Biomedical subjects

Y Kluger

Publications and source records attributed to Y Kluger.

134 records · Page 8Linked to original sources

PubMed1989

[Routine omentectomy during Tenckhoff catheter insertion for peritoneal dialysis].

Peritoneal dialysis is now one of the main methods of treating acute and chronic renal failure, and the number of patients treated by continuous ambulatory peritoneal dialysis (CAPD), instead of hemodialysis, is increasing. The most commonly used device for CAPD is the Tenkhoff catheter. The major complications after its insertion are infection and catheter obstruction. To reduce the incidence of obstruction and related complications, usually the result of omental occlusion of catheter ports, we performed routine omentectomy on insertion of the catheter. During 1984-1987 we inserted 56 Tenckhoff catheters for CAPD in 32 males and 20 females ranging in age from 2.5 to 83 years (mean 50.1 +/- 19.7). 32 suffered from end-stage renal disease and 20 from acute temporary renal failure. In 87% local anesthesia was used, and in the others general anesthesia. Omentectomy was performed in 81%. In only 8 patients (15%) omentectomy could not be performed, as the omentum was either too short or was adherent to the abdominal wall as a result of previous abdominal surgery. In an additional 2 patients the omentum was not resected, in 1 because of previous surgery for a perforated duodenal ulcer and in the other because the procedure was performed at the bedside. Peritonitis followed in 14 cases, but in 12 of them it completely resolved after administration of antibiotics. Over a follow-up period of 32 months there was only 1 case of catheter obstruction, significantly fewer than reported in other series. We conclude that routine omentectomy during insertion of the Tenckhoff catheter for CAPD under local anesthesia is safe and reduces the incidence of catheter obstruction during short and long term use.

Acute Kidney Injury↗

PubMed1989

[Torsion of the appendix in a child].

Torsion of the vermiform appendix is a rare condition that simulates acute appendicitis. An 8-year-old girl with symptoms suggestive of acute appendicitis is reported. At operation the appendix was found to be twisted 72 degrees and was resected.

Acute Disease↗

PubMed1989

[Repair of large abdominal wall defects with expanded polytetrafluoroethylene].

Most abdominal wall defects can be repaired by primary closure. However, when the defect is so large that there is tension on closure, use of prosthetic material is indicated. Expanded polytetrafluoroethylene has the advantages of low rates of infection, foreign body reaction and adhesion formation, making it the material of choice for repair of large abdominal wall defects.

Abdominal Muscles↗

PubMed1989

[Swallowed toothbrush: an indication for immediate endoscopy].

Foreign body ingestion is a common problem encountered in the emergency room. A swallowed toothbrush poses a special problem as it never passes through the GI tract spontaneously. Early endoscopy and removal is recommended. We report a 16-year-old girl who accidentally swallowed a toothbrush which was extracted via endoscopy without complications.

Adolescent↗

PubMed1989

Convulsions induced by aminocaproic acid infusion.

Aminocaproic acid is a widely used antifibrinolytic agent. Serious adverse effects associated with its use are rare, but we report on a patient with liver disease and cirrhosis who experienced a grand mal seizure during the intravenous administration of aminocaproic acid. Clinicians should be alert to the occurrence of this adverse effect in patients with no previous neurological problems.

Aminocaproates↗

PubMed1988

Traumatic intratumoral hemorrhage secondary to a ventriculoperitoneal shunt.

We report a case of a 14-month-old boy with a primary intraventricular oligodendroglioma and obstructive hydrocephalus. The child underwent a bilateral ventriculoperitoneal shunt and developed a massive and fatal intratumoral hemorrhage initiated by a mild trauma when introducing the left ventricular catheter. To our knowledge, this is the first report in the literature of such a complication during a shunting procedure for obstructive hydrocephalus of tumoral origin.

Cerebral Hemorrhage↗

PubMed1984

Rosetting index (E rosettes/mouse rosettes): a simple diagnostic and prognostic value in CLL.

The rosetting index (E rosettes/mouse rosettes) was evaluated in 34 controls, 4 chronic benign lymphocytosis and 28 CLL patients, grouped according to the Rai classification: 6 asymptomatic stage 0 patients (lymphocytosis less than 10,000/mm3) with a rosetting index of 0.35 +/- 0.2; 11 asymptomatic stage 1-2 patients (lymphocytosis 10,000-40,000/mm3) with a rosetting index of 0.19 +/- 0.11; 9 symptomatic stage 3-4 patients (lymphocytosis greater than 40,000/mm3) with a rosetting index of 0.09 +/- 0.09 and 2 T-CLL patients post splenectomy and 4 chronic benign lymphocytosis patients with a rosetting index of 25 +/- 15. The average rosetting index for the controls was 10.0 (range 3.5-54). Student's t test was p less than 0.0001 for groups 1, 2 and 3 and p less than 0.02 for group 4. These results show that the rosetting index is helpful for the characterization of B-CLL in all stages, the rosetting index decreases with the proliferative activity of the disease and could be used as a prognostic factor, and the rosetting index is significantly increased in T-CLL and chronic benign T lymphocytosis thus being useful in differentiating these conditions from the early stage of CLL, when the SmIg is not conclusive of a monoclonal proliferation.

Animals↗

PubMedDate not supplied

Hypothermic blood substitution enables resuscitation after hemorrhagic shock and 2 hours of cardiac arrest.

Uncontrollable hemorrhage accounts for a large proportion of total mortality in both civilian (31%) and military (47%) trauma victims. Hypothermia is a relatively safe method that could provide total body protection during hypovolemic shock and facilitate surgical intervention as a potentially life-saving procedure. This study tested the hypothesis that profound hypothermia and complete blood replacement in an established canine model, would facilitate resuscitative therapy from exsanguinating hypovolemic shock. Adult dogs were prepared for extracorporeal bypass using closed-chest peripheral cannulation under general anesthesia. Controlled hypotensive, hemorrhagic shock (mean arterial blood pressure < 50 mmHg) was induced for 30 min at normal temperature followed by temporary resuscitation using crystalloid infusion for approximately 10 min. Using our established procedure, the dogs were then cooled externally to 27 degrees C before initiating blood substitution with Hypothermosol (Cryomedical Sciences, Inc. Rockville, MD) via the extracorporeal pump. The heart was arrested during further cooling to below 10 degrees C and Hypothermosol was recirculated for 2 hr, with (3 dogs) or without (5 dogs) 1 hr of circulatory arrest. During rewarming the animals were autotransfused, weaned from the pump, and allowed to recover. All dogs (n = 8) survived, all but one with complete neurologic recovery: blood chemistry samples examined immediately after the procedure showed significant differences (p < 0.05) in only a few parameters, including creatine kinase (CK-BB and CK-MB), compared with the previous group of control dogs. The consistent survival of dogs showing apparently normal neurologic, physiologic, and biochemical recovery supports the concept that profound hypothermia using a protective hypothermic blood substitute could provide time for therapeutic resuscitation of currently intractable trauma cases.

Animals↗