[Postoperative course and tactics of aftercare in hyperthyroidism]. / Postoperativer Verlauf und Taktik der Nachsorge der Hyperthyreose.

In a follow-up study of 112 patients who had subtotal thyroidectomy because of Graves' disease and nodular goitre with hyperthyroidism, 81% were euthyroid, 10,7% developed hypothyroidism and 8% had persistent or recurrent hyperthyroidism. 12,5% of the euthyroid patients had goitre; 10 of these patients had cold thyroid nodules. The assessment of the dignity of the cold nodules and guidelines for the therapeutic procedure are stressed. The importance of considering clinical findings on one hand and thyroid function tests on the other hand in the choice of effective treatment - prophylaxis against euthyroid goitre, substitution with hormones, iodine-131 therapy, antithyroid drugs or reoperation - is outlined.

[Roentgen morphology after vagotomy]. / Röntgenmorphologie nach Vagotomie.

Vagotomy is often followed by changes in the shape and motoric function of the stomach which usually return to normal in the course of a few months. The morphological changes which are typical for the different surgical techniques are described on the basis of references and the authors' own findings. X-ray examination contributes towards distinguishing regular postoperative changes from complications. The necessary long-term follow-ups to discover any possible recurrence of ulcers should be supplemented by gastroscopy.

[Arteriovenous fistula of the A. vertebralis after catheterization of V. jugularis interna (author's transl)]. / Arteriovenöse Fistel der Vertebralisgefässe nach Katheterisierung der Vena jugularis interna.

The article reports on an arteriovenous fistula between the a. vertebralis and the v. vertebralis with blood flowing off via the v. vertebralis, v. cervicalis profunda and v. brachiocephalica. The fistula occurred after application of a central venous catheter to the v. jugularis interna.

[Mediastinal emphysema after thoracotomy (author's transl)]. / Mediastinalemphysem nach Thorakotomie.

A mediastinal emphysema was seen via x-ray film in 35 of 40 patients after opening of the mediastinum by longitudinal sternotomy. After about a week it was found in approximately every second patient; after 14 days it had been fully absorbed by all patients. Mediastinal emphysema could occur in conjunction with a cutaneous emphysema, and pneumothorax, respectively. Occasionally a pneumopericardium is seen even in the recumbent patient. Safe diagnosis of mediastinal emphysema is possible in the anterior lower mediastinum projected on to the cardiac silhouette if the x-ray film is taken obliquely.

[Posttraumatic osteolysis of the distal clavicula end (author's transl)]. / Posttraumatische Osteolyse des distalen Klavikulaendes.

Posttraumatic osteolysis of bone is rare. Its etiology is unknown. A case of posttraumatic osteolysis of the distal clavicle end is reported. Differentialdiagnostical and ethiological relations are discussed. The literature of posttraumatic osteolysis especially of distal clavicle osteolysis is reported.

[Preoperative clinical, radiological and nuclear medical diagnostic and intra-operative findings in frontobasal cerebrospinal fluid fistula (author's transl)]. / Präoperative klinische, radiologische und nuklear-medizinische Diagnostik und intraoperativer Befund bei frontobasaler Liquorfistel.

In 71 patients with rhinosurgical closed fronto-basal cerebrospinal fluid fistula the pre- and intra-operative findings are compared. Cerebrospinal fluid rhinorrhea in 80% and purulent meningitis in 44% were seen. In X-ray 52% fractures and 32% cloudiness of the paranasal sinuses were found, there were 21% false negative results. By nuclear medical examination the cerebrospinal fluid leak was identified in 59%, the result was false negative in 15%. The site of the cerebrospinal fluid fistulas could be preoperative determinated by clinical signs in 96%, by X-ray in 22%, and by scintigraphy in 44%.

[The diagnosis of liver metastases. A comparison of sonography, scintigraphy and biochemical findings (author's transl)]. / Diagnostik von Lebermetastasen. Vergleichende Untersuchung zum Stellenwert von Sonographie, Szintigraphie und Laborparametern.

The value of biochemical methods, scintigraphy and sonography in the diagnosis of liver metastases was compared in 150 patients. Of the laboratory methods, gamma-GT proved the most suitable screening method. A negative scan was of considerable value in excluding liver metastases. Positive findings are not always definite and require confirmation. Ultrasound, because of its high accuracy, is the most valuable method for excluding or demonstrating liver metastases. Suggestions for diagnostic procedures are made as a result of these findings.

[Electron microscopic observations on the effect of laser beams on the retina of the rabbit (author's transl)]. / Elektronenmikroskopische Beobachtungen über die Einwirkung von Laserstrahlen auf die Netzhaut des Kaninchens.

After laser irradations, retinas of 13 rabbits were examined by electron microscope. The laser focus was set between 30 min and 140 h or 6 weeks in advance. The anatomical separation between the retina and the connective tissue of the choriocapillary in all the lesions is preserved by an intact Bruch's membrane. Destruction of the pigment epithelium, rod layer, and outer granular layer occurs in the early stages after coagulation. Later the nuclei of the rods show various stages of degeneration with simultaneous increases in the volume of the Müller's cells. The cytoplasma of the Müller's cells penetrates the nuclei of the sensory cells undergoing degeneration. Proliferation of the pigment epithelium begins after about 20 h. The first appearance of macrophages in the retina is visible after 30 h. Between 92 and 140 h in the area of the pigment epithelium, variously differentiated cells, which partly contain pigment granules and lamellary inclusion bodies, form. Some cells or cell groups which are visible might represent histiocytes within the Bruch's membrane 35, 45, 68, and 92 h as well as 6 weeks after coagulation. They partly cross the outer layer of the Bruch's membrane and neighboring connective tissue of the choroid. According to our studies, pigment epithelial cells, choroidal histiocytes, and Müller's cells participate in the phagocytosis.