Biomedical subjects
Publications and source records attributed to W Usbeck.
Evaluating our results of anterior-lateral chordotomy in 88 patients suffering from intractable pain, we can state that this is a useful surgical procedure. Today however it has to be replaced by the so-called percutaneous cervical chordotomy.
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Among numerous factors which induce or exacerbate pancreatitis infection of the biliary-tract--with or without lithiasis--is important. In suitable cases intervallic restoration of this tract is the best way to avoid recidivation. From a total of 624 patients in our department with cholepancreatitis in 225 cases this therapy was performed. After a recidivation of pancreatitis which required hospitalisation within at least 3 years was to be seen in 4.7%.
A report is given on 40 spinal cord tumours in children and infants, the diagnosis of which was considerably delayed in part. 28 children were hospitalised because of fixed paralysis, incomplete or complete compression of spinal cord or cauda. Persisting pain in various sections of the spine, often combined with abnormalities in posture and position are suspicious on tumour as long as another cause is proved. X-ray pictures and analysis of lumbarcerebrospinal fluid are in the most cases of decisive importance for a progressing diagnosis. Myeloscintigraphy is specially useful for an early and exclusing diagnosis.
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839 patients with acute haemorrhage from the upper gastro-intestinal tract were treated in the last 14 years. In 72 cases the cause of bleeding was extremely rare. To find the correct diagnosis in acute situations the best is, to do emergency fiberoptic gastroscopy and in some special cases selective angiography. Without clear diagnosis the mortality rate in such cases will be too high.
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Treatment of patients with head and brain injuries is highly dependent on qualified initial care, diagnostic and therapeutic activities inside the clinic, the after treatment outside the hospital and rehabilitation. Every patient of this kind has to be observed for at least two days in a hospital. Before discharge the diagnosis has to be defined. The author proposes a new classification: slight, middle, severe and highly-severe brain injury.
The necessity of an exact documentation of mental disorders after cranio-cerebral injuries in their temporal development is stressed. There is a quantitative relation between functional psychosis and the underlying cerebral process. Close observation of the course enables the surgeon to diagnose intracerebral complications early.
The clinical picture of electrolyte-losing villous tumours localized in the rectum or colon is represented by own observations and the literature. Diagnostic errors arising from disturbances of water and electrolyte balance are emphasized. In order to find out the optimal therapy, classification of the tumour according to clinical criteria is recommended.
After operative procedures of greater extent stress ulceration in the stomach or duodenum can arise, sometimes perforating the wall. Unfortunately, such perforations are not diagnosed in time. In a postoperative breakdown of the circulation, which otherwise cannot be explained, stress ulceration and perforation should be taken into consideration.
On the basis of 500 myelogramms carried out with hexaiodated, water soluble, and rapidly absorbable Dimer X, the experiences gained in the diagnoses of damages of the lumbar intervertebral disks are presented. It can be stated that Dimer-X myelography has proved to be very useful for the recognition of space-narrowing processes in the lumbar region. No serious complications were observed. Most of the troubles, including, for example, transitory headache and the like, correspond to those sometimes found after simple lumbar punctures.
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An analysis of primary epineural end to end sutures of transsected peripheral nerves, operated upon before 1970, showed good motor and sensory function in only 60%. With the new perineural suturing technique without tension and if necessary by using autologous nerves for bridging large nerve defects the good results raised to 87%.
Seventy-three Torkildsen drainages are reported, of which 61 and 12 were performed on tumor patients and in the case of benign aqueduct occlusions due to congenital malformations or chronic inflammations, respectively. The results are quite satisfactory providing due consideration is given to both the basic ailment and the preoperative condition. The Torkildsen drain has proven extremely useful in the therapy of selected cases of occlusive hydrocephalus.