RESUMO
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.
Assuntos
Deslocamento do Disco Intervertebral/diagnóstico por imagem , Mielografia/métodos , Complicações Pós-Operatórias/diagnóstico por imagem , Adulto , Feminino , Humanos , Deslocamento do Disco Intervertebral/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva , Aderências TeciduaisRESUMO
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.
Assuntos
Ácido Iotalâmico/análogos & derivados , Meglumina/efeitos adversos , Meninges/efeitos dos fármacos , Mielografia/efeitos adversos , Sorbitol/análogos & derivados , Adulto , Feminino , Humanos , Ácido Iotalâmico/efeitos adversos , Masculino , Pessoa de Meia-Idade , Espaço Subaracnóideo , Aderências TeciduaisRESUMO
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.
Assuntos
Neoplasias da Medula Espinal/diagnóstico por imagem , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Mielite Transversa/diagnóstico por imagem , Mielografia , Compressão da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/secundárioRESUMO
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%.
Assuntos
Abdome/cirurgia , Obstrução Intestinal/cirurgia , Seguimentos , Motilidade Gastrointestinal , Humanos , Complicações Pós-Operatórias/cirurgia , ReoperaçãoRESUMO
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.
Assuntos
Traumatismos Craniocerebrais , Concussão Encefálica/diagnóstico , Traumatismos Craniocerebrais/classificação , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/terapia , Feminino , Alemanha Oriental , Hematoma Epidural Craniano/diagnóstico por imagem , Hematoma Epidural Craniano/cirurgia , Humanos , Masculino , Planejamento de Assistência ao Paciente , RadiografiaRESUMO
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%.
Assuntos
Nervos Periféricos/cirurgia , Técnicas de Sutura , Humanos , Traumatismos dos Nervos Periféricos , Nervo Sural/transplante , Transplante AutólogoRESUMO
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.
Assuntos
Vértebras Cervicais/lesões , Fraturas Ósseas/cirurgia , Luxações Articulares/cirurgia , Humanos , Laminectomia , Complicações Pós-Operatórias/etiologia , Prognóstico , Quadriplegia/cirurgia , Fusão VertebralRESUMO
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.
Assuntos
Dor Intratável/cirurgia , Medula Espinal/cirurgia , Humanos , Complicações Pós-Operatórias/etiologia , Prognóstico , Tratos Espinotalâmicos/cirurgiaRESUMO
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.
Assuntos
Mama/cirurgia , Mama/patologia , Feminino , Seguimentos , Humanos , Hipertrofia , Cirurgia PlásticaRESUMO
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%.
Assuntos
Doenças Biliares/complicações , Pancreatite/etiologia , Consumo de Bebidas Alcoólicas , Ampola Hepatopancreática/patologia , Colestase/complicações , Hepatite/complicações , Humanos , Estudos RetrospectivosRESUMO
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.
Assuntos
Hemorragia Gastrointestinal/etiologia , Doença Aguda , Aneurisma/complicações , Angiografia , Divertículo Esofágico/complicações , Tecnologia de Fibra Óptica , Hemorragia Gastrointestinal/diagnóstico , Gastroscopia/métodos , Humanos , Neoplasias Intestinais/complicações , Jejuno , Leiomioma/complicações , Estômago/irrigação sanguíneaRESUMO
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.
Assuntos
Traumatismos Craniocerebrais/complicações , Transtornos Neurocognitivos/etiologia , Adulto , Coma/etiologia , Humanos , Exame Neurológico , Prognóstico , Inconsciência/diagnóstico , Inconsciência/etiologiaRESUMO
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.
Assuntos
Carcinoma/epidemiologia , Neoplasias Gastrointestinais/epidemiologia , Adulto , Fatores Etários , Idoso , Carcinoma/cirurgia , Neoplasias do Colo/epidemiologia , Neoplasias Gastrointestinais/cirurgia , Alemanha Oriental , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Neoplasias Retais/epidemiologia , Neoplasias Gástricas/epidemiologiaRESUMO
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.
Assuntos
Deslocamento do Disco Intervertebral/diagnóstico por imagem , Iotalamato de Meglumina , Vértebras Lombares/diagnóstico por imagem , Mielografia/métodos , Humanos , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgiaRESUMO
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.
Assuntos
Adenoma , Neoplasias Retais , Adenoma/diagnóstico , Adenoma/patologia , Adenoma/cirurgia , Idoso , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/diagnóstico , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Desequilíbrio HidroeletrolíticoRESUMO
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.
Assuntos
Úlcera Duodenal/complicações , Úlcera Péptica Perfurada , Úlcera Gástrica/complicações , Adolescente , Adulto , Idoso , Apendicectomia , Colecistectomia , Úlcera Duodenal/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuroma/cirurgia , Peritonite/etiologia , Complicações Pós-Operatórias , Úlcera Gástrica/etiologia , Estresse Fisiológico/complicações , Doenças do Nervo Vestibulococlear/cirurgiaRESUMO
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.
Assuntos
Derivações do Líquido Cefalorraquidiano/métodos , Hidrocefalia/cirurgia , Neoplasias Encefálicas/complicações , Aqueduto do Mesencéfalo/anormalidades , Humanos , Hidrocefalia/etiologiaRESUMO
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.
Assuntos
Nervo Acessório , Excisão de Linfonodo/efeitos adversos , Imperícia , Pescoço/cirurgia , Paralisia/etiologia , Adolescente , Adulto , Prova Pericial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-OperatóriasRESUMO
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.