Biomedical subjects
Publications and source records attributed to J Schöche.
A report is given on the application of external fixateurs for the treatment of complicated fractures of the cervical vertebral column and fractures of the dens. Basic principles of application and construction are represented. The effectiveness of the method if an intraspinal space occupation is excluded is proved by means of X-ray pictures.
In the cellular examination of suction material of 100 brain tumour operations, which was obtained by means of ultrasound aspiration, the following essential findings were obtained: Homogenisation, cavitation, cellular changes, effects on the vascular walls, and very rarely small-area haemorrhages. The determination of the tumour type was possible in all cases, the results were checked by independently performed biopsies.
A report is given on the method of the tumour aspiration of cerebral tumours by means of power ultrasound. After classical exposure of the tumour--obligatory performance with physical-pharmacological reduction of the metabolism and in most cases under hypotension--the tumour is destroyed by ultrasonic power and simultaneously aspirated. A report is given on 50 cerebral tumour operations, which were carried out in Karl-Marx-Stadt within two years, using the tumour aspiration system "Aspirus 120". Finally the advantages of the method are summarised and dangers interpreted. At the end a valuation of the method is attempted and an outlook is given.
On the basis of experience gained in operations for cerebral tumours rich in blood vessels in 50 patients the advantages of the combination of a pharmacological-physical reduction of the metabolism and hypotension is dealt with. Nitroprusside sodium hypotension is inferior to this procedure. The experience gained in the different groups is broken down in detail.
In a period of 15 years, 16 intracranial meningiomas of the childhood and adolescence were examined radiologically. The neuroradiological findings obtained are analysed and compared with those obtained in adults. The particularities resulting from this comparison, which above all concern the angiographic picture of meningiomas in juvenile patients, are worked out and discussed. As a result, some conclusions can be drawn which may be of practical importance: As is the case with other cerebral tumours in childhood, meningiomas in most cases give rise to reliable radiological signs of an increase in intracranial pressure. The changes of the cranial bones indicating the presence of a meningioma, which are well-known signs in adults, are found in children almost as frequently. While pneumo-encephalography in most cases permits a reliable localisation of the tumour, it does not permit a diagnostic statement with respect to the kind of the tumour. In three patients the air filling made larger cysts visible which obviously occur more frequently in children than in adults. The angiographic picture of meningiomas in childhood often differs from that in adults with regard to the vascularisation type as well as the phase course, so that differential-diagnostic difficulties may arise. However, when considering the above mentioned peculiarities of the vascular picture of memingiomas in children, it appears to be possible to make a preoperative diagnosis of the kind of the tumour with the help of the angiogram also for children. The increased vascular supply via branches of the A. carotis externa, which is frequently found in neningiomas, cannot in our opinion be considered as a decisive type-diagnostic criterion; it must be considered as an expression of an increased participation of the dura and thus also occurs in other space-occupying intracranial processes.
Among 65 patients operated by lumbar disc in 1977 we encountered 5 women after gynecological tumour operations. 4 of those patients not became symptom free. The relation of mechanical factors, obstruction and circulation changes seemed to be of importance for the evaluation of ischialgia in those cases and led to spinal root and root sheath damages.
Among 503 deadly brain injuries 71% have been caused by traffic accidents. In 93 patients the brain injury was not the direct cause of death. Total observations included: 170 intracranial haemorrhages; 106 smashes of the skull and 104 contusions. In patients with subdural and epidural haematomas angiography and trepanation were used in few cases.
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An account is given of a case of artificial perfusion of isolated organ after operative correction of an angiographically recorded standstill of the circulatory system. Criteria of cerebral death and determination of the time of death are discussed.
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