Biomedical subjects
Publications and source records attributed to R Kunz.
Description of the fundus picture in a case of traumatic angiopathic retinopathy (Purtscher's disease). The authors present a report on a 19-year-old man who had a chest injury. Ophthalmoscopic changes were found in one eye only. The fundus alterations are compared with those found in cases of fat embolism.
The quality of the endothelium in 15 patients with transplants after penetrating keratoplasty was analyzed. Donor age was not taken into account (average age of donors 65.8 years). At the time of the investigation the mean age of the grafts was comparatively high (oldest donor 92 years). There were only a few morphological changes in the endothelium and visual acuity was satisfactory. Even with low cell count (625/mm2) the graft had normal clarity. A number of pathologic changes in corneal endothelial cells after keratoplasty are described.
Among the author's patients a number of cases were identified with quite clear symptoms of atopic keratoconjunctivitis, and a photographic documentation was made. All of these patients had a history of allergy and a hereditary taint. In cooperation with dermatologists neurodermitis constitutionalis was diagnosed, and verified by determining the serum IgE concentration and the allergic specific antibody. The patients underwent conservative treatment with sodium cromoglycate, steroids and vasoconstrictors. In one case the authors used cryocoagulation with a successful result for intensive hyperplastic conjunctivitis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Examination of terminal esophageal function shows that a physiological reflux does most likely exist. However, with most methods a mechanical irritation cannot be excluded. With the help of gastric reflux scintigraphy and by drawing up time-activity graphs, it was shown that in 7 of 12 asymptomatic test subjects at least 1 and at the most 7 reflux episodes could be observed within 1 h. This study shows that the gastric reflux scintigraphy is at present the most sensitive method of demonstrating a gastroesophageal reflux. The results allow conclusions on the function from the morphology, if consideration is taken of the fact that the sphincter function of the gastroesophageal junction is not carried out by means of a circular sphincter, but rather by means of a specially arranged muscle fibre system of the stretching-closing-mechanism kind.
The CT findings in 80 patients with confirmed portal hypertension due to intrahepatic block were analysed retrospectively. The findings included ascites, hypo-dense areas in the liver, nodular or irregular liver contour, the inability to define intrahepatic portal vessels with narrow window settings, the so-called "kissing" sign and evidence of hepato-fugal collaterals and thickening of the wall of the oesophagus. Electronic measurements of various organs (liver, spleen) and vessel diameters (portal vein, superior mesenteric vein) provide parameters which permit classification of patients into the cirrhotic group, as compared with a control group. The statistical significance of this classification was checked by the Kolmogoroff-Smirnoff test.
The results of a discriminant analysis for the objective diagnosis of cirrhosis of the liver are reported. Eight quantitative parameters seen on CT which, by themselves, are not diagnostic, were studied, and three relationships found to be of discriminatory significance; they are the diameter of the superior mesenteric vein, the ratio of the diameter of the caudate lobe and the right lobe of the liver and a quotient derived from the splenic and hepatic index. Cirrhosis of the liver with portal hypertension could be distinguished with a specificity of 100%, an accuracy of 96% and a sensitivity of 94%.
The case histories of 110 patients with hydatid disease were evaluated for localisation of the cysts, operative treatment and postoperative complications. Pericystectomy and hydatectomy were the most frequently performed operative procedures. 1 of 37 patients, who were followed up, showed a relapse (2.7%). If consideration is taken of the postoperative complications, hydatectomy is a suitable operative procedure for hydatid disease in comparison with pericystectomy.
The blood supply of the extrahepatic bile ducts was investigated in 15 human specimens. Human embryology explains the origin of the main blood supply in this area by the a. pancreaticoduodenalis posterior superior, the a. cystica and the a. hepatic propria. Other arteries are inconsistent and functionally unimportant. 2 or 3 marginal arteries are predominant in the arterial system surrounding the common bile duct. Surgery of the extrahepatic bile ducts should be performed with respect to this particular arterial network.
34 fatigue fractures have been observed since 1976. The distribution frequency corresponded roughly to data given in the literature. Analysis of records showed that those fatigue fractures which were not localised in the metatarsal region and had uncharacteristic bone changes radiographically, caused in part considerable diagnostic difficulties. Six selected own cases demonstrate problems encountered not only by the specialist but also by the practising doctor.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The aneurysms in 35 380 autopsies over a period of 25 years have been investigated with reference to etiology, sex, age, morphology, localization, additional factors, complications and clinical diagnosis. There were a total of 1706 aneurysms (362 of cerebral arteries, and 1344 of the aorta and further arteries). The most frequent current cause of aneurysm is arteriosclerosis (80%), followed by idiopathic medianecrosis of Erdheim-Gsell (9.7%) and syphilis (3.7%). Arteriosclerotic and syphilitic aneurysms are most frequently found in patients over 60. In medianecrosis the age ceiling is 40-70 years for men and over 60 years for women. With the exception of medianecrosis (dissecting aneurysms), the great majority of cases are morphologically true aneurysms. The most frequent localization of rupture is the retroperitoneal tissue (arteriosclerosis), the pericardial sac and the pleural cavity (syphilis, medianecrosis). Approximately every fourth aneurysm found in the autopsy series had been clinically diagnosed.
The abdominal angiograms of 381 patients were critically reexamined for the existence of collateral circulation in cases of renal artery stenosis or occlusion. Typical renal artery stenosis was found in 39 patients; among these, 17 had a collateral circulation, which was extrarenal in 15 and intrarenal in two. Collateral circulation involving the lumbar arteries was most common. In two patients a collateral circulation was established via the inferior mesenteric artery.
In 33 patients with malignant teratoid testicular tumours, the retro-peritoneal lymph nodes were surgically removed after lymphograms had been carried out. Histological examination of the lymph nodes showed retroperitoneal metastases in 42% (14 out of 33). In 25 of the 33 patients, there was agreement between lymphography and histology; diagnostic accuracy of lymphography was about 76%. In the presence of positive findings, accuracy was 87%.5%, for negative findings it was 72%. The more frequent false negative findings are due to anatomically determined failure of contrast filling of aortic lymph nodes; the less common false positive findings are produced by involution of lymph nodes.
Three angiographic observations showing partial mesenteric vascularisation of renal tumours were made. Problems in diagnosis and therapy arising from this are discussed.