Biomedical subjects
Publications and source records attributed to R Minda.
Primary malignant mesenchymal tumours were seen in 2.4 per cent of all autopsy cases with primary CNS-tumours. Primary leptomeningeal sarcomatosis is rare in this group of tumours. We discuss the rare disease on the basis of the case history of a 26-year-old patient.
Penetrating head trauma in children causes uncommon and potentially life-threatening injuries. We report on a case of penetrating cranial stab wound to the right parietal region of the head to a 29-week fetus. The child was delivered by emergency Caesarian section. Neurosurgical intervention after birth was necessary. The injury caused a posthaemorrhagic hydrocephalus. Real-time ultrasound examination visualises the brain damage and the development of a hydrocephalus e vacuo.
After a short synopsis of the at present ascertained knowledge of the anatomy and pathophysiology of the cerebral blood supply the possibilities of the vascular-surgical treatment are discussed. The desobliteration of extracranial vessels, PTA, vascular resections and appliances of bypass are no concurrent operation techniques, but such ones which are individually to be adapted. The importance of the clinical and non-invasive diagnostics is put before the digital subtraction angiography and the direct angiography. On the basis of the experience of 461 own surgical interventions the stage-conditioned diagnosis is required. Stage II of the transitory ischaemic attack is preferred. In unilocular mediastenoses the extra-intracranial anastomosis now as ever hat its qualification.
Primary melanoblastomas of the Central Nervous System are comparatively rare tumors. Lumpy or diffuse forms may occur either alone or in combination. On the basis of actual case histories, diffuse cerebral and medullary melanoblastoma is presented as a rare cause of occlusive hydrocephalus.
In 2 to 3 per cent of the severe craniocerebral occlusions of the cerebral basic arteries are observed. Traumatic vertebralis and basilaris thromboses are very rare. In view of the modern procedure in diagnostics and therapy the prognosis of these life-threatening traumatic consequences are not infaust. According to a casuistic information pathophysiology, diagnostic procedure and therapeutical possibilities, microsurgical or by local fibrinolysis, are discussed.
On the basis of clinical material consisting of 147 brain tumors, the authors carry out a comparative investigation involving the site of the ensuing operation to ascertain the accuracy of the clinical and paraclinical diagnoses. Computed tomographic findings were deliberately excluded with the intention of focusing on the accuracy attainable by traditional means. Clinical findings, X-ray examination of the skull, ophthalmological findings, electroencephalographic and echoencephalographic data, nuclear diagnosis, and angiographic findings were all taken into account.
The authors re-examine cases of complete peripheral nerve injury of the upper extremity. Motor activity and sensibility assessment make use of Highet's scale. Some general principles of surgical treatment of peripheral nerve injuries are presented and individual factors which influence its results are worked out, e.g. moment of diagnosis, kind of nerve suture, moment of operation, age of patient, grade of injury, concomitant injuries, and length of graft. Conclusions are drawn for the concept of treatment.
Long-lasting, high-degree, degenerative alterations of the vertebral column and the abnormal fixation of the dural sac as pathogenetic factors of a transdural advancing of sequestered lumbar hernia of the intervertebral disks are discussed.
A specific clinical course of light covered craniocerebral traumas patients, corresponding to 2 per cent of all clinically treated craniocerebral traumata. Twilight states and transient neurological and ophthalmological symptoms characterise the clinical picture. The prompt reversibility of the symptoms indicates a functional damage requiring a differential-diagnostic consideration of morphological sequelae of traumas, for which instrumental diagnostics and, if required, surgical consequences are necessary.
The function of mitochondria was considered to be an indicator of ischemic injury of the rat kidney, and the respiration of isolated mitochondria was measured in different metabolic states. The respiratory control index (RCI) was chosen as a parameter of mitochondrial intactness. The results indicate that normothermic in vitro ischemia leads to a rapid decrease of RCI and an almost complete loss of respiratory control within 45 min. Hypothermia during ischemic exposure proved to be an effective protection against mitochondrial injury as indicated by a prolonged coupled respiration and an RCI of about 2, even after 24 h of ischemic kidney storage. The ischemia-induced decrease of RCI was mainly due to a progressive decrease of active-state respiration, whereas the alterations of resting-state respiration were only small. The decline of active-state respiration was paralleled by a decrease of an uncoupled respiration rate. After termination of in vivo ischemia the RCI increased very slowly. Normal RCI values were not obtained until 7 days after onset of blood reflow, which supports the assumption of long-term damage due to ischemia.
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Animal experiments were carried out to clarify if a unilateral stenosis of the vertebral artery leads to a typical symptomatology and if a surgical therapy may be promising. The left vertebral artery was stenosed in 12 rabbits. The result was checked for 3 weeks electro-encephalographically and doppler-sonographycally. Conclusions after this long-term experiment: 1) A unilateral stenosis of the vertebral artery leads to a brain stem symptomatology. 2) This symptomatology shows determined development in dependence of the time. 3) Correlates of the brain stem lesion by vertebral stenosis were discovered electroencephalographically they were increased by specific activation methods. 4) The expected success produced the operative removal of the artificial stenosis of the vertebral artery. 5) The blood flow of the vessels which are of interest could be controlled by means of the ultrasound doppler-sonography during the whole experiment.
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.
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