Biomedical subjects
Publications and source records attributed to E Willenberg.
The contribution deals with an intracranial teratoma that seems unusual with regard to the discrepancy between the volume of the tumour and the duration, 56 years, of its clinical latency.
Even at the present time, the surgical treatment of carotico-cavernous fistulas still presents problems. The author gives a brief review of the diagnosis, incidence and pathology and a detailed survey of the earlier methods of treatment, as well as those used at present, particular attention being drawn to the intravascular invasive procedures. It appears appropriate to rationalize the methods used today, namely ligation, embolization and coagulation. The author describes the use of his own successful method, in which injection of a tissue adhesive with an acrylate base (FIMOMED) through a double lumen microcatheter remains the method of choice.
Two thirds of a group of patients with 40 space-restricting processes in the region of the spinal canal were submitted to an operation in the stage of an incomplete transverse syndrome. A striking fact was that these patients had tumours of different histological classifications which were localised in the thoracic and thoraco-lumbal transitional region Tumours in the cervical and cervico-thoracic transitional region were mainly operated on in their early stages. They had a considerably shorter period of anamnesis from the beginning of the clinical symptoms up to the operation. A cause of the different periods of anamnesis with different localisations is discussed.
The authors describe the use of the ultrasound Doppler technique for the postoperative control of extra-intracranial bypasses. They arrive at the result that the Doppler sonography, because of an agreement of sonographic and angiographic findings 85 per cent, should be given preference. Moreover, an ultrasonic examination does not involve any inconvenience or risks for the patient.
The application of microsurgery is suited to enlarge the indication to operative interventions in lesions of the brachial plexus and to improve the results of their neurosurgical treatment. On the basis of a follow-up study of an adequate clinical material consisting of 16 patients during the last 4 years the results of the treatment report and postulates are formulated concerning the pre-examinations, the indication and the neurosurgical approach.
From 1974 to 1980, 4577 patients admitted to the surgical Dept of the Medizinische Akademie Magdeburg with head injuries were screened for being drunken. In the period concerned a significant increase of head injuries in combination with alcohol consumption could be demonstrated. Every surgical unit (outpatient, inpatient) taking care of those persons should be equipped with the devices for blood alcohol determination. In every case those patients suspected of being drunken should be kept under strict inhospital observance.
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Management of intracranial cerebral circulatory disorders represents a relatively new interesting and delicate field in neuro--and vascular surgery. Today, we know the reconstructive and constructive microsurgical approach to brain vessels in man. Most surgeons practise the constructive procedure. The authors criteria for selection of patients are presented. The aim of surgical therapy is to increase the blood flow because retrograde blood supply by the collateral system is anatomically or functionally insufficient.
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The authors describe a method for measurement of temperature that originates from the polymerisation of the adhesive Fimomed (alpha-n-butylcyanoacrylate). The intravascular application of the adhesive is taken as a basis of the measurement. This kind of application is applied by the authors for the closure of arterio venous fistulae. The measurement of the temperature with this method did not show both in the centre of polymerisation and in the surroundings any doubtful value if not more than 3 ml adhesive was applied. However the measurement of the temperature which originates from the polymerisation is recommended in all cases before any plane sticking is applied.
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The tissue adhesive Fimomed (made in GDR), which is supplied in a non-sterilised form, was tested for its bacteriostatic behaviour. No such behaviour was found for Gram-negative bacteria, so that in view of the typical microorganisme occurring in hospitals sterilisation of the adhesive by means of gamma rays or an aseptic filling by the manufacturers is suggested.
The authors describe a case of spinal lipomeningocele at the L2 to L4 level, detailing the properties of growth, clinical characteristics, diagnosis, and surgical therapy of such types of swelling.