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Biomedical subjects

K Wilhelm

Publications and source records attributed to K Wilhelm.

At least 235 records · Page 13Linked to original sources
PubMed1981

Antibiotic concentrations in blood and tissue. Intraoperative ischemia as a model for the determination of tissue concentrations using mezlocillin and oxacillin as examples.

Blood present in the tissue distorts the results obtained during measurement of antibiotic tissue levels. The greater the blood supply to the tissue, the bigger the error when tissue levels are measured. The examination of tissue removed during temporary intraoperative ischemia is an alternative to the indirect mathematical method of correcting errors of blood level measurement. This technique was tested by determining tissue concentrations after i.v. injection of 4 g mezlocillin and 2 g oxacillin. The tissue was removed during operations on limbs after the application of an Esmarch's bandage. Determination of hemoglobin in ischemic tissue confirmed exsanguination so that the 6-((R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenylacetamido )-penicillanic acid-Na (mezlocillin) and 5-methyl-3-phenyl-4-isoxazolylpenicillin (oxacillin) concentrations determined corresponded to the actual tissue levels. The concentrations of mezlocillin and oxacillin in fat, skin, tendon, muscle, ganglion, aponeurosis, tumour, ligament, subcutis, synovial fluid, epineurium and serum are given in the text.

Adult↗
PubMed1981

[Replacement of the distal radius joint surface with silicone rubber in animal experiments on monkeys].

According to appearance in high percentage the recent techniques of prosthetic implants are not sufficient in cases of destruction of wrist or arthrosis. Therefore in most cases even intensive physical training cannot give adequate function by full pain relief. With the development of a silicon-caoutchout-prosthesis to replace only cartilage surface without fixation with cement we get a new way, to implant without extensive-resection of bone. The prosthetic material ist very similar to cartilage in hardness and elasticity. Examinations were made on 8 baboons with the result that there was no restriction in function even at full load 6 weeks postoperatonem. Radiological examinations in an observation period of 9 months did not show any significant change as to destruction in the surrounding of prosthetic stem or the articulating surfaces of cartilage and prosthesis.

Animals↗
PubMed1981

[The supinator syndrome. Diagnosis - therapy - results].

The compression of the r. profundus of n. radialis by m. superior is a rare nerve compression syndrome of the upper extremity. In many cases its diagnosis is very difficult. 14 patients with a emg-manifest supinator syndrome were examined after operation. The examinations were performed as to etiology, symptoms and postoperative status depending on pre-operative duration of trouble.

Adult↗
PubMed1980

[Secondary surgery for restoration of nerve function (author's transl)].

The technique of nerve-suturing belongs in modern times to the domain of microsurgery. Without implementing the posibilities offered by microsurgery, nerve-suturing - even directly end-to-end - is obsolete. In order to obtain a sufficient functional end-result, suturing under tension must be avoided at all costs. Knowledge of this has given rise to the common interposition nerve grafts. Even with interposition grafts, no cases of growth-disturbances, including a failure of the nerve to grow or disturbances in function because of growth, have been observed in children. For a good post-op. results, a continual therapy with neurotropic medicaments, physiotherapy and faradisation, and neurophysiological checks on progress made in renervation are absolutely essential.

Child↗
PubMed1980

[Ligamental injuries of MCP joints (author's transl)].

Injuries of the ligaments and capsule of the MCP joints are frequently seen in the hand surgical service. A great part of these injuries are caused by trauma during competitive athletic games. Capsule and ligamental injuries of the 3rd and 4th digit can be treated conservatively by fixation to the next digits. Ruptures of the collateral ligaments of the 1st, 2nd and 5th digit as well as injuries with accompanying fracture or joint instability have to be surgically repaired. The different types of ligamental ruptures and their surgical treatment are discussed.

Diagnosis, Differential↗
PubMed1980

[Rupture of the extensor pollicis longus tendon].

On the basis of an extensive follow-up study, the transfer of the extensor indicis tendon to the thumb following rupture of the extensor pollicis longus is recommended as the procedure of choice. If attention is paid to certain technical details, good to very good results can be obtained.

Humans↗
PubMed1980

[Tendolysis].

From 1974 to 1977, 238 cases of tenolysis were performed. 72% or 171 cases were available for follow-up evaluation. In order to have reproducible values, the study was performed according to the schemes recommended by VERDAN, by WHITE and by KELLY. Good to very good results were obtained in 60% of the flexor tendon tenolyses and 78% of the extensor tenolyses. The results were dependent on the severity of the scarring, location of the injury, duration of immobilization, time interval from last tenolysis procedure, associated injuries, cause of the injury and age of the patient. On the basis of this study, a significant improvement can be expected following tenolysis if the correct indications are followed.

Adolescent↗
PubMed1980

[Nerve lesions following injuries of the upper limbs in childhood (author's transl)].

A total of 93 cases of nerve lesions in the limbs in children is reported. After blunt trauma (n = 53), there was most often damage to the ulnar nerve (n = 28), especially in the area of the elbow joint, followed by the radial nerve (n = 14) and the median nerve (n = 11). Causes were primary pressure and scar compression following fractures of the elbow and forearm, where ventral re-siting and/or neurolysis were necessary in serious denervation processes. Among the cutting injuries (n = 40), the lesions in the area of the underside of the wrist severing the ulnar and median nerves, more rarely the radial nerve, are particularly mentioned. They have a good prognosis following microsurgery. Independent of their localisation, the following have a poor prognosis: all crushing injuries, multiple injuries, multilation lesions and non-visible stretching and tearing in the area of the plexus.

Arm↗
PubMed1980

[Results of flexor tendon repair in children (author's transl)].

83 children with 109 injuries to flexor tendons were re-examined according to the Buck-Gramcko scheme. On the basis of this, we can say that surgery to the flexor tendons in children gives better results than in adults. In pre-school children there can be widely differing results, since the necessity of post-operative care is not appreciated. These results could certainly be improved by painstaking care on the part of the doctor, combined with therapy in the hands of specially trained personnel and corresponding inclusion of the mother. In no case could be observe any disadvantage to the further growth of the hand bones, after surgery to the flexor tendons, including transplantation of a flexor tendon. Generally speading speaking, there appear to be no contraindications in children, as long as general principles are observed. In about one-third of the cases, a further improvement in function of the flexor tendor can be gained by secondary tenolysis.

Adolescent↗
PubMed1979

[Genesis and treatment of Achilles tendon rupture (author's transl)].

Recent experimental studies on the Achilles tendon show that a rupture of the tendon can be caused by trauma. This statement is supported by the results of special examinations on intraoperatively excised tendon tissue. In the treatment of the rupture, the choice of surgical technique depends on the age of the rupture at the time of surgery. Ruptures less than 5 days old are sutured end to end with absorbable sutures whereas older ruptures frequently require a tendinoplasty. Finally we are developing an etiopathological interpretation of Achilles injury. From this it may be concluded that this was perhaps the first traumatic rupture of Achilles tendon to be described in the literature.

Achilles Tendon↗
PubMed1979

1,3-Bispyridinium-dimethylether mono- and dioximes: synthesis, reactivating potency and therapeutic effect in experimental poisoning by organophosphorus compounds.

Nine bispyridinium oximes containing two pyridinium rings linked by dimethylether were synthesised. Each compound had on one of the pyridinium rings a hydroxyiminomethyl group in position 2 or 4, while the other ring was unsubstituted or had a methyl or a hydroxyiminomethyl group in position 2 or 4. The reactivating potency and therapeutic effect of the oximes were tested on two organophosphates: O,O-dimethyl-2,2-dichlorovinylphosphate (DDVP) and O-ethyl-S-(2-diisopropylaminoethyl)-methylphosphonothioate (VX). The reactivation was measured on human erythrocyte acetylcholinesterase and the therapeutic effect was evaluated on male albino rats. The oximes with a hydroxyiminomethyl group in position 4 in the pyridinium ring were good reactivators of both phosphorylated and phosphonylated acetylcholinesterase. They were also very effective given together with atropine against VX and DDVP poisoning. The compounds are almost as effective as PAM-2, but PAM-2 is less toxic.

Acetylcholinesterase↗
PubMed1979

[Differential diagnosis of tumors of the soft tissue of the forearm: an atypical palmaris longus muscle].

Bellies of the palmaris longus which are situated in an atypical position can appear as tumors of soft tissues on the flexor side of the forearm. Besides a central position a distal bicipital and a doubled variant can be observed. We report the case of a 22 years old female patient, with a "tumor" on the flexor side of the forearm of plum-size. Previous surgery had been interrupted when musculature appeared. During the revision we found a belly of the palmaris longus in a central position, situated proximal to the flexor retinaculum. The belly of musculature was 5 cm long and 2 cm wide. After extirpation of the tendinous and muscular parts the patient was free of symptoms.

Adult↗
PubMed1979

[Functional improvement in the treatment of large soft tissue defects of the thumb by a free tissue transplant].

The advantages of free transplantation used to cover defects of the thumb are demonstrated with the aid of a clinical example. A 27 years old patient had lost large parts of the covering soft tissue as well as the nerves and vessels on the flexor side of the distal phalanx of his left thumb. After a single wound toilet the thumb could hardly be used because of the reduced mechanical resistance to stress, the missing sensibility and a severely disturbed circulation. This kind of large soft tissue defect at a functionally important location can now be covered with a free composite tissue transplantation. We took a neurovascular flap out of this patient's forefoot and anastomosed it with the vessels and nerves of the proximal phalanx of the thumb. After an uncomplicated healing the covering soft tissue could be mechanically stressed and was well supplied with blood. Three month later a beginning sensibility can be proved. After 2 years the fully rehabilitated patient shows a good functional result with a two-point discrimination of 10 millimeters.

Adult↗