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A scrotal mass as initial manifestation of necrotising pancreatitis is very rare. In addition, the diagnosis is very difficult because diseases that occur more frequently produce similar symptoms. Therefore, it is very important to think about rare entities in the differential diagnosis for testicular pain.

Clinical Relevance of Accessory Spleens Following Elective and Emergency Splenectomies Background: With respect to the various functions of the spleen, a careful risk-benefit analysis must be done before splenectomy. Methods: During 10 years, 211 splenectomies were carried out in our hospital. In 185 of these clinical cases the documents were complete for an analysis. Results: The most frequent indications for surgical treatment were immunothrombocytopenia (22.2%) and lymphogranulomatosis (18.9%) followed by spleen bleedings (24.3%) of traumatically, iatrogenic or spontaneous origin. Postoperative complications such as pulmonary and cardiological disorders, disorders in wound healing, and abscesses could be found in 31.3% of the elective and in 80.4% of the emergency cases. 5.2 and 21.9% of the patients died after elective treatment and emergency surgery, respectively, resulting in an overall mortality of 10.8%. In the latter group death was mostly related to the severe concomitant injuries. The main problem during the postoperative period is the high rate of infections which could be attributed to the loss of an immunologically active organ. Postoperative thrombocytosis was temporary in most cases. A sepsis developed in 4.9% of the patients with a lethal outcome in 2.7% of the cases. 13.5% of the patients showed accessory spleens. In those patients suffering from immunothrombocytopenia and lymphogranulomatosis, they were even found in 22 and 20% of the cases, respectively. 12.1% of the 58 reinspected patients showed accessory spleens; some of them even had multiple accessory spleens. Mostly, solitary accessory spleens were found. They were located in the neighborhood of the spleen or – after splenectomy – in the former spleenic area. The size of accessory spleens ranged between some millimeters and 5 cm with an average length of about 1–2 cm. Accessory spleens were either completely unobtrusive with no function at all, or they can take over some spleenic functions, regardless of their size and location. Especially in combination with immunothrombocytopenia, they may be responsible for the failure of an otherwise successful splenectomy. However, relapses after splenectomy could not generally be attributed to accessory spleens since relapses also occurred after additional exstirpation of accessory spleens. Conclusion: As some accessory spleens take over specialized functions of the spleen while others remain unobtrusive, the benefit of splenectomy for the treatment of blood-related malignancies is hardly foreseeable.

Von Januar 1992 bis Dezember 1996 wurden in der Chirurgischen Universitatsklinik Bonn (Dir. Prof. Dr. A. Hirner) 221 Manner und 79 Frauen wegen Bronchialkarzinomen (n=197), Lungenmetastasen (n=49), sonstigen malignen Lungentumoren (n=48) und Bronchialkarzinoiden (n=8) operiert. Das Durchschnittsalter betrug 63,8 Jahre. Von den mannlichen Patienten waren 51%, von den weiblichen 14,7% an Bronchialkarzinomen erkrankt; bei der histologischen Typisierung der Bronchialkarzinome ergab sich fur Manner und Frauen folgende Verteilung: Plattenepithel-CA 36,7%/8,9%, Adeno-CA 23,1%/40,5%, groszellige CA 6,8%/5,1%, kleinzellige CA 2,7%/1,3% und sonstige maligne Lungentumoren 12,3%/3%; fur Lungenmetastasen 8,7%/7,7% und fur Bronchialkarzinoide 1,7%/1%. Rund 40% der Patienten wiesen anamnestisch Lungenvorerkrankungen auf. Nikotinabusus wurde von 52,4% betrieben; 70,5% der Patienten mit Plattenepithel-CA und 71,4% mit kleinzelligen CA waren Raucher mit einer mittleren Packungsjahr-Belastung von 50 PY. In 26,3% der Falle kam es zu postoperativen Komplikationen, meist Pneumonien und bronchopleuralen Fisteln. Nach einer medianen postoperativen Zeit von 7,1Monaten fanden sich bei 64,9% der Patienten Lokalrezidive u./o. Fernmetastasen. Die durchschnittliche mediane Uberlebenszeit bei Bronchialkarzinomen lag bei 32 Monaten, die 5-Jahres-Uberlebensrate bei 11%; bei den sonstigen malignen Lungentumoren betrug sie 14 Monate und die Uberlebensrate sank nach 41 Monaten auf 0%. Die 5-Jahres-Uberlebensrate bei Lungenmetastasen betrug 60,5% und bei Bronchialkarzinoiden lag die 31/2-Jahres-Uberlebensrate bei 100%.

A scrotal mass as initial manifestation of necrotising pancreatitis is very rare. In addition, the diagnosis is very difficult because diseases that occur more frequently produce similar symptoms. Therefore, it is very important to think about rare entities in the differential diagnosis for testicular pain.

1 In segments of human right atrial appendages and pulmonary arteries preincubated with [3H]-noradrenaline and superfused with physiological salt solution containing desipramine and corticosterone, the involvement of imidazoline receptors in the modulation of [3H]-noradrenaline release was investigated. 2 In human atrial appendages, the guanidines aganodine and DTG (1,3-di(2-tolyl)guanidine) which activate presynaptic imidazoline receptors, inhibited electrically-evoked [3H]-noradrenaline release. The inhibition was not affected by blockade of α2-adrenoceptors with 1 μM rauwolscine, but antagonized by extremely high concentrations of this drug (10 and/or 30 μM; apparent pA2 against aganodine and DTG: 5.55 and 5.21, respectively). 3 In the presence of 1 μM rauwolscine, [3H]-noradrenaline release in human atrial appendages was also inhibited by the imidazolines idazoxan and cirazoline, but not by agmatine and noradrenaline. The inhibitory effects of 100 μM idazoxan and 30 μM cirazoline were abolished by 30 μM rauwolscine. 4 In the atrial appendages, the rank order of potency of all guanidines and imidazolines for their inhibitory effect on electrically-evoked [3H]-noradrenaline release in the presence of 1 μM rauwolscine was: aganodineBDF 6143 [4-chloro-2-(2-imidazolin-2-yl-amino)-isoindoline]>DTGclonidine>cirazoline>idazoxan (BDF 6143 and clonidine were previously studied under identical conditions). This potency order corresponded to that previously determined at the presynaptic imidazoline receptors in the rabbit aorta. 5 When, in the experiments in the human pulmonary artery, rauwolscine was absent from the superfusion fluid, the concentration-response curve for BDF 6143 (a mixed α2-adrenoceptor antagonist/imidazoline receptor agonist) for its facilitatory effect on electrically-evoked [3H]-noradrenaline release was bell-shaped. In the presence of 1 μM rauwolscine, BDF 6143 and cirazoline concentration-dependently inhibited the evoked [3H]-noradrenaline release. 6 In human atrial appendages, non-adrenoceptor [3H]-idazoxan binding sites were identified and characterized. The binding of [3H]-idazoxan was specific, reversible, saturable and of high affinity (KD: 25.5 nM). The specific binding of [3H]-idazoxan (defined by cirazoline 0.1 mM) to membranes of human atrial appendages was concentration-dependently inhibited by several imidazolines and guanidines, but not by rauwolscine and agmatine. In most cases, the competition curves were best fitted to a two-site model. 7 The rank order of affinity for the high affinity site (in a few cases for the only detectable site; cirazoline=idazoxan>BDF 6143>DTGclonidine) is compatible with the pharmacological properties of I2-imidazoline binding sites, but is clearly different from the rank order of potency for inhibiting evoked noradrenaline release from sympathetic nerves in the same tissue. 8 It is concluded that noradrenaline release in the human atrium and, less well established, in the pulmonary artery is inhibited via presynaptic imidazoline receptors. These presynaptic imidazoline receptors appear to be related to those previously characterized in rabbit aorta and pulmonary artery, but differ clearly from I1 and I2 imidazoline binding sites. British Journal of Pharmacology (1997) 122, 43–50; doi:10.1038/sj.bjp.0701343

The role of angiotensin in the pathophysiology of mesenteric vasospasm raises the question whether angiotensin-converting enzyme (ACE) inhibitors can influence the sequelae of shock on the mesenteric circulation. The purpose of this study was to investigate the effect of captopril on the metabolic consequences of the nonocclusive mesenteric infarct. Thirty pigs were used. The cardiogenic shock was induced by an infusion of 10% hydroxyethyl starch into the pericardium over 10 min. In all groups, except the control group, the ACE inhibitor captopril was given as a bolus of 0.25 mg/kg and then 10 mg/kg/min continuously up to a total of 50 mg. The positive effect of captopril on the mesenteric circulation was verified by a significantly smaller increase of lactate, lesser pH decrease in the superior mesenteric vein. The shock-induced acidosis in the mesenteric circulation was less profound in therapy groups as compared with the control group. Systemic therapy with ACE inhibitor is more effective than local application. The effect of captopril treatment inherently relies on the timing of initiation.

Thromboembolisch verursachte Milzinfarkte sind eine bekannte Komplikation im Rahmen eines arteriellen embolischen Geschehens. Die hier vorgestellten Falle eines Milzinfarkts sind als Komplikation der endovaskularen Therapie beim infraabdominellen Aortenaneurysma aufgetreten. Diesbezugliche Komplikationen im Zusammenhang mit der konventionellen Chirurgie des Aortenaneurysmas sind in der Literatur nicht beschrieben. Anzunehmen ist, dass durch die endoluminare Manipulation und im Rahmen der Implantation diese Embolie ausgelost wurde. Anhand der Kasuistiken werden die moglichen Ursachen sowie therapeutischen Konsequenzen diskutiert.

The qualitative and quantitative MRI findings in 16 patients with focal nodular hyperplasia (FNH) of the liver are described; nine of these were confirmed histologically. A central scar is typical of FNH and provides a reliable diagnosis. This finding was seen in half the cases. If the scar is not demonstrable, the following features suggest the diagnosis: smooth margins, homogeneous signal distribution, increased signal intensity in T2-weighted spin-echo images and reduced signal intensity in inversion-recovery sequences. The T1 and T2 relaxation times in FNH are increased by about 30% compared with normal liver tissue.

Duplications of the gastrointestinal tract are congenital anomalies seen in about 0.2% of all children. These include the rare gastric duplications. Latter diagnosis is usually made in the first months after birth on recurrent vomiting by detection of an abdominal tumor. The most important imaging modality is ultrasonography. The case of a prematurely born child weighing 1900 g is presented in whom at the age of three weeks a gastric duplication of the greater curvature was diagnosed and who was successfully treated by resection. The postoperative follow-up for 24 months was uncomplicated.

We studied two families with five affected members suffering from ptosis and slowly progressive limb-girdle muscle weakness. All patients had abnormal decremental response on low-frequency nerve stimulation, but there were no repetitive responses to single stimuli. The patients improved on anti-acetylcholinesterase drugs. Intercostal muscle was obtained for special studies from one patient of each family. In vitro microelectrode studies were done in Patient 1. Miniature end-plate potentials were of low amplitude, and the quantal content of the evoked end-plate potentials was normal. Light microscopy revealed a marked type 1 fiber predominance. Acetylcholinesterase reactivity was dispersed over increased length of individual fibers in Patient 2. On morphometry of the end-plate ultrastructure, the number of secondary synaptic clefts per neuromuscular junction and the expansion of the postsynaptic area were markedly reduced. In Patient 1, but not in Patient 2, the envelopment of the nerve terminal by Schwann cell was increased. Acetylcholine-receptor (AChR) density was reduced as judged by the reduced immunoreactivity to antibodies against different receptor subunits. Immunohistochemical analysis of proteins known to be involved in orchestrating the end-plate structure showed deficiency of the AChR-associated protein utrophin. These patients appear to have a defect in the development or maintenance of the postsynaptic clefts; whether this defect results from or causes a reduced expression of utrophin or AChR is unclear.

1 In segments of human right atrial appendages and pulmonary arteries preincubated with [3H]-noradrenaline and superfused with physiological salt solution containing desipramine and corticosterone, the involvement of imidazoline receptors in the modulation of [3H]-noradrenaline release was investigated. 2 In human atrial appendages, the guanidines aganodine and DTG (1,3-di(2-tolyl)guanidine) which activate presynaptic imidazoline receptors, inhibited electrically-evoked [3H]-noradrenaline release. The inhibition was not affected by blockade of alpha 2-adrenoceptors with 1 microM rauwolscine, but antagonized by extremely high concentrations of this drug (10 and/or 30 microM; apparent pA2 against aganodine and DTG: 5.55 and 5.21, respectively). 3 In the presence of 1 microM rauwolscine, [3H]-noradrenaline release in human atrial appendages was also inhibited by the imidazolines idazoxan and cirazoline, but not by agmatine and noradrenaline. The inhibitory effects of 100 microM idazoxan and 30 microM cirazoline were abolished by 30 microM rauwolscine. 4 In the atrial appendages, the rank order of potency of all guidelines and imidazolines for their inhibitory effect on electrically-evoked [3H]-noradrenaline release in the presence of 1 microM rauwolscine was: aganodineor = BDF 6143 [4-chloro-2-(2-imidazolin-2-yl-amino)-isoindoline]DTGor = clonidinecirazolineidazoxan (BDF 6143 and clonidine were previously studied under identical conditions). This potency order corresponded to that previously determined at the presynaptic imidazoline receptors in the rabbit aorta. 5 When, in the experiments in the human pulmonary artery, rauwolscine was absent from the superfusion fluid, the concentration-response curve for BDF 6143 (a mixed alpha 2-adrenoceptor antagonist/imidazoline receptor agonist) for its facilitatory effect on electrically-evoked [3H]-noradrenaline release was bell-shaped. In the presence of 1 microM rauwolscine, BDF 6143 and cirazoline concentration-dependently inhibited the evoked [3H]-noradrenaline release. 6 In human atrial appendages, non-adrenoceptor [3H]-idazoxan binding sites were identified and characterized. The binding of [3H]-idazoxan was specific, reversible, saturable and of high affinity (KD: 25.4 nM). The specific binding of [3H]-idazoxan (defined by cirazoline 0.1 mM) to membranes of human atrial appendages was concentration-dependently inhibited by several imidazolines and guanidines, but not by rauwolscine and agmatine. In most cases, the competition curves were best fitted to a two-site model. 7 The rank order of affinity for the high affinity site (in a few cases for the only detectable site; cirazoline = idazoxanBDF 6143DTGor = clonidine) is compatible with the pharmacological properties of I2-imidazoline binding sites, but is clearly different from the rank order of potency for inhibiting evoked noradrenaline release from sympathetic nerves in the same tissue. 8 It is concluded that noradrenaline release in the human atrium and, less well established, in the pulmonary artery is inhibited via presynaptic imidazoline receptors. These presynaptic imidazoline receptors appear to be related to those previously characterized in rabbit aorta and pulmonary artery, but differ clearly from I1 and I2 imidazoline binding sites.

Zu den congenitalen Lungenanomalien gehoren differentialdiagnostisch die cystische adenomatoide Malformation (CCAM), die pulmonale Sequestration, das congenitale lobulare Emphysem (CLE) und die bronchiogenen Cysten. Bei pathologischen Veranderungen der kindlichen Thoraxaufnahme, aber auch bei rezidivierenden pulmonalen Infekten, auch im Erwachsenenalter, mus an eine angeborene Misbildung der Lunge differentialdiagnostisch gedacht werden. Oft sind sie einfach in der Lungenrontgenaufnahme zu identifizieren, die genaue Differenzierung ist dagegen haufig schwierig. Trotz der differenzierten bildgebenden Diagnostik ist in manchen Fallen eine endgultige Diagnose erst intraoperativ moglich. Congenitale Anomalien der Lunge sind selten, dennoch klinisch eine wichtige Differentialdiagnose, insbesondere bei unklaren rezidivierenden pulmonalen Infekten. Ziel der Behandlung ist eine fruhe Diagnose und die Entfernung der betroffenen Lungenabschnitte.

In recent years the implantation of self-expanding metal-stents has been recommended as a palliative kind of therapy for dysphagia caused by esophageal carcinoma. The metal-stent has a high flexibility, so that it can fit according to the preformed angel of the esophagocardial transition and does not cause a feeling of pressure when placed in the cervical position. From July 1992 to February 1995 in the surgical department of the University of Bonn 21 patients have got a self-expanding Nitinol stent. No dislocation, bleeding or perforation occurred. The dysphagia improved in all patients. The lethality rate was 9.5%, the mean survival rate 4,6 month. The growth of the tumor through the mesh of the stent was a problem which occurred from the tenth week onwards after implantation. Even when the self-expanding metal-stent does not solve all problems, it enlarges the spectrum of palliative kinds of therapy.

We present the results of a study based on an animal model concurring whether captopril can improve microcirculation in the small intestine in nonocclusive mesenteric ischemia dependent on when therapy is begun. Cardiogenic shock was produced by pericardial tamponade with starch solution. The flow in the carotid artery could be reduced to 43% of the preshock value. In four therapy groups and a control group the intestinal microcirculation was examined by laser Doppler flowmetry in the serosa and mucosa. The measurements were taken at regular intervals during the 4 h of the experiments. Captopril was either given systemically or locoregionally through the upper mesenteric artery. Therapy was given at the beginning of the shock or 1 h after induction of shock at a dosage of 0.25 mg/kg body weight as a bolus and continuous application of 10 micrograms/kg body wt. Concerning the hemodynamic changes during shock the group receiving captopril systemically at the beginning of shock showed a significant (P = 0.05) improvement in microcirculation compared to the controls and other therapy groups. Flow reduction was seen in the controls (156-32 relative flow units = RFU) in group Ia (systemic therapy 1 h after shock), as well as the controls (129 to 12 RFU) and, in group Ib (systemic therapy beginning with shock) a flow rise could be seen (307 to 481 RFU). In group IIa (local therapy 1 h after shock) (a steady flow was seen (168-170 RFU) and in group IIb (local therapy beginning with shock) and group Ib an increase in flow was also measured (226-303 RFU). This positive effect of captopril on the intestinal perfusion was observed when applied 1 h after the induction of shock.

The emergency treatment of the enterothorax is problematic due to weak lung functions and unstable hemodynamics, and because it does not influence the stage of maturity of the lungs. By delayed operation children with a critical starting position have a greater chance to survive, after their condition has been stabilised by intensive care treatment. During the stabilising period we managed to decrease the FiO2 level below 50% and to decrease the pCO2 level to 43 +/- 13 mm Hg in our patients (n = 10). Furthermore we succeeded to raise the O2 degree of saturation from 72 +/- 13 to 89 +/- 9%. The pH level went up from 7,238 +/- 0,181 to 7,394 +/- 0,060. If the condition of the patients worsens during the stabilising period--in our patients the stabilising period was between 12 and 24 hours--immediate operation is indicated. We have no experience so far in using ECMO in such situations.

Forty-two patients with locally advanced breast cancer (n = 8) or recurrent breast cancer (n = 34) received regional chemotherapy (mitoxantrone 25 mg/m2 per 24 h) via the internal mammary artery or other vessels of the subclavian artery. To prevent artery thrombosis 500-1000 U heparin per hour were administered i.v. Tumour perfusion was monitored by intra-arterial angio-CT. Remission rates (CR + PR) were 100% (primary breast cancer) and 89% (recurrent tumours), respectively. Intra-arterial chemotherapy was well tolerated. No complications were noted.

Congenital esophageal atresia is seen in 1 out of 3000 living births today. The cause of this malformation is a disturbance of the separation of the esophagus, trachea, and lung during their embryonic development. The resulting abnormalities have many different forms but can classified into five major groups as described by Gross-Vogt [1] (Fig. 1). During pregnancy, a hydramnion can frequently be noted, and the postpartum clinical consequences can include choking or coughing. Already during the first hours, the regurgitated gastric juices can pass into the lungs and cause chemical pneumonia and atelectasis. Therefore, an early diagnosis and proper treatment are of vital importance.

Die Neoplasien der Leber stellen 0,5–2% aller kindlichen Tumoren dar. Unter den malignen Lebertumoren nimmt das Hepatoblastom mit ca. 50% die Spitze ein, gefolgt vom hepatozellularen Karzinom mit ca. 40%. Die Inzidenz der Lebertumoren zeigt eine Spitze im 1. Lebensjahr und nimmt dann kontinuierlich ab. Die fokal-nodulare Hyperplasie (FNH) stellt eine Raritat im Sauglingsalter dar. Im Alter von 7–14 Jahren spielt sie differentialdiagnostisch eine grosere Rolle.

Bei der kongenitalen Zwerchfellhernie (Enterothorax) besteht ein vital bedrohlicher Zustand fur das Neugeborene mit einer Letalitat zwischen 50% und 80%. In den letzten 3 Jahren wurden in unserer Klinik 8 Neugeborene wegen eines Enterothorax operiert. In keinem Fall erfolgte die Operation notfallmasig, sondern nach einer praoperativen Stabilisierung innerhalb von 12 bis 24 Stunden post parturn. Zwei Kinder verstarben postoperativ, die ubrigen gedeihen zum Zeitpunkt der Nachuntersuchung regelrecht. Ziel der praoperativen Intensivtherapie ist die Reduktion des pCO2 auf

The qualitative and quantitative MRI findings in 16 patients with focal nodular hyperplasia (FNH) of the liver are described; nine of these were confirmed histologically. A central scar is typical of FNH and provides a reliable diagnosis. This finding was seen in half the cases. If the scar is not demonstrable, the following features suggest the diagnosis: smooth margins, homogeneous signal distribution, increased signal intensity in T2-weighted spin-echo images and reduced signal intensity in inversion-recovery sequences. The T1 and T2 relaxation times in FNH are increased by about 30% compared with normal liver tissue.

Wave channeling with 350 KeV electrons in germanium crystals, the thicknesses of which were 1.8 and 3.0 μm, is studied by measuring the anisotropic X-ray-Kα- and bremsstrahlung yield. The intensity variation is controlled by the Bragg positions of the beam which are due to crystal planes of low Miller indices. A two-dimensional angle-scan picture shows patterns which are the same as the Kikuchi ones in that angle region. The reciprocity theorem gives the correlation between these two cases of wave channeling and wave blocking (Kikuchi pattern). Wellen-Channeling von 350 keV-Elektronen in Germanium-Einkristallen, deren Dicke 1,8 und 3,0 μm betragt, wird durch Messung der anisotropen Rontgen-Kα- und Bremsstrahlung-Ausbeute untersucht. Die Anderungen der Ausbeute werden durch die Bragg-Winkel des Strahles zu Ebenen mit niedrgen Miller-Indizes charakterisiert. Die zweidimensionalen Winkel-Raster-Abbildungen zeigen eine Struktur, die den Kikuchi-Bildern im gleichen Winkelbereich entspricht. Das Reziprozitats-Theorem erklart den Zusammenhang zwischen den beiden Fallen Wellen-Channeling und Wellen-Blocking (Kikuchi-Bilder).

A prototype of a measuring device is described, which reads the tube peak voltage and the switch-on time of x-ray units by means of two radiation detectors with different energy dependences due to detector materials (Caesium Iodine and Silicon). With a storage oscilloscope the curves of the tube voltage and the relative absorbed dose rate of intensifying screens can be displayed. The measuring range of the tube peak voltage is 60 kV to 150 kV. It is possible to measure exposure times of radiography equipment above 2 ms wit sufficiently low uncertainty. The tube peak voltage has been read with a relative uncertainty below 5% for almost all dose rates, which arise in practical application of medical x-ray units, and its calibration is made by means of x-ray apparatus with tube voltage reading, which has been compared to a Ge(Li) spectrometer. The stability of tube voltage reading of the measuring device is only effected by radiation damage of the detectors after a long time of utilization. The small diameter of the probe permits the accommodation of other probes, ionization chambers, phantoms, etc. in the radiation field at the same time.

Design and performance of a simple voltage and electron-current regulation for an 1 MV-Van de Graaff-generator is described. Each of the two circuits consists of a slow integral and a faster proportional regulation unit. The long-time-voltage-stability is ± 2 − 3%. The current-stability is about ± 1%.

Measurements of energy spectra of 0.25- and 0.5-MeV electrons backscattered from aluminium foils, 2.5 up to 110 mg/cm 2 thick, are reported. The angular distributions and the backscattering coefficients are given, too. Energy spectra for scattering angles near to 90° from the direction of the incident beam show a peak, due to single scattering. The variation of the most probable energy loss with the target thickness is shown and functions are given for the dependence of the most probable energy loss on the primary energy and of the maxima of the angular distributions on the target thickness. The angular distribution for saturation thickness and the dependence of the backscatter fraction on the target thickness are found to be in good agreement with Monte Carlo calculations of Berger.

Bombarding thin single crystal films with electrons an increase of K X-ray yield is observed if a crystallographic axis or plane is rotated into the beam direction. In the case of epitaxial foils the shape of the yield peaks is of Gaussian type and the width is larger than twice the Bragg-angle depending strongly on target preparation. We have investigated these peaks around the [111] axis of a germanium single crystal thinned by ion-sputtering to a thickness of about 1 pm. An exact agreement of the width with twice the Bragg-angle and a fine structure related to the Kikuchipattern was observed.

A prototype of a measuring device is described, which reads the tube peak voltage and the switch-on time of x-ray units by means of two radiation detectors with different energy dependences due to detector materials (Caesium Iodine and Silicon). With a storage oscilloscope the curves of the tube voltage and the relative absorbed dose rate of intensifying screens can be displayed. The measuring range of the tube peak voltage is 60 kV to 150 kV. It is possible to measure exposure times of radiography equipment above 2 ms wit sufficiently low uncertainty. The tube peak voltage has been read with a relative uncertainty below 5% for almost all dose rates, which arise in practical application of medical x-ray units, and its calibration is made by means of x-ray apparatus with tube voltage reading, which has been compared to a Ge(Li) spectrometer. The stability of tube voltage reading of the measuring device is only effected by radiation damage of the detectors after a long time of utilization. The small diameter of the probe permits the accommodation of other probes, ionization chambers, phantoms, etc. in the radiation field at the same time.

Esophageal cysts are among the embryonic malformations of the gastrointestinal tract. They develop from persisting diverticulum-like evaginations of the embryonic esophagus. The esophageal cyst is usually asymptomatic and is frequently diagnosed as an incidental finding. Since, however, a clear differentiation from malignancies is not possible with conventional diagnostic procedures. Surgical treatment is advisable in these cases.

The influence of X-ray Flashes on the germinative faculty of cress seeds has been studied. The experiments show that the radiation damage produced by X-ray flashes (τ < 0,5 μs) is much stronger than the influence of continuous radiation if the absorbed dose is the same. With a dose of about 0.3 Gy, it is possible to reduce ther germinative faculty from 99 % to 85 % while the same dose of continuous radiation shows no significant influence on the growth process. The result indicates that short soft X-ray flashes with high intensity are particularly important in the production of biological defects and should be considered in radiation protection.

Von 1358 Appendektomien wahrend der letzten 8 Jahre waren 73 Patienten (5.4%) uber 70 Jahre alt. 11% von ihnen hatten intraoperativ einen blanden Appendixbefund, 38% waren perforiert. Die (im Vergleich zu den Jungeren) hohere Perforationsrate hatte ihre Ursache vor allem in der haufig atypischen Anamnese, dem blanden Untersuchungsbefund auch bei fortgeschrittener Entzundung und der Diagnoseverschleppung durch den behandelnden Arzt. Hauptkomplikationen waren Wundheilungsstorungen und Pneumonien. Die Letalitat betrug 11%, Todesursachen waren vor allem pulmonales und cardiales Versagen. Die Herausforderung zur Verbesserung der Ergebnisse betrifft Chirurgen, Anasthesisten und den Hausarzt.

The K radiation yield increases by bombarding thin single crystal films with electrons not only in directions of crystallographic axis but also in planes. The half width of the peaks in the range of 200 keV is about 3 deg.