Klinische Beobachtungen an Schussverletzungen peripherischer Nerven

Ohne ZusammenfassungSeit Abschluss dieser Arbeit sind drei weitere Kriegsmonate verstrichen, ein weiteres Vierteljahr der Beobachtung und Wertung der therapeutischen Erfolge und Misserfolge bei unseren Nervenschussverletzten.Bei aller Vorsicht im abschliessenden Urteil wissen wir heute, dass ein Teil der Schusslähmungen — vorwiegend Plexussschüsse — jeder konservativen und operativen Behandlung trotzt; die Lähmungserscbeinungen bleiben bestehen und die fortschreitenden Atrophien und sonstigen trophischen Störungen machen die betroffene Gliedmasse zu einer funktionell und ästhetisch vollkommen wertlosen. Sollte man nicht bei Patienten mit derart funktionsuntüchtigen oder sogar bewegungshindernden und deformierten Gliedmassen — zumal bei dem günstigen Stande unserer heutigen Prothesentechnik — unter streng-kritischer Indikationsstellung eine sekundäre Amputation vornehmen dürfen? Diese Frage bedarf unseren Erfahrungen und Beobachtungen nach jetzt der ernsten Prüfung und Diskussion.Wir haben einen Pat. mit schwerer atrophischer Lähmung durch Schussverletzung des Plex. brachial. (Verwundung Januar 1915, Operation Mai 1915) dieser Tage dem Chirurgen zur Amputation überwiesen.Meinem sehr verehrten Chef, Herrn Geheimen Medizinalrat Meyer, sage ich aufrichtigen Dank für das meiner Arbeit entgegengebrachte gütige Interesse und die Ueberlassung des Materials. Ferner danke ich auch an dieser Stelle dem Herrn Garnisonarzt und den Herren Chefärzten und ordinierenden Aerzten hiesiger Lazarette für ihr gütiges Entgegenkommen, sowie Herrn Dr. Pelz und Herrn cand. med. Herrmann für freundliche Unterstützung bei Untersuchung der Kranken.     

Ueber Pupillenstörungen bei Dementia praecox

Ohne Zusammenfassung     

Imaging and retention measurements of selenium 75 homocholic acid conjugated with taurine,and the carbon 14 glycochol breath test to document ileal dysfunction due to late radiation damage

In order to assess ileal dysfunction in patients with complaints after pelvic radiation therapy, retention measurements and scintigraphic imaging with selenium 75 homocholic acid conjugated with taurine (⁷⁵Se-HCAT), combined with the carbon 14 glycochol breath test, were evaluated in 39 patients. In 22 patients without ileal resection the results of the⁷⁵Se-HCAT test and the breath test differentiated between a normal functioning ileum (both tests negative) and ileal dysfunction as a cause of complaints (one or both tests positive). Among the patients with ileal dysfunction, the combination of both tests permitted those with bacterial overgrowth (breath test positive,⁷⁵Se-HCAT negative) to be separated from patients with evidence of bile acid malabsorption (⁷⁵Se-HCAT positive, breath test positive or negative). In 17 patients with small-bowel resection, the⁷⁵Se-HCAT test helped to estimate the severity of bile acid malabsorption with implications for therapy. In this group the breath test was false-negative in 7 cases with abnormal⁷⁵Se-HCAT. Additional systematically performed scintigraphic imaging improved the accuracy of the⁷⁵Se-HCAT test, revealing cases with prolonged colonic accumulation of the radiopharmaceutical, causing spurious retention values. In conclusion, assessment of ileal dysfunction by nuclear medicine techniques in post-irradiation conditions provides information about the aetiology and therefore the possibility of adjustment in the clinical management. Offprint requests to: R.A. Valdes Olmos     

Abnormal geometry of the distal radioulnar joint: MR findings

Previously developed criteria of normal distal radioulnar joint (DRUJ) axial geometry were applied to routine magnetic resonance (MR) images of 50 wrists. All wrists lacked clinically evident DRUJ instability. An attempt to apply the three geometric criteria to seven of the cases was not possible, since the prescribed landmarks were not visible. The remaining 43 cases were retrospectively divided into a symptomatic group (25 wrists), with clinical abnormalities referable to the ulnar side of the wrist, and an asymptomatic group (18 wrists), with no such abnormalities. Abnormal DRUJ geometry was found in 12 symptomatic and 2 asymptomatic wrists. This difference between the groups is significant (p=0.02), suggesting that many symptomatic wrists exhibit different DRUJ geometry than is found in most asymptomatic wrists.     

A preliminary study of sex-related differences in prolactin responses to dopamine blockade and insulin hypoglycemia and in penfluridol plasma levels in schizophrenic patients

Twelve healthy chronic schizophrenic patients were treated with the long-acting oral dopamine (DA) receptor blocker penfluridol (100 mg orally) for 6 weeks. Plasma prolactin (PRL) levels were measured during insulin-tolerance tests (ITT) performed at the end of the drug-free period (7-10 days) and during weeks 1 and 6 of penfluridol treatment. Simultaneous PRL and penfluridol plasma levels were determined just prior to, and at 8, 72 and 120 h after penfluridol administration during weeks 1, 5, and 6. During penfluridol treatment women (N = 4) had a greater increase in their maximal PRL increments after ITT as compared to the men (N = 8). Analyses of (peak) plasma penfluridol and PRL concentrations 8 h after penfluridol administration revealed a trend towards lower plasma penfluridol levels during weeks 5 and 6 and significantly higher PRL levels in women compared to men during weeks 1 (P less than 0.01), 5 (P less than 0.02), and 6 (P less than 0.02). The consistent sex-related differences in the PRL responses to DA blockade, and to insulin-induced hypoglycemia and in the penfluridol plasma levels in our study support the view that sex-related changes need to be considered not only in the hormonal responses to various pharmacological agents, but also in the assessment of the plasma levels of these drugs.     

Plattenepithelcarcinome auf r?ntgengesch?digter Haut der H?nde

Ohne Zusammenfassung     

Noninvasive flowmetry in vascular surgery: Use of a noninvasive electromagentic flowmeter

Using anin vitro model, the measurements made using a noninvasive electromagnetic flowmeter have been validated using standard square wave electromagnetic flowmetry. Clinically, the noninvasive electromagnetic flowmeter provides information as to the functional significance of vascular occlusive disease that is not available through other techniques, gives an accurate, quantitative measurement of the peak pulsatile blood flow through a limb, thus providing an index of tissue perfusion and therefore, the degree of involvement of the disease in the peripheral, vascular system. Presented at the Post-congress Meeting on Noninvasive Flowmetry in Angiology, of the 21st Congress of the Japanese College of Angiology, Fukuoka, Japan, October 30–November 1, 1980.