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Biomedical subjects

J F Lange

Publications and source records attributed to J F Lange.

52 records · Page 3Linked to original sources
PubMed1989

Repeat hepatectomy for recurrent malignant tumors of the liver.

The results of 34 repeat hepatectomies for recurrent malignant tumors of the liver in 28 patients are reported herein. There was no operative mortality, and the morbidity rate was 15 per cent. No instances of postoperative hepatic insufficiency were observed. Only five of the repeat hepatectomies were extensive (three or more hepatic segments). Thirteen resections were performed upon 11 patients for recurrent hepatocellular carcinoma. Four of these patients are still alive, one patient with a known recurrence (a mean survival time of 33 months with a range of four to 54 months). Ten resections were performed upon nine patients for recurrent metastases from the colon and rectum. Five of these patients are alive, four without apparent recurrence (a mean survival time of 13 months and a range of one to 35 months). Eleven resections were performed upon eight patients for recurrent miscellaneous malignant tumors, and four patients are alive, of whom three have a recurrence. The results of this study demonstrate that some patients benefit from repeat hepatectomy for recurrence of malignant hepatic tumors. Repeat hepatectomy is technically highly feasible. Economic hepatic resection with a sound oncologic basis (segmentectomy) is the operation of choice.

Adolescent↗
PubMed1987

The protective effect of a reduction in intestinal flora on mortality of acute haemorrhagic pancreatitis in the rat.

Both colectomy and intestinal lavage combined with kanamycin instillation proved effective in reducing mortality from sodium taurocholate-induced acute haemorrhagic pancreatitis (AHP) in the rat, supporting the concept that the intestinal flora must be considered a major factor influencing mortality in AHP in the rat. The results of this study are consistent with the clinical observation that abdominal sepsis is the most frequent cause of death in severe acute pancreatitis. The conclusions of the study advocate clinical trials in which besides established symptomatic treatment, intestinal decontamination is the main goal of therapy in severe acute pancreatitis.

Acute Disease↗
PubMed1986

Experimental pancreatitis in the rat: role of bile reflux in sodium taurocholate-induced acute haemorrhagic pancreatitis.

Mortality of sodium taurocholate-induced acute haemorrhagic pancreatitis in the rat was prevented by biliary diversion. Bile reflux into the pancreas after the induction of pancreatitis is postulated to be a major factor affecting mortality of this popular model of acute pancreatitis. The reduction of pancreatic secretory volume during pancreatitis is thought to be the cause of this phenomenon. Bile reflux augments dehydration by its stimulation of ascites production. It is suggested that sodium taurocholate-induced pancreatitis in the rat can only be extrapolated to human disease if bile reflux indeed plays a significant role in acute pancreatitis in man.

Acute Disease↗
PubMed1986

Pathways of enzyme transfer in sodium taurocholate-induced acute hemorrhagic pancreatitis.

The pathways of enzyme transfer from the pancreas into the systemic circulation were analyzed in sodium taurocholate-induced acute hemorrhagic pancreatitis in the rat by estimating lipase concentrations in blood, lymph and ascites. During the first few hours of pancreatitis high enzyme levels were observed in thoracic duct lymph. However, cannulation of the thoracic duct did not prevent a significant increase in the lipase concentration in peripheral blood. The portal vein lipase concentration was found to exceed the peripheral values by approximately 10%. Extremely high concentrations of lipase were measured in the ascites collected during pancreatitis. When the ascites was transferred to the peritoneal space of healthy rats, a significant increase in the lipase concentration in peripheral blood was measured. This increase could not be prevented by transection of the parasternal lymphatics. It was concluded that the hematogenous rather than the lymphatic transport of lipase from the pancreas and the peritoneal surface is the most important pathway. In this respect, this study does not support thoracic duct drainage but advocates peritoneal lavage as a logical therapeutic measure to reduce the concentration of circulating toxic substances from the pancreas in acute pancreatitis.

Acute Disease↗
PubMed1986

Acute cholecystitis in the elderly--a retrospective study.

Retrospective study on the management and results of treatment of acute cholecystitis in elderly patients. From 1965 to 1985, 147 patients over 74 years of age were treated, 38 conservatively, 76 by cholecystectomy, 32 by cholecystectomy plus exploration of the common bile duct and one by cholecystostomy. There was a high mortality in male patients (19.3%) after emergency operations (17.3%) and after choledochotomy (21.8%) compared to an overall mortality of 12.9%. No correlation was found between clinical presentation plus associated diseases and therapeutic results. The data compare favorably with other studies.

Acute Disease↗
PubMed1982

A promising treatment of pancreatic abscess.

Pancreatic abscess is a notorious complication of acute pancreatitis. A promising surgical approach to this condition is described in a case report. Dorsal drainage of the retroperitoneum is the essential feature of the procedure. It is possible that the indication for this approach extends beyond pancreatic abscess to include all cases where drainage of the pancreatic and peripancreatic areas is indicated.

Abscess↗
PubMedDate not supplied

Rotation of the terminal ileum in laparoscopic right hemicolectomy.

This case report describes rotation of the terminal ileum in a patient who had a laparoscopic right hemicolectomy. To prevent this complication, the terminal ileum should be inspected laparoscopically for rotation before exteriorization of the terminal ileum and, in addition, after completion of the anastomosis.

Adenomatous Polyps↗
PubMedDate not supplied

Traumatic rupture of the stomach after Heimlich maneuver.

Fatal complications following the performance of the Heimlich maneuver have been reported. A 76-year-old woman presented to the emergency department with signs of respiratory distress, abdominal pain and distension one day after airway obstruction and subsequent resuscitation. Despite successful immediate laparotomy and repair of a ruptured stomach, she later succumbed to the sequelae of aspiration of gastric contents and dehiscence of the gastric tear. This is the 4th case of stomach rupture and the 7th reported fatal complication following the Heimlich maneuver. It is recommended that persons who undergo the Heimlich maneuver be examined and observed by a physician, as soon as possible, to rule out complications.

Aged↗
PubMedDate not supplied

Mesenteric panniculitis of the mesoappendix.

A rare case of mesenteric panniculitis mimicking appendicular mass is presented. At laparotomy panniculitis localized in the mesoappendix and concomitant chronic appendicitis were found. A pathogenetical association is suggested by the Authors. The need for careful follow-up is stressed.

Aged↗
PubMedDate not supplied

The role of computed tomography in the management of acute pancreatitis.

Sixty-three patients with the clinical diagnosis of acute pancreatitis were submitted to contrast enhanced CT examination. As compared to Ranson's objective clinical parameters, CT grading according to Hill et al. as modified by Balthazar et al. was found to reflect accurately the severity of acute pancreatitis. Evaluation of serial CT examination did not reveal any significant progression in classification during the course of acute pancreatitis. The presence of hypodense areas in the pancreas as a single parameter seems to have a distinct prognostic value. In only one out of five pancreatic abscesses was the presence of gas bubbles observed on CT. It is concluded that contrast enhanced CT has a definite place in the management of acute pancreatitis.

Acute Disease↗