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Biomedical subjects

G Kootstra

Publications and source records attributed to G Kootstra.

At least 109 records · Page 6Linked to original sources
PubMed1991

Diabetes induction and pancreatic transplantation in the cynomolgus monkey: methodological considerations.

The aim of this study was to develop a model for pancreatic transplantation in the primate in order to test a new immunosuppressive drug. Initially, streptozotocin was used to induce insulin-dependent diabetes mellitus, but it was found to be ineffective and associated with a high morbidity. Furthermore, streptozotocin-induced insulin-dependent diabetes mellitus did not always persist, thus invalidating the evaluation of pancreatic graft function. Therefore, total pancreatectomy was introduced and combined with the pancreatic allotransplantation as a single procedure. Enteric diversion of the pancreatic juice was chosen since this avoids exocrine pancreatic insufficiency and facilitates the oral administration of the test drug. Intra-arterial monitoring of blood pressure and blood gases during the operation and avoidance of hypothermia in the animal were found to be the most important factors contributing to a successful outcome from the operative procedure.

Animals↗
PubMed1991

A survey of vascular access for haemodialysis in The Netherlands.

After nearly 30 years of access surgery for haemodialysis, a survey of vascular access in a large population seemed relevant in order to analyse the state of the art. On 1 January 1988, 2195 patients in 52 centres in The Netherlands (population 14,714,900) were on long-term haemodialysis and 588 on continuous ambulant peritoneal dialysis (CAPD) for renal insufficiency. A questionnaire was mailed out, to which there was 100% response. Of all the patients on long-term haemodialysis, 70% had a Cimino fistula, 22% a graft fistula, and 6% a more proximal arm fistula. The remaining 2% had a Scribner shunt. Of all the graft fistulae, the expanded polytetrafluoroethylene (ePTFE) graft was the one most used (58%), followed by the homologous vein graft (25%), the autologous vein graft (13%), and those made of other materials (4%). Preference for acute access was recorded; catheterisation of the subclavian vein was used almost exclusively in 17 centres, while in 24 centres it was chosen in more than 50% of the cases. The femoral vein was almost always the choice for acute access in 6 centres and it was selected in more than 50% of the cases in 17 centres. Another alternative, the Scribner shunt, was applied in selected cases in 22 of the 52 centres. Percutaneous transluminal angioplasty (PTA), as a method for treating stenoses in vessels used for vascular access, was applied routinely in 5 centres and occasionally in 19 centres.

Adult↗
PubMed1990

[Appendectomy à froid; a superfluous operation?].

A retrospective study was made of the course of the disease of 69 patients who during an uninterrupted period had been admitted with the diagnosis of acute appendicitis with infiltrate. After the usual conservative treatment, elective appendectomy à froid was scheduled for a few months later. On completion of the study, 61 of the 69 patients had been operated. Three patients had been operated on earlier than planned, because of recurrent abdominal complaints, while two patients had developed acute appendicitis. Two patients proved to have a carcinoma of the colon, one a carcinoid and three, an encapsulated abscess. Of the 61 patients operated on, 43 had no symptoms at the time of the appendectomy à froid. The authors advise no longer to perform appendectomy à froid; however, in patients over 40 years of age the possibility that a malignancy is causing the abdominal symptoms should be excluded.

Appendectomy↗
PubMed1990

[Current treatment of bilateral recurrent inguinal hernias using preperitoneal Marlex mesh prosthesis].

In the literature recurrence after operation for a recurrent inguinal hernia varies from 3 to 36%. For bilateral recurrent hernia the risk of recurrence is even higher. The results of a preperitoneal Marlex prosthesis in these patients are excellent. After this procedure we saw no new recurrences in 35 patients with 70 recurrent hernias. There was no surgical mortality; in 2 patients superficial infection occurred and there were 4 inguinal haematomas. The preperitoneal Marlex prosthesis appears to be the ideal solution for bilateral recurrent inguinal hernias.

Aged↗
PubMed1990

Intra-uterine testicular torsion.

Two cases of intra-uterine testicular torsion of the intravaginal type are presented. Orchiectomy of the affected testicle and contralateral orchidopexy were performed in both cases, followed by an uneventful postoperative course. Classification, clinical presentation, pathogenesis and treatment are discussed.

Humans↗