Search

Die ausgepragte Neigung der erythro-Formen einiger Ephedrin-Derivate, durch Walden'sche Umkehrung am C-Atom 1 der Seitenkette in die threo-Isomeren uberzugehen, wird unter sehr verschiedenen Reaktionsbedingungen in der Literatur beschrieben1–5). Obwohl in den letzten Jahren die Umlagerung ephedrinahnlicher Verbindungen mit Thionylchlorid haufig untersucht wurde, ist beim N-Acetyl-d,l-norephedrin die Reaktionsfolge und deren sterischer Verlauf noch unaufgeklart. Deshalb werden nachstehend die isolierbaren Zwischenprodukte dieser Umlagerung hinsichtlich ihrer Konstitution und Konfiguration beschrieben.

High ileal diversion has been performed on 26 children with destroyed ureteral function in the authors' experience. Fifteen were azotemic when diverted. Renal function has improved or stabilized in 21 of the 23 patients (91%) who survived operation followed for as long as 8 years. Pyelographic appearance has improved or stabilized in 34 of 39 kidneys (87%) in these children. Ten patients were diverted more than 5 years ago. Renal function has improved or stabilized in all seven who are now alive. High ileal diversion has thus proved to be safe and reliable. Although azotemic children also can be salvaged, the authors advocate earlier high diversion of kidneys drained by badly dilated and poorly functioning ureters.

The natural history of prostatic cancer is reviewed in brief with emphasis on transitions in cellular differentiation. Diagnostic features are appraised in conjunction with prognostication of the clinical course. Radical prostatectomy is considered the best form of treatment for the isolated prostatic nodule with preserved cellular differentiation. Endocrine therapy should be withheld until manifestations of cancer spread are evident.