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Biomedical subjects

P M Go

Publications and source records attributed to P M Go.

61 records · Page 4Linked to original sources
PubMed1987

Mucosal alterations in the reservoir of patients with Kock's continent ileostomy.

Mucosal alterations in the reservoir of 10 patients with Kock's continent ileostomy were investigated and compared with normal ileal mucosa. Morphometric measurements showed a decreased villus length and an increased crypt length as compared with the control group. When the villus to crypt ratio was related to the time elapsed after the continent ileostomy operation, a decrease could be found. Light microscopy evaluations showed colon-like characteristics, which was confirmed by the detection of goblet-cell hyperplasia and the occurrence of sulphomucin-producing cells in the reservoir's mucosa. The number and type of neuroendocrine cells, however, remained unaltered. Dysplastic changes did not occur.

Follow-Up Studies↗
PubMed1981

Polyethylene glycol embedded tissue sections for immunoelectronmicroscopy.

Several methods for tissue embedding in polyethylene glycol (PEG) were compared with regard to their applicability for pre-embedding immunoelectronmicroscopy. Existing embedding procedures gave unsatisfactory results and therefore a modified procedure was developed. This method, consisting of very brief tissue infiltration with PEG 1500, to which 3% water is added, allowed adequate tissue sectioning. Using these sections for preembedding immunoelectronmicroscopical localisation of glucagon in bovine pancreatic islets adequate ultrastructural morphology was obtained in combination with excellent preservation of peptide hormone immunoreactivity.

Animals↗
PubMedDate not supplied

Outcome of 49 repairs of bile duct injuries after laparoscopic cholecystectomy.

Treatment of bile duct injuries after laparoscopic cholecystectomy is still under discussion. The aim of this study was to evaluate the results of end-to-end or biliodigestive anastomosis for various types of bile duct injury. Patient charts of 49 (0.81%) classified bile duct injuries from a national survey of 6076 laparoscopic cholecystectomies in The Netherlands were analyzed. The median follow-up after repair was 183 days (range 14-570 days). Statistical analysis showed that an end-to-end anastomosis was preferred by the surgeons for less severe bile duct injuries and a biliodigestive repair for more severe injuries. Three patients died owing to a delayed detected bile duct injury. Twelve bile duct strictures occurred after repair, leading to a stricture rate of 25%. The time elapsed between repair and occurrence of a stricture was 134 days (range 13-270 days). The type of repair or the severity of the bile duct injury did not determine the outcome of the repair. Histologically proved cholecystitis predisposed a stricture at the repair site. It was concluded that treatment of bile duct injuries is associated with a high stricture rate at the repair site of the anastomosis. End-to-end anastomosis is mostly successful for the less severe injury detected during laparoscopic cholecystectomy. For all other cases this repair can at least be considered a temporary internal drainage procedure. The biliodigestive anastomosis can best be considered a delayed repair after a drainage procedure has resolved the local inflammatory status.

Adult↗
PubMedDate not supplied

Five years of laparoscopic cholecystectomy in The Netherlands.

Since its introduction in spring 1990, laparoscopic cholecystectomy has become the treatment of choice for uncomplicated gallstone disease in The Netherlands. Several nation-wide surveys conducted by the authors show a rapid diffusion of this operation. 70-75% of all cholecystectomies are performed laparoscopically in almost all Dutch hospitals. The incidence of common bile duct lesions was relatively high at the beginning (1% in 1991) but declined to 0.68% at the end of 1992. It is assumed that the incidence of these lesions will decrease further to a percentage comparable to that after conventional cholecystectomies of 0.5%. The wound related complications of 1.65% is rather low. Despite the reduction in operative morbidity and early resumption of full activity resumption laparoscopic cholecystectomy has met financial restraints, because of the budget system in The Netherlands. There are no incentives for surgeons, hospital management and health insurance companies to stimulate laparoscopic cholecystectomy. The social-economic benefit of the operation is difficult to quantify in the current health care system in The Netherlands.

Activities of Daily Living↗
PubMedDate not supplied

Endoscopic surgery teleconferencing.

Modern telecommunication allowing the transmission of digitalized voice and images through telephone lines has expanded to medicine. The Integrated Digital Network System (ISDN) can be used to transmit 128 kbit/sec (ISDN-2) to 2 Mbit/sec (ISDN-30). Together with smart compression techniques a teleconferencing system can be implemented to transmit images of an endoscopic operation. In this paper 2 such experiments are described. In the first experiment a laparoscopic cholecystectomy performed in the Netherlands is followed at the same time by surgeons in Hawaii through ISDN-2 lines. In the second experiment a laparoscopic hernia repair was followed in Orlando during a congress using ISDN-6 lines. The images sent over the ISDN-2 lines are rather blurry with rapid movement. The images over the ISDN-6 lines were more acceptable. Data compression and decompression results in a time delay of approximately 1 second, which seems not disturbing during the connection. The cost of communication is comparable to telephone communication, which makes this form of telecommunication feasible in surgical practice.

Algorithms↗