[The place of emergency laparoscopy in trauma surgery (author's transl)].
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Biomedical subjects
Publications and source records attributed to K Hennig.
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After intravenous injection the distribution of iodine-labelled diethylstilbestral-diphosphate (cytonal) was investigated in various organs of the rat. For this purpose the concentration of activity in the organs of the animals were established by measurements of specimens in the bore-hole counter and scintigrams were made by means of a small animal scanner. The result was an unequivocal temporary dependence of the enrichment of the substance in the organs. The greatest enrichment was found 10 minutes after injection in the liver, then followed blood, kidneys, adrenal glands, seminal vesicles, prostate, abdominal wall and the fatty tissue surrounding the prostate. The blood activity relatively decreased. 7 days after injection an unambiguously higher activity was to be proved in the liver, kidney, adrenal gland than in the blood, whereas the enrichment of iodine-labelled diethylstilbestraldiphosphate in prostate, seminal vesicle, fatty and muscular tissue was always below the enrichment of the blood. But in every case the relation of organ activity to blood activity changed in favour of the organ activity, also with regard to the prostate. 10 minutes after injection the concentration of the activity of the seminal vesicle was somewhat higher than that one of the prostate, but in the further course it was below the concentration of the activity of the prostate. During the first two hours the fatty tissue surrounding the prostate showed a clearly and after the third day a slightly lower activity concentration than the prostate. On the basis of this distribution of the activity for the scintigraphy of the prostate above all a temporary interval of about 10 minutes to 3 hours after the injection of labelled cytonal is involved. The results cause us to perform investigations in men concerning the pharmacokinetics and the possibility of using radioactively labelled cytonal.
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Nine cases of distal brachial artery injury were discussed. We refer to case No. 7 in which a complete dorsal displacement of the artery occurred through the fracture-line of the epicondyle. Trauma caused dislocation, laceration, or spasm of the artery, with or without intravascular thrombosis. Vascular spasm should not be diagnosed unless an arteriogram is available. If not done preoperatively, it can be done during operation. In this case inspection of the vessel during operation seems essential. Venous interposition is satisfactory for bridging defects of the distal brachial artery even in the elbow region.
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A method for the simultaneous determination of the effective renal plasma flow and of the glomerular filtration rate with the help of 131J-o-iodohippuric acid and 169Yb-DTPA using a double isotopic technique is described. Apart from this the method serves for the establishment of the filtration fraction. 40 patients with different clinical pictures (glomerulonephritis, pyelonephritis, cystic kidneys, stenosis of the renal artery) were examined. The clearance values established by us were in the areas characteristic for the clinical pictures. Pathological conditions could be established which are not yet characterized by an increase of the fixa of the urine in the serum. By the determination of the filtration fraction differential-diagnostically important insights are afforded. The examination is methodically simply to be performed and is of little stress for the patient. Therefore it seems to be suitable for the routine examination.
Errors in the interpretation of bone scans with 99mTc-diphosphonate may be due to summation of radio-activity from superimposition of various bone structures. Lesions with increased bone turn-over as well as reactive hyperaemia result in increased uptake. The possibility of extraosseous uptake of diphosphonate must be borne in mind during the evaluation of bone scans. The kidneys and lower urinary tract must be considered. Absent or slight uptake by the kidneys with good demonstration of bone suggests increased diphosphonate uptake by the bones. Special attention should also be paid to zones of decreased uptake, since these are also due to abnormalities in the bone.
Experiences in the intraoperative use of an ultrasonic doppler-flowmeter are described. The method can be helpful when performing various operations within the field of generalsurgery and vascular surgery.