[Post-operative lumbar myelogram. Morphology and indications for repeat examinations in patients with disc prolapse (author's transl)]. / Das postoperative lumbale Myelogramm. Morphologie und Stellenwert bei der Rezidivdiagnostik des Bandscheibenvorfalls.

The morphology and indications for performing post-operative contrast examinations have been analysed in 131 myelograms. Leptomeningeal reactions and adhesions were found in varying degrees of severity in 34 to 75% of post-operative cases; it proved difficult to correlate this finding with the neurological features. The value of repeat myelograms is much reduced after surgery or after previous contrast examinations. It is probable that this is due in part to tissue changes resulting from the surgery or from a proliferative reaction induced by the contrast medium.

[Late meningeal changes after dimer-X-myelography in the absence of surgery (author's transl)]. / Leptomeningeale Spätveränderungen nach Dimer-X-Myelographie ohne operativen Eingriff.

Myelography with Amipaque was carried out in a group of 28 patients who had had previous Dimer-X-myelography, but no surgery. In 12 cases there was radiological evidence of a meningeal reaction. In all these cases there were chronic changes in the lumbar subarachnoid space. The original myelograms showed no evidence of adhesive changes in the root pouches. It was not possible to correlate the radiological findings of the meningeal changes with the severity or type of neurological diseases.

[Complex neurological investigations of space-occupying lesions in the spinal canal (author's transl)]. / Ergebnisse der komplexen neuroradiologischen Diagnostik raumeinengender Prozesse des Spinalkanals.

Problems of early diagnosis of space-occupying intraspinal lesions are discussed in relation to 335 patients on whom surgery had been carried out. Advances in neuroradiological methods are considered. The development of new contrast media has resulted in a reduction of the risk of invasive procedures and this should lead to diagnosis of space-occupying spinal lesions at a very early stage. It is now possible to diagnosis small tumours before they cause compression of the cord or of nerve roots.

[Observations in postoperative ileus]. / Beobachtungen beim postoperativen Ileus.

In the last ten years it was necessary to perform a relaparotomy in 615 cases = 4.93% of 12,464 primary abdominal operations. 215 patients suffered from a mechanical ileus. In analysing 305 cases of the last 5 years it was to discover that of 138 patients the diagnosis mechanical ileus was correct in 102 cases only. In doubtful cases it is therefore advisable to use a water-soluble contrast medium in order to decide for or against surgery. Last but not least the frequency of relaparotomies is clearly dependent on the abilities of the surgeon. In proving this question there were surgeons with 1.2% relaparotomies and others with 18.1%.

[Problems concerning head and brain injuries (author's transl)]. / Probleme der Schädel-Hirn-Verletzungen.

Treatment of patients with head and brain injuries is highly dependent on qualified initial care, diagnostic and therapeutic activities inside the clinic, the after treatment outside the hospital and rehabilitation. Every patient of this kind has to be observed for at least two days in a hospital. Before discharge the diagnosis has to be defined. The author proposes a new classification: slight, middle, severe and highly-severe brain injury.

Nerve suture without tension, a method for repairing transected peripheral nerves.

An analysis of primary epineural end to end sutures of transsected peripheral nerves, operated upon before 1970, showed good motor and sensory function in only 60%. With the new perineural suturing technique without tension and if necessary by using autologous nerves for bridging large nerve defects the good results raised to 87%.

[New trends in treating fractures and dislocations of the cervical spine (author's transl)]. / Beobachtungen über Wandlungen in der Therapie von Frakturen und Luxationen der Halswirbelsäule.

Critical analysis of 50 patients suffering from fractures and dislocations of the cervical vertebral column proved that in most cases conservative as well as surgical treatment have satisfactory results. As long as no contraindications exist priority is given more to surgical procedures today.

[Has the classic chordotomy a future? (author's transl)]. / Hat die offene antero-laterale Chordotomie zur Schmerzausschaltung heute noch ihre Bedeutung?

Evaluating our results of anterior-lateral chordotomy in 88 patients suffering from intractable pain, we can state that this is a useful surgical procedure. Today however it has to be replaced by the so-called percutaneous cervical chordotomy.

[Do the results of reduction-plasties of the breast justify indications for operation?]. / Rechtfertigen die Ergebnisse von Reduktionsplastiken der Mamma die Indikation zur Operation?

From 1961-1985 we have made by cause of hyperplasia 226 mammaplasties. By continuous follow-up examinations we found out that more than 90% of our patients were quite satisfied with the result and its remarkable that in some cases the women were more happy than the doctor. At all times we have seen a medical indication in order to do a mammaplasty. But before such an operation it seems necessary to analyse the structure of personality. For sake of the surgeon and the surgical method psychopathic personalities should be refused.

[Considerations on the etiology of pancreatitis]. / Einige Gedanken zur Atiologie der Pankreatitis.

Among numerous factors which induce or exacerbate pancreatitis infection of the biliary-tract--with or without lithiasis--is important. In suitable cases intervallic restoration of this tract is the best way to avoid recidivation. From a total of 624 patients in our department with cholepancreatitis in 225 cases this therapy was performed. After a recidivation of pancreatitis which required hospitalisation within at least 3 years was to be seen in 4.7%.

[Haemorrhage from the upper gastro-intestinal tract; rare causes (author's transl)]. / Beobachtungen bei seltenen Blutungen aus dem oberen Magen-Darm-Trakt.

839 patients with acute haemorrhage from the upper gastro-intestinal tract were treated in the last 14 years. In 72 cases the cause of bleeding was extremely rare. To find the correct diagnosis in acute situations the best is, to do emergency fiberoptic gastroscopy and in some special cases selective angiography. Without clear diagnosis the mortality rate in such cases will be too high.

[Reversible mental disturbances in craniocerebral injuries (author's transl)]. / Reversible psychische Störungen nach Schädel-Hirn-Verletzungen.

The necessity of an exact documentation of mental disorders after cranio-cerebral injuries in their temporal development is stressed. There is a quantitative relation between functional psychosis and the underlying cerebral process. Close observation of the course enables the surgeon to diagnose intracerebral complications early.

[Relation of various important figurs in the oncology of gastrointestinal carcinomas to age]. / Die Beziehungen einiger wichtiger Kennziffern in der Onkologie der Magen-Darm-Karzinome zum Lebensalter

The most important localisations of cancer, because they are most frequent, within the gastrointestinal tract are situated at the stomach, colon and rectum. By reason of frequency of these tumours in the upper years of age their distribution in dependence from age the manner of therapy performed within the groups of age are important. These numerals were found out in the Erfurt Region of men fallen ill in 1960-1969. They are explained in relation to age. There is the opinion it shall be possible to improve ascertainment and results of therapy by scooping all means in the upper years of age too.

[Value of Dimer-X myelography in the diagnosis of lumbar intravertebral disk lesions]. / Zum Wert der Dimer-X-Myelographie bei der Diagnostik von lumbalen Bandscheibenschäden.

On the basis of 500 myelogramms carried out with hexaiodated, water soluble, and rapidly absorbable Dimer X, the experiences gained in the diagnoses of damages of the lumbar intervertebral disks are presented. It can be stated that Dimer-X myelography has proved to be very useful for the recognition of space-narrowing processes in the lumbar region. No serious complications were observed. Most of the troubles, including, for example, transitory headache and the like, correspond to those sometimes found after simple lumbar punctures.

[Elektrolyte-losing rectum adenoma (author's transl)]. / Das elektrolytverlierende Rektumadenom.

The clinical picture of electrolyte-losing villous tumours localized in the rectum or colon is represented by own observations and the literature. Diagnostic errors arising from disturbances of water and electrolyte balance are emphasized. In order to find out the optimal therapy, classification of the tumour according to clinical criteria is recommended.

[Unrecognized perforations of gastric und duodenal ulcers after surgery (author's transl)]. / Uber unerkannte Perforationen von Magen- und Dudenalulzera nach operativen Eingriffen.

After operative procedures of greater extent stress ulceration in the stomach or duodenum can arise, sometimes perforating the wall. Unfortunately, such perforations are not diagnosed in time. In a postoperative breakdown of the circulation, which otherwise cannot be explained, stress ulceration and perforation should be taken into consideration.

[Treatment of occlusive hydrocephalus with Torkilksen's drainage]. / Unsere Erfahrungen bei der Behandlung des Okklusivhydrozephalus mit der Torkildsen-Drainage

Seventy-three Torkildsen drainages are reported, of which 61 and 12 were performed on tumor patients and in the case of benign aqueduct occlusions due to congenital malformations or chronic inflammations, respectively. The results are quite satisfactory providing due consideration is given to both the basic ailment and the preoperative condition. The Torkildsen drain has proven extremely useful in the therapy of selected cases of occlusive hydrocephalus.

[Paralysis of the accessory nerve following operations in the lateral triangle of the neck]. / Haftpflichtbegutachtung bei Akzessoriusparesen nach Lymphknotenexstirpation im seitlichen Halsdreieck

In the last 3 years we had to express our opinion on 11 cases which after operations in the neck resulted in a paralysis of the N. accessorius. In 8 cases we had to state a fault of the operating surgeon. More exactness is apparently required in the operations.

[Comparison between the diagnostic findings of esophago-gastro-bulboscopy and standard radiographic diagnosis]. / Zum Vergleich der diagnostischen Aussage von Osophago-Gastro-Bulboskopie und Standard-Röntgendiagnostik.

On the basis of a computer-supported evaluation of the data of 1,808 patients who underwent endoscopy (endoscopy of the superior alimentary tract) the comparison of X-ray-findings and findings of the endoscopy could be made in 887 patients. For 124 patients with an oesophageal and gastric tumour, respectively, and for 146 patients with a gastroduodenal ulcer a control of the findings by superordinate parameters (findings of operations and post-mortem examinations) are present. The result was an accordance between 90 and 98%. The accordance of the evidence of the two methods varies depending on the group of diagnosis. For the oesophageal carcinoma it is 90%, for the gastric carcinoma ca. 77%, for the ventricular ulcer and the duodenal ulcer in every case 70%, while the X-ray diagnosis "no abnormality discovered" could be endoscopically confirmed only in 56%. From this result necessary conclusions concerning the further concept of the diagnosis of diseases of the superior alimentary tract.