[Splenosis: a rare cause for pelvic pain (diagnosis and modern therapy with pelviscopy). A case report]. / Splenose: Eine seltene Ursache für Unterleibsschmerzen (Diagnose und moderne Therapie per pelviscopiam). Ein Fallbericht.

Definition, diagnosis, and therapy of splenosis are demonstrated by presenting a case report. Operative pelviscopy, performed twice, would be the best method for diagnosis and therapy of splenosis compared with the treatment with radiation or laparotomy.

On the occurrence of enoate reductase and 2-oxo-carboxylate reductase in clostridia and some observations on the amino acid fermentation by Peptostreptococcus anaerobius.

Enoate reductase present in Clostridium kluyveri and Clostridium spec. La 1 could be detected in three strains of C. tyrobutyricum and ten clostridia belonging to the groups of proteolytic and saccharolytic or proteolytic species, respectively. In C. pasteurianum, C. butyricum and C. propionicum enoate reductase could not be found even after growth on (E)-2-butenoate. A 2-oxo-carboxylate reductase was present in rather low activities in the non-proteolytic clostridia which produce enoate reductase. High activities (up to 10 U/mg protein) of 2-oxo-carboxylate reductase were found in six of ten proteolytic clostridia. The substrate specificities of the enoate reductase and the 2-oxo-carboxylate reductases from the proteolytic clostridia were determined with different alpha, beta-unsaturated carboxylates (enoates) and 2-oxo-carboxylates, respectively. Enoates as well as 2-oxo-carboxylates are intermediates of the pathway by which amino acids are degraded. An explanation is offered for the long known but not understood fact that in the Stickland reaction isoleucine always acts as an electron donor and leucine and phenylalanine can be electron acceptors as well as donors. Peptostreptococcus anaerobius converting some amino acids to the same products as C. sporogenes did this also with the intermediates which were found for the reductive deamination of amino acids in C. sporogenes, however, in crude extracts reduction of enoates occurred only in an activated form.

Treatment of female infertility due to tubal obstruction by operative laparoscopy.

The advent in recent years of safe endocoagulation (thermocoagulation within the abdomen) has permitted operative laparoscopic treatment of the tubal factor in infertility in selected cases. This paper reviews the results of operative laparoscopy in 223 cases treated for infertility between 1971 and 1976. Tubal occlusion was present in 133 patients before surgical intervention. Following operative laparoscopy, tubal patency was demonstrated in 67% on testing at the time of operation and in 12% at the first postoperative hydrotubation. In only 21% of cases was tubal patency not achieved by these methods. Those cases requiring isthmic salpingostomy, ampullary or isthmic-tubal implantation, or end-to-end anastomosis were further treated by laparotomy and microsurgery. Ninety cases of pelvic endometriosis were treated by a combination treatment of thermocoagulation, ovarian cyst resection, and the antigonadotropin agent, danazol. Ovariolysis, salpingolysis, fimbrioplasty, and salpingostomy can easily be performed using operative laparoscopy as the method of choice with a minimum of complications, shortened hospitalization time (2 days), and the potential for a repeat procedure or a follow-up laparotomy should this be necessary. The pregnancy rate following laparoscopic treatment for the correction of distal tubal occlusion was 30.5% and for endometriosis genitalis externa, 40%. These rates compare favorably with the rates following procedures involving laparotomy and microsurgery for correction of similar lesions.