Lytic effector cell activity and major depressive disorder in patients with breast cancer: a prospective study.

The study examined lymphokine-activated killer cell (LAK) and natural killer (NK) cell activity in breast cancer patients prior to surgery as compared to effector cell lysis in patients with non-malignant breast tumors, further in connection with lifetime diagnosis of major depression, severity of current depression, anxiety and coping styles. Follow up studies covered a period of 6 and 12 months. Prior to surgery, life time diagnosis of major depressive disorder, trait anxiety and coping styles did not discriminate patients as far as effector cell lysis is concerned. LAK activity but not NK activity was reduced in patients with actual depressive symptoms (P < 0.01) and high state anxiety (P < 0.05). These findings support the hypothesis that LAK activity is a state marker of actually existing depression and anxiety prior to surgery. Affective rather than coping measures showed significant differences in LAK activity. For LAK activity, 1 year after surgery the only predicting factors were Tamoxifen therapy and chemotherapy.

Gastric blood flow, mast cell degranulation and micromorphology of gastric mucosa following experimental haemorrhagic shock in dogs.

Ischaemia of the gastric mucosa in haemorrhagic shock appears to be one of the principal factors underlying acute bleeding from the upper gastrointestinal tract. In the present experimental study on dogs the changes of blood flow in the upper gastrointestinal tract were recorded by direct flow measurement in the pertinent vessels. Fourteen mongrel dogs were subjected to haemorrhagic shock lasting for 3 and 4 h. A decline of 46 per cent cardiac output was observed while coeliac artery blood flow decreased by 40 per cent and gastric artery blood flow by 60 per cent. All stages of stress ulcers were documented by light and electron microscopy. In addition, pronounced degranulation of mast cells preceding major tissue damage was observed. In the light of these findings a cascade of events is thought to be present resulting in the development of stress ulcer.

[Problems of a stage-based therapeutic approach to surgery in breast carcinoma (author's transl)]. / Zur Problematik der stadiengerechten Chirurgie des Mammakarzinoms.

A therapeutic concept dependent on staging of breast carcinoma is presented: 1. Stage T0-T1 N0 M0: wide local excision or quadrant resection with axillary lymph-node excision. 2. Stage T2 and T3 N0-N1: simple mastectomy (Patey). 3. Stage T4 or N2: radical mastectomy (Rotter). 4. Stage N3 or M1: tumour excision according to the T-stage, lymph-node excision, local excision of affected distant lymph nodes. With equal therapeutic results the smaller and cosmetically-preferable surgical procedure is to be recommended.

[Stress ulcer-an experimental study (author's transl)]. / Das Stressulkus-eine experimentelle Studie.

This experimental study demonstrates by means of electromagnetic flow measurements that hypovolaemic shock results in a significant decrease in gastric flow. 14 mongrel dogs were subjected to haemorrhagic shock for 3 or 4 hours. Significant histological changes are seen in the gastric mucosa as a result of the haemodynamic changes, especially when the duration of shock was 4 hours. All stages of stress ulcer from the superficial erosion to deep ulcers were documented. The possibility that the mast cell plays a pathogenetic role as mediator in the origination of a stress ulcer is considered.

[Functional gastric surgery (author's transl)]. / Funktionelle Magenchirurgie

Twenty years of intensive clinical and experimental research have resulted in the successful development of a modern model of gastric secretory and motility physiology as a basis for further differentiating work in this field. Conventional gastric resection as principal method in the treatment of benign hypersecretory gastroduodenal ulcers seems to be superseded by selective proximal vagotomy with pyloroplasty on the basis of excellent results with this procedure. Selective proximal vagotomy can be carried out in place of the standard Billroth resection procedure in 80% of cases. However, the attainment of technical perfection by a few skilled specialist surgeons at selected centres and the precise evaluation of gastric secretion data both pre- and postoperatively are prerequisites for a successful outcome.

[Roentgenmorphologic findings in single homotransplantation of non immunosuppressive treated canine lungs (author's transl)]. / Röntgenmorphologie der unbehandelten homotransplantierten Hundellnge

According to plain chest roentgenography correlated to needle biopsies the following grades in the course of rejection after single lungtransplantation could be evaluated. 1) Begin of rejection: perihilar alveolar infiltrate. 2) Increase of the infiltrates (positive Airbronchogram). 3) Almost total consolidation of the graft. 4) Complete consolidation of the graft, mediastinal hernia caused by the own lung.

[Bronchospirometric function on homotransplanted canine lungs after long-time preservation (author's transl)]. / Die bronchospirometrisch gemessene Funktion der langzeitkonservierten homotransplantierten Hundelunge

In the present study 12 canine lungs perfused in a BELZER perfusion unit for 17 hours using Albumine solution were homotransplanted. Bronchospirometric evaluation up to the 21st postoperative day have shown sufficient function. There is no remarkable difference in minute ventilation, alveolar ventilation and oxygen uptake when compared with non-stored lung homografts.

[Primary malignant tumours of the small intestine (author's transl)]. / Primäre maligne Dünndarmtumoren

In the years between 1936 and 1973 19 patients with malignant tumours of the small intestine were admitted to the 2nd Department of Surgery, University of Vienna. Analogous to the findings of large-scale investigations adenocarcinomas (7 cases) preponderate in the upper small intestine in our case material, while lymphosarcomas and carcinoids mainly occur in the ileum. A radical surgical procedure was possible in 11 cases. The adenocarcinomas have the most unfavourable prognosis, whilst survival times of up to 10 years were found with lymphosarcomas and carcinoid tumours.

[Changes of lung function in experimentally induced emphysema before and after unilateral homotransplantation of the canine lung]. / Veränderungen der Lungenfunktion bei experimentell erzeugtem Emphysem vor und nach einseitiger Lungenhomotransplantation am Hund.

Pulmonary function studies after single-lung homotransplantation in dogs with experimentally induced emphysema. Pulmonary emphysema was induced in 8 bastard dogs by intratracheal instillation of papain (dose 2 mg/kg 3 to 5 times in 6 to 10 weeks). Development of emphysema was documented by weekly pulmonary function studies. The emphysematous animals underwent single-lung homotransplantation. Postoperative studies of lung function were performed immediately after transplantation and 1 week postoperatively. Bronchospirometric measurement revealed that ventilatory function and oxygen consumption of the graft was at least equal to the animal's own emphysematous lung. Up to 1 week after transplantation there is no evidence of serious ventilation-perfusion imbalance.

[Lung functions after single-lung homotransplantation in dogs (author's transl)]. / Lungenfunktion nach einseitiger Lungenhomotransplantation am Hund

Unilateral homotransplantation of the lung was performed in ten healthy mongrel dogs. Assessment of pulmonary function was obtained immediately after transplantation ten days and four weeks postoperatively. A conventional endotracheal tube was used for measurement of total lung function. A special tube was deviced for bronchospirometric measurements in dogs. A moderate increase of tidal volume and marked increase of respiratory rate and minute ventilation could be noted immediately after transplantation. Oxygen consumption was not changed significantly. There was a marked decrease in arterial pO2-level following transplantation, which was improved during the follow-up studies and found within normal limits at the tenth postoperative day. Bronchospirometry immediately following transplantation revealed equal ventilation values of both lungs, but oxygen consumption of the transplant was reduced 50% compared to the recipient's own lung. On the tenth postoperative day ventilatory function of the transplant was found close to that of the recipients own lung. Oxygen consumption in respiratory equivalent at this time averaged two thirds of the animal's own lung. Four weeks following transplantation no further significant change of respiratory function could be noted.

[Pulmonary function tests following single lung homotransplantation in emphysematous dogs (author's transl)]. / Lungenfunktionsuntersuchungen nach einseitiger Lungenhomotransplantation an emphysematösen Hunden

Experimental emphysema was induced by multiple intratracheal instillation of Papain in a dose of 2 mg/kg body weight in 4 bastard dogs. Development of emphysema was objectivated by pulmonary function tests. Increase of static lung compliance, decrease of lung elastance, and increase of air-way resistance were observed. In addition arterial pO2 decreased while pCO2 remained constant. Following single lung homotransplantation there was an increase of respiratory rate and minute ventilation, the transpulmonary pressure rose in the first postoperative days, static lung compliance was diminished. Four weeks after transplantation typical functional changes of emphysema could be demonstrated concerning the slope and appearance of the compliance loops. Arterial pO2 however remained within the normal range. This functional behaviour does not support the concept of a ventialtion perfusion imbalance after lung transplantation in emphysema patients. Respiratory insufficiency therefore is probably caused by an alveolar type of rejection.

[The effect of hypovolaemic shock on the pancreas (author's transl)]. / Die Auswirkung des hypovolämischen Schoeks auf das Pankreas

Morphological changes similar to those found in acute pancreatitis were found at autopsy of ten patients who had died following temporary hypovolaemic shock. In an experimental study it was demonstrated by means of electromagnetic flow measurements that hypovolaemic shock results in a significant decrease in pancreatic flow, which is paralleled by a significant decrease in oxygen consumption of the organ in spite of a compensatory increase in the arterio-venous oxyhaemoglobin difference. These haemodynamic changes are followed by hypoxic cell damage mainly in the periphereal areas of the pancreatic acini, with resultant necrosis, as found in acute pancreatitis.

[Pulmonary homotransplantation in the dog with contralateral ligation of the pulmonary artery and subsequent contralateral pneumonectomy]. / Lungenhomotransplantation am Hund mit Ligatur der kontralateralen Arteria pulmonalis und nachfolgender kontralateraler Pneumonektomie

Five mongrel dogs underwent a left side pulmonary homotransplantation and simultaneous contralateral pulmonary artery ligation using a standardized operative technique. The contralateral lung of the recipient was successfully removed on the first postoperative day. From the present study may be concluded that the transplanted lung is able to provide adequate respiratory function immediate postoperatively and is able to tolerate the total cardiac output in the presence of increased vascular resistence of the recipient contralateral lung.

[Electron microscopic investigation following canine pulmonary transplantation with regard to functional effects (author's transl)]. / Elektronenmikroskopische Untersuchungen der transplantierten Hundelunge und ihre funktionelle Bedeutung

QUESTION: The function of alveolar macrophages in correlation with immunological stimulation, consequently also in pulmonary transplantation, are a subject of discussion. In this study the alveolar manifestations of rejection following pulmonary transplantation, are a subject of discussion. In this study the alveolar manifestations of rejection following pulmonary homotransplantation are investigated by electron microscopy. MATERIALS AND METHODS: In 20 healthy dogs (body weight between 7 and 19 kg) a left side pulmonary homotransplantation was performed using a standardized method. 2 randomized groups of 10 animals each were formed, one undergoing immunosuppressive therapy, the other none. Needle biopsies (Menghini needles) were taken in both groups at the onset of rejection daily until death of the animals (on the 5th to 12th postoperative day). At death of the animals always total rejection of the homograft was observed. The other animals were subjected to a scheduled immunosuppressive therapy (KREUZER et al. 1973, RADASZKIEWICZ et al. 1974). Needle biopsies were taken only at the stage of a clinically or roentgenologically ascertained crisis of rejection. Before implantation of the homograft and 20 mins after occlusion of anastomoses and onset of circulation in the transplant biopsies were taken, too, to exclude early changes or alterations in the donor. The lung specimens 2 mm in size) obtained by biopsy were fixed in phosphate buffered OSO4 and buffered phosphate solution by usual alcohol series. After embedding in epon the specimens were studied by electron microscopy. RESULTS: In the group not undergoing immunosuppressive therapy beginning with the 3rd post-operative day perivascular lymphocytic and plasmacellular infiltrates were seen which increased during the course of rejection. In both groups a swelling and vacuolization of endoplasmatic reticulum, cytoplasmic microvilli with bridge formation accompanied by an increase of alveolar macrophages and by augmentation of lamellar bodies in granular pneumocytes were noted following operation. A correlation between the increase of lamellar bodies and increase of surfactant has been shown previously.