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Biomedical subjects

W Glinz

Publications and source records attributed to W Glinz.

At least 73 records · Page 4Linked to original sources
PubMed1979

[Diagnostic arthroscopy and arthroscopic surgery: experiences with 500 knee arthroscopies].

A diagnosis by clinical examination and arthrography was not possible in 160 out of 500 arthroscopically examined patients, most of them with post-traumatic knee disorders. In 157 cases the clinical diagnosis was wrong, and in another 58 cases incomplete. Only in 89 patients (18%) arthroscopy proved the clinical diagnosis to be correct. At arthroscopy, a meniscal injury was found in 156 patients (medial meniscus 57, lateral meniscus 64, both menisci 8). With regard to the menisci a previous arthrography was found correct only in 103 out of 213 cases, i.e. in 48%. Lesions of the articular cartilage were present in 210 patients, although they were expected clinically in only one third of these cases. Normal intraarticular structures were found in 95 examinations. The arthroscopic examination was insufficient three times because of a protruding fat pad, and wrong in 2 patients in whom an arthroscopically diagnosed meniscal tear could not be found at arthrotomy. The morbidity of arthroscopy is small. Only complications: A local allergic reaction because of a wound spray in four cases, bronchial asthma following general anesthesia in two patients. No infection occurred. Several therapeutic procedures may be carried out through the arthroscope. So loose bodies were removed from the joint in 39 and partial meniscectomy performed in 13 patients, all of them being treated as out-patients.

Cartilage, Articular↗
PubMed1979

[Drainage and lavage in abdominal trauma].

Peritoneal lavage is a reliable procedure in diagnosis of posttraumatic intra-abdominal bleeding. The method is extremely sensitive. If the return is found weakly positive, the lavage catheter should be left in position until the situation is cleared. Insufflation of air through the catheter may be used in diagnosis of a ruptured diaphragm. In the first days after trauma, peritoneal lavage may as well be helpful to detect secondary bleeding (for example in delayed rupture of the spleen) in unconscious patients or during mechanical ventilation. Postoperative drainage of the abdomen, too, is of considerable diagnostic value: for assessment of postoperative bleeding and in diagnosis of delayed intestinal perforation or insufficiency of a sutured bowel lesion. In pancreatic trauma, adequate drainage of pancreatic secretions prevents arterial arrosion or the formation of a pseudocyst. Determination of amylase in the drained fluid guides the further therapy: duration of total parenteral nutrition, suppression of pancreatic activity by drugs, removal o the drains. Tactics in draining the abdominal cavity after trauma should take into consideration an optimal removal of blood and secretions as well as the mentioned diagnostic value. In specially indicated cases the drainage system also should allow to perform peritoneal dialysis.

Abdominal Injuries↗
PubMed1978

[Complications of arthroscopy. A review of 3714 cases (author's transl)].

This review is drawn from a total of 3,714 knee arthroscopies carried out on patients from six clinics. The diagnostic value of arthroscopy at this site is established for it can improve prognostication, prevention and treatment of derangements of the knee. The complications of the procedure, both theoretical and in practice, have been considered by subdividing them into four groups. Firstly, the infection rate following arthroscopy alone was nil. Secondly, minor articular cartilage damage attributable to the instrument occurred in just over 2% of cases. This complication is more common when the technique is first being learned and is usually avoidable when experience has been gained. Thirdly, complications of a general nature included four cases of subcutaneous emphysema produced by the insufflation of gas, and 22 instances of an allergic skin reaction to the disinfectant preparation. Finally, failures in the technique itself resulted from the instrument bending or breaking when negotiating the condyles. This occurred on 26 occasions. In a further seven instances the fat pad was entered and distended in error, thus preventing examination of the joint. Overall, the complication rate was acceptable low and confirmed that arthroscopy can be safely applied clinically.

Cartilage, Articular↗
PubMed1977

[Diagnosis of chondral injury in trauma of the knee joint (author's transl)].

Diagnosis of chondral lesions as the only injury in knee trauma is difficult: Lesions of the cartilage were found by arthroscopy, months or years after trauma, in 153 patients; the diagnosis was never suspected immediately after injury. Chondral lesions may be suspected from clinical examination but never proved. Contrast arthography may reveal the injury in exceptional cases. Only arthroscopy or arthrotomy can really prove or exclude injury to the cartilage. Arthoscopy is to he preferred because of the far lower morbidity and is more reliable because of a better view of the articular surfaces.

Acute Disease↗
PubMed1977

[Septicemia in the intensive care of severely injured patients].

In surgical intensive care septicaemia, confirmed by bacteriological culture, was found in 46 out of 1143 severely injured patients. Source of this complication was infection of the respiratory tract in 43%, intraabdominal infection in 17%, and a septic wound in 15%. Mortality was 50%. Early diagnosis (fever, increase of leucocytes and toxic signs in differential blood count, thrombocythemia, decrease of anorganic phosphate), prophylaxis, and treatment are discussed.

Adolescent↗
PubMed1976

[Specific probelms in the intensive care of patients with multiple injuries (author's transl)].

Respiratory problems such as throacic injuries, shock lung, fat embolism aspiration are predominant in a specialized intensive care unit for patients with multiple trauma. The most important pulmonary complications are tension pneumothorax (in which case an immediate diagnosis is essential), atelectasis, lesions of the trachea, and pulmonary infections (12 percent of the patients). With severe head injuries it is often difficult to decide whether intensive care is justified. Unfortunately, there are no clear criteria for an early assessment of the prognosis in many of these cases.

Adult↗