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By means of inverse polarography, the authors determined tin selectively after double extraction with diethylammonium diethyl dithiocarbamate (DADDTC) in perchloric solution. The recovery rates were: in potatoes, 91.7 +/- 5.8%; in beef kidney, 85.0 +/- 22.7%; in beef liver 79.9 +/- 13.8%; and in milk, 69.8 +/- 11.4%. Possible interferences from other elements with the tin determination are discussed.

During the past 2 years we have treated 30 patients with an endotubus positioned by endoscopical and radiological control. In contrast to many other authors we have also used this method in proximal stenosing tumors. Our mortality rate lies at 16% with a mean post-operative survival time of 9 weeks. There were no deaths due to this procedure in patients (n = 18) with distally situated tumors. The hospital stay of patients treated using this method is much shorter than when surgery is employed, and the complication rate is much lower. If no problems are encountered, patients can be discharged after 2 days.

The aim of these examinations was a comparison of the tensile strength and the histology of single and two-layer sutured gastrotomies applied to rats. Independent of the applied suture material and suture technique all experiments resulted in the same tensile strength of the suture between the 5th and 7th postoperative day as in the control group. Differences of anastomotic dehiscence did not exist. The single-layer can be loaded as well as the two-layer suture. Any difference of the tensile strength of anastomosis depending on the suture material does not exist.

In a prospective random trial the intraoperative electro-stimulation test of Burge and Vane was conducted with 100 patients, in whom selective proximal vagotomy was performed for a duodenal ulcer. In 6 out of 50 patients histologically proved nerve fibres were found by the applying of the test. The postoperative acid values did not differ significantly between those patients who underwent the electrostimulation test and those who did not. The rate of recurrence was 8% in both groups 2-4 years after the operation. Obviously, the application of the test did not have any effect on the results.

A new preservation system is described. In this unit 17 dog kidneys were nonpulsatile perfused with hypothermic human albumin for 72 hrs and then transplanted. All kidneys started immediately to function and the PAH and inulin clearances attained normal values at least at the 7th postoperative day. The quality of the immediate function is referred to the applied perfusion pressure (20 mm Hg) and the applied temperature of the perfusion medium (7.5 degrees C). During preservation substrate utilization (oxygen, unesterified fatty acids) and the accumulation of toxic metabolic products (ammonia, uric acid) were controlled in the perfusate. Their importance concerning to the limitation of preservation time is discussed.

36 dog kidneys were perfused with different perfusion pressures (between 15 and 60 mm Hg) for 72 hrs and then transplanted. Hypothermic human albumin was the perfusion fluid. Kidneys perfused with a flow rate of 0.8 ml/g/min (21 mm Hg mean perfusion pressure) showed the smallest increase in kidney weight and the best function after transplantation. Renal vascular resistance was independent of the level of the perfusion pressure and renal oxygen consumption was independent of the applied flow rate.

Portacaval shunt (PCS) operations were performed on male inbred SD rats. The activity of liver gamma-glutamyltranspeptidase (GGT) increased a few days after the operation and remained high after several months. However, the activity was only present in periportal areas of liver lobules and was mainly restricted to the endothelial lining cells of periportal blood vessels. Phenobarbital sodium (CAS: 57-03-7) administration did not change the distribution of GGT. The activity of liver glucose-6-phosphatase disappeared in the centrilobular areas a few days after the operation but was present in the periportal areas. The distribution of this activity returned to normal after several months. The capacity of liver cells to store glycogen was significantly decreased following the PCS operation. Morphologic changes in hepatocytes observed after the PCS operation did not show similarities to those seen in preneoplastic livers. The nuclei of the small compact hepatocytes found in the animals with PCS were irregular in shape and stained intensively with hematoxylin and eosin. The large pale-staining cells in the periphery of liver lobes were GGT negative and their nuclei had a normal morphology. Neither morphologic nor histochemical changes consistent with preneoplastic and/or neoplastic stage were observed after 10 months in the liver when the PCS operation was performed on rats having received an ip dose (10 mg/kg) of diethylnitrosamine (CAS: 55-18-5) 2 weeks prior to the operation.

In order to better understand the feasibility and limitations of the autogen (White 1980), a computer simulation based on the fluctuating clay environment was used to test whether autocatalytic growth would occur under various conditions. The results suggest that overall accuracies of replication and translation in the range of 90% and 10%, and protoenzyme turnover numbers of 10--120 monomers/protoenzyme/day are adequate for exponential growth. Nucleation of the components of the autogen from random background oligomers would be extremely rapid if oligomers lengths 2--6 were adequately functional, whereas oligomer lengths much greater than 10 are prohibited. The autogen would most likely nucleate and grow to dominance either rapidly (10--100 cycles of roughly 1 day each) or not at all.

Clinical, x-ray and endoscopic follow-up of patients operated on for Zenker's diverticulum (pharyngo-oesophageal diverticulum) via myotomy and diverticulectomy permits conclusions in respect of functional results of this therapeutic concept and the preoperative diagnosis that our study has proved to be necessary. Usually the diagnosis can be made on the basis of the characteristic anamnesis. It is confirmed by means of an oesophagogram, if necessary with a gastrointestinal passage. Besides visualisation of Zenkers diverticulum, attention must be paid especially to associated neuromuscular functional disturbances of the oesophagus. Preoperative endoscopy is necessary in individual cases only. In respect of therapy, it appears mandatory to perform a sufficiently extended (3-5 cm) myotomy of the pars transversa musculi cricopharyngei because of the frequently seen disturbance of coordination of the pharyngo-oesophageal sphincter, besides removing the diverticulum.

807 patients with a duodenal ulcer were treated by a selective proximal vagotomy. Low inter- and postoperative complication rates led to a total mortality of 0.2%. Due to the maximum postoperative control the probability of suffering from a recurrent ulcer is 22.7%. Postoperative functional complaints appeared in 8-19% without the necessity of invasive treatment. A satisfactory result of the therapy was achieved in 73%. The clinical relevance of the analysis of gastric juice has to be discussed. A special emphasis was put on the description of frequency of follow-up examinations, the key of each clinical study.

Between 1971 and 1987, highly selective vagotomy (HSV) was carried out in 984 patients suffering from duodenal ulcer disease. In 97.3% of these cases, the surgical intervention was uncomplicated, the related mortality being 0.3%. During the follow-up period the postoperative condition of the patients was checked once a year wherever possible; in 92.3%, follow-up was continued until december 1987, the maximum period of postoperative follow-up being 16 years. No prognostically reliable indication of the risk of ulcer recurrence was obtained from an analysis of gastric juice. In 79.1% of the cases who underwent surgery, the result was good to satisfactory, while 11.7% had functional complaints such as dumping or diarrhea. The probability of developing a recurrent ulcer within 16 years after the initial operation was 29.7%. This rate of recurrence is determined among other things, by the discovery of clinically quiescent ulcers during the yearly follow-up examinations, when these are performed carefully, and over a sufficiently long period.

Thirty-six dog kidneys were perfused with different perfusion pressures (between 15 and 60 mm. Hg) for 72 hours and then transplanted. Hypothermic human albumin was the perfusion fluid. Enzyme release, kidney weight, and renal oxygen consumption were measured during perfusion. Kidneys perfused with a flow rate of 0.8 ml. per gram per minute (21 mm. Hg mean perfusion pressure) showed the smallest increase in kidney weight and the best function after transplantation. Renal vascular resistance was independent of the level of the perfusion pressure and renal oxygen consumption was independent of the applied flow rate. It is concluded that the perfusion pressure applied with hypothermic perfusion should be as low as possible because in this way kidney damage caused by perfusion can be avoided most easily.