[Preclinical care of the severely injured patient. 1: Medical measures at the accident site].
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Biomedical subjects
Publications and source records attributed to V Echtermeyer.
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The rate of pseudarthrosis in 726 conservatively treated fractures of the clavicula was 0.69%. The danger of hyperporoses lies in neurovascular compression. Errors in treatment pertain to wrong operative indications and inadequate osteosyntheses. Surgery should be performed only in 2nd and 3rd degree open fractures and/or concomitant neurovascular lesions (2.06%), in distal fracture dislocations with instability of the AC-joint (1.6%) and in cases of painful pseudarthrosis (n = 46). The implant of choice is the 3.5 DCP. Six cortical contacts must be achieved in each fragment.
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Five-week-old syngeneic, female BALB/c nude mice were injected i.p. with vincristine (VCR) and 5-fluorouracil (5-FU) to determine the LD 20 of these drugs under spf-conditions. One hundred fifty animals were given dosages similar to those administered clinically, and a complete autopsy was performed on all nude mice. Whereas VCR caused splenic atrophy and regressive changes in the jejunal epithelium, the application of 5-FU was followed mainly by regressive changes in the transitional epithelium of the bladder, and 67% of the animals developed pneumonia. These pathohistological changes were also seen after a combined chemotherapy, and a temporary leucopenia was reversible. These experiments showed that chemotherapy of nude mice with VCR and 5-FU is possible provided they have been successfully xenotransplanted with human colorectal adenocarcinomas.
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Two patients are reported which were operated for complications of small bowel diverticula. One was operated for a retroperitoneal tumor caused by a perforated diverticulum, which led to an inflammatory mass of the mesentery. In another patient adhesions produced acute intestinal obstruction.
A case of duodenal obstruction by a congenital duodenal web in a 34-year-old woman is presented. A mucosal diaphragm obstructed the duodenum. It showed an excentric opening of 0.8 cm diameter, but the dilated diaphragm caused a total stop during the last months. Despite a typical history, exact X-ray, and endoscopic examination, the correct preoperative diagnosis was not found, because nobody thought it possible, that a mucosal diapharm of the duodenum could persist for 34 years.
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Based on an epidemiological study of 582 active handball and soccer players the abilities and limitations were analysed for sports activities of 24 athletes with an ACL-deficient knee. 22 of the 24 athletes suffered from a straight anterior instability. 50% attempted to avoid cutting mechanisms. The level of motivation was better than in the whole population. Handball players could continue their sports better and longer than soccer players. However, 19 athletes had to be classified as "knee-abusers" because they continued their sports inspite of having complaints. If athletic participation following ligament injuries of the knee should be rated, an accurate quantification and qualification is imperative.