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Biomedical subjects

H E Carstensen

Publications and source records attributed to H E Carstensen.

At least 19 recordsLinked to original sources

Septic wound complications after whole bowel irrigation before colorectal operations.

Ninety-three patients for whom a colorectal operation was planned had their bowel prepared mechanically by orthograde irrigation. The tube was sited in the duodenum via the pylorus under X-ray and TV control. The procedure was discontinued in 2 patients (2%), 15 patients (16%) experienced nausea and vomiting, while 76 patients (82%) experienced no discomfort. The mean duration of the irrigation was 216 min (90-476 min) and the mean volume of fluid used 10.21 (5.0 -15.0 1). There were no significant differences between pre-irrigation and post-irrigation blood chemistry. Twenty-three patients developed postoperative abdominal wound sepsis (26.7%), 4 (4.7%) had an intraabdominal abscess; 9 out of 12 patients (75%) had perineal wound sepsis. Escherichia coli and Bacteroides were the dominant species cultured from colorectal mucosa during operation as well as from infected abdominal and perineal wounds. Although the irrigation technique seems to clean the bowel to a degree not previously seen, this in itself is no guarantee of avoiding post-operative wound sepsis after colorectal operations.

Adult

Cimetidine for severe gastroduodenal haemorrhage: a randomized controlled trial.

During a period of 12 months, 88 patients with severe haemorrhage from gastric or duodenal ulcers or from erosive gastritis completed a double-blind trial of either cimetidine or placebo. Only patients needing immediate blood transfusion were admitted to the trial. It was found that in patients with severe bleeding from gastric or duodenal ulcers neither the severity of bleeding nor the incidence of emergency surgery was reduced by cimetidine. Furthermore, the treatment did not improve the mortality rate. It is concluded that patients with severe bleeding from gastric or duodenal ulcers will not benefit from immediate treatment with intravenous cimetidine.

Adult

Glucagon stimulated plasma cyclic adenosine-3',5'-monophosphate in the differential diagnosis of jaundice.

The amount of plasma cyclic adenosine-3',5'-monophosphate was estimated before and 15 minutes after the intravenous injection of 1 milligram of glucagon in 34 patients with obstructive and in 23 patients with nonobstructive jaundice. After stimulation with glucagon, the median adenosine-3',5'-monophosphate concentration in obstructive jaundice rose fortyfold or more, while in nonobstructive jaundice, the increase was twentyfold or less. The difference was highly significant. The results indicate that this test can be useful in the differential diagnosis of obstructive and nonobstructive jaundice.

Cholestasis

In vitro test of heart muscle viability.

The purpose of the present study was to establish viability criteria for hearts perfused with a non-biological synthetic perfusate in a Langendorff type preparation. During hypothermic perfusion, the only discriminant between eight undamaged and four hypoxically damaged hearts was resistance to perfusion flow. At near normothermic conditions, the damaged hearts exhibited a decreased respiratory rate. It was also suggested that adrenalin stress of the isolated heart might be useful instead of orthotopic transplantation, as a final test of viability.

Animals

Construction and evaluation of a simple membrane oxygenator for small organ perfusion.

A simple membrane oxygenator for isolated organ perfusion is described. The membrane employed consisted of an ordinary silicone rubber tubing, 2 mm internal diameter, 0.3 mm wall thickness, the length of the tubing varying according to the required gas transfer. When describing the capacity of the oxygenator, it was found that the maximum gas transfer rate per unit membrane surface was an inadequate measure, since this would vary with both flow rate through the oxygenator and the gas binding capacity of the perfusate. The following formula for the function describing the relation between maximally possible change in gas concentration in the perfusate (C), flow rate (F) and actual change in gas concentration in the perfusate (U) was proposed: U=C-e(-bF), b being a constant specific for the gas and the membrane. This formula was tested by a series of in vitro experiments and proved to give a valid description of the capacity of the oxygenator. It was also found that carbon dioxide was always more easily transferred than oxygen, so that oxygen transfer capcity was the limiting factor in the use of the oxygenator. To facilitate the construction of the right size membrane, a nomogram was constructed for oxygen transfer.

Animals

[Funnel chest].

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Adolescent