[The spinal emergency. Urgent indications for surgical intervention in spondylogenic lumbar processes].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
A Rieger
Publications and source records attributed to A Rieger.
[The problem of infection in measuring brain ventricle pressure].
Catheters for ventriculometry were implanted into the lateral ventricles of 71 neurosurgical patients. Clinical symptoms of meningitis were recorded from 5.6 per cent of them. A positive bacterial culture was obtained in one case. Reference is made to the risk of infection, and prophylactic antibiotic treatment is advocated.
Brain Diseases↗
[Ultrasound tomography following surgery of tumors of the cerebellopontile angle].
After operations of the posterior fossa, ultrasonic tomography is a suitable noninvasive imaging procedure. After osteoclastic trepanation 45 patients were investigated with ultrasonic tomography. Below it were 18 patients with tumours of the cerebellopontine angle. A sector probe with a frequency of 3,5 MHz was used for the sonographical procedure. Ultrasonographical cross-sectional images were produced from occipital-retroauriculare or suboccipital. Solid processes have a definable echodense structure. Cystic processes and substantial defects of the brain are echopoor or echofree. Ultrasonic tomography allows an aimed application of CT controls.
Cerebellar Neoplasms↗
[Penetration of the abdominal drainage catheter of a ventriculo-abdominal shunt into the descending colon].
A case is described in which after a drainage of a Hydrocephalus internus that had been carried out since early infancy and repeated valve revisions a penetration of the abdominal catheter into the Colon descendens occurred.
Adolescent↗
[Ultrasound tomography in postoperative monitoring of infratentorial space-occupying lesions].
After osteoclastic trepanations of the posterior fossa for cystic or solid processes of the cerebellum and the cerebellopontine angle, ultrasonic tomography is a suitable imaging procedure. A mechanical sector probe with a frequency of 3.5 MHz is recommended as transducer. The postoperative ultrasonic findings are the basis for the sonographic observation of the further evolution. Cystic and solid processes can be localized and their dimensions metrically determined by means of multiple plane cross-sectional imaging. Ultrasonic tomography is recommended as a primary diagnostic method owing to its lack of invasivity and radiation exposure, simple handling and repeatability. As a consequence, CT examinations can be better aimed.
Adult↗
[Transabdominal lumbal ultrasonic tomometry--sonographic measurement of the lumbar spine].
Transabdominal sonography was carried out on 102 lumbar segments that were myelographically without abnormalities of the dural sack. A sector probe with a frequency of 3.5 mHz was used as transducer. Diameters of lumbar discs and lumbar canal were measured in a transversal plane. Echogenicity of the epidural fat in the lumbar canal allows to depict both the limitation of the dorsal outline of the lumbar discs and the dorsolateral vertebral arch. The following mean values were calculated for the spinal canal: Sagittal diameter-L5/S1:18.5 mm, L4/5:20.4 mm, L3/4:19.9 mm Transversal diameter-L5/S1:20.9 mm, L4/5: 21.4 mm, L3/4:21.2 mm Sonographic measurement of the spinal canal is possible.
Adolescent↗
Clinical effects of monoclonal antibodies (MAb 17-1A) in patients with metastatic colorectal carcinomas.
Ten patients with metastatic colorectal carcinoma were treated with MAb 17-1A (IgG2A). Before infusion, MAb was incubated in vitro with isolated autologous blood mononuclear cells. Treatment was given in repeated courses (2-4 times) to a maximum dose of 1000 mg of MAb 17-1A. One patient achieved a clinical complete remission, two patients had a minor response and one patient had stable disease for 5 months. The median survival for the four responders was 19 months compared to 7 months for the six non-responders. Therapy was well tolerated. In this series, 32 infusions of MAb 17-1A were given. The serum half-life of MAb 17-1A was approximately 22 hours. All patients developed anti-mouse antibodies of both IgG and IgM classes. No relation between adverse reactions and anti-mouse antibodies was seen. At 3 occasions allergic reactions were noted. Skin test with MAb 17-1A seems to reliably predict for allergic reactions.
Adult↗
[Ultrasonic tomography--a noninvasive, imaging study method in lumbar canal diagnosis].
Explore the source record for details and available documents.
Adolescent↗
[Aneurysm of the superficial temporal artery following extra-intracranial arterial bypass. A case report].
Fifteen months after an EIAB an aneurysm spurium develop 4 mm proximal to the anastomosis. The development of the aneurysm is discussed.
Cerebral Revascularization↗
Massive hematemesis due to an aorto-oesophageal fistula. Case report.
A patient with massive hematemesis due to an aorto-oesophageal fistula is presented. An aorto-oesophageal fistula is mostly a fatal disease. In the literature it is pointed out that recognition of the clinical syndrome with midthoracic pain, massive arterial hemorrhage and exsanguination after a symptom-free interval might ameliorate the prognosis. In the reported patient the correct diagnosis was not immediately suspected. The patient, however, survived a long operation and exsanguination without any major postoperative complications or sequelae.
Aortic Diseases↗
Preoperative short-term radiotherapy in rectal carcinoma. A preliminary report of a prospective randomized study.
Between 1980 and 1983, 373 patients with clinically resectable rectal adenocarcinoma entered a prospective randomized study aimed to evaluate the effect of short-term preoperative radiotherapy. Protocol violations were identified in 21 instances. Of the remaining 352 patients, 182 were randomized to surgical treatment only (S-group). Immediately, before surgery, 170 patients were irradiated to the pelvic region with 25 Gy (2500 rad) during a 5-day period (RT-group). Of these patients, 59% underwent abdominoperineal excision, 38% anterior resection, and 3% laparotomy only. At surgery distant metastases were discovered in 32 patients (9%). There were no significant differences between the groups in the distribution of age, sex, operative methods, and tumor stage according to the original Dukes' classification. During the follow-up time, ranging between 6 months and 3 years, tumor recurrence occurred in 35 patients, 19 in the S-group and 16 in the RT-group. Fifteen patients in the S-group had pelvic recurrence compared to 10 patients in the RT-group. Distant metastases occurred in six and eight patients, respectively. Two patients in each group had both pelvic and distant recurrence. There was no correlation between tumor recurrence and type of operation. Median time interval from diagnosis to pelvic recurrence was 10 months in the S-group and 16 months in the RT-group. Postoperative complications in the form of wound sepsis were slightly more common in the RT-group. In summary, the applied treatment regimen, is well-tolerated and apparently does not affect the Dukes' stage of the tumor. Although there is no statistically significant difference, there is a trend of less pelvic recurrence in patients receiving preoperative radiotherapy.
Adenocarcinoma↗
Medicine as social science: Rudolf Virchow on the typhus epidemic in Upper Silesia.
Rudolf Virchow's Report on the 1848 typhus epidemic is one of the neglected classics of "social medicine"--a term he did much to popularize. His analysis of the epidemic emphasized the economic, social, and cultural factors involved in its etiology, and clearly identified the contradictory social forces that prevented any simple solution. Instead of recommending medical changes (i.e., more doctors or hospitals), he outlined a revolutionary program of social reconstruction; including full employment, higher wages, the establishment of agricultural cooperatives, universal education, and the disestablishment of the Catholic Church. This article includes the first English translation of these long-term recommendations. It also locates Virchow's Report within the context of the Medical Reform Movement of 1848 and traces his influence on the subsequent development of social medicine. Parallels are drawn between Virchow's attempts to reform health care and current developments in the political economy of health.
Germany↗
Erythrocyte and plasma ferritin in normal subjects, blood donors and iron deficiency anemia patients.
Ferritin concentration has been determined with an immunoradiometric assay in plasma and washed sedimented erythrocytes after hypotonic lysis. There was a gradual decrease of plasma ferritin in the sequence normal males, normal females, blood donors and patients with iron deficiency anemia. Erythrocyte ferritin remained unchanged in normal males and females and in blood donors, but dropped significantly in the anemic patients. Correspondingly, the ratio of erythrocyte to plasma ferritin rose from less than 2 in healthy males up to 8 in persons with iron deficiency. Little, if any effect on plasma and erythrocyte ferritin was observed in 12 male and female volunteers when taking iron for 4 weeks. In 2 patients with iron deficiency anemia the blood counts were normalized within 2-3 months during oral iron substitution, accompanied by a drastic increase of the erythrocyte ferritin concentration to values far above normal. In contrast, the plasma ferritin concentration remained below normal. Thus, in iron deficiency erythrocyte ferritin is synthesized with priority in the presence of iron and, in addition to plasma ferritin, appears to be a useful parameter of the iron status.
Administration, Oral↗
The influence of heparin and curable resection on the survival of colorectal cancer.
During a five-year period 271 patients were operated on for cure of colorectal cancer. Heparin in low doses was given to 114 patients according to a thromboprophylactic routine. No thromboprophylactic agents were given to 157 patients. In all other respects treatment of the colorectal cancer was the same. Mean age and sex were the same for the two groups. The distribution according to Dukes' classification did not differ statistically. The 3-year survival and deaths due to cancer were registered for both groups. Crude survival rate and survival probability were calculated. No significant differences were found between patients receiving and not receiving heparin.
Adult↗
Prophylaxis of deep venous thrombosis in colorectal surgery.
A group of 230 patients undergoing elective colorectal surgery was analyzed for the presence of deep venous thrombosis (DVT). Prophylaxis against DVT was practiced with low-dose heparin (either 5000 IU every eight hours, or 5000 IU every 12 hours for seven days) in 199 patients. Prevention of infection was attempted with preoperative administration of Enterobiotic in 155 patients and of Vibramycin in 11 patients. DVT was diagnosed in 46 patients. The frequency of DVT did not differ significantly between patients who underwent resections of the colon and those who underwent rectal surgery. DVT was diagnosed in 27 of the 73 infected patients, which was significantly higher than the incidence of 19 with DVT among the 157 uninfected patients. The frequency of DVT among patients in the two heparin regimens was 15 and 17 per cent respectively, which was significantly lower than with untreated patients. No lethal pulmonary embolism was found and no patient showed clinical signs of embolism. It is assumed that measures aimed at reducing postoperative infection, combined with low-dose heparin, will reduce the incidence of postoperative DVT after colorectal surgery.
Adult↗
Fibrinogen catabolism in patients with postoperative infectious complications.
The biological half-life (TB) of 125I-fibrinogen was studied in 21 surgical patients, using a precordial counting technique. TB was calculated for the first 4 postoperative days (first phase) and for the 5th to 10th days (second phase). Daily calculations of TB were undertaken in 15 patients. In patients with a normal postoperative course, TB was 2.31 days (first phase) and 3.80 days (second phase). In patients with a postoperative infectious complication (PIC), TB was 1.74 days (first phase) and 2.21 days (second phase), which was significantly shorter than corresponding values in patients with normal postoperative course. The mean of the daily values of TB was significantly shorter in the second phase in patients with PICs compared to those with a normal postoperative course. Co-variance analysis of daily TB in the first and second phases showed no significant difference in 25/30 phases (83%). It is suggested that TB of 125I-fibrinogen can be used as a complement to the clinical diagnosis of PIC. Further studies are desirable to confirm the method.
Bacterial Infections↗
Postoperative deep venous thrombosis and infectious complications. A clinical study of patients undergoing colo-rectal surgery.
The connection between deep venous thrombosis (DVT) and postoperative infectious complications (PIC) was studied in 170 patients (mean age 65.7 and 40--86 years) who had undergone open large bowel or rectal surgery. DVT was diagnosed by the 125I-fibrinogen method. DVT of the legs was found in 36 patients. In 58 patients with PIC the frequency of DVT in 41 patients receiving low-dose heparin was 29% and in 17 patients without heparin prophylaxis 71% (P less than 0.01). In 112 patients without infection the frequency of DVT in 98 patients receiving low-dose heparin was 12% and 14 patients without heparin prophylaxis 7%. The frequency of DVT was significantly lower in patients without infection compared to those with PIC (P less than 0.001). Serious DVTs were more common in patients with PIC compared to those without PIC (P less than 0.05). It is concluded that infections after open large bowel and rectal surgery is an important risk factor for the development of DVT. Low-dose heparin significantly reduces the frequency of DVT in infected patients.
Adult↗
Effect of preoperative oral administration of oxytetracycline and neomycin on postoperative infectious complications in cases of cancer coli-recti.
A prospective randomized study on the effects of Enterobiotic (oxytetracycline + neomycin) given per os to patients operated upon electively and curatively for carcinoma coli and recti is presented. 75 patients were treated and 66 were controls. A highly significant reduction of peroperative total and Gram-negative bacterial growth from the bowel was registered and a probably significant reduction of anaerobic bacterial growth. In the whole material a highly significant lower incidence of wound sepsis and intra-abdominal infectious complications occurred in the treated group, compared with the control group. This applies also to the resection material, while the difference is of probable significance in the excision group. 13 of 66 patients died, 8 of septic complications, all in the non-treated group. There was no mortality in the pretreated group. The difference between the noninfected and the infected patient groups was significant as regards the preoperative intraluminal total growth of bacteria and the growth of Gram-negative bacteria. The subsequent non-infected patients show a significantly increased number of cultures not showing any growth of bacteria. No negative side effects of Enterobiotic therapy were noted.
Adenocarcinoma↗