Biomedical subjects
Publications and source records attributed to H Hansen.
For the corrective surgery of a Whitehead anus an uncomplicated operative treatment was developed, which up to now has been performed on 34 patients. The operative technique and the late results obtained are presented.
The blood supply of end-to-end staple and suture lines in the pig colon was compared. In 15 operated animals there was no anastomotic leak. Sporadic circumscribed areas of restricted circulation could be noticed in hand-sewn anastomoses. This effect was marked on the 7th and 14th postoperative day, when vascularisation of the anastomoses was increased. Such lack of vascular supply was not seen in stapled anastomoses. The intramural arteries passed through the B-shaped staples without hindrance. An unremarkable vascular pattern and a completed healing of the anastomoses were observed after 3 weeks in staple lines and after 4 weeks in suture lines.
We have previously demonstrated that enhanced glucose utilization in reperfused myocardium as assessed by F-18 2-deoxyglucose (FDG) and positron tomography predicts functional recovery. In this study, we compared segmental uptake of F-18 FDG with that of Tl-201 and Tc-99m (Sn) pyrophosphate (Tc-99m PPi) as conventional markers of tissue viability in seven dogs after a 3-hour intracoronary balloon occlusion and 20 hours of reperfusion. Myocardial blood flow was determined with microspheres. Regional retention fractions were calculated from tracer tissue concentrations, the arterial input function, and blood flow. Ischemic injury was assessed by triphenyltetrazolium chloride (TTC) staining and histologic analysis. At 24 hours, blood flow was 22% lower in reperfused than in control myocardium (p less than 0.05). Uptake of Tl-201 was related linearly to blood flow (r = 0.92), while glucose utilization and Tc-99m PPi were 2.9 (p less than 0.01) and 4.7 (p less than 0.05) times higher in reperfused than in control myocardium. Retention fractions of Tc-99m PPi increased with the degree of ischemic injury, while F-18 FDG uptake was highest in segments with mild cell injury. Thus, in ischemically injured myocardium, Tl-201 primarily reflects blood flow. F-18 FDG as a marker of glucose utilization identifies ischemically injured but viable tissue. The admixture of necrotic cells can be determined with Tc-99m PPi. Our results indicate that a dual tracer approach might best characterize the presence and extent of reversibly and of irreversibly injured tissue in a given myocardial region.
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Liver metastases of colorectal carcinomas were diagnosed by computed tomography in 116 patients. Several control examinations were made during the course of the disease. The therapeutic effect on the metastases is defined by measurements of the tissular density. Patients submitted to dearterialization or local chemotherapy showed a higher incidence of regressive tumor calcifications and necroses than untreated patients ans patients treated by systemic chemotherapy. The median survival of the untreated patients is 3.6 months, patients treated by systemic chemotherapy have a median survival of 7.9 months, and patients submitted to dearterialization and local chemotherapy show a median survival of 15.7 months. Patients treated by resection survived 36 months, which is about 10 months longer than the survival of patients treated by dearterialization, considering comparable metastatic stages. An increased survival after systemic chemotherapy was only observed in patients of stage 1.
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A central-venous, totally implantable catheter system was used in 56 patients, aged 7 months to 75 years, predominantly for cytostatic treatment. The observation period was maximally 22 months. Infections occurred in four patients with leukaemia and severe agranulocytosis (after faulty puncture, and after rupture of the connection between catheter and injection port). Long period of usability with low complication rate distinguishes the system from the conventional central-venous catheter one.
The diagnosis "prostatitis" is frequently a makeshift. It not uncommonly occasions long-term antibacterial chemotherapeutic measures which are often ineffective. The symptoms of "prostatitis" may be caused by an anogenital syndrome. This diagnosis can only be made on the basis of meticulous urological and proctological investigations. They frequently obscure the proctological cause of such symptoms (e.g. haemorrhoids).
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Ischemic heart disease (IHD) mortality of Connecticut firemen and policemen is studied for the years 1960-78, using death certificate data. The mortality of these two occupations is expected to be greater than that of other workers. Standardized Mortality Odds Ratios for firemen and policemen are greater than 1.00. Although some increased IHD risk for firemen and policemen is suggested, the exact role of occupational risk factors remains to be determined.
An acute bleeding rectal ulcer was the solitary condition in four patients. The cause of such an ulcer, which always results in heavy arterial bleeding, remains unknown. The source of bleeding is demonstrated by rectoscopy which may at times be difficult because of the large amount of blood in the rectum and the hidden position of the small ulcer. Sclerosing or circumferential suturing of the ulcer provides immediate cessation of bleeding and cure.
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In ulcerative colitis, polyposis coli, deep seated cancer and other diseases of the rectum the bowel continuity can be restored without loss of continence, despite the removal of the entire ampulla recti. After proctocolectomy and ileoanostomy the loss of the natural receptaculum is compensated through the positioning of an ileal pouch. After total resection of the rectum and coloanal anostomosis the excised ampulla is replaced with acceptable functional results by the mobilised left colon.
N-13 ammonia mimics certain properties of microspheres. It rapidly clears from blood into myocardium where it becomes fixed in proportion to myocardial blood flow. Used with positron emission tomography as a means for quantifying in vivo myocardial indicator concentrations, N-13 ammonia may be useful for noninvasive determination of myocardial blood flow with the arterial reference sampling technique. This possibility was examined in 27 experiments in 10 chronically instrumented dogs at control, high and low blood flows. Myocardial blood flow was calculated in vivo from the myocardial N-13 tissue activity concentrations derived from serial cross-sectional images of the heart, the 2 minute arterial input function and the withdrawal rate of arterial blood. These calculations were compared with blood flow determined by the standard microsphere technique. Blood flow determined in vivo with N-13 ammonia and positron emission tomography correlated with microsphere blood flow by y = -36.2 + 1.53x -0.0027x2 (r = 0.94 with a standard error of the estimate of 16 ml/min per 100 g). For flows from 44 to 200 ml/min per 100 g, the relation between in vivo and in vitro measured myocardial blood flow was nearly linear but reached a plateau at flows higher than 200 ml/min per 100 g. These results indicate that in dogs, blood flow in the physiologic range can be quantified in vivo with N-13 ammonia and positron emission tomography.