Compression of the celiac trunk (author's transl)

Besides the vascular changes caused by arteriosclerosis the compression stenosis is the most frequent form of the isolated restriction of the arteria coeliaca. The compression of the arteria coeliaca, caused by the ligamentum arcuatum medianum or a fribromatous ganglion tissue, can cause complaints similar to the symptoms of angina abdominalis: pains in the epigastrium, postprandial pains, loss of weight, nausea/vomiting, diarrhea, 93% of the patients with severe vascular compression have an abdominal vascular murmur. Of 31 patients with angiographically proved compression stenosis, 11 patients suffering from occlusion or intense stenosis had to be operated because of heavy complaints. The angiographic and intraoperative findings allow the conclusion that there is a connection between the extent of the stenosis and the clinical appearance. The decompression of the arteria coeliaca, in other words the detachment of the compressing tissue leads to total complaintlessness in 83% of the patients. If the arteria coeliaca is hypoplastic a vessel widening or a bypass operation is necessary to establish normal blood circulation in the epigastric organs.     

Compression of the ulnar nerve at the wrist due to an arthro-synovial cyst. Apropos of 2 cases

This study investigates the extent to which sunscreens protect humans from ultraviolet (UV)-radiation-induced immunosuppression. In the presence of solar-simulated UV, three sunscreens with differing UVA transmission were assessed for their ability to protect the contact hypersensitivity (CHS) response to nickel of 16 nickel-allergic subjects. The sunscreens contained 2-ethylhexyl para-methoxycinnamate (cinnamate), cinnamate with oxybenzone, or cinnamate with zinc oxide, respectively. All had sun protection factors of 10 and hence inhibited UV erythema to similar extents. Volunteers were irradiated on their backs with suberythemal UV daily for 5 d after application of the sunscreens and their base lotion to different sites. Nickel-containing patches were then applied to both UV-treated sites and adjacent, unirradiated control sites. Erythema caused by nickel CHS at each site was quantitated 72 h later with a reflectance erythema meter. In comparison of the nickel reactions of irradiated and unirradiated skin, there was 35% mean immunosuppression in unprotected UV-treated skin. Significant immunosuppression also occurred at sites irradiated through the narrow-spectrum cinnamate-only sunscreen but was prevented by the two broad-spectrum sunscreens. To determine whether UV-induced suppression of the nickel response is specific for cell-mediated immunity or reflects suppression of nonspecific inflammation, a further 16 subjects were patch-tested with a skin irritant, sodium lauryl sulfate (SLS), following a sunscreen and irradiation protocol identical to that of the nickel volunteers. UV had no significant effect on SLS responses. We conclude that nickel patch testing is a valid means of assessing UV-induced immunosuppression in humans and that even with suberythemal UV, immune protection was provided only by sunscreens filtering both UVA and UVB.     

Further observations on the anatomy of the ulnar nerve at the wrist

The mercury content of various parts of single fruit-bodies of the Yellow Bolete Boletus edulis (n = 26), the Field-Mushroom Agaricus campester (n = 23) and of Agaricus silvicola (n = 17) was determined by flameless atomic absorption spectroscopy. In each species the lowest mercury content was found in the stem (x = 1,96--3,21 mg/kg dry wt.), whereas the caps contained significantly more mercury (x = 4,19--6,97 mg/kg dry wt.). The highest mercury content was found in the gills and tubes (x = 4,85--8,77 mg/kg dry wt.), which contained significantly more mercury then the flesh of the caps (x = 3,11--5,60 mg/kg dry wt.). Young mushrooms seemed to contain more mercury then older ones.     

The traumatology of the articular disc of the wrist (author's transl)

At 89 Patients with painfull wrist and clinical symptoms like a lesion of the triangular disc, arthrography of the radiocarpal joint was performed. In 18 cases with corresponding arthrographical findings removal of the disc results in clear recovery respectively painlessness. That simple operation seems to be an alternative to the resection of the ulna and a replaceable method if symptomatology and arthrography are accordingly. The described proceeding becomes important because no recovery was seen by conservative treatment.     

Noise at work (author's transl)

In 1929, noise-induced lesions were accepted for the first time into the list of occupational diseases. Only "deafness or impairment of hearing bordering on deafness caused by noise" in workers from factories working and processing metals was recognised. Today the VII. Occupational Diseases Order is in force, according to which notifications and compensations may be carried through without regard to the type of factory. The effect of noise is divided into two large groups: 1. General "autonomic" reactions, 2. damage to the organ of hearing. For point 2 there are accurately defined concepts, specifications for the protection and detection of workers exposed to noise and methods of investigation. But there are also a number of problems in the sphere of the expert opinion. There are some difficulties with regard to preventive measures in the use of personal noise protection. Prominent in prophylaxis are sound level measurements.     

The facial nerve and the parotid gland (author's transl)

The modern histological classification of epithelial salivary gland tumours is described. An exact knowledge of the behaviour of each type of tumour permits correct surgical planning. Contrary to the teaching that the superficial parotidectomy is the minimal safe resection, the author feels that in many cases dependent on tumour site, size and histological type, a simple excision is sufficient. The application of microsurgical techniques permits careful and safe surgery.     

Improvement of utero-placental perfusion by transcutaneous nerve stimulation (author's transl)

A report is given on 37 patients with a diminished utero-placental perfusion. 12 patients underwent only once, 25 patients daily over 2 to 3 weeks a transcutaneous lumbo-sacral electric nerve stimulation. Both, the 12 patients stimulated only once and the 25 patients with daily stimulation, showed a significant increase of utero-placental perfusion measured by the method of radioisotope placental perfusion. Transcutaneous nerve stimulation (TNS) therefore could be used for therapeutic purpose in cases of placental dysfunction.     

Dumping-prophylaxis (author's transl)

The dumping syndrome is due to a vigorous reflex distension of the jejunum, caused by the stomach violently evacuating its contents. The aim of treatment is to overcome the drastic evacuation by restoring the rhythmic peristalsis of the stomach (eukinetics). This can be achieved by a special diet. Every meal should begin with well chewed solids (pulp) and avoid all fluids. With a well organised medical staff a complete success can be achieved. Surgical measures in Dumping can be avoided.     

Greater petrosal nerve surgery in long-term cluster headache (author's transl)

Report on three cases with cluster headache for a period of 10 to 20 years, respectively. This was healed by resection of the greater petrosal nerve. In these patients the nerve was found in a bony canal of a length of 5 to 6 mm between the geniculate ganglion and the facial nerve hiatus. In this region the nerve was blurred free, luxated from the canal, and resected. Histological control of this part of the nerve revealed a fibrosis of the peri- and epineurium and a degeneration of some nerve fibers. Histological control in a greater number of cases is recommended.