Biomedical subjects
Publications and source records attributed to J H Müller.
In a retrospective analysis 97 phlebograms of the leg of patients with ulcus cruris were evaluated. According to the phlebographic result a subdivision into Ulcus cruris varicosum (n = 66) and Ulcus cruris postthromboticum (n = 31) was made. The different phlebographic findings are discussed.
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The results of the percutaneous obliteration of the renal cysts in 68 renal cysts (6 cases of recidivation) are discussed. The use of an obliteration remedy is superior to the only submaximal depletion of cysts. The results after the sclerosation treatment with ethoxysclerol 2% were essentially better than after varicocid instillation. The sclerosation therapy may be performed only after a preliminary thorough angiographical clarification including renocystography. The excretion urograms are sufficient for the control examination.
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This is a report on 204 patients operated on for a blunt abdominal trauma in the period from January 1, 1964 to December 31, 1978. As a consequence of the blunt abdominal trauma, rupture of the spleen was found most frequently. In diagnosing blunt abdominal lesions peritoneal lavage as well as abdominal emergency angiography by have proved best apart from X-ray examination.
We think that the present paper insistently demonstrates the fact which is acknowledged by all but followed only by few how important is a unitary classification of the renal tumours in order to perform scientifically proved comparisons and valuations in all branches of the treatment of renal tumours including the results of the therapy. On the basis of the classification of our patients according to the TNM-system we could prove that the best results in the operative removal of the kidney with following irradiation were achieved in the categories T1 and T2, particularly when there were not yet present any metastases distant from the primary tumour.
On 22 auto- or homotransplanted kidneys of dogs a quantitative angiographic evaluation of the corticalis perfusion was carried out. For this purpose four special parameters were evaluated. With the help of the linear discriminance analysis we succeed in a sufficient secure separation between autografts impaired by ischaemia or shock on the one hand and homografts impaired by rejection on the other. It is referred to the prognostic significance of angiography in human graft kidneys with disturbed function.
Comparison of pre- and postoperative angiograms reveals no significant statistical difference concerning kidney size after successful reconstruction of the renal artery. This examination is based on planimetric data of 10 patients with haemodynamical important stenoses of the renal artery (including one patient with bilateral stenosis).
In 5 patients with angiographically normal coronary arteries and previous myocardial infarction (left ventricular a- or dyscinesia), measurement of coronary reserve revealed normal values. On average, patients with myocardial infarction and normal coronary arteries were younger than patients with angiographically proven obstructive coronary lesions (p less than 0,001), and did not exhibit a rise in coronary risk factors. These results suggest that in some cases myocardial infarction is due to acute, completely reversible occlusion or severe stenosis of larger coronary arteries without morphological or functional defects of coronary arteries detectable later on.
For the estimation of the haemodynamic and metabolic effect of 1 mg/kg phenoxybenzamine in a kidney donor with craniocerebral trauma model experiments were performed on dogs with hypovolaemic hypotension. The results show that phenoxybenzamine leads to vasodilatation in a constant aortic pressure of 80 mm Hg in the systemic circulation as well as in the renal circulation with different speed of reaction. Thus the arterial and venous O2 and CO2 partial pressure normalizes and the diuresis increases. On the other hand, the hypotension-conditioned metabolic acidosis and the symptoms of an acute renal failure may not be influenced.
Quantitative angiocardiographic examinations concerning the regional contraction of the left ventricle in 16 patients with acute myocardial infarction were performed. In comparison to a control group of 6 healthy male patients the determination of the speed of the medium regional shortening (MVRF) of 12 different ventricle segments resulted in typical findings deviating from the normal. On the second day after beginning of the infarction in the area of the myocardium affected by an acute infarction there existed as a rule severe hypokinetic and akinetic disturbances of the contraction (13 times), only in three cases slight paradoxical movements of the ventricular wall (dyskinesias) could be observed. The average speed of shortening of all segments together (MVRF) excellently represents the momentary global function of the ventricle. It comprises in the same way acutely and chronicly disturbed areas as well as also the function of regions of the myocardium which are not disturbed. MV/RF and systolic ejection fraction (SEF) show statistically a highly significant correlation of r = 0,797 (p less than 0.001). On the basis of the findings got considerations are performed concerning a proved differential therapy in the acute stage of the myocardial infarction.
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Which consequences result from these experimental results from practice? In the acute angiography in postoperative functional distrubance after transplantation of a human kidney is at first probably always to be reckoned with a rejection process, though this immunological process by no means must be in the foreground of the causal connection of several pathogenetic factors. Therefore, in our opinion it would then be assumed an ischaemia-conditioned cell damage of the tubulus by a longer lasting prefinal circulatory depression or due to a not optimal preservation, when there is in the angiogramme a clear discrepancy to the severity of the postoperative functional distrubance, i.e. when angiographically exists only a slight cortical ischaemia in an otherwise good arterial filling picture and a widely normal capillary filling phase.
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