Biomedical subjects
S Watt-Boolsen
Publications and source records attributed to S Watt-Boolsen.
Influence of thyroid surgery on voice function and laryngeal symptoms.
A comprehensive examination of voice function and laryngeal symptoms was applied systematically to 20 patients undergoing thyroid surgery. Patients were excluded from the series if there had been previous neck surgery or if postoperative indirect laryngoscopy showed abnormal cord mobility. Examination before operation showed that patients with sporadic non-toxic goitre or medically pre-treated toxic goitre had impaired voice function based on stroboscopy, electro-glottography, phono-oscillometry and determination of voice range, phonation time, pitch, and peak flow. Three months after thyroid surgery the voice function was significantly improved although not normal in non-toxic goitre patients, whereas the voice function in patients with thyrotoxicosis was unchanged. The number of laryngeal symptoms was significantly reduced in non-toxic goitres following surgery and unaltered in the group with thyrotoxicosis.
The prophylaxis of septic complications in colo-rectal surgery. A controlled trial of metronidazole and oxytetracycline.
The prophylactic effect of systemic metronidazole on infectious complications following elective colo-rectal surgery was compared with the prophylactic effect of oxytetracycline. Allocation to receive metronidazole or oxytetracycline was random. A total of 137 patients were accepted for the trial, 67 receiving metronidazole and 70 oxytetracycline. The numbers of abdominal wound infections, intra-abdominal infections, fever and deaths were few in both groups, and the differences statistically insignificant. Clinically significant side effects of the antimicrobial agents were not observed. The influence of the antimicrobial agents on colonic flora was also studied. No significant difference in the effect on colonic anaerobic flora was demonstrated, whereas the aerobic flora was significantly suppressed by oxytetracycline. It is concluded that systemic metronidazole, although acting solely on the anaerobic flora, is as effective as oxytetracycline in preventing postoperative infectious complications following elective colo-rectal surgery. The prophylactic use of metronidazole is advocated.
Pancreatic response and plasma secretin concentration during infusion of low dose secretin in man.
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The clinical use of radiological examination of the maxillary sinuses.
Two hundred and eighty-six patients were exposed to puncture and irrigation of 468 maxillary sinuses after completion of radiological examination. The radiological interpretations were made by the same radiologist and related to the clinical rate of demonstrable antral fluid in fully and not fully developed sinuses. Radiologically normal sinuses contained fluid in patients over the age of twelve in 15.3% and when under that age in 39%. The radiological findings should not override one's clinical judgment, and the age of the patient should be considered when conclusions are to be drawn from the radiological findings.
Late voice function after surgical injury to the recurrent nerve.
In the period 1960 to 1970, a total of 213 patients underwent subtotal thyroidectomy for benign cervical toxic goitre. Postoperatively, immobile vocal cord indicating paralysis of the recurrent nerve was found in 17 patients. In 8 patients, immobility of the vocal cord was permanent. Seven of the 17 patients received voice training which was initiated within 3 weeks after operation. After a period of 5-10 years, on an average 8 years, the 17 patients had a clinical and a comprehensive objective examination of the voice function comprising stroboscopy, electroglottography, phono-oscillometry, voice range, phonation time, peak-flow and pitch. Only a few complaints were ciliated whereas the objective examination of the voice function revealed abnormal findings in all but one patient. The findings were less abnormal in patients who had received early voice training. It is concluded that despite abnormal objective findings, all 17 patients found their voice function satisfactory. Moreover, early voice training seemed to offer a fair chance of minimizing late voice problems, whether the paralysis was permanent or transitory.
Non-occlusive intestinal infarction.
In a retrospective study of all post-mortem examinations and all celiotomies carried out at Glostrup Hospital in the period 1959-76, 81 patients with non-mechanical intestinal infarction were identified. Of these patients, 23 had suffered non-occlusive intestinal infarction. In 15 of the 23 patients the infarction was associated with cardiac disease and its treatment, in 2 patients it was associated with septic and haemorrhagic shock, and in 4 patients with still other diseases. Two patients were completely healthy, when struck by intestinal infarction. The course was fatal in 20 patients. It is concluded that non-occlusive intestinal infarction occurs often enough to be taken into consideration, whenever non-mechanical intestinal infarction is suspected. The treatment should be directed towards the conditions causing intestinal ischaemia.
Long-term observation of thyroid function after surgical treatment of thyrotoxicosis.
During the 10-year period from 1960 to 1970 a total of 213 patients with diffuse or nodular toxic goitre underwent subtotal thyroidectomy. A short-term preoperative treatment with antithyroid drugs and iodine was given systematically. The observation period ranged from 5 to 15 years, average 9 years. A total of 203 patients (95%) were traced and followed up. The concentration of se-T4, se-T3, and se-TSH was measured and in selected cases a TRH test and BMR was carried out in addition. All thyroid specimens were re-examined by the same pathologist for histological grading. It was found that 85% of the patients had been rendered euthyroid for 5 years or more. The recorded incidence of thyroid hypofunction was 6% and the incidence of recurrent thyrotoxicosis was 9% of the series. Se-TSH was found to be elevated in 17%. The correlation between elevated se-TSH and se-T4 values was calculated and found to be fairly reasonable (r = -0.66). It is concluded that subtotal thyroidectomy preceded by short-term antithyroid drug therapy supplemented ultimately with iodine offers significant advantages in the management of thyrotoxicosis by rendering 85% of patients euthyroid on long-term surveillance.
Retroventrikular dystopia of the lienal flexure of the colon. Case report about a new clinical entity.
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Acute segmental gastro-intestinal gangrene probably of clostridial origin. Report of a case.
A 29-year-old female suffering from acute terminal ileitis was subjected to laparotomy undertaken on the tentative diagnosis of acute appendicitis. The appendix was found to be normal and was removed. The course was complicated with segmental gastro-intestinal gangrene with fatal outcome. The involvement of histotoxic clostridial infection as a causative factor is discussed.