[How can Instructions and Motivation for a Pension Influence the Response in Questionnaires?]. / Beeinflussen Instruktionen und die Motivation für eine Rente die Beschwerdedarstellung in Fragebogen?

AIMS OF THE STUDY: The study investigates whether the motivation for obtaining a pension together with written instructions change the response bias in symptom scales as well as symptom validity test. MATERIALS AND METHOD: 80 warned and 91 unwarned claimants for disability pension due to a mental illness were recruited. Participants completed a socio-demographic questionnaire (with statements to measure motivation), the module A of the HEALTH-49 as well as the SIMS. RESULTS: ANOVAs (analysis of variance) showed that warned claimants had significantly higher scores in total assets in symptom scales of the HEALTH-49 as well as the SIMS compared to the unwarned claimants. Warned persons showed higher odds for an invalid value in the SIMS. A regression analysis revealed that the item "retirement means for me a chance to be healthy" can predict the criterion total score of the SIMS. CONCLUSION: Warnings may produce negative response bias in symptom scales. Patients made negative response bias when they hope to recover through their pension.

[A concept to improve wet-lab training in ENT surgery]. / Ein Konzept zur Verbesserung von Präparationskursen in der HNO-Heilkunde.

BACKGROUND: In literature and scientific societies no binding methodical-didactic recommendations or guidelines exist in order to design surgical training courses. The educating institutions plan, organise and evaluate the educational program on their own initiative. MATERIAL AND METHODS: Through a research project surgical training courses were investigated through structured surveys, expert discussions with course responsibles and trainers and analysis of participant's questionnaires. The investigation was performed by an pedagogical-psychological research institution. First implementations were installed and immediately included in the running process of evaluation. RESULTS: From the evaluation, specific alterations in the organisational and micro didactic process were implemented. In addition, changes in a long term process had to be implemented such as: (a) conception of the trainer role, (b) giving feedback and judge performance and (c) provide contents in a sophisticated manner. CONCLUSION: For advanced medical training providers a long term cooperation with a pedagogical institution seems to be highly advisable.

The effect of the volatile oil from ginger rhizomes (Zingiber officinale), its fractions and isolated compounds on the 5-HT3 receptor complex and the serotoninergic system of the rat ileum.

A contribution of the volatile oil from ginger rhizomes (Zingiber officinale Roscoe) on inhabiting the 5-HT3 receptor complex had been shown. In the present study a possible interaction of some compounds of the volatile oil with the 5-HT3 receptor system expressed in N1E-115 cells and with the serotoninergic system of the rat ileum was investigated. The volatile oil was obtained by steam distillation and fractionated using a silica gel column resulting in five fractions. Compounds of the fractions were identified by GC-MS. The influence of the volatile oil, its fractions and pure components on serotonin-induced [14C]guanidinium influx into N1E-115 cells was measured indicating the inhibitory interaction with the 5-HT3 receptor channel system. Most potent inhibitors of cation influx were the volatile oil, fraction 4, beta-pinene, terpinolene, alpha-copaene and alpha-phellandrene. The volatile oil and fractions 1 and 4 were not able to significantly influence either serotonin (10 microM)-induced maximum contraction of the rat ileum or the second phase of the biphasic contraction 2.5 min after serotonin addition. However, beta-pinene, terpinolene and alpha-phellandrene reduced both contractions. In conclusion, the volatile oil and distinct compounds such as terpinolene, beta-pinene and alpha-phellandrene interact with 5-HT3 receptor channel system and possess an antispasmodic effect at the rat ileum.

[Behavior of postoperative adhesions after intraperitoneal administration of fibrinolytic drugs in a rat model]. / Verhalten postoperativer Adhäsionen nach intraperitonealer Applikation von Fibrinolytika in einem Rattenmodell.

In a rat model, the effect of the intraperitoneal application of fibrinolytic agents on the development of adhesions was examined. Streptokinase and TPA reduced sero-serosal adhesions significantly, whereas urokinase did not reduce them. Intravascular coagulation was not affected.

[Results of surgical management of unstable pertrochanteric femoral fractures with the dynamic hip screw and T-plate]. / Ergebnisse der operativen Versorgung instabiler pertrochantärer Femurfrakturen mittels DHS und T-Platte.

The dynamic hip screw (DHS) is a widely used method of osteosynthesis. Nevertheless, supplying instable pertrochanteric fractures is problematic because the gliding screw may cause a considerable dislocation of fragments in lateral direction. Is there any alternative method disposable, bearing stability of DHS- osteosynthesis can be improved by adding a lateral T-plate. We reached full bearing stability in four cases.

[Ender nailing versus dynamic hip screw--a comparison of early postoperative results]. / Ender-Nagelung versus Dynamische Hüftschraube (DHS)--Ein Vergleich früh postoperativer Verläufe.

Proximal fractures of femur may be alternatively treated by implantation of dynamic hip screws or Ender-nails. Estimation of the value of both measures is to be done by analysis of the early postoperative course. Full load bearing capability was obtained in 83% of all cases with Ender-nails as against 68% of all cases after implantation of hip screws. Duration of operation was clearly shorter and the need for blood transfusions was reduced by implantation of Ender-nails. The amount of specific technical complications was equal in both procedures. There were no differences in the postoperative ability to walk.

[The value of serum endotoxin determination after gastrointestinal interventions]. / Die Wertigkeit von Serum-Endotoxin-Bestimmungen nach gastrointestinalen Eingriffen.

Serumendotoxins were measured in 11 patients after gut surgery and compared with healthy people as a standard. In cases of uncomplicated course 3 to 4-fold raised serumendotoxin levels were observed in a typical two-peak pattern. It was not before the fifth day following operation that serum levels declined constantly. In contrast to these findings, patients suffering from septic complications showed a permanently raised endotoxin level, which correlated well with their clinical course. Therefore single peaks of serumendotoxin measured after operation should not be overvalued. Constantly raised levels following operation, however, may indicate some kind of septic complication.

[Advantages and disadvantages of ultrasound dissection of benign struma. A report of experiences after 2 years clinical use]. / Vor- und Nachteile der Ultraschalldissektion der benignen Struma. Ein Erfahrungsbericht nach 2jähriger klinischer Anwendung.

Ultrasonic dissection of goitre allows a controlled resection. This method saves time and diminuishes risk of operation. Not suturing the remnants of thyroid gland, optimal blood supply is obtained and hazard for the recurrent laryngeal nerve is decreased. Loss of blood is insignificant. To increase acceptance of this method, handling of apparatus has to be improved.

[Results of cryosurgery in the treatment of inoperable tumor stenoses of the anus and rectum]. / Ergebnisse der Kryochirurgie bei der Behandlung inoperabler Tumorstenosen des Anus und Rektums.

Inoperable tumor stenosis of anus and rectum may be treated surgically only by implantation of artificial anus. Cryosurgery proves to be a feasible alternative in order to maintain free passage of the gut. The cryoprobe is introduced through a rectoscopy under direct view. Visible tumor is touched with the tip of the cryoprobe and subsequently temperature is lowered to approximately -19 degrees C. Usually anesthesia is not required. From 1976 to 1989, 213 patients had been treated by cryosurgery in our department. In 23 cases the use of an artificial anus became inevitable afterwards.

[Insulinoma. Results of surgical treatment]. / Insulinome. Ergebnisse der chirurgischen Therapie.

The insulinoma is the most common pancreas tumour with endocrine activity, with more than 2,000 cases being described in the literature worldwide. The first successful extirpation was performed by Graham in 1928. Clinical appearance is characterized by severe paroxysmal hypoglycaemia together with inadequately increased serum insulin levels. Surgery is indicated in such situations because of limited effectiveness of medicamentous therapy. Surgical approach and long-time results are discussed in this paper, with reference being made to 13 cases of the authors.

[Experience with the ultrasonic aspirator in surgery of benign goiter]. / Erfahrungen mit dem Ultraschallsauger in der Chirurgie der Struma benigna.

In 60 cases intracapsular resection of goiter was performed by using ultrasonic aspirator. The superior pole vessels and the inferior thyroid artery were not touched, the recurrent laryngeal nerve was not identified. Minimal hemorrhage in the intra- and postoperative period, operation time saving in comparison with conventional subtotal thyroidectomy, no temporary and no permanent damage to the recurrent laryngeal nerve and no wound infection were observed. Not suturing the remnants of thyroid optimal blood supply was obtained. There were no hypoparathyroidism and but one case of hypothyroidism.

[Computer-assisted drug therapy of incomplete ileus]. / Rechnerüberwachte medikamentöse Therapie des inkompletten Ileus.

Auscultation of bowel sounds has a decisive position in management of intestinal paralysis, although personal bound interpretation and documentation may give rise to problems. Our computerized electronic analysis system of bowel sounds permits easy objectivation of auscultation findings. This noninvasive method is optional a repeatable. We investigated 15 patients suffering from intestinal paralysis using this method. Good correlations between clinical findings and the results of our analysis allow reliable estimations of therapeutic measurements. Dosage of drugs influencing peristalsis is facilitated.

[New aspects of surgical therapy of acute gastroduodenal hemorrhage]. / Neue Aspekte der chirurgischen Therapie der akuten gastroduodenalen Blutung.

The chances for conservative treatment of bleeding ulcers have been expanded by progress in endoscopic haemostasis. Surgery, nowadays, is in many cases applied only to patients with uncontrollable recurrent haemorrhage, after the internist's efforts have failed. This has increased lethality from 20 to 44 percent. To improve results, elective operation is recommended in the no-bleeding interval, following endoscopic haemostasis.

[Computer-assisted analysis of intestinal sounds for assessing the motility of the gastrointestinal tract]. / Rechnerunterstützte Darmgeräuschanalyse zur Motilitätsbeurteilung des Gastrointestinaltraktes.

Intestinal noise analysis by means of a computerized analyser is a method by which various functional states of the gastro-intestinal tract can be diagnosed. Interference noise from respiration and cardiac action can be suppressed by filtering. Frequency patterns determined were in good correlation with the clinical picture and auscultation findings. It is, basically, possible to identify the original causative organ.