Problems of postoperative respiratory insufficiency (author's transl)

Postoperatively patients are particularly endangered by the development of respiratory failure. All parts of the gas-exchange between the atmospharic air and the metabolizing cell are to be considered as a unit. The increase of dead-volume-respiration and intrapulmonary shunting is of great importance for the development of arterial hypoxaemia. Early diagnosis of impaired gas-exchange and an adequate treatment are emphasized. CPAP and intermittent mandatory ventilation are therapeutic methods, well approved in clinical practice.     

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.     

Effects of tofisopam on gastric functions in rats (author's transl)

The effects of tofisopam on gastric functions were examined in rats. Intracerebroventricular (i.c.v.) injection of tofisopam (50 ot 100 microgram) increased both basal gastric acid output and mucosal blood flow (MBF) in rats anesthetized with urethane, while intravenous injection of tofisopam (10 mg/kg) did not change the basal gastric acid output. Ten micrograms of tofisopam, i.c.v., a dose which did not show any effect on the basal gastric acid output, significantly inhibited the decrease in gastric acid output induced by noradrenaline (5 microgram, i.c.v.). Tofisopam (10 mg/kg, i.v. or 100 microgram, i.c.v.) showed no effect on the increase in gastric acid output induced by electrical stimulation of the lateral hypothalamic area (LHA). These results, together with the previous findings, suggest the tofisopam (i.c.v.) acts on the nucleus dorsalis n. vagi and/or LHA and competes with noradrenaline. The gastric acid output was increased remarkably under water-immersion stress, and this increase lasted during the stress-loading, but the MBF did not show a corresponding increase. Pretreatment of rats with tofisopam (100 mg/kg, intraduodenal) significantly increased the MBF and inhibited the ulcer formation caused by the stress. From these results, tofisopam may restore the unbalance between sympathetic and parasympathetic nervous tones induced by stress-loading.     

Physiopathology of idiopathic respiratory distress syndrome (author's transl)]

Physiopathology of idiopathic respiratory distress syndrome is reviewed and bases for a correct management are given. Special mention is made of pulmonary surfactant system, biosynthesis of surfoactive material and techniques used to predict appearance of pulmonary maturity.