[Diagnosis and differential diagnosis of adnexitis].
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Biomedical subjects
Publications and source records attributed to W Stoll.
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The passage of a tube through the nose to the epipharynx is potentially dangerous during the nasotracheal intubation because of the possibility of cuff damage, obstruction of the tube, the impossibility of advancing the tube and contamination. It seems therefore useful to protect the cuff e.g. by a finger stall, but using this procedure complications can occur which are reported. A better solution to protect the cuff will be shown.
4 cases are presented of bilateral injury of the skull base with transverse fractures of the middle cranial fossa. The pathogenesis of these fractures is discussed, pointing out the typical patterns of these lesions.
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The conjunctival approach combined with the lateral canthotomy incision is very appropriate for exploration and reconstruction of orbital fractures and provides exposure medially and laterally. 18 pure blow-out fractures, 16 zygomaticomaxillary fractures and 6 other middle-face traumas were treated in that way. No serious complications ever occurred in our series, except one suture granuloma. Based on own experience and satisfactory functional and cosmetic results this technique should be preferred instead of the infraorbital and the subciliary incision.
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An analysis of ball injuries treated during the last 3 years at Münster University Eye Hospital revealed a difference in the kind of traumata caused by air-filled balls and by solid, inelastic balls. The pathomechanism of a "contusion-suction trauma" is discussed; this would offer a satisfactory explanation not only for injuries of the anterior segment, but also for retinal changes at the outer periphery and the posterior pole.
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Cytostatics- and radiation-induced alterations of the lung were investigated in 18 children after tumour-therapy by means of lung perfusion scintigraphy. 13 patients (Hodgkin- and non Hodgkin lymphoma, acute lymphocytic leukemia with mediastinal tumour, Ewing-sarcoma, and intrathoracal neuroblastoma) received epidiaphragmatical radiation and cytostatics. All 32 lung-scintigrams of these children 1-23 months after cessation of therapy were pathological. 5 patients (acute lymphocytic leukemia, Histiocytosis X) received cytostatics only. 1-6 months after cessation of therapy in these children 6 lung-scintigrams were pathological, one was normal. After cessation of tumour-treatment scintigraphical improvement of disturbed perfusion occurred in 9/18 patients only. In 6 children a deterioration of lung-perfusion was registered. Lung-scintigraphy is a method for testing pulmonary perfusion in diagnosis and therapy control in childhood malignancies. The results of this study indicate that prophylactic provisions against pulmonary damage during oncologic therapy are necessary.
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The first known case of a 20-year-old cystic fibrosis patient in Switzerland, ending at 40 weeks' gestation in delivery by cesarean section performed under peridural anesthesia is presented. Obstetric care of the patient was complicated by pneumonia during the 31st week of pregnancy. The epidemiology, pathogenesis and clinical symptoms of cystic fibrosis, the problems anticipated during pregnancy, delivery and childbed in patients with cystic fibrosis, and the questions surrounding therapeutic abortion and contraceptive counseling are discussed.
Since 1972, telecobalt irradiation plus intrathecal methotrexate (ITMTX) has been successfully replaced in Jena by intrathecal colloidal radioactive gold (198Au) plus ITMTX for meningosis prophylaxis in leukemia. Seventy-three children with acute lymphocytic leukemia (ALL) were given 1.24-4.89 mCi (45.8-181 MBq) of colloidal 198Au IT after successful initiation of remission. During cytostatic therapy, the following relapses occurred: meningosis leucaemica, five patients (6.8%); bone-marrow relapse and the meningosis leucaemica, one patient; and bone-marrow relapse, 20 patients (27.4%). In 18 children, combination chemotherapy was terminated after two and a half or three years of treatment. After that time, one meningeal relapse and six bone-marrow relapses occurred. Within the first 24 hours after application of radioactive gold, headaches, vomiting, and fever occurred in less than 10% of the children. An apathy syndrome, leukecephalopathy, or severe infections, were not observed in a single case. Radioactive gold spreads in the subarachnoid space and is phagocytized by the arachnoidea. The tumoricide effect extends selectively over the space of distribution of the latent meningosis leucaemia. The cerebral parenchyma remains unaffected by radiation. Thus, radioactive gold may be preferable to telecobalt irradiation in preventing central nervous system leukemia.
Using a statokinesimeter which records displacements of the center of gravity, the reactions of the postural balance were registered. A test battery with the Romberg-test, the Tandem-Romberg, and two performances on a tilting table is presented. The different gradings of the test battery can be used for quantification of the severity of vestibular disturbances. The findings in 117 healthy persons were compared to those in 46 patients with vestibular disorders. It is suggested that clinical application of this method may be useful. The influence of age, height, and weight is demonstrated.