Sausage resection of ischemic intestine

In a critically ill neonate, simple ligation of intestinal segments to be preserved for a second look procedure allows expeditious resection of intervening necrotic segments.     

Muscle biopsy — Still a matter of methodological considerations

Summary A method of open muscle biopsy is described which is not so invasive for the patient and not traumatic for the muscle tissue. The biopsy is performed with the patient under local cutaneous anesthesia. The sample can be obtained from a defined part of the muscle. It allows morphological-quantitative evaluation of a sufficient amount of fibers to arrive at reliable results. The advantages of the described method compared with other open and needle biopsy procedures, especially with regard to the method of anesthesia, are discussed.

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Zusammenfassung Es wird ein Verfahren der offenen Muskelbiopsie beschrieben, das für den Patienten wenig invasiv and für das Muskelgewebe atraumatisch ist und unter Lokalanästhesie durchgeführt wird. Die Muskelproben können aus einem definierten Bereich entnommen werden and gestatten die morphologisch-quantitative Auswertung eines hinreichend großen Materials, um zu zuverlässigen Ergebnissen zu gelangen. Die Vorteile der Methode gegenüber anderen Verfahren der offenen und Nadelbiopsie, insbesondere das Anästhesieverfahren, werden diskutiert.

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This investigation was supported by the Deutsche Forschungsgemeinschaft, Az. Ap 30/2-1     

Vital capacity restitution curve: prognostic value in chronic decompensated respiratory insufficiency

From a series of 50 patients with acute decompensation of chronic obstructive lung disease (38 of whom were treated by mechanical ventilation), the authors demonstrate the prognostic value of an easily obtained parameter of respiratory function: the vital capacity restitution curve (VCRC). From daily measurements of vital capacity, beginning on the day of admission, a graph is constructed which shows an initial period of increase in the degree of restitution, followed by stabilization of the values. An analysis of the various parameters embodied in this graph provides information about the prognosis. Such graphs can be divided into 3 zones of prognostic value: a favourable zone, an intermediate zone (mediocre survival with or without mechanical ventilation) and an unfavourable zone (death during the acute phase). Although a favourable prognosis can be made after 4 days of observation and almost always by the 10th day, an unfavourable prognosis cannot be made before the 21st day.     

Chlorocarbamate-mustard-linked 1,1,2-triphenylbut-1-enes with a selective antitumor activity on mammary tumors containing estrogen receptors

Summary A 1,1,2-triphenylbut-1-ene with a 4-OH group at one C-1 phenyl ring and a chlorocarbamate mustard moiety at the second C-1 ring (compound 3) was synthesized in order to obtain a cytotoxic estrogen with a specific antitumor effect on estrogen-receptor-containing tumors. This compound was tested in comparison to the carrier (compound 1) and a compound (2) having a carbamate mustard group on both C-1 phenyl rings. The estrogen receptor affinity of compound 3 was only about one-quarter lower than that of compound 1, but much higher than that of compound 2. Compounds 2 and 3 showed only partially irreversible binding to the receptor owing to their relatively low alkylating properties. The growth inhibition of the receptor-positive MCF-7 breast cancer cell line by compound 3, but not by compound 1 or 2, was more pronounced than the inhibition of the receptor-negative line MDA. In vivo the hormone-dependent, transplantable mammary tumor MXT M3.2 of the mouse was much better inhibited by compound 3 than its hormone-resistent line MXT OVEX. Compounds 1–3 had no antiestrogenic properties in the mouse, but estrogenic activity was in the order 1>3>2. From these results and because the antitumor activity of compound 3 was superior to that of compounds 1 and 2 in the hormone-dependent tumor models, a selective, receptor-mediated cytotoxic effect of compound 3 on estrogen-receptor-positive tumors in obvious.Supported by the Deutsche Forschungsgemeinschaft, SFB 234 and the Matthias Lackas StiftungDedicated to Prof. Dr. M. F. El Etreby on the occasion of his 50th birthday     

Pathogenesis and therapy of gallbladder perforation

Findings on admission to hospital and after surgery recorded from 35 patients with gallbladder perforation were compared to findings obtained from 98 patients with cholecystitis, with a view to establishing determining factors in pathogenesis of gallbladder perforation and for the purpose of improving therapeutic strategies. That comparison was part of a retrospective analysis. Biological behaviours regarding perforation were found to be hard to assess, though "early operation" was found to reduce the risk of perforation and post-perforation lethality.     

Penile studies and heterosexual partners. Peniscopy, cytology, histology, and immunocytochemistry

The male partners of 20 women with human papilloma virus (HPV) infection (subtypes 6, 11, 16, and 18) were studied. These men were unsuspecting and allowed investigation "for scientific reasons" in the context of the abnormal findings in their female partners. Peniscopy (study of the penis with a colposcope) was abnormal in 17 cases. In the cytologic-brush preparations of the urethra, hyperkeratosis (visualized with the modified Papanicolaou technique) occurred in all cases, but koilocytosis in only one. Both urothelial cells and squamous cells in the urethral samples were positive for HPV, as shown in the immunocytochemistry. In the histologic sections taken from flat lesions there was hyperkeratosis, dyskeratosis, and abnormal nuclear maturation. The authors concluded that, using simple techniques, subtle disturbances in maturation of nuclei and cytoplasm can be established in penile epithelium of these sexual partners. Similar changes are established in other HPV lesions. It seems likely that a significant proportion of the male population is infected in countries were HPV an important factor in cervical carcinogenesis.