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Biomedical subjects

R Van Hee

Publications and source records attributed to R Van Hee.

At least 55 records · Page 3Linked to original sources

Calcitonin gene-related peptide-like immunoreactivity in the human small intestine.

Calcitonin-gene-related-peptide (CGRP)-like immunoreactivity was localized in nerve fibres, neuronal somata and in mucosal endocrine cells of the human small intestine. Immunoreactive enteric neurons were more numerous in the submucous plexuses than in the myenteric plexus. Morphologically, they predominantly had the appearance of type II neurons. The majority of the CGRP-like immunoreactive nerve fibres ran within the ganglionic nerve plexuses. Only a small proportion could be observed in the lamina propria, the lamina muscularis mucosae, or the circular and longitudinal outer smooth muscle layer. These findings suggest that within the wall of the human small intestine neuronal CGRP of either extrinsic or intrinsic origin exerts its effect chiefly on other enteric neurons, and might be indirectly involved in the regulatory functions of the human small intestine.

Adult↗

[Not Available].

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Anatomy↗

Gastric emptying for solids in patients with duodenal ulcer before and after highly selective vagotomy.

In a series of 31 duodenal ulcer patients (23 males and 8 females), who underwent a highly selective vagotomy, gastric emptying characteristics of a solid meal, labeled with [99mTc]stannous colloid, were assessed before, two weeks and six months after operation. The clinical diagnosis was confirmed by endoscopy and x-ray; failure of treatment with H2 antagonists or antacids during 1-18 (mean 5) years was the direct indication for operative treatment. A temporary delay in gastric emptying is noted two weeks after operation (T1/2: 124 vs 57 min). After six months, gastric emptying time has practically normalized. It appears that this is the result of the preservation of the antropyloric vagal nerve supply. In these patients, a 10% recurrence rate is noted, comparable to the results in the literature. Highly selective vagotomy proves to be a safe and effective procedure with few side effects. It does not impair gastric motility.

Adult↗

Gastric emptying of liquids after highly selective vagotomy for duodenal ulcer.

In a group of clinical patients with duodenal ulcer submitted to highly selective vagotomy, gastric emptying studies were performed pre-operatively and 2 weeks and 6 months after surgery. A standard liquid meal labeled with radioactive technetium was used for scanning. In this group of duodenal ulcer patients, no abnormal emptying was noted prior to surgery as compared with controls. After highly selective vagotomy, the gastric emptying time for liquids was statistically shorter as compared with preoperative values. It is concluded that highly selective vagotomy may be the operative treatment of choice for duodenal ulcer patients with respect to acid secretion, but that it alters gastric motility and emptying significantly.

Duodenal Ulcer↗

Pancreatic function after seromyotomy of the canine stomach.

Anterior gastric seromyotomy combined with posterior truncal vagotomy has been proposed as an acid-reducing operation for patients with duodenal ulcer. Section of the posterior vagal trunk could, however, be held responsible for reduced pancreatic function, seen in patients after bilateral truncal vagotomy. In this study the pancreatic function after anterior gastric seromyotomy and posterior truncal vagotomy has been evaluated in a series of canine experiments by means of a direct hormone stimulation test. No reduction of the basal or stimulated exocrine pancreatic secretion was noted after this type of vagotomy.

Amylases↗

Peliosis hepatis associated with liver and retroperitoneal abscesses.

A 33-year-old woman was admitted because of coma and severe shock. CT-scan of the abdomen showed the presence of multiple liver abscesses associated with a retroperitoneal abscess which were drained percutaneously. A liver biopsy showed diffuse peliosis. After resolution of the abscesses the patient's general condition improved and she could be discharged from hospital. Peliosis hepatis is an uncommon disorder characterized by dilated sinusoids with formation of blood lakes. Many pathogenetic mechanisms and causal agents have been proposed. Liver biopsy is necessary to establish diagnosis. By withdrawing the offending drug or treatment of the underlying disorder, regression may be observed.

Abscess↗

Current management of traumatic chylothorax.

The development of a traumatic chylothorax is an uncommon but serious clinical entity. Two cases of traumatic chylothorax are reported. The anatomy and physiology of the thoracic duct and the etiology, diagnosis and management of traumatic chylothorax are discussed.

Adult↗

Pseudotumor formation in polytetrafluoroethylene-dialysis fistulae.

We report two patients with formation of pseudotumors along a polytetrafluoroethylene (PTFE) graft used for dialysis access in chronic fistulae. We postulate a relationship with seroma formation, a known complication of PTFE vascular grafts used for dialysis purposes, possibly through lipolysis of the surrounding fat by a protein-rich exudate.

Aged↗

The effect of social factors on diagnosis and treatment of breast cancer.

This study was made to evaluate the influence of the socio-economic status of a particular population in Northern Antwerp on the epidemiology and treatment of breast cancer. Data concerning patient characteristics, breast cancer pathology, treatment and socio-economical factors were compared with regional, national and worldwide literature. The patients in this series were generally older (61% more than 65 years) and tumour stage was more advanced (only 23% T1 tumours). Treatment therefore was more aggressive. The patients in our population had a lower level of education and lower income, and from a social point of view were more disadvantaged: 21% belonged to the social category of widow(er)s and orphans, while 3% had no social security. Thirty percent of patients in this series declared that late hospitalization depended on their social or financial situation. Preventive care and medical services should therefore be directed to socially and financially disabled classes of patients.

Adult↗

Evaluation and functional assessment of flexor tendon repair in the hand.

Seventeen patients with 28 flexor tendon injuries were examined after tendon repair. The current most frequently used evaluation systems, including grip and pinch strength, were compared with functional outcome as assessed by a questionnaire, evaluating Disabilities of Arm, Shoulder and Hand (DASH). Good correlation was found between Total Active Motion (TAM) and the Original Strickland test (kappa = 0.85), however with reduced categories. Only limited correlation was found between the DASH-score and TAM (r = -0.33) as well as between the DASH-score and pinch strength (r = -0.35). We suggest reporting the average Range of Motion (ROM) of the complete finger as a percentage of the contralateral finger, instead of reporting the classified result, and to include assessment of pinch strength. It would be very useful to have an accurate functional outcome assessment, but DASH proves to be insufficiently sensitive.

Adolescent↗

Surgical anatomy of the inguinal region: implications during inguinal laparoscopic herniorrhaphy.

INTRODUCTION: In laparoscopic inguinal hernia repair the inguinal region is approached and hernia repair performed from the interior side instead of the classical open external access. Exploration and placement of staplers in the internal inguinal region during laparoscopic hernia repair may sever different anatomical structures, or induce specific complications such as nerve entrapment, neuralgia, hematomas or osteitis. The incidence of these complications may be reduced by careful dissection of the preperitoneal tissues and by placing a prosthetic mesh without the use of stapling. As laparoscopic techniques evolved, different sizes of meshes have been used. An exact determination of mesh size was hitherto not investigated. AIM: Cadaver studies of the topography of blood vessels and nerves in the preperitoneal tissue in this region were carried out in order to assess a safe position and adequate size of the prosthetic mesh. METHODS: Dissection in 6 preserved human female cadavers was performed to define the actual surface of the internal inguinal region. A physical model was developed to formulate the ideal size of the prosthesis. Specific measurements were used to define the maximal size of the meshes, so as to place them without stapling, and without inducing neurovascular complications. RESULTS: The designed physical formula defines the size of the mesh as a function of the maximum intra-abdominal pressure, the size of the abdominal wall defect and the abdominal wall tension. CONCLUSION: On mathematical and physical grounds our study points out that the size of the currently used prosthetic mesh (10 x 15 cm) is large enough to be placed without stapling so that with proper placement no recurrences should occur.

Dissection↗

Intramural duodenal hematoma of pancreatic origin.

Non-traumatic intramural hematoma of the duodenum is an unusual clinical entity. Indeed, in a majority of 70% of patients intramural hematoma of the duodenum is caused by a blunt, frequently minor abdominal trauma. The main etiology of non-traumatic intramural hematoma of the duodenum in the adult is overdose anticoagulant therapy. Rarer causes include pancreatic disease, blood dyscrasia or vascular collagen disease. In this presentation a case of pancreatitis-induced intramural duodenal hematoma is discussed and compared with corresponding data in the literature.

Adult↗

Isolated colonic injury following blunt abdominal trauma.

A case of delayed diagnosis of colonic injury after blunt abdominal trauma leading to faecal peritonitis is presented. Diagnostic problems and possibilities as well as treatment of these injuries are reviewed. The key to diagnosis remains the serial clinical and ultrasound examinations.

Abdominal Injuries↗

Gastric emptying rate for solid and for liquid test meals in patients with dyspeptic symptoms after partial gastrectomy and after vagotomy followed by partial gastrectomy.

BACKGROUND/AIMS: Gastric emptying rate for solid and for liquid test meals was investigated retrospectively in patients with longstanding epigastric distress after partial gastrectomy, either as primary treatment or after failure of vagotomy for peptic ulcer in order to find an explanation for the postoperative symptoms. METHODOLOGY: Radionuclide-labeled liquid and solid test meals were used to evaluate gastric emptying rate, at least one year after surgery. RESULTS: The lag phase for liquid test meals disappeared in all operated patients. Partial gastrectomy usually lead to fast emptying but this resective procedure, if performed after vagotomy, lead to stasis in a significant number of patients. Gastric emptying rate for solids increased in only a few of these symptomatic patients. In most of them however, there was a normal to decreased emptying rate. If a vagotomy had preceded the resective procedure, gastric emptying rate decreased significantly. CONCLUSIONS: In all these symptomatic patients, gastric emptying had been disturbed for at least one type of test meal. This makes investigation for both meals necessary, especially since there is a lack of correlation. Furthermore, if vagotomy fails to prevent ulcer recurrence, one should carefully consider all options before performing partial gastrectomy since gastric emptying rate after these consecutive procedures worsens considerably.

Adult↗