[When must pulmonary tuberculosis be treated surgically even today?]. / Wann muss heute noch eine Lungentuberkulose chirurgisch behandelt werden?

Out of 571 patients with a chest complaint 58 were operated on for TB of the lungs. The average age was 43. With the exception of 9 patients, who were suspected of having a primary carcinoma of the lung, the operation was basically carried out after unsuccessful antituberculostatic therapy. The need to operate has to take into account adequately not only the morphological and functional changes in the lungs but also the social circumstances of the patient. In 78,7% of operations resections of lung tissue were used. 66,7% lobectomies, 18,8% wedge dissections, 8,3% pneumectomies and 6,2% bilobectomies were carried out. There were no deaths after operations. Surgical therapy of TB of the lungs still plays an important part in the treatment of TB and its success is mainly dependent on the timing in accordance with the indication.

[Our experiences with the gallium-scintigraphy in case of sarcoidosis of the lungs (author's transl)]. / Unsere Erfahrungen mit der Gallium-Szintigraphie der Lungensarkoidose.

The comparing examinations of patients suffering from a sarcoidosis of the lungs by the help of roentgenograms, scintigraphies of lung perfusion of 67-gallium and bioptic examinations admit to conclude as follows: In the stages I and II the activity-accumulation of radioactive gallium corresponds nearly to the alterations becoming visible in the X-ray-graph. Consequently, increases of lymph nodes and active granulomatous interstitial or centriform infiltrations may be presented. In case of a successful treatment the activity-incorporation is not to be proved anymore. As to time the alterations also coincide with the radiogram. In single cases the epithelioid nodule may be proved bioptically and microscopically when the active process already has stabilized spontaneously or by a treatment. In these cases the radioactive gallium is incorporated no more. The proof of 67-Ga-activity has a special signification in case fibrotic alterations have already appeared. The examinations prove that a granulomatosis may continue to exist when already distinct X-ray-symptoms of a fibrosis are present. Consequently, the granulomas may appositionally develop and cause an additional fibrosis. Therefore, in case of an existing infiltration of the lungs the combination of a definite lesion in the form of a fibrosis and a persisting formation of granulomas rather means a rule than an exception. A perfusion scintigram may be altered pathologically by a granuloma as well as by a fibrosis. Disorders in perfusion caused by granulomas are reversible.