Possibilities and limits of electron microscopy (author's transl)

This review evaluates the electron microscopical imaging techniques used today. Reviewed are transmission method, indirect imaging of surfaces by replica and surface decoration, and direct imaging of surfaces by means of scanning, emission, and mirror electron microscopy. For each method the respective limit of resolution and the possibilities of application are described. Especially, the methods of high-resolution and of high-voltage electron microscopical techniques will be pointed out as being actual means of investigation stressing electron microscopy up to the limits given by physics and technique.     

Possibilities and limits of outpatient surgery (author's transl)

The aims of modern outpatient surgery include: the comprehensive development of ambulatory therapy especially the repertoire of operations, preclinical standardized diagnostic procedures, postoperative outpatient care and rehabilitation. The main reasons for this development are analyzed. In order to make further progress in the direction indicated the number of surgeons working in outpatient departments will have to be increased. Own experiences in outpatient saphenectomy, excisions of Dupuytren's contracture, haemorrhoidectomy, mastectomy, herniorrhaphy, enucleation of cold nodes in the thyreoid gland (171 operations between 1972 and 1974) encourage further efforts in this direction.     

Experimental gastric cancer (author's transl)

Methods have been established to produce gastric cancer in rats and dogs by administration of N-methyl-N'-nitro-N-nitrosoguanidine or of the ethyl derivate. The agent is administered in drinking water or by a pellet diet soaked in the carcinogen. Histologically well differentiated and poorly differentiated types of adenocarcinoma and signet-ring cell tumors are induced in several months with greath reliability. Metastases were observed in both rats and dogs with gastric carcinoma. The carcinogenic effect could be enhanced by surface active agents, sodium chloride, iodoacetamide, insertion of plastic beads into the stomach and gastroenteroanastomosis. Follow-up studies by radiologic, endoscopic and bioptic examinations are possible in the dog. There are similarities in these experimental tumors to those in man and thus they provide means for the investigation of histogenesis, prevention, and chemotherapy of gastric cancer. An adenocarcinoma of the glandular stomach of a Wistar rat was successively transplanted to new born rats of the same strain.     

Neonatal gastric perforation (author's transl)

Three cases of neonatal gastric perforation of unknown etiology are presented. All three patients are female, one of them a second twin and two of them less than 2,000 g. in weight. All the patients were born under anoxic deliveries and needed resuscitative treatment. Digestive and respiratory symptoms started in all between the 2nd and the 4th days of life. Diagnosis, clinically suspected, is established radiologically. Perforations were surgically closed in all three patients. Two remain alive.     

Possibilities for cultural diagnosis of vaginal flora (author's transl)

Reported in this paper are some possible approaches to culturing of vaginal flora. Plastic slides and various selective culturing media are described. The results so far achieved are likely to suggest that the above approach is applicable in practice.     

Possibilities of ultrasonic diagnosis in fetal abdominal monstrosities (author's transl)

The diagnostic possibilities of intrauterine ultrasonic assessment of the fetal abdomen by rapid B-scan are described on the basis of two cases (megalocystis/megaloureter syndrome and omphalocele with cloaca formation). Other examination methods of prenatal diagnosis to confirm the findings are also discussed, but their diagnostic significance is even more limited than that of sonography, individual cases excepted. Although early detection of neural tube anomalies is the most important application of ultrasound, pronounced monstrosities of the fetal abdominal region are also definitely recognisable via ultrasonic examination.     

Acute solitary gastric erosion (Dieulafoy) (author's transl)

Acute solitary gastric erosion (Dieulafoy) is one rare cause of fulminant, fatal acute gastric haemorrhage. Conservative treatment is usually lethal and elimination of the source of haemorrhage by active surgical intervention is the only possible form of therapy. The key to successful surgical treatment is early preoperative diagnosis by means of emergency gastroscopy.     

On gastric corpus-pyloric antrum inhibitory reflexes (author's transl)

Twenty eight adults dogs fasted over night were used under Nembutal anesthesia. The influences of distension of the pouch which was made on gatric corpus on the motility of gastric pyloric antrum were investigated. The following results were obtained. 1) Any changes were not observed on the motility on gastric pyloric antrum by distension of gastric corpus pouch by a pressure of 20 mmHg, but a stepwise elevation of the lumen pressure of the pouch from 50 mmHg to 100 mmGh, elicited a remarkable relaxation of the tone and inhibition of motility of the pyloric antrum. These inhibitory responses were not abolished by the bilateral cervical vagotomy or by the bilateral splanchnicotomy respectively, but these inhibitory reflexes were disappeared completely after the transection of both extrinsic nerves. 2) The inhibition of motility of gastric pyloric antrum were also elicited by the electric stimulation of the central cut end of vagal branch or of splanchnic branch which innervated the gastric corpus respectively. 3) It may be concluded that the reflex pathways of the gastric corpus-pyloric antrum inhibitory reflexes involve not only in vagus nerves but also in splanchnic nerves.     

The syndrome of inappropriate secretion of vasopressin (SIADH) (author's transl)

The syndrome of inappropriate ADH secretion ("SIADH") was first recognized 1935 by Roth et al. and described in detail 1957 by Schwartz et al. The clinical symptoms (hyponatremia, hypertonicity of urine and inability to excrete a water load) are caused by inadequately elevated ADH secretion under a variety of situations and diseases. Some recent work was focused on the pathogenesis of this syndrome and new clinical findings (low plasma levels of uric acid and potassium) as well as special forms ("SIADH" without elevated vasopressin levels in plasma) are thought to be of relevance. New therapeutical recommendations will be discussed.     

Amoxicillin and its excretion into bronchial secretion (author's transl)

Various dates on amoxicillin (resorption, distribution, elimination, tissue passage, urinary excretion) are presented. The bacterial spectrum is more fully discussed. Amoxicillin is compared with ampicillin. Dosage and therapeutical results are presented. Within repeated bronchoscopic examinations necessary on account of bronchopulmonary affections determination of germs were done in 88 children. At the same time examination of ampicillin levels in bronchial secretions were performed after amoxicillin therapy with different high doses (3 x 125 mg to 3 x 750 mg) for 7 days. It could be shown that good antibiotic levels could be found in secretion specimens above all obtained 2 to 4 hours after the last amoxicillin administration. They could be found too, if there did not exist any purulent secretion or stronger inflammation. There are relations between the amount of dosage, the level in secretion as well as the influence on germs.     

Pathogenesis and clinics of gastric stump carcinoma (author's transl)

Statistics of postmortem examinations and retrospective long-term observations indicate a disposition of the resected stomach for the development of a primary carcinoma. The risk to develop a carcinoma after resection for peptic ulcer shows a two- to three-fold increase compared to gastric cancer mortality of the normal population. Because of the lack of typical symptoms for gastric stump cancer surgical treatment will occur late and the 5-years survival rate is only 1.38%. The cause of the increased cancer risk after gastric resection seems to be the atrophic gastritis in the gastric remnant which is found after a few years.     

Multiple gastric carcinoid, its diagnosis in gastric polyposis (author's transl)

Carcinoid of the stomach, hormonally inactive, is diagnosed with MDP, gastroscopy and biopsy. Solitary carcinoids are treated with excision in toto with immediate histology of the edges. Multiple gastric carcinoids require gastrectomy.     

Hepatotoxic effects of drugs in childhood (author's transl)

Drugs and toxic induced hepatopathies in children are commented, analyzing their types and mechanisms of toxicity, metabolism of drugs in the liver, classification and main clinical syndromes founded. A practical management of diagnosis, therapeutic and prophylactic measures are briefly described.