Annales chirurgiae et gynaecologiae. Supplementum
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Ann Chir Gynaecol Suppl · Jan 2000
ReviewHyperbaric oxygen therapy in acute necrotizing infections with a special reference to the effects on tissue gas tensions.
Clostridial gas gangrene and perineal necrotizing fasciitis or Fournier's gangrene are rare but serious infections with an acute onset, rapid progression, systemic toxemia and a high mortality rate. The aim of this study was to investigate the efficacy of surgery, antibiotic treatment, surgical intensive care and in particular the role of hyperbaric oxygen (HBO) in the management of these infections. An experimental rat model was used to investigate the possibilities for measuring tissue oxygen and carbon dioxide tensions during hyperbaric oxygen treatment. ⋯ When examining the subcutaneous PO2 levels measured from patients with necrotizing fasciitis, the PO2 was regularly higher in the vicinity of the infected area than in healthy tissue. In general, HBO treatment resulted in a marked increase in tissue oxygenation in both healthy tissue and in the vicinity of infected tissue. The hyper-oxygenated tissue zone surrounding the infected area may be of significance in preventing the extension of invading microorganisms.
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Ann Chir Gynaecol Suppl · Jan 1996
The effect of tumor necrosis factor-alpha on wound healing. An experimental study.
The inflammatory phase in wound healing is considered to be a preparatory process for the formation of new tissue. A monocyte-derived cytokine, tumor necrosis factor-alpha (TNF-alpha), is a highly conserved molecule known to play a major role in the pathogenesis of gram-negative shock. Besides this, previous experimental studies show that TNF-alpha may have either a beneficial or detrimental role in wound healing. ⋯ Indomethacin alone stimulated collagen production by 40%. In vivo IL-1 decreases the formation of normal granulation tissue. This effect may be partly due to IL-1 stimulated secretion of PGE2.
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Ann Chir Gynaecol Suppl · Jan 1994
Review Comparative StudyMicroinvasive lumbar disc surgery. A study on patients treated with microdiscectomy or percutaneous nucleotomy for disc herniation.
During the last two decades, new microinvasive techniques have been introduced into the treatment of lumbar disc herniation. The potential benefits of microinvasive disc surgery are the reduced surgical trauma to the tissue, increased safety due to good visualization of the operation field under the microscope and, consequently, reduced postoperative morbidity and shorter hospitalization in comparison to conventional surgery. In this study, we evaluated the use of microdiscectomy and percutaneous nucleotomy in the treatment of patients with lumbar disc herniation. ⋯ During follow-up for 6 months, the mass effect resolved completely in 10 of these patients but in 15 patients, MRI subsequently revealed either a disc prolapse or a protrusion. In addition, a protrusion was detected in 7 patients with no postoperative mass effect. There was, however, no association between these MRI findings and the clinical outcome of the patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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Ann Chir Gynaecol Suppl · Jan 1987
Interventional ultrasound in diagnosis and treatment of ovarian cysts.
In 46 patients, age 17-46 years, 48 simple ovarian cysts with the median diameter of 4-14 cm were punctured using ultrasonic quidance. The aspirate of cysts was examined cytologically. The punctured cysts were observed by ultrasonic examinations performed one month and three months after the punctures. ⋯ Out of 46 patients of the study, 14 (30%) had to be operated, while 32 (70%) did avoid from laparotomy due to the puncture. In cytological examinations no malignant cells were established. Besides one haematoma, no complications appeared.
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HELLP syndrome is a triad of hemolysis, elevated liver enzymes and low platelet count during pregnancy and it is proposed to be a sign of severe preeclampsia. We present two mothers with this life-threatening condition. In the first case, the syndrome appeared after a twin delivery at 34 weeks of pregnancy. ⋯ Both she and the infants survived. In the second case, the mother had all classic signs of severe preeclampsia at the 27 week of pregnancy. After 3 days' intensive care, a cesarean section was performed and both the mother and the child survived.