[Subtotal thyroid gland resection in immunogenic hyperthyroidism: results of a 9-year period]. / Subtotale Schilddrüsenresektion bei immunogener Hyperthyreose: Ergebnisse eines 9-Jahreszeitraumes.

UNLABELLED: From 01. 01. 1980-31. 12. 1988 149 patients with Graves' disease were subtotally thyreoidectomized with little rests of 2-3 g on each side. The nervi recurrente and the parathyreoids were exposed. RESULTS: There was only one permanent pulsy of the recurrence nerve and no permanent hypoparathyreoidsm. 146 patients could be observed: two had a recidiv and must be treated with radiojodine. 70% of our patients were hypothyreotic, 20% euthyreotic. We think that the operation is the therapy of choice in young patients with Graves' disease.

[Pediatric inguinal hernia in continuous ambulatory peritoneal dialysis]. / Zur Problematik des kindlichen Leistenbruches unter CAPD.

We report on the case of an 11-year-old boy suffering from juvenile nephronophthisis who developed bilateral inguinal hernia (on the right as a recurrence of the neonatal operation) 5 days and 4 months after starting CAPD treatment. Before the peritoneal dialysis there had been no clinical signs and no history of inguinal hernia. On the basis of this we emphasise some particular features of inguinal hernia under CAPD treatment such as an increased risk of incarceration, the importance of genital and scrotal swelling as an early symptom, the value of peritoneography as a diagnostic aid, and the need for high ligation of the patent processus vaginalis together with reduced postoperative volumes of the peritoneal dialysate.

[Gnotobiotic studies on SPF mice in relation to a study of tumor development in the colon after cholecystectomy]. / Gnotobiotische Untersuchungen an SPF-Mäusen im Rahmen einer Studie zur Tumorentwicklung im Kolon nach Cholezystektomie.

The relation between cholecystectomy and colon carcinogenesis has not been fully elucidated. As bacteria may be involved in the carcinogenic process, we investigated the effect of cholecystectomy and dimethylhydrazine (DMH) administration to SPF NMRI mice with regard to tumour genesis and bacterial colonisation of the intestine. It results from this study that cholecystectomy does not influence tumour genesis and that 6-7 months post operationem and DMH administration tumours and bacteria originally not found in the animals develop: clostridia, eubacteria spec. which cannot be differentiated and E. lentum. Theses changes appear in group II of mice (laparotomy and DMH) and group III (cholecystectomy and DMH), but not in group I (controls). From the results of this study we cannot conclude whether the tumours or the new bacteria appeared first. Biochemical investigations of C. innocuum, C. paraputrificum and C. tertium indicated that these bacteria metabolised bile acids by a specific metabolic step only but not produced carcinogenic substances themselves. If bacteria are involved in tumorgenesis, different species may be involved producing a carcinogenic environment by metabolic chain reactions. We know of such a bacterial collaboration in anaerobic infections.

[Sonography of the neck in hypercalcemic crisis]. / Halssonographie in der hypercalcämischen Krise.

In hypercalcaemic crisis sonographic identification of an enlarged parathyroid permits the indication for parathyroidectomy. This is particularly important as determination of the parathormone concentration to find out the cause of hypercalcaemia takes too long and thus delays diagnosis and therapy. In two patients with symptoms of crisis successful parathyroidectomy was performed solely on the basis of a raised serum calcium concentration and a sonographically proven enlarged parathyroid.

[Localization of enlarged parathyroid glands in hyperparathyroidism. Experiences with and role of computed tomography]. / Lokalisationsdiagnostik der vergrösserten Nebenschilddrüsen beim Hyperparathyreoidismus. Erfahrungen und Stellenwert der Computertomographie.

40 patients with primary hyperparathyroidism, 2 with and 38 without previous surgery had computed tomography (CT) and ultrasonography (US) preoperatively. CT correctly identified enlarged glands in 75%, US in 80%. In 7.5% US was correctly negative. In 12.5% CT has shown only a correct suspicion. Us was false positive in 2.5%, CT in 5%. US was false negative in 10%, CT in 7.5%.

[Concentrations of bile acids in serum, urine and feces in patients with gastrointestinal diseases. Effect of peptide diet in comparison with a normal diet]. / Gallensäuren-Konzentrationen in Serum, Urin und Stuhl bei Patienten mit gastrointestinalen Erkrankungen. Einfluss einer Peptiddiät im Vergleich zur Normalkost.

The influence of a peptide diet on the concentration of bile acids in serum, urine and stools of patients with gastro-intestinal diseases was investigated. The concentration of bile acids in the samples from the patient group treated with a peptide diet showed no significant differences to the control group, who received a normal diet. Therefore, it can be ascertained, that a peptide diet, in comparison to a normal diet, has no reducing or stimulating effect on the composition and concentration of bile acids in serum, urine or stools; both parameters, i.e. the composition and concentration of bile acids, remain unchanged.

[Animal experiment studies of embolia cutis medicamentosa]. / Tierexperimentelle Untersuchungen zur Embolia cutis medicamentosa.

Embolia cutis medicamentosa (ECM) is a rare complication after intramuscular injection of certain drugs, resulting in local necrosis of skin and muscle at the injection site. The pathogenesis is still not clear. Drugs and their effective substances, from which an ECM recently was described (depot penicilline, antirheumatic drug combinations), were injected intraarterially, periarterially, and intramuscularly into the hind legs of rats. The legs were examined macroscopically and histologically. Complete skin and muscle necrosis of the hind leg was only found after intraarterial injection of the incriminated drugs. The most important single effective substance was phenylbutazone. From the experiments it is concluded that the intraarterial injection mode is the most likely pathomechanism of lokal skin and muscle necrosis in the ECM arising from the incriminated drugs.

[Enlargement surgery of duodenal stenosis caused by chronic pancreatitis with a pedicled open jejunal graft]. / Erweiterungsplastik einer durch chronische Pankreatitis bedingten Duodenalstenose mittels gestielten offenen Jejunumtransplantates.

A method of enlarging localized duodenal stenosis is described in a case of chronic pancreatitis. After incision of the duodenum in the stenosis area, the defect is closed by an open, vascularized jejunum transplant. This method has several advantages over by-pass procedures. The physiological passage of the ingesta is preserved. Other methods such as a pedicle graft from the stomach or the colon may be functionally equally good, but more dangerous.

[Beware: propafenon potentiates the effect of oral anticoagulants]. / Cave: Propafenon potenziert Wirkung von oralen Antikoagulantien.

In a 68 years old female patient with premature ventricular contractions who was treated with phenprocoumon (Marcumar) because of pulmonary infarction, propafenon (Rytmonorm)--a new anti-arrhythmic drug--lead to an increased effect of coumarin. Inspite of pausing with coumarin for eight days the low Quick rates (less than 15%) did not increase until propafenon was stopped. Afterwards the coumarin treatment was continued with 1,5 to 3 mg a day. In case of a combined treatment with propafenon and coumarin Quick rates should be controlled frequently.

[Atenolol in the treatment of premature ventricular contractions. A double blind study in 68 patients (author's transl)]. / Die Behandlung ventrikulärer Extrasystolen mit Atenolol Eine Doppelblindstudie mit 68 Fällen.

The effects of atenolol, a cardioselective beta-blocker, on premature ventricular contractions (PVC) were tested in 68 patients in a double blind trial. 35 patients received 100 mg atenolol p.o/day for 5 days, 33 patients received placebo. A computer-based monitoring system permitted an accurate count of all PVC over a 10-hours pre-drug period and after a 5-days treatment. In both groups there was a significant reduction in PVC frequency, but there was no significant difference between the atenolol group and the placebo group. 45 of 68 patients had a coronary heart disease as cause of PVC, 22 patients in the atenolol group and 23 patients in the placebo group. The statistical examination of those patients only showed results different from the total group. In the atenolol group there was a significant reduction in PVC frequency, average reduction 85% (p less than 0.001). The reduction of PVC frequency inthe atenolol was significantly greater than in the placebo group (p = 0.009). There was a significant reduction in systolic blood pressure and heart rate in the atenolol group, too. Atenolol is an alternative drug in the treatment of PVC in patients with coronary heart disease. The reduction of blood pressure and anginal attacks is an advantage over other conventional antiarrhythmic drugs.

[Alterations of humoral and cellular immunity after splenectomy (author's transl)]. / Veränderungen des humoralen und zellulären immunsystems nach Splenektomie.

In twenty-seven splenectomized patients, who had undergone splenectomy for trauma (n=13) and thirty-one immunologically healthy persons, matched for age and sex, the following immunological parameters were examined: Serum immunoglobulins M, A, G, D and E, complement factors C3, C4 and the serum haemolytic complement activity (Ch 50), as well as the ratio and in vitro reagibility of B-and T-lymphocytes measured by transformation responses to the non-specific mitogens Phytohämagglutinin, Concanavalin A and Pokeweed-Mitogen. The phagocytic capacity of polymorphonuclear neutrophils was tested by the Nitroblue tetrazolium test. Total peripheral lymphocytes, B- und T-lymphocytes from splenectomized patients were significantly higher than in healthy controls (p less than 0.01). The PHA response in splenectomized patients was significantly depressed (p less than 0.01) as compared to nonsplenectomized controls. Also IgM serum concentration was found to be significantly lower in these patients (p less than 0.01). No differences were observed between patients, who had been splenectomized 7 months to 5 years or 6 to 14 years ago. The comparison of persons splenectomized for traumatological or haematological disorders showed statistically no significant differences. The importance of the spleen for the primary immune response is discussed.