[Present role of urethrocystography in the diagnosis of female stress incontinence]. / Stellenwert der Urethrozystographie bei der Diagnostik der weiblichen Stressharninkontinez heute.

Urethrocystography was performed in 72 women with stress urinary incontinence (SUI). The radiological findings were compared with the clinical diagnosis. 8 Patients with a normal radiological study had SUI grade I by clinical criteria. Explanations of this discrepancy are discussed. In 4 cases the interpretation interfered with a large cystocele. In 60 patients (83.5%) the radiological study confirmed the clinical diagnosis and supported the gynaecologist in the indication for operation on SUI. However this indication cannot be based on the radiological study by itself; it must in fact take into account all the other aspects of the disease.

[Indications for reconstructing injured veins in associated arterial lesions (author's transl)]. / Indikation zur Rekonstruktion verletzter Venen bei gleichzeitigen arteriellen Läsionen

The authors have organized therapeutic measures in simultaneous bullet injuries to the arteries and the veins of the extremities on the basis of experience attained in 26 cases. 1. Simultaneous reconstruction of an injured artery and its satellite vein must be aimed at in all instances; 2. even the smallest injuries to the arterial intima favour acute arterial thrombosis, if the satellite vein has been tied up simultaneously; 3. acute arterial occlusion is not caused by the isolated ligature of the vein but by the deep, extended venous thrombosis building up on it; 4. where a main vein is ligated, anticoagulant therapy must be initiated immediately to prevent deep venous thrombosis; 5. simultaneous reconstruction of both the arterial and the venous flow systems must be maintained by postoperative anticoagulant therapy. The paper goes into details of thrombectomy, the technical details of vein reconstruction, the question of whether the establishment of a temporary arteriovenous anastomosis is indispensable,, and injuries to veins associated with fractures and dislocations.

Closing base wedge osteotomy: an evaluation of twenty-four cases.

A review of 24 closing base wedge osteotomies was performed. Data were collected on preoperative and short and long term postoperative x-rays to evaluate parameters that are changed postsurgically. Information was also collected by questioning and examining the patients during a long term follow-up. Shortening of the first metatarsal, dorsiflexion of the first metatarsal, as well as proximal articular set angles and other biomechanical aspects are discussed. Conclusions are presented as they pertain to these case studies.

Total first joint replacement in hallux valgus and hallux rigidus. Long-term results in 484 cases.

Long-term results of 484 cases of Silastic total first joint replacement are presented. The history, discussion of other total first implants, and a descriptive surgical technique with a discussion of complications are also presented. The authors propose a new, universal grading system for assessment of results following bunion surgery.

The tilt-up osteotomy for correction of intractable plantar keratoses.

The purpose of this paper is to describe and follow-up a new surgical technique used for the correction of intractable plantar keratoses. Twenty-five osteotomies were studied from 8 to 20 months postoperatively. The results showed a 60% success rate, but a patient satisfaction rate of 92%. The tilt-up osteotomy is a promising new procedure for the correction of intractable plantar keratoses.

[Hydatid disease of liver and its complications (author's transl)]. / Die Leberechinokokkose und ihre Komplikationen

This is a report on 121 cases of hydatid disease of liver. The alteration of the false cyst, explaining the most common complications of the disease, is discussed. Complications were present in 61 (50.41%) of our 121 patients: calcification in 13.22%, infection in 10.74%, perforation in bile ducts in 9.91%, thorax in 5.78% and abdominal cavity in 10.74% of our cases. Diagnostic importances of clinical findings, immunoelectrophoretic studies and radioisotopic liverscanning is emphasized. In 28 cases the complete excision of cysts were carried out, in 110 cases only removal of the hydatid membrane was performed. Other therapeutic methods are discussed. Of 108 treated patients 7 died postoperatively: they were all over 70 years old.

Paraplejia: manifestacion clinica de la rotura traumatica de la aorta toracica. / Paraplegia: clinical manifestation of traumatic rupture of thoracic aorta

La rotura traumatica de la aorta toracica constituye una grave complicacion del traumatismo cerrado de torax causando la muerte inmediata en 80% de los casos.La lesion producto de interrelacion de multiples fuerzas asienta el 50% de los casos en el istmo aortico. Su diagnostico clinico es presuntivo confirmandose por la aortogragia. Su tratamiento que constituye siempre una emergencia debe realizarse con metodos que protejan los organos distales a la seccion de la isquemia resultante del clampeo y tiende a restablecer la continuidad aortica mediante un injerto protesico. Ilustramos en la presente comunicacion un caso de esta grave afeccion caracterizada por una forma de presentacion rara: la paraplejia

Analisis de 43 hepatectomias. / Analysis of 43 hepatectomies

Se analizan 43 resecciones hepaticas en relacion a su patologia y oportunidad operatoria, concluyendose que las hepatectomias por trauma deben diferirse hasta que el enfermo este estabilizado y que las hepactectomias en pacientes septicos se deben evitar en vista de la alta morbimortalidad que las acompana

El clampeo supradiafragmatico en los aneurismas de aorta abdominales rotos. / Supradiaphragmatic clamping of ruptured abdominal aorta aneurysms

Los autores preconizan el clampeo aortico supradiafragmatico por toracotomia anterolateral izquierda a nivel del 7o. y 8o. intercostal en los aneurismas de aorta abdominal rotos, para poder controlar la hemorragia y el consiguiente colapso con muerte subita en el momento del abordaje abdominal. Relatan un caso que fuera operado 44 dias antes por una hemorragia digestiva por ulcus duodenal, habiendo sido comprobado en esa oportunidad un aneurisma de aorta subrenal y habiendo sido inclusive planteada como causa de esa hemorragia una complicacion del aneurisma confirmandose la no participacion del mismo en el accidente rojo, los autores plantean el tratamiento simultaneo de ambos patologias. Por ultimo preconizan la via de abordaje transversa bitransrectal extendida hacia ambos lados sobre los musculos anchos del abdomen supra o infraumbilical, a ras del ombligo, con lo que se logra un buen dominio de la aorta infrarenal

Isquenia intestinal en la cirugia re / Intestinal ischemia in the repairing surgery of the abdominal aorta

La isquemia intestinal es una complicacion grave de la cirugia reconstructiva de la aorta abdominal, que involucra generalmente el colon izquierdo, mas raramente el intestino delgado o ambos simultaneamente. Es mas frecuente como complicacion de la aneurismectomia. La incidencia de esta complicacion se ve del 0.2 al 10% de los casos. Los autores lal observaron 7 veces en 216 intervenciones de reconstruccion aortica (3.24%). La mortalidad global de la colitis isquemica es del 40%, cuando la isquemia es transmural la mortalidad del 90%. De los 7 casos a los que hacen referencia los autores 5 fallecieron (71,42%). Los autores discuten los distintos factores que pueden condicionar la instalacion de una isquemia intestinal. Se discute la prevencion de esta complicacion por medidas que deben ser tomadas en el pre e intraoperatorio. Se destacan los elementos clinicos que permitem realizar el diagnostico de isquemia constituida, asi como las medidas paraclinicas que la certificaram.