[Appendix cancer].
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Biomedical subjects
Publications and source records attributed to W Blauensteiner.
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A report on 100 consecutive esophagoenteric anastomoses (EEA stapler) following total (esophagojejunostomy) or proximal gastrectomy (esophagogastrostomy) is presented. The following intraoperative problems occurred: insufficiency of the purse string suture [4], lumen of the esophagus too small [1], rupture of the esophageal wall [4], incomplete rings [4]. Fatal postoperative complications included two cases of insufficiency of the esophagojejunostomy, whilst the remaining six postoperative deaths were not linked to the use of the stapler (operative mortality 8%). Follow-up showed no recurrence at the stapler line, but two anastomotic strictures occurred. The EEA stapler is a helpful instrument to reduce leakage at the esophagoenteric anastomosis and, hence operative mortality after total and proximal gastrectomy.
From 1976 to 1985 we treated 236 patients with fractures of the calcaneum without additional injuries to the legs or pelvis. Among 129 patients, 22 female/107 male, with an average age of 50 and 42 years, respectively, we performed a total of 141 fractures of the calcaneum. The average post-traumatic follow-up was 6 years. For 62 fractures we performed conservative therapy with immobilization in plaster and for 79 fractures, reduction and percutaneous drill wire fixation. The fractures were classified according to Boehler, Watson Jones, and Essex Lopresti, and on the basis of the tuber joint angle (Boehler's angle). The resulting groups, however, were not homogeneously structured. Of 82 intraarticular fractures with fragment dislocation, 19 were treated conservatively and 63 surgically. Boehler's angle at trauma was 14 degrees in the conservative group and 2 degrees in the surgical group. The more severe types of fractures were thus treated by surgery. There were two Sudeck's dystrophies with conservative and three with surgical treatment. Inadequate surgical technique (drill wires extending greater than 2 mm over the bone and insufficient compression) led to the following complications: 10 drill wire perforations without subsequent complications, 8 drill wire migrations, 2 deep infections. In four patients drill wires had to be shortened, and in 1 patient drill wires had to be shortened, and in 1 patient drill wires were misplaced and had to be corrected. Surgically treated fractures were followed by arthrodesis in 2 patients, medialization of the lateral wall of the calcaneum in 1 patient, and peroneal tendon revision in 1 patient.(ABSTRACT TRUNCATED AT 250 WORDS)
The influence of thrombosis prophylaxis on the occurrence of heterotopic ossification after implantation of total hip endoprostheses was analyzed in a series of randomized studies. When low-dose heparin or dextran 40 was administered, the rate of ossification was comparatively high (30.1% and 65.1%). When a combination of acetylsalicylic acid and an antirheumatic (oxyphenbutazone) or low-dose heparin with an antirheumatic (indomethacin) was administered, the ossification rate became significantly lower (6.2% and 16.7%). No severe ossification (Arcq degree III) was observed in the groups given an antirheumatic in addition to thrombosis prophylaxis.
Four children with leukemia (1.6% of all leukemia patients) treated between 1979 and 1984 developed aseptic bone necroses, all of them at multiple sites. The average time from starting chemotherapy to developing bone necroses has been 19 months (range 9 to 28 months). This is a well known complication of corticoid therapy, but corticoids may not be the only aetiological factor. Other antineoplastic agents and leukemia for itself have been associated with aseptic bone necroses. Bone and joint pain caused by aseptic bone necroses can mimic leukemic relapse, so the diagnosis may be difficult. The increasing number of long term survivors in childhood leukemia, who underwent aggressive polychemotherapy, could make this problem more common in the near future.