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Biomedical subjects

H A Müller

Publications and source records attributed to H A Müller.

At least 73 records · Page 4Linked to original sources
PubMed1983

[Diagnosis and therapy of capitulum humeri fractures].

Report of four cases of fracture of capitulum humeri treated by operation. The necessity of an exact preoperative radiological diagnostic work-up including lateral tomography of the elbow is pointed out. It is described how difficulties occurring during and after surgery can be avoided by choice of an adequate approach and a suitable internal fixation. Presented is the radio-volar approach and temporary fragment fixation with K-wires from ventral to dorsal. Three cases treated in a similar way show the efficiency of the procedure.

Elbow Joint↗
PubMed1982

The value of spinal computed tomography in diagnosis of herniated lumbar discs.

In this study the diagnostic value and topographical accuracy of spinal computed tomography (CT) in hte preoperative diagnosis of lumbar disc herniations were tested in 36 patients with surgically proven herniated discs. All patients also underwent metrizamide myelography. CT findings and myelograms were compared and correlated with the surgical observations. Especially in demonstrating exact diagnosis (lateral or more medial protrusion), and in showing the extent of upward or downward displacement of free disc material, CT provides valuable preoperative information. As a non-invasive diagnostic procedure, spinal CT scan may replace lumbar myelography in many patients with radicular lumbar pain.

Humans↗
PubMed1982

[Diagnostics and therapy of osseous elbow lesions in the growing skeleton].

Osseous elbow lesions in the growing skeleton often involve problems of diagnosis, indication and therapy which are essentially different from those occurring in adult persons. Beyond its task to prove or to exclude a fracture line, X-ray diagnosis also has to search systematically for discernible soft tissue modifications (adipoid signs) or for disturbed correlations of positions and axes. When adopting an indication for conservative or surgical treatment, it has to be considered that rotation faults are not compensated during the further growth of bones and that an insufficient reposition of an epiphysis fracture causes a tendency towards an increase of the joint deformity when the bone is growing. The treatment of a bone fracture aims not only at a good elbow joint function which can be achieved even by a conservative, insufficient reposition, but also at an exact reposition and a reliable fixation during the short healing time. In most cases, the latter is only possible by means of fine metal implants (drilling wires and screws for little fragments which, by way of exception, do not touch the epiphyseal cartilage). This is the only way to avoid joint deformations and defective positions in adolescents which can promote the formation of destructive arthroses in adults. As opposed to fractures in adult persons, the functional result is not deteriorated by an additional immobilization for a period of three to four weeks effected in order to guarantee the so-called "minimal osteosynthesis".

Adolescent↗
PubMed1982

[Thoughts on the so-called "radius-capitellum axis" (author's transl)].

We have studied 438 patients radiologically in order to observe the so-called "radius-capitellum axis". In about a quarter of people with normal elbows the axis passes lateral to the middle portion of the capitellum, so that even when there is marked deviation, there is no certainty that the humero-radial joint is abnormal. Deviation of the axis can be caused by changes in the shape of the capitellum or of the radius, or by distension of the capsule of the elbow joint, or by various changes in muscular pull.

Arthritis↗
PubMed1982

[Computer tomography after medullary nailing of the tibia].

Computer tomographic examination of the tibia was carried out in ten patients two days to four years after removal of an intramedullary nail. Sclerosis of the marrow cavity and cortex and bone formation in the nail track are characteristic findings. They have been correlated with the appearances on conventional x-rays. Changes in the density of the marrow cavity, which is normally increased around the previous nail tract, do not necessarily indicate the presence of infection. In the absence of complications, the increased marrow space density may return to normal negative values corresponding with fat density.

Adult↗
PubMed1982

[Lipohaemarthrosis (author's transl)].

Besides the presence of blood in an injured joint, fat-containing blood can also be found in the joint with intra-articular fractures. This condition, which can be demonstrated by x-ray film, is known as lipohaemarthrosis. We found this to be the case in 8 out of 295 patients with shoulder dislocation. The origin, significance and differential diagnosis of this condition are described.

Adult↗
PubMed1981

[The anatomy, radiology and clinical features of fractures of the sacrum (author's transl)].

In the presence of multiple injuries, 30% of fractures of the sacrum are missed on the first examination. The clinical features are non-specific and are often obscured by other injuries. Interruption or displacement of contrast lines on the A. P. view, if bilateral, are definite evidence of a fracture. In evaluating films of the sacrum it is therefore recommended that these lines be examined carefully. Such changes were found in two thirds of longitudinal and one third of horizontal fractures. Special attention should also be paid to the lateral and cranial articular processes, since these are areas of weakness in the pelvis and are predisposed to fracture.

Accidents, Traffic↗
PubMed1981

[Pre-operative staging of bronchial carcinomas: a comparison of computed tomography and conventional radiography (author's transl)].

Pre-operative staging was carried out in 52 out of 112 patients suspected of having bronchial carcinomas, using computed tomography and conventional radiology. CT was superior in demonstrating tumour infiltration of the mediastinum, of the thoracic wall and of metastases in mediastinal lymph nodes. Conventional radiology was better for demonstrating intrabronchial tumour and metastases of bronchopulmonary lymph nodes. By extending CT to the upper abdomen, it was possible to show metastases in 18% of patients.

Adenocarcinoma↗
PubMed1981

[The value of CT in the pre-operative diagnosis of disc prolapse (author's transl)].

A disc prolapse can be directly visualised by CT. Forty patients with a clinical diagnosis of disc prolapse were examined pre-operatively. The following criteria were noted: 1. Level, 2. lateralisation, 3. medial or lateral position, 4. differentiation between protrusion and sequestration, 5 displacement of the sequestrum. In 38 patients surgery was performed. Criteria 1 to 3 had been correctly diagnosed in 35 and 34 resp. and Ct proved equally reliable in respect of criteria 4 and 5. It is concluded that the combination of clinical examination and CT provides adequate diagnostic information before surgery. Myelography should be used only where there is still doubt.

Cervical Vertebrae↗
PubMed1981

Ferritin: a reliable indicator of iron supplementation in patients on chronic hemodialysis/hemofiltration treatment?

Four hundred and forty-two serum ferritin determinations were performed in 144 patients on chronic intermittent hemodialysis treatment with intravenous iron substitution and/or oral iron substitution. Iron substitution should be done individually according to regular serum ferritin determinations. Intravenous iron substitution is easier to regulate. Iron substitution exceeding 100 mg per month normally leads to a slowly progressing iron overload except in those patients with additional blood loss or on chronic hemofiltration treatment. Iron administration should not be evaluated according to ferritin levels in patients with additional complications such as active hepatitis, tumors, infectious diseases, and operations. In these cases evaluation of iron storage can only be estimated by bone marrow examination.

Administration, Oral↗
PubMed1981

[Cytodiagnosis of malignant non-Hodgkin's lymphomas in effusions (author's transl)].

Body cavity effusions in malignant non-Hodgkin's lymphomas, particularly in the early stages of those neoplasms, are rare in comparison to the far more common effusions in other malignant diseases and in inflammatory processes. Therefore, the cytological differential diagnosis is of great importance. Of 7,000 pleural and 1,700 ascitic effusions, only 42 cases were malignant non-Hodgkin's lymphoma and in 30 lymphoma was suspected. When lymphoma is suspected, particularly low-grade lymphoma, there are great difficulties in making a differential diagnosis. Using the more or less typical cellular and nuclear criteria of the various lymphoma types, an attempt was made to classify the unequivocal lymphomas according to the Kiel classification of malignant non-Hodgkin's lymphomas. In principle these criteria are the same in cytological and histological examinations. In 31 cases the lymphoma subtype could be specified and confirmed in part by subsequent histological examination. Apart from the suspect lymphoma cases (40%), cases of a low grade of malignancy were predominantly observed (28%). Lymphomas with a high grade of malignancy were less frequently encountered (15%), a proportion similar to that of unclassifiable lymphomas (16%). Apparently the cytological and karyological criteria are not yet adequate to classify lymphomas from conventionally prepared cytological specimens with a higher degree of accuracy.

Adolescent↗
PubMed1981

[Osseous lesions in the elbow region in adolescents and adults (author's transl)].

Analysis of roentgenographs of injured elbows must go beyond the identification or exclusion of a line indicating a fracture, especially in children and adolescents. Decisive diagnostic pointers can be supplied by the displacement of fatty bodies, which is a very sensitive indicator of an intra-articular growth, as our postmortem examinations have shown. A systematic search for disturbances of relative positionings (which are defined e.g. by the radius-capitulum axis or the ventral longitudinal humerus axis) and consideration of the sequence in time of the appearance of ossification centres in elbows of children, will prevent gross mistakes in the assessment of the pathological situation.

Adolescent↗
PubMed1981

[Special fractures of the capitulum humeri (author's transl)].

Whenever radiographs in the elbow region do not present a clear picture, the physician should consider the possibility of a lesion of the capitulum humeri, despite the fact that this is rather rare. In such cases, the anteroposterior radiographs of the elbow may not present any abnormal findings. In most cases, crescent-shaped or elliptic bone chips in the bend of the elbow or dorsally in the interarticular space of the elbow joint will lead to the proper diagnosis. Classification into groups according to Hahn-Steinthal, Kocher-Lorenz and Krösl can lead to errors if employed too rigidly. In our opinion, lateral tomography of the elbow should always be performed whenever there is any suspicion of a lesion of the capitulum humeri. This will definitely clarify the origin and nature of the fragment, which may be of importance for the selection of the surgical approach and the type of surgical treatment chosen.

Adult↗