Biomedical subjects
Publications and source records attributed to W Düben.
A total of 57 consecutive cases of complete acromioclavicular dislocations are reported. They were treated by open reduction and Balser's hook plate fixation supplemented by ligament suture.
Following a 400 mg preoperative oral dose, ofloxacin concentrations were measured preoperatively in serum and at the time of tissue removal in serum, gall bladder fluid, the gall bladder wall, liver tissue, muscle, fascia, subcutaneous fat and skin. Serum values were more or less constantly above 3 mg/l at all times. The highest intraoperative ofloxacin concentration was 11.85 mg/l in the gall bladder fluid. In the gall bladder wall, liver and muscle, concentrations were slightly higher than in the serum, whereas concentrations in the fascia, subcutaneous fat and skin were clearly lower than serum concentrations. Good activity was observed with regard to the MIC90 of the pathogens most commonly encountered in surgical wards.
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In general surgery patients, endometrioses can occur in the gastro-intestinal tract; they can also appear as cicatricial endometrioses or can be manifested as other, rare localisations of endometriosis tissue. In many cases it is not possible to arrive at a pre-operative diagnosis which is histologically established. Hence, treatment in endometriosis of the colon is surgical resection in order to delineate it against carcinoma and for the purpose of treating cicatricial stenosis which is usually associated with endometriosis. In cicatricial endometrioses and cysts in the inguinal region, diagnosis became possible only after surgery and postoperative histological examination.
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From 1973 to June 1982, 218 patients older than 70 years (148 women, 70 men) suffering from acute bowel obstruction were seen at our Dept. The mortality rate came up to 33%. Main causes of the ileus were incarcerated hernias and colonic obstruction (25% each). In case of an incarcerated hernia the authors emphasize early operation and colostomy in case of colonic obstruction due to tumour stenosis.
The decrease of activity of leucine aminopeptidase in gastric mucosa and liver cells after truncular vagotomy in rats may be due to disturbances in protein metabolism. The increasing activity of alkaline- and acid phosphatase signals catabolic metabolism. After three weeks all phosphatase reactions return to normal.
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There are about 15-30 patients reported in the literature, who suffered from well established, isolated Crohn's disease of the stomach. Another case is reported here, who had gastrectomy, since a diagnosis of gastric carcinoma had been made before and during surgery. When histological findings are negative, very extensive diagnostic procedures have to be performed in order to exclude this entity and to avoid useless gastric surgery. A clearcut recommendation as to surgery in cases of stenosis of the pyloric region cannot be given; the experience from the case described however would tend to favour treatment by gastrectomy.
The excretion of azlocillin into the human biliary tract was investigated in 8 patients with a T-tube in the common bile duct after intravenous injection of 2 g. Samples of serum and common duct bile were assayed from 15 min to 12 hours after injection. Biliary tract levels generally run parallel to serum levels but were about 15 times higher than those. Peak levels in T-tube bile averaged 1137 mg/l 60 to 90 min after administration. 12 hours after administration there were still mean concentrations of 13 mg/l to be found. It is concluded that azlocillin concentrations in bile exceed for a long time the minimum inhibitory concentrations for gram-negative and gram-positive causative organisms (above all E. coli, enterococci, Klebsiella spp., Proteus spp., staphylococci) of biliary tract-infections.
Studies on serum and tissue (cutis, muscle and liver) concentrations were carried out with mezlocillin (Baypen), a semi-synthetic new acyl ureidopenicillin, in 51 patients. Serum half life was 59 minutes. The highest concentrations were measured in the cutis, the lowest in the muscles. Concentrations in the liver were found to be relatively constant and persistent.--The efficacy and tolerance of mezlocillin were examined in 48 patients affected by 56 mostly severe infections, which were treated with a dose of 5 g twice or three times daily. The indications for antibiotic treatment were bronchopulmonary infections, peritonitis, soft tissue infections, biliary and urinary tract infections and postoperative febrile conditions of unknown origin. Clinical cure was achieved in 78.5% and an improvement of symptoms in 5.4% of infections. 76% of the causative microorganisms were eliminated. Mezlocillin was locally and systemically well tolerated.
X-rays of 91 patients who underwent gastric surgery between 1973 and 1977 were retrospectively evaluated. We found 16 large mucosal prolapses through the gastroduodenal anastomosis and another six with a so-called anastomosis bulge. Of these patients, 77% presented complaints in relation to delayed gastric emptying. When analyzing the prolapse frequency, patient age at the time of surgery, type of surgery, and suture technique, we found that mucosal prolapse occurred mostly in older patients with an extensive gastric resection after oralis-partialis anastomosis and after employing the two-layered suture technique.
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