Ethical aspects of animal experimentation.
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Animal Rights↗
Biomedical subjects
R Van Hee
Publications and source records attributed to R Van Hee.
The effect of stress on gastric emptying rate measured with a radionuclide tracer.
BACKGROUND/AIMS: Stress can delay gastric emptying rate. This phenomenon has not yet been investigated with a physiological solid test meal or a regional analysis. METHODOLOGY: We investigated the gastric emptying rate in beagle dogs using a radio-labeled solid test meal and a gamma camera. The transport to an unknown environment served as a stress stimulus. This offers the advantage to mimic fairly well the clinical situation just before a diagnostic or therapeutic procedure. Control values were obtained after the third investigation, in which all dogs were accustomed to the environment. RESULTS: Regional analysis of the emptying curves from the whole gastric region revealed that the length of the lag phase increased with stress, but the post-initial emptying rate remained unchanged. Emptying of the fundus changed hardly, but the antropyloral motor activity decreased during stress. CONCLUSIONS: Gastric emptying rate is impeded during stress. It is necessary to limit the unnatural stress-stimuli, in order to mimic the clinical situation. Measurement techniques that influence directly gastric emptying or act as a stress-stimulus by themselves are undesirable. A radionuclide solid test meal is preferable and a regional analysis reveals the impairment of the antral motility as the mechanism of the delay of gastric emptying.
Animals↗
Giant diverticulum of the colon: report of two new cases and review of the literature.
Diverticulosis coli affects more than one in three individuals older than 65 in the Western world. Giant diverticulum of the colon is an extremely rare complication of diverticular disease; only 113 cases, mostly situated in the colon sigmoideum, have been reported in the world literature. Two new cases of giant diverticulum of the colon sigmoideum, with totally different clinical presentation, diagnosis, and management, are reported-one being the cause of chronic anemia and the other presenting as an acute abdomen. Based on a review of the literature, an update on symptomatology, diagnosis, pathogenesis, and therapeutical options of this rare disorder is provided.
Aged↗
Ileal intussusception due to invagination of Meckel's diverticulum.
A middle-aged patient is reported who came to laparotomy after a six months period of abdominal complaints. Extensive investigations couldn't explain his symptoms. At laparotomy he was found to have an ileal intussusception due to an invaginated Meckel's diverticulum. These events are confronted with other collected literature reports. Symptomatology and treatment are discussed.
Humans↗
[Jeremy Thriverius (1504-1554): humanist doctor, born 500 years ago].
Jeremy de Drijvere or Thriverius (1504-1564) has been an important medical personality in our Habsburgian Low Countries in the 16th century. In 1537 he got the medical doctor's degree at the University of Leuven, where he was appointed few years later as professor of medicine. He was mostly interested in pathology and has translated and commented several works of Hippocrates and Galen. Moreover, Thriverius has published many original medical treatises in which he gives account of his personal experience and of certain diagnostic innovations, amongst others concerning the symptoms of scabies. Finally Thriverius was a renovator of medical teaching. Even if he has remained in favour of the Galenic tradition, de Drijvere may be considered a humanist and an excellent representative of the new ideas of medical Renaissance.
Belgium↗
Organ donation in Belgium: discrepancy between offer and demand.
Belgium shows one of the highest numbers of patients with terminal renal failure, treated by means of dialysis, compared to other European countries. Transplantation accounts for only one third of the therapeutic modalities in these patients. As the number of new patients, presenting with terminal renal failure, is equally rising, an always growing discrepancy exists between offered kidneys and patients, desperately waiting for these organs. The same holds true for other organs, as heart, pancreas and liver. This study examines the multiple causes that induce this growing discrepancy and points to some solutions and suggestions that can deal with it.
Belgium↗
The insulin test after highly selective vagotomy. Prognostic value in a series of 73 patients followed for 4-10 years.
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Adult↗
The management of bronchopleural fistulas.
Bronchopleural fistulas remain a severe complication of pulmonary surgery and pulmonary disease. Treatment often requires multiple surgical interventions. The etiology, the methods for diagnosis and the different possible therapeutic procedures are discussed.
Aged↗
A modification of the Visick grading for the evaluation of duodenal ulcer operations.
A series of 150 patients with duodenal ulcer, treated by means of a highly selective vagotomy, is presented. The clinical follow-up of 100 patients, treated for more than three years, was assessed according to the Visick classification. A thirteen percent recurrence rate was noted in this series. Recurrences could either be cured easily by medical treatment or induce long lasting medication or operative intervention. A subdivision of the Visick 4 class of patients is proposed in this study, taking into account this quite different evolution of ulcer recurrences after highly selective vagotomy.
Adolescent↗
Surgical treatment of pancreatic pseudocysts.
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Adolescent↗
The screening value of the amylase-creatinine clearance ratio in acute pancreatitis.
The screening value of the amylase creatinine clearance ratio in acute pancreatitis is studied. A series of 28 patients with pancreatic disease is compared with 80 controls and 82 patients with other intra-abdominal disease. The greatest specificity of the amylase creatinine clearance ratio value is reached at the 3.5 level. The amylase creatinine clearance ratio value proves to be of interest, not only in the diagnosis of acute pancreatitis but also in differentiating mild and heavy forms of pancreatitis.
Abdomen, Acute↗
Peritoneal lavage in acute pancreatitis. An experimental and clinical study.
Experiments were performed to evaluate the use of peritoneal lavage in dogs, in which an acute non fatal necrotic-hemorrhagic pancreatitis was obtained by means of intraductal sodium-taurocholate injection. A single lavage of 2 liters of a balanced solution 6 hours after the pancreatitis onset produced a temporary biochemical improvement, as evidenced by the amylase, lipase and alcaline phosphatase values. Triple lavage with or without heparin, performed after 6, 18 and 24 hours, produced on the other hand clearcut reduction in mortality rates and long lasting improvement of the biochemical parameters. Two patients with operatively confirmed necrotic hemorrhagic pancreatitis were treated by the lavage method during three days. The treatment resulted in a significant improvement of the clinical condition and the biochemical parameters of both patients.
Acute Disease↗
[Conservative treatment of a traumatic biliopleural fistula].
Conservative management of a traumatic biliopleural fistula. A female patient, 13 years of age, developed a right-sided haemothorax after a stab wound in the right para-vertebral region. Pleural effusion reoccurred after thoracic drainage was stopped. Ten days after the injury, thoracic puncture enabled a diagnosis of biliopleural fistula to be made, confirmed by ERCP and CT-scan. The fistula closed after repeat thoracic drainage combined with prophylactic antibiotic therapy.
Adolescent↗
Complications of drainage.
Several complications, resulting from drainage, are discussed. These include severe tissue reactions, leakage from bowel anastomoses, obstruction and perforation of small or large bowel, herniation, leaving behind a foreign body, severe bleeding and the induction of infection. Several of these complications are illustrated with case histories. Moreover a review of the literature on the subject is given. In view of these complications, the author warns against too liberal or too long drainage procedures.
Adult↗
Results of simple suture for perforated peptic ulcer.
A series of perforated peptic ulcer, mainly treated by simple suture, omentoplasty and drainage, is presented. The mortality rate, amounting 13.5%, as well as the postoperative sequelae are discussed. Recurrences or persistent symptoms induced reoperations in 63% of the patients. A comparison between our results and the figures from the literature is given, essentially focused on the choice to be made at the moment of the laparotomy for perforation.
Aged↗
The unexpected thyroid cancer: surgical attitude.
A series of 18 patients with unexpected well-differentiated cancers of the thyroid is presented. This proved to be a high percentage of all patients operated for "benign" thyroid disease (6.5%), and a substantial percentage of all patients operated for thyroid cancer (44%). Preoperative investigations consisting mainly of thyroid function tests, ultrasound, scintigraphy, and fine needle aspiration biopsy, were not contributive for cancer. Intraoperative suspicion of malignancy induced extended surgery in one patient and frozen section biopsies in another 5 patients, with 3 positive answers resulting in immediate more radical operations. In 12 patients unsuspected cancer was diagnosed at paraffin section. This resulted in reoperation in 8 patients. Considering a number of arguments, we advocate a therapeutical guideline which makes a distinction between tumours which should be reoperated and tumours which are adequately treated by the initial resection.
Adenocarcinoma, Follicular↗
Selective rupture of the Wirsung duct: a rare form of pancreatic trauma.
A patient with a traumatic pancreatic lesion, confined to the Wirsung duct, is presented. At first laparotomy, the diagnosis was missed. Posttraumatic acute pancreatitis led to endoscopic pancreatography, disclosing the exact localization of the lesion. Left pancreatectomy led to rapid recovery. A late postoperative pancreatic fistula healed without problems.
Abdominal Injuries↗
Functional results after total gastrectomy with enteric pouch reconstruction. A review of 34 cases.
34 patients with gastric carcinoma, treated by total gastrectomy, had a reconstruction procedure, consisting of a pouch as proposed by Lygidakis or as a variant of the procedure: the beta-modification. In 31 patients a total gastrectomy was performed for histologically proven gastric adenocarcinoma. Two patients presented with a gastric lymphoma and one with a gastric leiomyosarcoma. Operative mortality was 8.8%. Two patients (5.8%) developed leakage of the oesophago-enteral anastomosis and subsequently died from sepsis, while a third patient died from a postoperative pneumonia. Early complications occurred in 4 patients and consisted of dysphagia, due to stenosis of the oesophago-enteric anastomosis. All 4 patients (12.9%) were treated with endoscopic dilatation and were cured of their dysphagia. One patient developed a late peptic ulcer at the pouch anastomosis and needed a reintervention. Nine patients died from extension of their primary disease within the first postoperative year. The 22 surviving patients are all without symptoms and regained their pre-illness weight. In conclusion, the proposed technique of pouch reconstruction has an acceptable operative mortality and morbidity comparable to or even better than in previously described methods. The long term functional results are better and more patients gain weight.
Adenocarcinoma↗