Biomedical subjects
Publications and source records attributed to W Kapral.
In this paper it is tried to give an answer whether Bassini-plastic as compared to the excellent results of Shouldice operation should be further performed. In a consecutive series of 197 Bassini operations from 1982-1986 we found after a mean follow up time of 6.8 years a 3.2% recurrency rate. We suggest therefore that Bassini operation may be carried out furthermore.
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This is a report concerning 26 cases with subtrochanteric femoral fractures treated by "Ender" nailing. This operation can be performed quickly and allows early mobilisation of the patients. Most of the fractures consolidate within three months. Motility of knee and hip joint was good in the follow up group of eleven patients.
This is a pilot study concerning the question, whether herniorrhaphy is associated with the production of spermaantibodies. The influence of operation or trauma in production of spermaantibodies was investigate as well as the question, whether preexistant spermaantibodies disappear after herniorrhaphy. The following statement was done: 1. Patients with inguinal hernia have no increased coincidence of spermaantibodies in comparison with other men. 2. There is a tendency of more frequent appearance of spermaantibodies in patients after operation or trauma including herniorrhaphy, but no significancy. 3. After herniorrhaphy spermaantibodies appear in about 20%. 4. Preexisting spermaantibodies may frequently disappear after herniorrhaphy.
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The following points are made against the background of experience recorded by the author from 115 cases of Meckel's diverticulum: Active intra-operative search for Meckel's diverticulum continues to be justified in the course of all operations in which such search appears to be practicable without traumatisation of the intestine due to the given surgical access route and which would not imply the risk of germ transmission. It is, of course, necessary to remove any macroscopically changed Meckel's diverticulum. Removal of the macroscopically inconspicuous Meckel's diverticulum is recommended, as well, since grave microscopic pathology may be concealed under the surface and because possible damage would be clearly outweighed by the benefit achieved from removal of an even macroscopically inconspicuous Meckel's diverticulum. Any Meckel's diverticulum accidentally discovered in a patient in somewhat advanced age should be removed, since the author's own experience against reports by other authors is likely to suggest that the rate of diverticular complications is relatively high in advanced age groups. It is absolutely imperative to look for Meckel's diverticulum in all cases in which intra-operative findings are in disagreement with clinical examinations prior to surgery, particularly in cases in which signs of acute appendicitis were pre-operatively recorded, whereas bland appendix was found on surgery.
This is a report about 50 fractures of the femoral neck, treated in a ward for general surgery. Impacted valgus fractures generally do not need surgery. Osteosynthesis only with Böhler nail have no good results. Hemiprosthesis of femoral head on elderly patients is a good method and generally not followed by protrusio acetabuli.
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An account is given in this paper of the anatomic and physiological peculiarities of congenital inguinal hernia in male children. Particular reference is made to testicular disorders which usually result from even slightest traumatisation of the spermatic cord. A critical appraisal is made of parameters used in the past for assessment of surgical results. Removal of hernial sac with or without posterior pararectal repair was applied in the author's hospital to 185 boys with hernia of whom 87.5 per cent underwent follow-up checks. Minor testicular disorders were recordable from only 4.7 per cent of them. The author has invented a new surgical method to cope with congenital hernia of boys (Melker's method). Due consideration is given, in that approach, to the anatomic and physiological peculiarities involved, and the intervention is widely non-invasive to the spermatic cord. Reported in this paper are the results obtained from 67 cases of whom 97 per cent had undergone follow-up checks. Follow-up intervals were between one and three and a half years during which period no case of atrophy, dystrophy or dystopia of testicles was recorded at all.
Using the long intestine tube (MAS) we expected to prevent early postoperative ileus. 160 cases were retrospectively examinated in order to answer whether the tube is an effective prevention for early postoperative ileus, and which danger the patient is submitted to using the tube. We found out that the incidence of early postoperative ileus using the tube is about 1.9% and the tube is doing harm by producing necroses of the bowel wall in 1.8%.
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Examination for Meckel's diverticulum is generally performed in each case of laparotomy where the incision allows observation of the small bowel without danger of spreading the infection. In 65 cases, pathologic alterations were found in 14 (= 21,5%). Postoperative bowel obstruction due to resection of Meckel's diverticulum has been found twice (3%), one patient died. It is suggested that Meckel's diverticulum be removed whenever possible.
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Occurrence of ganglion on the wrist in the scaphoid region in connection with protuberance of the scaphoid bone is statistically of high significance. As ganglions result from mucoid degeneration of connective tissue following microtraumata, the scaphoid protuberance may cause ganglion to appear most frequently at a localization above the scaphoid bone on the wrist. We suggest that this localization be called 'loco typico'.
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