Aneurysm of the iliofemoral vein.

In this clinical case we report the use of the superficial femoral vein as an autologous venous interposition graft for the reconstruction of the iliofemoral vein in a 21-year-old female who presented with an asymptomatic primary aneurysm of the left iliofemoral vein. The choice of surgical technique used is discussed.

[A new extension device for treatment of tibial fractures]. / Ein neuer Extensionsapparat zur Behandlung von Unterschenkelfrakturen.

By means of a newly developed traction frame it is possible to maintain the reduction of a tibial fracture while implementing an internal or external fixation. This traction frame makes it even possible to perform intramedullary nailing of tibial fractures on a normal operation table.

[Use of hydroxyapatite for determination of antibiotic concentrations in bone]. / Uber die Bedeutung des Hydroxilapatits bei Konzentrations-bestimmungen von Antibiotika im Knochen.

A new method to determine antibiotic bone concentrations is presented. The bone fragments, obtained during hip joint replacement operations in 10 patients were investigated for antibiotic activity after i.v. application of 2 g of oxacillin and 4 g of mezlocillin. We were able to show that both penicillins do not penetrate into the inorganic bone part (hydroxylapatite). Therefore the concentrations measured are related to the organic bone part and are expressed in units per volume rather than in units per weight. With this method the differences between spongious and cancellous bone observed so far are diminished to values without any statistical difference. After 2 g of oxacillin and 4 g of mezlocillin the concentrations are 13.1 mg/l and 34.0 mg/l, respectively. The serum concentrations measured are compared to the bone concentrations. The terminal serum half-life is 63 min for oxacillin and 80 min for mezlocillin when the drugs are given simultaneously.

Early post-operative endoscopy after biliary tract surgery.

Immediate post-operative complications such as obstructive jaundice, biliary fistulae or gastrointestinal hemorrhage, occurring after biliary tract surgery can be diagnosed endoscopically. The causes of bile flow obstruction and leakage from the common bile duct can be identified using ERC. In many cases the diagnosis can be followed by endoscopic treatment, therefore obviating re-laparotomy. Between 1972 and 1979 we carried out early post-operative ERC or esophago-gastro-duodenoscopy in a total of 94 patients after biliary tract surgery. In 75 patients with residual gallstones and 4 cases with overlooked stenoses of the papilla, successful papillotomies were carried out. The procedure was unsuccessful in one case with an extremely narrow papilla. Complete removal of stones was achieved in 72 cases. In two other patients with gastroduodenal stress ulcers, bleeding was stopped by submucosal infiltration.

Palliative bile duct drainage - a new endoscopic method of introducing a transpapillary drain.

An endoscopic method for placing an internal drain in the bile-duct is described. Compared to the nasobiliary suction-tube this method has the advantage that it guarantees the physiological flow of the bile into the duodenum, and that the patient is in no way inconvenienced. For high-risk or inoperable cases the method can be considered as an alternative to choledochoduodenostomy.