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Biomedical subjects

W Neugebauer

Publications and source records attributed to W Neugebauer.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Acute post-traumatic cholecystitis. Caused by or following polytrauma?].

Traumatic acute cholecystitis is of secondary importance beside many other complications in the polytraumatised patient, since it is rarely diagnosed--possibly too rarely. Difficulties often arise because of a multitude of injuries, which are often life-threatening and which must be given top priority (3). Men are chiefly involved (4). In most cases, the condition is preceded by shock, but not necessarily by gallstones (10, 11). First pointers in literature were given by Mennenga (8). As early as 1939 he pointed out that blunt abdominal trauma may produce tears in the gallbladder and bile duct regions. Marre (7) described acute signs in the upper abdomen due to rupture of the bile duct. Genesis of post-traumatic acute cholecystitis is still unclarified. Apart from rupture or perforation of the gallbladder or bile ducts, it is mainly shock (4, 9, 12) which is considered to be an important causative factor.

Abdominal Injuries↗
PubMed1982

[Conservative therapeutic procedure of fractures of the os calcis based on late results (author's transl)].

Difficult fractures of the calcaneus are therapeutic problem today. From 1965 to 1977 147 patients were non-operative treated in the department of general surgery - including cases from department of orthopedic surgery. 67 patients with fractures of the os calcis were controlled between 3 and 15 years after accident. The various methods of conservative treatment are discussed. The early functional treatment had the better late results than other conservative methods i.e.: fewer pain and better flexibility of the talo-calcaneo-navicular and talo-calcanean joint, sooner taking up of the former occupation and lower decrease in performance.

Calcaneus↗
PubMed1981

[Lesions of the epiphyses - classification - therapy - prognosis (author's transl)].

Between 1970 and 1980 53 children with epiphyseal injuries were treated. Analysing these 53 cases we found that metaphyseal lesions of the epiphyseal plate (i.e. epiphyseolysis, separation of the epiphysis with triangular metaphyseal fragment) heal completely, even in those cases in whom an open reduction was necessary. Conservatively treated epiphyseal injuries (i.e. fracture of the epiphysis, crushing of the epiphyseal plate) showed bad results. Contrary to these results 80% of open reduced injuries showed good results. We can conclude that epiphyseal injuries do not necessarily end in disturbances of growth or malformation if surgical correction of the injury is done as early as possible and if the injured extremity is immobilised at least 3 to 5 weeks. Destruction of the epiphyseal vascular system can only be avoided by surgical reposition of the epiphyseal injury.

Child↗
PubMed1981

[Value of scintigraphic examination methods with 99mTechnetium in injuries of the epiphyseal cartilage (author's transl)].

The value of scintigraphic examinations of injuries involving the epiphyseal plate is to be seen to ensure the correct diagnosis of the lesions type I and type V according to Salter and Harris. Further on the results of these scintigraphic examinations allow a better planning of the therapeutic procedure. Experimental findings in rabbits succeeded to predict the seriousness and an early prognosis. The disturbances of the epiphyseal blood flow can be diagnosed by 99m Tc-O4 labeled erythrocytes and 99m Tc-O4 labeled albumin microspheres. 99m Tc-MDP skeletal scintigraphy gives the information at which time the repair is done and full weight bearing is possible.

Animals↗
PubMed1981

[The problems of blunt abdominal trauma accompanied by cranio-cerebral trauma (author's transl)].

From 1967-80, 276 blunt abdominal traumas were surgically treated at the Chirurgische Universitätsklinik Tübingen. In the course of these, cranio-cerebral trauma was the most apparent accompanying injury. Diagnostic difficulties were considered one major cause among others for the high mortality rate of 40%. The diagnostic procedure is described and the special significance of peritoneal lavage for the diagnostic procedure and the importance of intraoperative autotransfusion for the therapy is emphasized.

Abdominal Injuries↗
PubMed1981

[Prevention of complications in the spring nailing according to Ender and Simon-Weidner].

Since 1977, the Ender and Simon-Weidner nailing technique has been increasingly used at the Surgical University Clinic in Tübingen. This is an simple, gentle, low-risk procedure for surgical stabilization of pertrochanter femoral fractures and fractures of the lateral femoral neck in elderly people. Errors in external rotation are not always avoidable with this procedure, but they are tolerated with a lower surgical mortality than in the more complex method of osteosynthesis. Intraoperative complications are caused by faulty positioning, bad reposition of the fracture, false selection of the pinning site and nail length as well as insufficient splaying of the nails in the femoral head. Postoperative complications occur with distal as well as cranial displacement of the nails. Further complications are caused by placing a normal burden on the fracture too quickly and by the necessity of changing nails. Instructions will be given as to how these errors can be avoided.

Aged↗
PubMed1980

[The scintigraphic diagnosis and follow-up of injuries to the epiphyseal plates (author's transl)].

Injuries to the epiphysel plates without involvement of the epiphyses or metaphyses, such as crush fractures or pure epiphysiolysis may be difficult to diagnose radiologically. Thirteen bone scans after damage to the growth plate have been performed on eight children. These indicate that these scans are able to diagnose lesions of the epiphyseal plates at an early stage and with certainty. The scintigrams also provide information concerning the healing process of the plate; they indicate when healing has been completed and when the extremity can be used for weight-bearing again. Radiation exposure of the children during scintigraphy with 99mTc-polyphosphate is within acceptable limits.

Adolescent↗
PubMed1980

[Measurement of compressive forces at the external fixator by means of a dynamometer to prevent subsequent osteosynthesis after bone fracture (author's transl)].

Bone fractures treated with an external fixator tend to heal more slowly than with an internal fixator, since the tension of the fixator gradually relaxes and this decrease in pressure is not counteracted on any way. A dynamometer makes possible an exact measurement of effective compressive forces and an adjustment of the tension of the fixator. A special feature of the apparatus is an elastic metal ring. The apparatus is mounted on the free ends of both tubes of the fixator for measuring and adjusting the tension. This should be done once a week. Supported fractures are put under an axial compression of 50 kp. In the case of comminuted and defect fractures, an axial compression of 5 kp should be begun after 5 weeks, and this dosage should be increased every week.

Fracture Fixation↗
PubMed1979

[Primary carcinoma of the extrahepatic bile ducts (author's transl)].

From 1957--1977 193 patients were treated at the surgical clinic of the University of Tübingen for carcinoma of the extrahepatic bile ducts. Gall bladder carcinoma made up 139 cases; 54 were of bile duct carcinoma. The tumors were no longer operable in two-thirds of the patients with extrahepatic bile ducts cancer. The life expectancy rate of five years for patients with gall bladder carcinoma held for 7%. Up to now only one patient with a bile duct malignancy has survived longer than five years. In the last decade essentially no improvement of median life expectancy has occurred despite improved operating techniques. Due to uncharacteristic, misleading upper abdominal symptoms, patients who suffer gall bladder or bile duct cancer are unfortunately accurately diagnosed only after the carcinoma has overcome organ borders or is already metastatic. There is reasonable hope for improved early prognosis of extrahepatic bile duct carcinoma with ERCP (Endoscopic Retrograde Cholangio-Pancreaticography) and computer-tomography. Because the possibility of a relationship between gall bladder stones and/or the chronic inflammation of gall bladder and bile ducts and the development of cancer is not out of the question, widespread prophylactic cholecystectomy and gall passage cleansing should be employed.

Adenocarcinoma↗
PubMed1979

[Intraoperative autotransfusion (author's transl)].

Intraoperative autotransfusion is an advantageous and safe method of blood replacement. In our clinic this method is established as a routine procedure in all cases with suspected massive bleeding. We used the IAT in 141 cases of surgical haemorrhage. The mean indications for IAT in surgery were emergency operations necessitated by blunt abdominal or thoracic trauma. Altogether 390 l of blood have been retransfused with an AT -- volume per patient ranging from 1 to 20 l. On an average 2,8 l per patient were transfused. Contraindications of blood replacement are tumour surgery, septic surgery, contamination by large intestinal contents and rupture of the uterus. For anticoagulation ACD-solution has been used, only in vascular surgery systemic heparinization was preferred. The main advantages of autologous intraoperative transfusion are the immediate availability of blood, the absence of the risk of hepatitis and of incompatibility reactions, reduction of pressure on the blood banks and lower transfusion costs.

Anticoagulants↗
PubMed1979

[Circular transhepatic drainage as a palliative surgical measure in central bile duct obstruction].

A transhepatic drainage tube was used in 27 patients suffering from echinococcus alveolaris of the liver of malignant process of the portal fissure from 1967 to 1978. If an hepatocholangioenterostomy is not possible, another surgical palliative procedure is necessary for drainage of the bile. The transhepatic drainage tube is a simple palliative method. The technique of this procedure, the indications, the possible complications, and the advantages are reported.

Adolescent↗
PubMed1978

[Comparative study on single layer and two layer anastomoses of small intestine (author's transl)].

The one layer anastomosis after Gambee is compared with the two layer anastomosis after Dick at the small bowel of 20 minipigs. The end-to-end anastomosis after Gambee consists of an interrupted, inverting suturing of the bowel wall. Dick suggested a closed method, applying bronchial clamps before resecting the bowel. Seromuscular sutures and inner all layer sutures are inserted interrupted. Experimental studies have been done after 4, 7, 14 and 21 days. In Histology two layer anastomoses caused delayed wound healing after 4 days. Twenty-one days after the operation histological findings in both groups were equal. Microangiographic studies showed, that in single layer anastomoses revascularization began 3 days earlier than in two layer anastomoses. Measuring of the bursting strength showed no significant differences. All parameters suggest equal value of both techniques. In our opinion the two layer anastomosis after Dick combines the advantages of a closed method with a simple, easy performable technique. We therfore apply it all over the gastrointestinal tract with exception of esophagel and rectal anastomoses.

Animals↗