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Biomedical subjects

C Kallman

Publications and source records attributed to C Kallman.

8 recordsLinked to original sources
PubMed1993

Biliary complications of laparoscopic cholecystectomy.

Laparoscopic cholecystectomy has rapidly become the preferred treatment for symptomatic gallstones. Although this procedure has certain advantages over open cholecystectomy, concern has been expressed regarding the potential for bile duct injuries. In an effort to understand the scope of this problem, a retrospective review was performed of all patients referred to UCLA after having sustained biliary injuries during laparoscopic cholecystectomy. Over a 14-month period, 10 patients were referred to UCLA with 12 major bile duct injuries. One patient had a false positive cholangiogram leading to an unnecessary biliary-enteric bypass and subsequent dehiscence, resulting in a biliary fistula. Six patients were referred on an acute basis, whereas four patients underwent attempted biliary reconstruction at outside facilities and were ultimately referred with either a biliary stricture or a fistula. Review of cholangiograms suggested that bile duct anomalies were present in five patients. There did not appear to be a relationship between the use of either electrocautery or laser and bile duct injuries. To date eight patients have been successfully managed via Roux-en-Y hepaticojejunostomies, with a mortality rate of 0%. Although the exact frequency cannot be ascertained from the current study, our data demonstrate that major biliary complications do occur during laparoscopic cholecystectomy. Most of these injuries, however, can be safely and successfully treated with surgical biliary reconstruction. Early diagnosis and treatment with liberal use of intraoperative cholangiography and a low threshold for conversion to open laparotomy appears to be associated with a more favorable outcome.

Adult↗
PubMed1983

Cognitive abilities of language-delayed children.

The performance and verbal IQ scores for the WPPSI and WISC-R were compared for two groups of children aged 5 to 8 1/2 years, one normal and one specifically language delayed (SLD). There 34 to 38 children in each group. In accordance with selection procedures, performance IQ scores were not significantly different across the two groups. Both verbal and full scale IQ were significantly lower for the SLD than for the normal group. Profiles of verbal subtest scores differed for normal and SLD children but profiles for performance subtest scores did not. Variability of performance subtest scores was not greater for the SLD than for the normal children. The results do not support the hypothesis that language delay in children is related to a nonverbal cognitive deficit.

Child↗
PubMed1983

Respiratory illness and hypophosphatemia.

We retrospectively reviewed the charts of 308 admissions to a pulmonary disease ward and 100 admissions to the general medical service over one year to find the prevalence, sequelae, and etiology of hypophosphatemia. The overall prevalence of low serum phosphate levels (less than 2.4 mg/dl) occurring at least once during hospitalization in chest patients was 17 percent, but was higher in patients with respiratory infections (28 percent). Moreover, the prevalence of hypophosphatemia on admission (before institution of intravenous fluid or drug therapy) was ten times higher in patients with respiratory infections than in patients with noninfectious respiratory illness or general medical patients (21 vs 2 percent, p less than 0.001). Serum phosphate less than 2.0 mg/dl occurred in 4 percent of patients. Twenty-seven percent of the patients (including two with ventilatory failure) with abnormally low serum phosphate levels had symptoms or signs of uncertain etiology later explicable by the presence of hypophosphatemia. The most common additional laboratory finding associated with hypophosphatemia was elevation of muscle enzymes. Although mortality was no higher in hypophosphatemic patients, hospital stay was twice as long as that of patients with normal levels of serum phosphate. No correlation was found between simultaneous arterial blood gases and serum phosphate levels. Two patients given antacids had severe hypophosphatemia and worsened ventilatory function; phosphate-binding antacids should be used judiciously in patients with severe respiratory disease, since they may lead to the development or worsening of hypophosphatemia and diminished ventilatory function.

Female↗
PubMed1981

A reexamination of some nonverbal perceptual abilities of language-impaired and normal children as a function of age and sensory modality.

A battery of nonverbal perceptual and memory tests were given to 35 language-impaired (LI) and 38 control subjects. Three modalities of tests were given: auditory, visual, and cross-modal (auditory and visual). The purpose was to reexamine some nonverbal perceptual and memory abilities of LI children as a function of age and modality of stimulation. Results failed to replicate previous findings of a temporal processing deficit that is specific to the auditory modality in LI children. The LI group made significantly more errors than did controls regardless of modality of stimulation when 2-item sequences were presented rapidly, or when more than two stimuli were presented in series. However, further analyses resolved this apparent conflict between the present and earlier studies by demonstrating that age is an important variable underlying modality specificity of perceptual performance in LI children. Whereas younger LI children were equally impaired when responding to stimuli presented rapidly to the auditory and visual modality, older LI subjects made nearly twice as many errors responding to rapidly presented auditory rather than visual stimuli. This developmental difference did not occur for the control group.

Aging↗