Biomedical subjects
Publications and source records attributed to H H Meyhoff.
A study based upon 23 patients revealed substantial within- and between-observer variation, when 14 senior and junior surgeons under blindfold conditions were requested to measure the distance from the thoracic cage to the lower border of the liver in the midclavicular and midsternal lines. Clinical decisions should accordingly not rely heavily upon a palpatory estimate of liver size.
Effects of clonidine (Catapresan) on urethral closure pressure profile were investigated in five patients with minor urologic complaints. Plasma norepinephrine was measured as an index of sympathetic nervous activity. Intravenous injection of clonidine resulted in a pronounced fall in maximum urethral pressure. Plasma norepinephrine concentration decreased as expected. There was a statistically significant correlation between changes in plasma norepinephrine and urethral pressure after clonidine. These findings are discussed in relation to the known effects of alpha-adrenoceptor blocking drugs on urethral pressure. Clonidine may be useful in the treatment of some patients with functional infravesical obstruction.
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The between-observer variation was evaluated through three independent estimates of preoperative prostatic weight in each of 40 patients. Error in the estimates was of considerable magnitude irrespective of size of prostates. Experienced urologists did not attain a more reliable estimate than unexperienced doctors. Only about 2/3 of estimates were correct within a range of +/- 25 g. However, there was a statistically significant correlation between estimated and actual operative prostatic weight.
A series of 106 patients with biliary tract stones is reported. The patients underwent supraduodenal choledochotomy, with an attempt to carry out conventional sanitation of the biliary tract, before a transduodenal sphincterotomy was done. Indication for sphincterotomy was mainly presence of wedged papillary stones or multiple common duct stones. Of the entire series, 52 attended for follow-up study after a period of at least 2 years postoperatively, and underwent intravenous cholangiography, 51 patients had papillary stones removed via the sphincterotomy. Stones were missed in 8 of 102 patients, but were passed spontaneously in 2 patients during the observation period. Postoperative mortality was high (10%)--4 patients developed a fatal pancreatitis. It is concluded that the procedure of sphincterotomy allows certain identification and removal of wedged papillary stones, but does not always allow that missed stones will be passed spontaneously. The possible significance of transpapillary drainage in the subsequent development of pancreatitis is considered.
The renal handling of dimercaptosuccinic acid and hippuran differs. This might be used in unilateral obstructive nephropathy in order to predict potential functional recovery following intervention. The theory was evaluated on a retrospective basis in 17 patients, who primarily had a nephrostomy. If the DMSA-uptake rate in the diseased kidney was more than 10 per cent higher than that of hippuran, the uptake rate of hippuran increased following relief of obstruction. Use of the two radiopharmaceuticals, thus, may have great impact on the clinical decision, since in case of a difference some function may be saved by immediate intervention.