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Biomedical subjects

P L Klemm

Publications and source records attributed to P L Klemm.

3 recordsLinked to original sources

[Bilateral traumatic dissection of the carotid artery].

Bilateral carotid artery dissection is a rare and unusual complication of blunt cervicofacial trauma. The diagnosis of a carotid injury is rarely suspected in trauma patients with neurological deficits. Neurological symptoms may develop in a delayed fashion. Angiography should be considered in trauma patients with hemiplegia and a normal mental status and in patients with blunt cervical trauma with an abnormal neurological examination. Initial heparinisation can prevent arterial thrombosis and neurological deterioration.

Adolescent↗

[The regional explantation team: an important contribution to organ procurement for transplantation in the Netherlands].

If organ donations concern not only the kidneys, but also the liver, pancreas and, sometimes, the heart and (or) lungs, several surgical removal teams, often from different (foreign) transplantation centres, may be involved. This has created organizatory problems resulting in loss of organs for transplantation. In the Nijmegen area since October 1994 a removal team has been active that in the regional donor hospital removes all abdominal organs from the donor on behalf of the various transplantation centres. This regional removal team performed 105 multi-organ explanations in the period from October 1994 to December 1997. The reports that came back from the transplantation centres that had received the organs showed that none of these organs had been lost for transplantation through organizatory problems or anatomical damage. Experiences of operating room staff involved were positive: it was especially the standard surgical techniques and the quiet in the operating room that were appreciated. Special removal teams may greatly improve the evolution of organ donation in the Netherlands.

Female↗

[Two cold legs].

Bilateral acute lower limb ischaemia is rare. Usually the diagnosis is based on clinical findings. In four patients, three women aged 51, 48, and 72 and a man aged 64 years, bilateral acute ischaemia of the lower limbs was diagnosed, due to different causes: arterial cardiac myxoma embolism, arterial thrombosis probably due to paraneoplastic coagulopathy, aortic dissection, and arterial thrombosis due to cardiac insufficiency, respectively. The management of these conditions includes restoring the circulation as soon as possible. Reperfusion can be achieved by thromboembolectomy or thrombolysis. In patients with underlying atherosclerosis angiography is useful, but time loss must be avoided. The outcome in patients with bilateral ischaemia of the lower limbs depends on the preoperative ischaemia time and the cardiac situation. The mortality varies between 20 and 50%.

Aged↗