Biomedical subjects
Publications and source records attributed to V Nutz.
Painful glomus tumors near the coccyx have not yet been described before. Three patients with coccygodynia were treated by excision of the glomus coccygeum. All of them were free of pain afterwards. Two glomus tumors were found. The tumors of the glomus coccygeum are compared with the well-known glomus tumors "Masson".
13 patients with gastrointestinal hemorrhage underwent a scintigraphic examination to localize the bleeding. In 6 patients Tc-99m labeled red blood cells, in 7 patients Tc-99m sulfur colloid were used. Scintigraphy could demonstrate an intestinal bleeding in ten patients, in whom the conventional examinations, and among them 7 abdominal angiographies had failed. 5 of them had to be operated after that, whereby the scintigraphic findings were verified. One of the three patients with negative scintigraphy had to undergo an operation because of continuous bleeding. The methods of scintigraphy and their indication in gastrointestinal hemorrhage are discussed.
Goitre operations were done in 2114 patients; 1648 patients had a simple solitary nodule or multinodular goitre with regressive changes. Malignancies were found in 54 cases with a clear-cut predominance of papillary carcinomas. Nearly half of the goitres diagnosed as solitary nodules preoperatively were shown to be multinodular. This discrepancy was taken into account in the determination of the rate of malignancy. Malignomas were found in 4.6% of "true" solitary nodules and in 2.8% in multinodular goitres. These findings confirm our liberal indications for operation in multinodular goitres with regressive changes also in the area of endemic goitre. The high incidence of microcarcinomas in our patients can thus be explained.
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43 patients had 51 endoscopic sphincterotomies within 4 years; there were 2 complications, 7 patients had to have surgery in spite of endoscopic sphincterotomy. Stones, which had been left unnoticed in the choledochus during surgery could be removed in all cases endoscopically. These results speak in favour of endoscopic sphincterotomy, if compared to results of other non-operative treatments of retained bile duct stones such as percutaneous stone extraction. Endoscopic sphincterotomy has been widely used meanwhile and may be apt now to be introduced as a routine procedure also in smaller hospitals.
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Severe trauma leads to considerable losses of nitrogen in the first days after the accident. As nutritional efforts cannot reduce these losses sufficiently, an adjunctive therapy using the anabolic steroid nandrolone decanoate (Nd) was applied. In a double-blind study 10 male multiple-traumatized patients each received 50 mg of Nd on day 3 and 25 mg of Nd on day 6 after the trauma, an additional 10 patients received placebo only. Both groups had identical nutritional support. Nitrogen balance, total nitrogen excretion as well as plasma amino acid concentration, and urine amino acid excretion were measured daily. The anabolic agent improved the nitrogen balance mainly by reducing nitrogen excretion. 3-Methylhistidine excretion and renal amino acid losses were decreased. Nandrolone decanoate increased the concentration of total plasma amino acids. The underlying principle seems to be an amino acid-saving mechanism with a renal site of action. It is shown that in the early posttraumatic period nandrolone decanoate improves nitrogen metabolism. Further studies are required to determine whether this offers a clinical benefit to trauma patients.