[Long-term observations on different methods of nephropexy]. / Langzeitergebnisse bei unterschiedlicher Nephropexietechnik.

In 29 patients with nephroptosis two different methods of nephropexy were compared; nephropexy using sutures passing through the parenchyma (n = 16) and nephropexy using tissue adhesives (n = 13). The first group was mobilized 3.5 days after operation, whereas the second group was mobilized one day after operation. On later follow-up 79% of the patients had no or minor complaints. Those patients who had the same disturbances as preoperatively had all been treated by nephropexy using sutures passing through the parenchyma. In 56% of this group radiological recurrence was seen, whereas in the group using tissue adhesives there was only 8% radiological recurrence. We think therefore that the nephroxepy using tissue adhesive is the simplest and least traumatic method.

[Hyperparathyroidism. Quantitative determination of specific skeletal changes in the radiography of the hand]. / Hyperparathyreoidismus Quantitative Erfassung der spezifischen Skelettveränderungen im Röntgenbild der Hand

1. The extent to which skeletal involvement in hyperparathyroidism can be detected by X-ray remains an unsolved issue. The present investigation, aimed at resolving this problem, was carried out in 44 patients with primary (PHPT) and 57 subjects with secondary hyperparathyroidism (SHPT) due to terminal renal insufficiency. For comparison, 49 age-matched controls were included in this series. Subperiostal resorption of the phalanges of the hand was considered pathognomonic and graded according to a semiquantitative system using a magnifying lens. The data were compared with the serum calcium and alkaline phosphatase values. 2. Pathological subperiostal resorption was detected in 38.5% of the PHPT and in 56% of the SHPT patients while the controls showed 4% (false) positive results. A highly significant correlation between the extent of bone resorption and alkaline phosphatase was found (PHPT: r=0.80, SHPT: r=0.71, p less than 0.001). No correlation of the X-ray findings to the serum calcium could be detected. Compared to the degree of skeletal involvement demonstrated by X-ray, the alkaline phosphatase was significantly lower in SHPT than in PHPT. In PHPT on the other hand, subperiostal resorption was prominent among female patients aged over 40 years, while no prevalence for sex and age was found in the SHPT group. 3. These results demonstrate that a clinically relevant degree of bone involvement in hyperparathyroidism may be easily and reliability assessed by evaluating X-rays of the hands by means of a magnifying lens. Increased bone resorption in hyperparathyroidism appears to be paralleled by an increase of osteoblastic activity as assessed by elevation of alkaline phosphatase. In SHPT due to chronic renal failure, however, a relative osteoblastic insufficiency seems to exist. In PHPT, the prevalence of subperiostal bone resorption in women aged over 40 years may be compatible with a skeletal protecting effect of intact ovarian function (estrogens).

[Urogenital-tuberculosis: pathogenesis, diagnostic approach, roentgenologic pathology, staging and remarks for differential diagnosis (author's transl)]. / Zur Abklärung der Urogenitaltuberkulose (UGT): Pathogenese, diagnostische Taktik, Röntgenpathologie, Stadieneinteilung und differentialdiagnostische Anmerkungen

The diagnostic tactics in the clarification of urogenital tuberculosis are referred to the changes for the individual examinations mentioned. Some tables show the results of radiological investigations on 200 patients with proved renal tuberculosis, the extend of the triple staging proposed by us being specified. In addition to expositions on the radiopathology of urogenital tuberculosis, the differential diagnosis is indicated, its focus lying in the comparsion of 118 patients with clinical-bacteriological and/or histologically confirmed non-specific chronic pyelonephritis. The comparison of patients from two 3-year groups 1959-1961 and 1971-1973 as well as between natives and foreigners shows a change in the clinical radiological picture of renal tuberculosis.

[Inhibition antibodies identified as anti-IgE]. / Als Anti-IgE indentifizierte Hemmantikörper.

Ten years ago the author described a precipitating agens which has been seen by immunreaction serum before and after desensitization. Now it was possible to identify it as Anti-IgE. Our first terminus was "Hemmantikörper" (inhibition antibody). Contrary to Cooke's "blocking antibody" (= IgG) Anti-IgE is an IgM-Antibody. According to earlier statement once more could be established that "Hemmantikörper" are specific to allergen but not specific to the individuum.

[Value and limits of different method in diagnosis and differential diagnosis of retroperitoneal tumors within the lymphatic systems (author's transl)]. / Aussagewert und -grenzen verschiedener Untersuchungsmethoden bei der Diagnose und Differentialdiagnose im Lymphsystem entwickelter retroperitonealer Tumoren

The demonstration of retroperitoneal intralymphatic primary or secondary tumors requires a progressive radiological investigation beginning with simple methods and advancing to more complicated ones. Radiological lymphography is a method which is superior due to its ability to demonstrate small structures in lymphatic vessels and lymphnodes. However, the usefulness of lymphography is limited partially to the retroperitoneal lymphatic system and to gross changes. To improve diagnostic accuracy further diagnostic measures are needed, namely intravenous urography, venocavography, lumbar venography of catheter, sonotomography of the upper abdomen and lymphatic scintigraphy. Exstirpation of lymphnodes- possibly by explorative laparotomy- and histopathological examination enables an extact assessment of lymphnodes of microscopical dimension as determination of the tumor type. The value and limits of complementary methods and the criteria for the diagnosis and differential diagnosis of metastatic lymphnodes and lymphoreticular systemic diseases are discussed. The significance of lymphography for evaluation of topographic expansion of pathological lymphnode changes, the further course of the disease and the effect of therapy according to the authors' experience are presented. It is stressed that the value of lymphography in diagnosing the type of disease is limited.

Epidural analgesia for the treatment of multiple ribfractures.

Epidural analgesia can be the choice of therapy for all patients with ribfractures and only minor coexisting injuries who are conscious and able to cooperate. In these cases we believe that EA is equivalent or even better than artificial ventilation with all its problems. Generally these patients are far easier to handle and one needs less nursing staff. The dignity of the patients can be maintained and the convalescent time in the intensive care unit is shorter. The criteria for the treatment and for measuring the progress of the patients with multiple ribfractures are discussed.

[Attempts at the introduction of a clinico-immunological therapy for malignant tumors]. / Versuche zur Einführung einer klinisch-immunologischen Therapie maligner Tumoren

The basis for an immunoncological therapy was investigated by culture of lymphocytes incubated with autologous tumor-antigen. The methods of isolation and cultivation are adapted to conditions of reinfusion. The effectiveness of tumor-aggressive action is demonstrated as transformation to lymphoblasts (indirect action) and tumor-cytolysis (direct action) in mixed lymphocyte-tumorcell culture.