of serum T4 after 2 weeks treatment was 49% and the fall in serum T3 57%. The results were similar in the iodide treated patients; the mean falls in serum T4 and T3 being 47% and 64%, respectively. Serum lithium values varied between 0.1-1.25 mEq./l; lithium side effects were minor. In a companion study 20 patients were treated with carbimazole alone. The responses in this group were less impressive; the mean falls in serum T4 and T3 at 2 weeks being 18% and 36%, respectively. It is concluded that lithium is a safe adjunct to conventional antithyroid drug therapy in the initial treatment of acute thyrotoxicosis.