Biomedical subjects
Publications and source records attributed to D Kötter.
Posttraumatic osteolysis of bone is rare. Its etiology is unknown. A case of posttraumatic osteolysis of the distal clavicle end is reported. Differentialdiagnostical and ethiological relations are discussed. The literature of posttraumatic osteolysis especially of distal clavicle osteolysis is reported.
Eighteen patients with fractures of the pelvis were examined by computer tomography. The results were compared with those of conventional radiological diagnosis. In each case the bone injuries were accurately diagnosed, in some patients additional information was obtained or the findings corrected. It was also possible to demonstrate injuries to pelvic, abdominal and retroperitoneal organs and injuries to other regions of the body, such as the skull and thorax. Haematomas could be directly demonstrated and additional information, useful for plannng surgery, was obtained.
The acute hemodynamic effects which occur after a quick infusion (500 ml per 10 minutes) of hydroxyethyl starch, dextran 60 or autologous blood with identical hematocrit were studied in three groups of 10 patients each on the first day after laparotomy. If blood is infused there is only a moderate increase of the total perfusion (+18%) observed, however hydroxyethyl starch or dextran 60 infusions result in a striking increase of the cardiac output (+34%, +44%, respectively). There is no significant difference among the latter two groups. Thus, hydroxyethyl starch as well as dextran 60 can be considered as a potent volume substitute, if an acute effectiveness is wanted.
Different species of animals (warm-blooded, poikilotherms and cold-blooded) were exposed to oxygen high pressure (OHP) (1-4 ata) for 2-8 h. OHP revealed (a) a different vulnerability in various species; (b) an inverse correlation between basal oxygen consumption and their vulnerability; (c) the critical point of the toxic effect of OHP in normothermia was an exposition time of 2 h with 2 ata OHP; (d) morphological changes of lung, CNS and vessels -- intense folding of alveolar septa with cell hyperplasia and hypertrophy; (e) electron-microscopical demonstration of damaged endothelial cells with total or partial occlusion of the capillaries.
In eight lung autotransplants and six normal lungs the vasomotor activity was tested with norepinephrine and acetylcholine. In autotransplants and normal lungs both substances elicit the same effects. The long-term interruption of the central innervation does not provoke a vasoconstriction in lung autotransplants.
A simple method of dystopic cardiac transplantation as a left-heart bypass was experimentally studied and details of the method are described. The hemodynamic investigation of this biological assisted circulation on the normal and failing heart, which was induced by subtotal occlusion of the asc. aorta, as well as its longtime support of the chronically damaged left myocardium showed the efficacy of this method. The advantages of this biological method in comparison to that of mechanical devices and orthotopic cardiac transplantation are discussed.
The effects of dopamine on the pulmonary vascular resistance were investigated in 7 normal and 9 autotransplanted canine lungs during perfusion in situ. Dopamine (up to 13,5 gamma/kg BW, rapid injection) acts as a vasoconstrictor by alpha-receptor stimulation. Vasodilative effects could not be registered neither by very small amounts of dopamine nor during alpha-blockade with phentolamine. No difference could be detected between the vascular reactions of normal and autotransplanted lungs.
At the end of an abdominal operation, a Teflon catheter was inserted into the portal vein, where it remained for nine days. Thus, blood samples could be withdrawn for analyses, and pressures could be recorded. The investigations were carried out in 41 patients who had a gastric or intestinal operation and had an uncomplicated postoperative course. The pressures in the portal vein and the arterioportal oxygen content difference were constant with 7 to 8 millimeters of mercury and by 2 volume per cent, respectively, during the period of all nine postoperative days. The pressure gradient between portal and central veins was about 6 millimeters of mercury. By infusing 350 to 500 milliliters of dextran 60 on day one or two postoperatively, the cardiac output was elevated about one-third, the central venous pressure increased from 0.9 to 4.9 millimeters of mercury and the portal venous pressure increased from 7.8 to 9.7 millimeters of mercury. This means that the pressure difference between the portal and central veins diminished. Simultaneously, the oxygen content difference between the systemic and pulmonary artery decreased from 4.7 to 3.3 volume per cent and between the systemic artery and portal vein, from 1.8 to 1.3 volume per cent. By assuming a constancy of the oxygen consumption in the region of the mesenteric circulation during infusion, it can be calculated from the behavior of the arterioportal oxygen content difference that the flow increase in the portal vein nearly equals that of cardiac output. The physical transhepatic resistance decreased about 50 per cent.
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