[Steroid hormone receptor status of colorectal cancers]. / Zum Steroidhormonrezeptorenstatus kolorektaler Karzinome.

Tumor samples of 26 consecutive colorectal carcinomas were studied for the presence of steroid hormone receptors for estrogen and progesterone. In all cases, the estradiol receptor binding capacity was below 2 fmol/mg cytosol protein. In 4 of 26 samples, progesterone receptor levels from 13 to 23 fmol/mg cytosol protein were observed. Because of the identification of steroid receptors in some cases and single reports in literature about tumor regression under hormone therapy of colorectal carcinoma, further investigations seem indicated to study the hormone sensitivity of colorectal carcinoma.

[Surgical treatment of liver metastases from colorectal carcinoma]. / Chirurgische Therapie von Lebermetastasen kolorektaler Karzinome.

Between 1978 and 1985 a total of 49 patients (20 women and 29 men, aged 31-78 years) were operated upon for liver metastases of a colorectal carcinoma. Metastasis recurrences occurred in 42 of 46 patients (91%). Three patients died in connection with the operation (6.1%). The five-year survival rate was 10.7%. Neither number, site and volume of the metastases, level of carcinoembryonic antigen concentration, tumour differentiation, stage or site of primary tumour, nor type of operation (enucleation or hemihepatectomy) had any influence on survival rate. Since most of the recurrences in the liver had occurred after enucleation at the site of the previous resection, it is feasible that the results could be improved by extending the area of resection.

[Adenoma of the papilla of Vater. Diagnostic and therapeutic problems of a rare site for an adenoma]. / Adenome der Papilla Vateri. Diagnostische und therapeutische Problematik einer seltenen Adenomlokalisation.

Intermittent jaundice and recurrent colicky upper abdominal pain in two patients, aged 46 and 48 years, were found by endoscopy to be due to an adenoma of the papilla of Vater. Transduodenal local excision with papilloplasty made both patients free of symptoms.

[Post-traumatic radio-ulnar synostoses in childhood]. / Posttraumatische radioulnare Synostosen im Kindesalter.

This article reports on five children treated surgically during 1973-1975 for posttraumatic radioulnar synostosis. The synostoses had developed as a complication after a proximal radial fracture. Lesion of the proximal ulna plays an important part in creating such an osseous union. Another factor of equal importance is the traumatization of the tissues during surgical treatment of the fracture, especially if debris of the periosteum and fine bone fragments additionally enter into the space between radius and ulna. Formation of excess callus, and hence synostosis, is also promoted if repositioning or re-repositioning of a proximal radial fracture is effected too late. The article presents the technique of surgical treatment of proximal radioulnar synostosis with Lyodura sheathing. Follow-up examination of the five children during an observation period of five years showed good results in two children, a moderate result in one, and poor results of surgery in two cases. Improved results may be expected from further improvement of the surgical method, such as resection of the bicipital tuberosity (tuberositas radii) or from additional partial sheathing of the ulna at the side facing the radius.

[Segmental arteriosclerotic occlusion of the infrarenal aorta]. / Segmentaler arteriosklerotischer Verschluss der infrarenalen Aorta.

Atherosclerosis involving the terminal aorta usually is a diffuse process that commonly includes the iliac and femoral arteries. Less frequently, the lesions are limited to the infrarenal aortic segment with normal distal vessels. Patients with isolated occlusion or stenosis of the infrarenal aorta tend to be younger, more often female and have slower progression of atherosclerotic lesions. There is a causative relationship of this well-localized form of atherosclerosis to the use of oral contraceptives and heavy smoking. In 90% of the cases, surgery of these lesions is limited to endarterectomy. End results are satisfactory in a majority of the patients. Percutaneous transluminal angioplasty produces satisfactory early results for concentric stenosis, although long-term results have not yet been established.

[Mesenteric cysts in childhood]. / Mesenterialzysten im Kindesalter.

5 children with mesenteric cysts, 3 boys and 2 girls, aged 2 to 10 years, were admitted with acute abdominal pain. In adults the most common symptom is chronic abdominal pain whereas in children the onset of symptoms is acute due to intestinal obstruction. Sonography, performed in two patients, is the diagnostic method of choice. Excision of the cyst required resection of the small intestine in 2 patients, while simple enucleation was possible in 3. All 5 patients survived, and there have been neither complications nor recurrences. Early recognition and appropriate resection of these occasionally life-threatening malformations are associated with a good prognosis.

[Symptoms and therapy of aortic bifurcation embolism]. / Symptomatik und Therapie der Aortenbifurkationsembolie.

31 patients underwent embolectomy for acute embolism of the aortic bifurcation. In most instances paralysis of the extremity (84%) was present, sudden onset of pain (16%) was less common. Neurological disease had been considered in 55%. The heart was source of emboli in 92%. Postoperative complications were mainly due to renal failure (23%) and irreversible limb ischemia (10%) requiring amputation. Mortality after embolism of the bifurcation was 39%. The major cause of death was cardiac failure (58%) followed by renal failure and pulmonary embolism. Even after long delay (4 weeks) successful operation is possible due to adequate collateral circulation supplying the extremity until the blockade is removed.

[Femoral neck fractures in childhood]. / Die Schenkelhalsfraktur im Kindesalter.

Twenty-eight fractures of the neck of the femur occurred in children between 1963 and 1982 were treated and followed up at the Pediatric Surgical Hospital of the University of Mainz. Three children had transepiphyseal fractures (type I), eight children transcervical fractures (typ II), six children cervicobasal fractures (typ III), and eleven children pertrochanteric fractures (typ IV). Surgical intervention was performed in fifteen children, and thirteen children were submitted to conservative treatment. The results were evaluated according to a new system considering troubles, mobility, and X-ray findings. The evaluation showed good results in twenty children, bad results in two children, and satisfactory results in one child. Five children could not be evaluated. Complications necessitating an osteotomy with change of the bone position were only seen after conservative treatment. The therapeutic procedure applied in order to prevent the most severe complication, i.e. the aseptic necrosis of the femoral head, is pointed out.

[Necrotizing inflammation of the vulva--a symptom of Richter intestinal wall hernia]. / Nekrotisierende Entzündung der Vulva--Symptom einer Richterschen Darmwandhernie.

Parietal hernias, often also known as Littre's hernia and Richter's hernia, are a special kind of inguinal hernias. In this type of hernia, part of the abdominal (intestinal) wall is strangulated in "calotte form" in the hernial orifice; as a result, parietal hernias often cause only mild complaints and are surgically treated only in the late stage of enterocutaneous faecal fistula. In contrast to incarcerated inguinal hernias resulting in diffuse faecal peritonitis via infarction and necrosis, parietal hernia of the Richter type is locally restricted in extension because of the narrow hernial orifice, as far as the extension into the abdominal cavity is concerned; intestinal patency is usually maintained. The possibility of the existence of a perforated parietal hernia should always be considered in necrotising inflammations in the inguinal and vulvar regions, even if abdominal signs and symptoms are absent.

[Rectal carcinoma in childhood]. / Rektumkarzinom im Kindesalter.

The authors report on the case of a 12-year-old girl on whom surgery was performed for primary carcinoma of the rectum with a case history of one year. The tumour had already infiltrated the vagina. Abdominoperineal amputation of the rectum was performed. An extended tumour relapse and metastases in the liver were found on relaparotomy which had to be performed three years later The prognosis was, therefore, unfavourable indeed. Numerous publications prove that carcinoma of the rectum must be given differential diagnostic consideration even in childhood, especially if there are unclear deposits of blood in the faeces in conjunction with abdominal pain and loss of weight. Usually, the "fatal pause" between the first symptoms and the correct diagnosis is too long. Once the disease has progressed to an advanced stage, carcinoma of the rectum has a very unfavourable prognosis even in children. Simple digito-rectal examination can decisively improve the survival rate.

[Thoughts on the so-called "radius-capitellum axis" (author's transl)]. / Betrachtungen zur sog. "Radius-Capitulum-Achse".

We have studied 438 patients radiologically in order to observe the so-called "radius-capitellum axis". In about a quarter of people with normal elbows the axis passes lateral to the middle portion of the capitellum, so that even when there is marked deviation, there is no certainty that the humero-radial joint is abnormal. Deviation of the axis can be caused by changes in the shape of the capitellum or of the radius, or by distension of the capsule of the elbow joint, or by various changes in muscular pull.

Structural transformation of the phagosomal membrane in Tetrahymena cells endocytosing latex beads.

A model system with a high phagosomal membrane turnover has been developed: During a 45-min period Tetrahymena cells endocytoze 186 latex beads (diameter: 2.02 mum) per average cell; 166 of these beads are then exocytozed in the course of the following 145 min. During the endocytotic phase an average cell is approximated to fabricate 1200 mum2 phagosomal membrane. Freeze-etch electronmicroscopy reveals that both fracture faces of the nascent phagosomal membrane are associated with the typical 85 A-particles in approximately equal numbers. Mature phagosomal membranes, however, show an unequal particle distribution. Smooth areas, smooth areas bordered with a fracture rim, and particle-associated depressions up to a diameter of 130 nm can be observed especially on fracture faces of mature phagosomes in the endocytotic phase. These are discussed with respect to membrane fusion.

Reversible, thermotropic alteration of nuclear membrane stucture and nucleocytoplasmic RNA transport in Tetrahymena.

We examine the effect of cooling upon the freeze-etch ultrastructure of nuclear membranes, as well as upon nucleocytoplasmic RNA transport in the unicellular eukaryote Tetrahymena pyriformis. Chilling produces smooth, particle-free areas on both faces of the two freeze-fractured macronuclear membranes. Upon return to optimum growth temperature the membrane-associated particles revert to their normal uniform distribution and the smooth areas disappear. Chilling lowers the incorporation of [(14)C]uridine into whole cells and their cytoplasmic RNA. Cooling from the optimum growth temperature of 28 degrees to 18 degrees C (or above) decreases [(14)C]uridine incorporation into cells more than into their cytoplasmic RNA; chilling to below 18 degrees C but above 10 degrees C causes the reverse. [(14)C]Uridine incorporation into whole cells and their cytoplasmic RNA reflects overall RNA synthesis and nucleocytoplasmic RNA transport, respectively. RNA transport decreases strongly between 20 degrees and 16 degrees C, which is also the temperature range where morphologically detectable nuclear membrane transitions occur. This suggests that the nuclear envelope limits the rate of nucleocytoplasmic RNA transport at low temperatures. We hypothesize that a thermotropic lipid phase transition switches nuclear pore complexes from an "open" to a "closed" state with respect to nucleocytoplasmic RNA transport.