[Microincision intraocular lens with plate haptic design. Evaluation of rotational stability and centering of a microincision intraocular lens with plate haptic design in 12-19 months of follow-up]. / Mikroinzisionsintraokularlinse mit Plattenhaptik. Rotationsstabilität und Zentrierungsverhalten einer Mikroinzisionsintraokularlinse mit Plattenhaptik im Nachbeobachtungszeitraum von 12-19 Monaten.

BACKGROUND: Evaluation of rotational stability of a microincision intraocular lens with plate haptic design (*Acri. Smart 46S, *Acri.Tec AG) and its centering in the capsular bag after implantation. MATERIAL AND METHOD: In a total of 43 eyes in 37 patients a foldable, spherical microincision cataract surgery (MICS) intraocular lens (IOL) with plate haptic design was implanted through a 1.4-mm microincision by means of an injector system. The IOL was marked prior to implantation to allow exact determination of its endocapsular position. After 1 1/2 years the best corrected visual acuity, refraction, centering and rotational stability of the IOL were determined. RESULTS: No rotation or decentration was observed in any of the 42 eyes 12-19 months postoperatively. On the first postoperative day 1 IOL rotated in the counterclockwise direction by approx. 6 degrees as a result of flattening of the anterior chamber. Its position then remained stable. No unwanted complications occurred. CONCLUSIONS: Conclusions: *Acri. Smart 46S is a safe, effective and stable IOL that can also be used as the basis of complex refractive optical systems, e.g. for correction of astigmatism.

[Phacoemulsification and vitrectomy with the erbium:YAG laser and phacoemulsification with the neodymium:YAG laser]. / Phakoemulsifikation und Vitrektomie mit dem Erbium:YAG-Laser sowie Phakoemulsifikation mit dem Neodymium:YAG-Laser.

There are an increasing number of possible applications for the use of Erbium:YAG and Neodymium:YAG lasers in ophthalmology. Laser-phacoemulsification as well as Erbium-laser vitrectomy is of major interest. We report on the underlying technology and more than 1-year-experience using the PHACOLASE (Asclepion-Meditec, Jena, Germany, 10-100 Hz frequency, 5-50 mJ single pulse energy) for phacoemulsification and pars plana vitrectomy and the Lyla-Dodick laser photolysis (A.R.C. Laser, Eckental-Forth, Germany, 1-20 Hz, up to 8 mJ single pulse energy). The Erbium:YAG-laser as well as the Neodymium:YAG-laser enabled us to extract lenses with up to medium hard nuclei. Moreover, the Erbium laser enabled fast vitrectomy with little mechanical traction. In many of our initial surgical operations we had to change to mechanical vitrectomy due to initial technical problems. No new complications occurred intra- or postoperatively. The handpiece worked well in removing vitreous bodies, but was not feasible for cutting membranes. Modified handpieces for this purpose are under development.

[Roentgen diagnostic staging program and treatment of subluxation of the talar supinator]. / Röntgendiagnostisches Stufenprogramm und Behandlung der Subluxatio tali supinatoria.

In case of 380 patients (286 operated), who were followed up, we will prove the usefulness of an already some years ago by us recommended step-program with timely, personal and economically defensible expense for opportune and complete diagnosis of frequent fibular ligamentous injuries in the ankle joint. Measurements of x-rays in stress are demonstrated, also principles of treatment including operative-technical details. Only consistent measures offer good prerequisites for healing with restored function.

[Therapy of osteomyelitis]. / Zur Therapie der Osteomyelitis.

Exogenic post-traumatic bone infection has come strongly into focus of attention, as compared to haematogenic cases. Complex prophylaxis against such infection, therefore, is of great importance. The initial phase of bacterial osteomyelitis must be identified and must be followed by immediate action, as early treatment is absolutely essential. That is why the routes of infection, which depend on the extent of injury and on the mode of primary treatment, as well as all areas affected must be fully detected. Substantial therapeutic steps should include radical sanitation, stabilisation (especially fixateur externe), different variants of drainage, and autogenic spongiosa transplantation. New results have become available also in the context of supplementary specialised antibiotic therapy and coverage of soft tissue.

[Fundamental research in ultrasonic surgery. IX. Splenic surgery using cavitation ultrasound--an experimental animal study of aspiration and sealing technics with ligament FIMOMED]. / Grundlagenuntersuchungen zur Ultraschallchirurgie. IX. Mitteilung: Milzchirurgie mit Hilfe von kavitativem Ultraschall--eine tierexperimentelle Studie zur Aspirations- und Versiegelungstechnik mit Ligament FIMOMED.

A farther alternative for the conservation of the spleen represents the ultrasonic aspiration and sealing technique by means of the monomeric tissue adhesive Ligament Fimomed. The effectiveness of the method was proved by histomorphologic investigations in animal experiment with the porcine spleen. The method was effective in nearly all injuries across to the longitudinal axle of the organ even with a larger parenchymal defect and also in case of splenic tumor. The control of hemorrhage succeeded promptly and surely. Not any postoperative complication appeared.

[Liver and spleen surgery using cavitating ultrasound]. / Leber- und Milzchirurgie mit Hilfe von kavitativem Ultraschall.

Liver and spleen can be selectively skeletized by means of ultrasonosurgery (10-200 W/cm2, 20-40 kHz). These are technological solutions which have provided major prerequisites for low-risk oncosurgery. The technique (ultrasonic sealing) can as well be used in conjunction with monomeric tissue glues to safely and hermetically seal areas of resection of injuries in parenchymatous organs. It has yielded good clinical results in liver and spleen surgery. Based on stringent indication, ultrasonosurgery can provide benefits to patient and surgeon in both oncosurgery and traumatology of liver and spleen.

[Hypocaloric nutrition in the early postoperative phase in patients following colorectal surgery]. / Die hypokalorische Ernährung in der frühen postoperativen Phase bei Patienten nach kolorektalen Eingriffen.

In patients with colorectal tumors of stages T4 N0-N1 and M0 the effectiveness of hypocaloric nutrition in the early postoperative period was monitored. Only patients without a disturbed nutrition state in the preoperative period were selected for this procedure, in which Schmoz' 6-point-system (Hb, albumin, transferrin, anthropometries and immune state) was used for this distinction. The nutrition solution used was Infesol (40.0 g amino acids to 100.0 g sorbitol in 11). The postoperative control of protein values showed that all values were normal; only albumin decreased from the norm on the second postoperative day. Nitrogen losses in 24-h urine were on average 15 g N, with an N intake of 9.5 g daily. All patients were fed by the peripheral-venous way. Complications were minor and were favorable compared to those observed in a group given hypercaloric nutrition.

[Basic studies of ultrasound surgery. VIII. Experimental animal studies of power ultrasound surgery of the swine pancreas]. / Grundlagenuntersuchungen zur Ultraschallchirurgie. VIII. Mitteilung: Tierexperimentelle Untersuchungen zur Leistungsultraschallchirurgie am Schweinepankreas.

The technique of the power ultrasound was tested in vitro and in vivo in 20 porcine pancreas. Simultaneous temperature measurements and laboratory tests do not produce any restriction. Enzymatic disorders were provable adequate to the clinical course. The ultrasonic effect guarantees a nearly riskless dissection in the layer. Joining processes, by adding Ligament-FIMOMED, produced a waterproof occlusion of parenchymal wounds. The cross-section of the pancreas with the pancreatic duct was sealed sufficiently. Also the jointed pancreato-jejunostomy remained sufficient. The reaction of the pancreatic parenchyma to the power ultrasound was small. A scarred metaplasia evolved immediately at the adhesive as a chronic atrophic interstitial pancreatitis. Only in case of occlusion of the pancreatic duct this alteration comprehended the whole pancreas.

[Basic research in ultrasound surgery. VII. Comparative animal experiments after intestinal anastomosis by suturing, ligament gluing with Fimomed and ultrasound sealing with ligament Fimomed]. / Grundlagenuntersuchungen zur Ultraschallchirurgie.VII.Mitteilung: Vergleichende tierexperimentelle Untersuchungen nach Darmanastomosierung mittels Naht, Ligament Fimomed-Klebung und Ultraschallversiegelung mit Ligament Fimomed.

Animal experimental anastomoses in the small intestine of Mini-Lewe-pigs showed that even sufficient anastomoses free of stenosis can be obtained by using the sticking respectively the ultrasound sealing method. The foreign-body reaction in the surroundings of the suture was approximately equally strong as on the gluten. All animals did not show any specialty in the postoperative course. The use of butylcyanidacrylic is possible in the human intestine as also shown in the literature. The use is indicated if advantages are to be expected in face of a suture anastomosis in clinical sight.

[Tumor removal using performance ultrasound. Report of 50 brain tumor operations]. / Tumorentfernung mit Leistungsultraschall. Bericht über 50 Hirntumoroperationen.

A report is given on the method of the tumour aspiration of cerebral tumours by means of power ultrasound. After classical exposure of the tumour--obligatory performance with physical-pharmacological reduction of the metabolism and in most cases under hypotension--the tumour is destroyed by ultrasonic power and simultaneously aspirated. A report is given on 50 cerebral tumour operations, which were carried out in Karl-Marx-Stadt within two years, using the tumour aspiration system "Aspirus 120". Finally the advantages of the method are summarised and dangers interpreted. At the end a valuation of the method is attempted and an outlook is given.

[Basic research on ultrasound surgery. VI: Comparative histological liver findings following treatment of the wound with ultrasound welding and suturing]. / Grundlagenuntersuchungen zur Ultraschallchirurgie. VI. Mitteilung: Vergleichende histologische Leberbefunde nach Wundversorgung mittels Ultraschallfügens und Naht.

Liver cuts were performed on 21 Mini- Lewe pigs and then closed with suture in one case, and by ultrasonic welding of Fimomed - Gelaspon conglomerate in the other. Macroscopic assessment in situ and the histological examination of cut out liver areas regularly showed perifocal inflammatory peritoneal reactions and abscess formation for the sutured regions. From a histological point of view the liver tissue in the regions subjected to ultrasonic treatment reacted more strongly than after suture, particularly in the form of lobule structure disturbances, focal hepatitis, hepatic duct proliferation and destruction, and cholangitis. All of these were limited to the immediate vicinity of the conglomerate with its fibrous demarcation, which remained identifiable until the end of the experiment after a year and a half. The experiments resulted in the sucessful closure of the liver wounds in all cases where ultrasonic welding of Fimomed - Gelaspon compound was used. Application to human medicine is, however, not yet justified.

[Brain tumor removal with an ultrasound aspirator]. / Hirntumorentfernung mit einem Ultraschallaspirator.

A report is given on the application of an ultrasound aspirator for the removal of cerebral tumours. After the description of physical and surgical fundamentals, a report is given on the respective patients. Then hazards an advantages are described as far as they can be summarized already today.

[New modifications in end-to-end anastomosis between the esophagus and small intestine in animal experiments]. / Neue Modifikation einer termino-terminalen Anastomose zwischen Osophagus und Dünndarm im Tierexperiment.

A new modification of an end-to-end anastomosis between esophagus and small intestine is described. The anastomosis intramural shifted step by step does not lead to any insufficiency or stenosis as well in the animal experiment. Long-term results are still expected. This technique has already been proved for entero-anastomoses in the patient.

[Fundamental studies of ultrasonic surgery. 5. Ultrasonically forced polymerization of Ligament-Fimomed in joining biological tissue]. / Grundlagenuntersuchungen zur Ultraschallchirurgie.

About basis investigations to the mode of action, the energy transformation, and to the polymerization heat of Ligament-Fimomed adhesive is informed over the ultrasonic osteosynthesis. A prompt activation of the monomeric tissue adhesive is attained at the contact region with the osseous tissue by means of low frequency power ultrasound. The mechanism of the connecting formation and characteristic temperature-time course are shown.