[Extreme soft tissue hypertrophy of both hands of "uncertain origin"]. / Extreme Weichteilhypertrophie beider Hände "unklarer Genese".

The author reports on a 56-year old patient. At the age of 17 an asymmetric hypertrophy of the soft tissue isolated on both hands developed increasingly. Based upon differing diagnoses, corticoids and "black light - phototherapy" were attempted. In 1985 and 1986 surgery of both hands was performed. Finally in 1987, after 38 years, "Mycosis fungoides phase III" of the hands was diagnosed and adequately treated.

[Diagnostic value of aspartate aminotransferase in the cerebrospinal fluid]. / Zur diagnostischen Wertigkeit der Aspartataminotransferase im Liquor cerebrospinalis (Liquor-ASAT).

As datum, the range of aspartate aminotransferase in the cerebrospinal fluid of adults was determined on the basis of 153 fluid samples and compared with the values obtained from 356 neurological patients. A significant increase in enzyme activity was established in respect of CVI, polyneuropathy, acute encephalitis, and SAB. It was possible to eliminate any dependence of the aspartate aminotransferase activity on serum activity, total protein, and cell count. The increase in activity of aspartate aminotransferase in the cerebrospinal fluid is thus identified as an independent pathological fact, and thus it can be incorporated in diagnostic routine more particularly in the diagnosis of CVI disorders.

[The polytraumatized patient. One year's documentation with special reference to the prognostic significance of individual immune status (cell-mediated immunity)]. / Der polytraumatisierte Patient. Einjahresdokumentation unter besonderer Berücksichtigung der prognostischen Bedeutung der individuellen Abwehrlage (zellvermittelte Immunität).

Fifty-four patients with multiple trauma have been investigated in a prospective one-year documentation. The following features were documented and evaluated: circumstances of the accident, condition on admission, course under special consideration of the cell-mediated immunity with Merieux multitest, course after indoor treatment.

[Diagnostic value of alpha 1-acid glycoprotein in the cerebrospinal fluid]. / Zur diagnostischen Wertigkeit des sauren-alpha 1-Glykoproteins im Liquor cerebrospinalis.

Samples from 1415 neurological patients were used to study the diagnostic value of acid alpha 1-glycoprotein in the lumbar cerebrospinal fluid. The value of analysis for this substance is considered to lie in the detection of non-specific acute-phase reactions of various causes in the CNS with special reference to barrier problems. The large number of pathologically elevated values associated with acute inflammations of the meninges and cerebral parenchyme is particularly striking. The results of the studies are analyzed on the basis of comprehensive control investigations (n = 559).

[Is sonography useful in the diagnosis of hand surgery?]. / Ist die Sonographie in der handchirurgischen Diagnostik nützlich?

In five cases in which sonography was used the value of the results was later assessed by surgery and histology. With adequate equipment and experience in handling, sonography is effective but not absolutely necessary in routine diagnosis. For obscure cases the method is of objective diagnostic help.

[Diagnosis and therapy of iron deficiency anemia in pregnancy]. / Zur Diagnostik und Therapie der Eisenmangelanämie in der Schwangerschaft.

39 pregnant women, hemoglobin in serum less than or equal to 6,80 mmol/l were treated with Vitaferro, Folicombin and additional vitamins. Test groups were formed by means of randomisation. Hematological and clinicochemical parameters were measured before, as well as 2 and 6 weeks after starting treatment and the results were evaluated.--In the diagnosis of iron deficiency anemia in pregnancy serum iron concentration and iron-binding capacity are sufficient. The diagnosis is proved by an increase of the serum hemoglobin 2 weeks after starting therapy. For the total number of patients an increase of hemoglobin could be proved 2- and 6 weeks after starting therapy. However, the 3 chosen therapeutic methods did not show any differences in statistically proved values in form of therapeutic results. This is, in our view, due to given deviation and the specific character of the test group. During pregnancy iron deficiency anemia should be treated by doses more than 100 mg iron per day. Normalization of the hemoglobin under iron substitution is no indication for immediate interruption of the treatment.

[Fractures of the coxal femur end. Development of surgical treatment and rehabilitation (1973-1978)]. / Frakturen am koxalen Femurende. Entwicklung der operativen Versorgung und Rehabilitation (1973 bis 1978).

734 fractures of the proximal femur end treated between 1973 and 1978 are presented in order to demonstrate the progress of surgical treatment and rehabilitation as well as the advantages of certain methods.

[Special indication for bundle-nailing of the upper arm (author's transl)]. / Die besondere indikation zur Bündel-Negelung am Oberarm.

From the beginning of 1974 to the end of 1978, 100 fractures of the shaft of the humerus were treated in the Surgical Clinic II of the Darmstadt Municipal Clinics. 50 of these fractures were treated conservatively, whereas 25 were treated osteosynthetically with a broad A.O. plate (A.O. = Arbeitsgemeinschaft für Osteosynthese) or D.C. plate, and 25 by means of intramedullary osteosynthesis with bundle nailing, both these groups achieving stability of movement by this treatment. Attention is drawn to the special indication for bundle nailing when treating fractures of the shaft, with particular emphasis on pathological fractures and spiral shaft fractures, sometimes combined with subcapital humerus fractures in elderly persons. Other conditional indications are fractures of the shaft of the humerus in polytraumatised patients and debris shaft fractures. Of the 25 patients treated by means of bundle nailing, 22 were evaluated roentgenologically, and 17 were followed up. The results are explained, giving a detailed description of the specific surgical technique.

[Mammography--its use in hand surgery]. / Die "Mammographie"--ihr Nutzen in der Handchirurgie.

"Mammography" is a special radiological technique employed for soft tissues. It is possible with this technique to detect microcalcifications in the breast, especially in the soft connective tissue of the mammary gland. In hand surgery it is often a problem to detect and diagnose radiolucent foreign bodies, soft tissue tumors, or even sometimes bone tumors. We have, therefore, on the basis of our special experience in "Mammography of the Tendo achilles" developed a similar technique for soft tissue diagnosis in hand surgery. In this study we give the exposure technique and four examples of this special investigation in osteoid osteoma, injuries with glass particles of a finger-joint, an explosion injury of the hand and an assessment of a glass injury of the soft tissues.

[Serum creatine kinase activity in psychoses]. / Die Kreatinkinaseaktivität im Serum bei psychotischen Patienten.

This is a report of the initial results of determinations of the creatine kinase activity in the serum of forty psychiatric and twenty-five neurological patients. A determination of the creatine kinase activity made in the first days of an acute endogenous psychosis invariably showed an increase in creatine kinase which returned to normal values after eight to fourteen days. Patients with residual schizophrenia, conditions of acute excitation accompanying psychopathy, and abnormal personality or circumscribed paranoid development showed creatine activity in the range of normal values. Alcoholics with incipient or strongly marked delirium tremens showed normal creatine kinase activity in those cases where the situation was not complicated by additional traumata or other accompanying diseases.

[Ion concentration in the cerebrospinal fluid in multiple sclerosis]. / Zur Ionenkonzentration im Liquor cerebrospinalis bei Multipler Sklerose.

The concentrations of electrolytes Na, K, Ca, Mg, and Cl and trace elements Cu and Zn were determined in the lumbar cerebrospinal fluids of forty patients with multiple sclerosis. Metal ion concentrations were measured using atomic absorption spectroscopy and flame photometry, respectively. Compared with corresponding values obtained from a control group, statistically significant increases in concentration of Na, Cl, Ca, and Zn have been found. Also reported are the results of determinations of ion concentrations in cerebrospinal fluids obtained from patients suffering from diseases other than multiple sclerosis. Possible causes of deviations from the norm are discussed.

[Diagnostic significance of cerebrospinal fluid IgG determination by radial immunodiffusion]. / Zur diagnostischen Wertigkeit der IgG-Bestimmung im Liquor cerebrospinalis mittels radialer Immunodiffusion

The concentration of immunoglobulin G in 455 cerebrospinal fluids has been determined. The results obtained are discussed together with the corresponding total protein and gamma-globulin values. Classification by seven constellations and their assignment to four groups of diseases (acute and inflammatory diseases, chronically inflammatory diseases, E. d., and tumors) allows valuable information to be obtained about the diagnostic significance of IgG determination in the cerebrospinal fluid. This is true especially of E. d. and also applies to an assessment of the activity of inflammatory processes. It is evident from the results of these studies that an evaluation of the IgG value is not possible without considering the total content of protein. The value found for the quotient (see article).