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Biomedical subjects

E Willenberg

Publications and source records attributed to E Willenberg.

At least 19 recordsLinked to original sources

[Diagnosis of obliterating vascular processes in the supraaortic area].

For the diagnostics of obliterating vascular changes in the supraaortic area the invasive diagnostics of the vessels is not to be renounced now as before. The indication to the angiographic investigation results from clinical, perfusion-scintigraphic and Doppler-sonographic-findings. Of 390 patients 289 pathological angiographic findings in the supraaortic vascular area. In 101 patients normal findings were stated. Altogether 509 individual pathological findings were represented. In the comparison of the results of the investigations in the various diagnostic methods the clinical neurological investigation showed itself as particularly evident method. It should be decisive for the indication to the invasive diagnostics. The correspondence between the angiographic findings and the result of the perfusion-scintigraphic and Doppler-sonographic investigations, respectively, was the greater the more expressed the extracranial vascular findings represented themselves. In 127 patients with multiple obliterating vascular changes the size of the pathological changes and their localization could be established only angiographically.

Arterial Occlusive Diseases

[Status of perfusion scintigraphy in the diagnostic strategy in cerebrovascular disorders and space-occupying lesions].

The results of an evaluation of the perfusion scintigraphy findings of 350 hospitalised neurological patients and 55 more strictly selected neurosurgical patients with cerebrovascular complaints, revealed an accuraty of 83%, a sensitivity of 89%, and a specificity of 83%. The selection of the patients had no influence on the results as a whole. Compared with contrast-medium angiography, incorrect diagnosis must be expected in 17% of the cases. This includes erroneous negative findings in 10% of the cases. Grounds for misinterpretations are suggested, and the biological and methodological limitations of the method are set forth.

Brain Ischemia

[Value of muscle biopsy in the assessment of the prognosis of brachial plexus paralysis].

Since Plexus brachialis lesions mainly occur in young persons, their socio-medical significance is undisputed. While the diagnostic rules are largely standardised, the time and the kind of the surgical intervention is disputed. The enzymic-histochemical examination of the denervated muscles of nine patients confirm the trend towards an intervention as early as possible. After only a few days serious changes of the mosaic structure of the muscles with a great number of histopathological particularities had occurred. After half a year, the muscles already showed considerable fibrous changes, so that re-innervation is highly restricted. The enzymic-histochemical and clinical findings largely correlate.

Adult

[Recording of cell-mediated immunity in patients with gliomatous brain tumors].

The cell-mediated immunity state by detecting lymphokine in the macrophage electrophoresis mobility test (MEM-test) was supervised in 9 patients with gliomatous cerebral tumors and 12 normal subjects. A positive lymphokine proof was provable by application of 100 micrograms antigen in 8 of 9 patients of the tumor group, however, in the control group in 1 of 12 probands. The MEM-test is a practical improvement of the immunodiagnosis especially for tumors of the nervous system despite the high technical and temporal expense.

Adult

[Non-Hodgkin lymphoma (NHL) as a primary finding in the central nervous system].

The clinical picture is dealt with on the basis of seven cases of primarily recognised non-Hodgkin's lymphomas in the CNS treated by us. Because of the frequently serious initial situation immediate surgical intervention can on the one hand improve or remove the paralysis and, on the other, it will lead to histological diagnosis. Elderly patients with a lower degree of malignity show a better prognosis.

Humans

[Delayed encephalopathy].

A specific clinical course of light covered craniocerebral traumas patients, corresponding to 2 per cent of all clinically treated craniocerebral traumata. Twilight states and transient neurological and ophthalmological symptoms characterise the clinical picture. The prompt reversibility of the symptoms indicates a functional damage requiring a differential-diagnostic consideration of morphological sequelae of traumas, for which instrumental diagnostics and, if required, surgical consequences are necessary.

Accidental Falls

[Measurement of polymerization heat of the tissue adhesive Fimomed (alpha-n-butylcyanoacrylate) reduced in the GDR].

The authors describe a method for measurement of temperature that originates from the polymerisation of the adhesive Fimomed (alpha-n-butylcyanoacrylate). The intravascular application of the adhesive is taken as a basis of the measurement. This kind of application is applied by the authors for the closure of arterio venous fistulae. The measurement of the temperature with this method did not show both in the centre of polymerisation and in the surroundings any doubtful value if not more than 3 ml adhesive was applied. However the measurement of the temperature which originates from the polymerisation is recommended in all cases before any plane sticking is applied.

Arteriovenous Fistula

[Bacteriostatic behavior of the tissue adhesive Fimomed (n-butyl-alpha-cyanoacrylate].

The tissue adhesive Fimomed (made in GDR), which is supplied in a non-sterilised form, was tested for its bacteriostatic behaviour. No such behaviour was found for Gram-negative bacteria, so that in view of the typical microorganisme occurring in hospitals sterilisation of the adhesive by means of gamma rays or an aseptic filling by the manufacturers is suggested.

Bacteria

[Lumbar lipomeningocele (case report)].

The authors describe a case of spinal lipomeningocele at the L2 to L4 level, detailing the properties of growth, clinical characteristics, diagnosis, and surgical therapy of such types of swelling.

Female

[Justification of bitemporal decompressive trepanation with duroplasty in severe closed craniocerebral injury].

In serious craniocerebral traumata in which the cerebral oedema cannot be controlled by conservative methods, the authors again recommend the performance of a bitemporal relieving trepanation reaching far in basal direction (adults 5 cm ø, children 4 cm ø). In case of closed traumata, the operation is started on the more affected side, in case of open injuries trepanation is first carried out on the other side. Detailed indications about the accompanying oedema treatment. The wide opened dura is covered with the temporalis fascia or with a free transplant.

Brain Injuries

[Incidence and diagnosis of lumbosacral pouch diverticula].

The myelograms of ninety-nine patients with an ischias symptomatology were analyzed. In fifteen of the subjects there were found lumbosacral radicular pouch diverticula which, after elimination of other nosogenic factors, were considered chiefly responsible for the clinical and neurological pictures observed in six cases. The pathological and anatomical, clinical and radiographic results described by the authors represent a disease picture which is little known and, hence, not generally included in the differential diagnosis of ischialgia, but which has been found to yield to neurosurgical treatment in selected cases.

Back Pain

[The value of possible skull-cap replacement surgery].

After describing the valence of the various possible plastic procedures for covering defects of the skull cap, the results obtained by the authors are presented. In childhood, autografting from the inner layer of the wing of the ilium or from the ribs is given preference. In adults, the authors carry out alloplasty with hot-polymerizing methacrylate in order to prevent a second surgical intervention for obtaining autogenous material. If surgery has to be carried out in the vicinity of the paranasal sinuses, autogenous cartilaginous cubes must be inserted between the sinuses and the alloplasty because direct contact of the alloplastic material with the sinuses exposed to infection hazards must be avoided.

Adult