Delayed onset of left-sided diaphragmatic hernia in a newborn.

Congenital diaphragmatic hernia usually causes severe respiratory distress presenting in the first hours of life. There is, however, a group of patients who may be asymptomatic during the perinatal period, but manifest the abnormality after days, weeks and even years. We report a delayed onset of left-sided diaphragmatic hernia in a three weeks old newborn with a favourable prognosis.

[Wound infection following arterial surgery in the pelvis-leg region]. / Die Wundinfektion nach Arterienoperationen im Becken-Bein-Bereich

In a series of 581 reconstructions of the aorta to the leg arteries, 28 cases (4.8%) developed wound infection with positive microbiological identification. There were 24 monoinfections with significant prevalence of Staphylococcus aureus and S. epidermis. Thirteen patients with prosthetic implants and one patient with autologous saphenous vein bypass showed graft infection, which occurred in 13 patients as a complication of reoperation for bleeding or graft occlusion in the early postoperative period. The incidence of vascular infection in patients without reoperation was 0.4%. The risk of wound infection could not be lowered by the use of prophylactic broad spectrum antibiotics. Five (33%) patients with graft infection died because of sepsis and/or rupture of anastomosis. In the group of 9 survivors there were 3 patients with excision of the graft and limb preservation without reconstruction, and 3 patients with partial or total excision of the graft and successful simultaneous axillofemoral or obturator bypass. From this study it is assumed that improvement of indication and operative technique in reconstructive procedures is more promising in preventing wound infection than the extended administration of prophylactic antibiotic drugs. In case of vascular infection the excision of the graft is very urgent and consequent "extraanatomic" reconstruction can prevent loss of limb and life.

[Study of turbulence in the normal and stenotic vessel]. / Untersuchungen zur Turbulenz im normalen und stenotischen Gefäss.

Velocity measurements were performed at the test bench, in dogs and in patients with pulsed ultrasound. A new zero crossing counter was used to measure the different frequencies of the doppler spectrum in real time. The ratio of the standard deviation of the radial mean velocity to the radial mean velocity expressed as a percentage proved to be a useful turbulence index to describe stability of flow.