Acta chirurgica Scandinavica
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Randomized Controlled Trial Clinical Trial
Diarrhoea following jejuno-ileostomy for morbid obesity. A randomised trial of loperamide and diphenoxylate.
The effect of loperamide and diphenoxylate on diarrhoea following jejuno-ileostomy for morbid obesity was investigated in 27 patients by means of a randomized fixed sample size, three-period cross-over trial. Both loperamide and diphenoxylate had significant effect on the diarrhoeas when compared with no treatment, but no significant difference was found between the two drugs. Loperamide is an acceptable alternative in the treatment of diarrhoea following jejuno-ileostomy.
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Renal cortical and medullary tissue oxygen tension, systemic oxygen supply as well as central and renal hemodynamics were investigated in dogs during graded hemorrhage and subsequent reinfusion of shed blood. The measurements of tissue gas tension were carried out by means of implanted Silastic tubes. The baseline renal cortical PO2 was 35 mmHg and the corresponding medullary PO2 25 mmHg. ⋯ Arterial blood PO2 was normal throughout the study. Renal venous PO2 fell during the deepest shock but consistently exceeded the corresponding tissue PO2 levels. It is concluded that hemorrhagic hypotension impaired tissue oxygenation of both cortex and medulla, the effect being greatest in the cortex.
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Obstruction of appendix vermiformis causing acute appendicitis. An experimental study in the rabbit.
In an experimental model using the rabbit, the role of obstruction in the pathogenesis of acute appendicitis was studied. Twenty-one animals were anaesthesized and underwent laparotomy. The appendices were obstructed by a balloon catheter introduced via a caecostomy. ⋯ In a total of 15 rabbits, experimental obstruction of the appendix resulted in inflammatory changes in the wall of the appendix, which histologically in all respects were similar to appendicitis in man. In the remaining 6 rabbits, either spontaneous release of obstruction or death early during the experiment occurred. Our experimental data suggest that obstruction is an important agent in the causation of acute appendicitis.
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Extradural haematomas (EH) do not always present with the classical picture of skull trauma followed by a lucid interval, deepening coma, unilateral enlarging pupil and hemiplegia. Symptoms and signs can be puzzling and complex in many cases of EH and may thus lead to dangerous therapeutic delay. ⋯ In this study the variables which from clinical experience seemed to be of main prognostic importance were related to the outcome in 44 patients with EH. A surgical decision-making table was compiled from these relationships in order to facilitate the decision process related to the diagnosis and therapy of EH.