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After allogeneic renal transplantation in 26 female pigs the kinetics of the immunological reactivity have been investigated in order to diagnose a rejection crisis. The animals were not treated with immunosuppressive substances. The antigen specific rosette test is an useful parameter for estimation of immune reactions against a graft. Moreover, the inhibition of this test by autologous serum taken in the course of a chronic graft rejection is caused by blocking factors. Therefore this inhibition test would be suitable for an exact determination of specific immune reaction against the graft. By exclusion of false positive results by means of the rosette reaction test a high significant correlation between the antigen specific rosette formation and the clinical symptoms of the rejection could be observed. As long as blocking factors are protecting the graft against activities of immunocompetent cells respectively their effector molecules, recipient serum is able to inhibit the rosette formation. On the other hand a strong increase of rosette forming cells in a pig whose serum does not show an inhibitory activity is correlated with clinical symptoms of a rejection.

The influence of 22 various infusions on the determination of the blood glucose by means of glucometer and DAB 7 (D.L.)-methods [o-toluidine, hexocyanoferrat (III)] was investigated. Only the principle of the newly developed apparatus glucometer is not disturbed by infusions and represents an alternative solution for surgery, urology, paediatrics and intensive medicine, particularly since the measuring value is present at any time in few seconds.

Our analysis of 378 patients made after operations for diseases of the gallbladder and bile tract underlines the demand of an exact preoperative diagnostic examination of other abdominal organs, e.g. the oesophagus, stomach, duodenum, liver and pancreas. The value of using modern intraoperative diagnostic procedures for the biliary tract is confirmed. Our analysis also demonstrates the necessity of traeting cholelithiasis surgically at an early stage. Complications of cholelithiasis include a higher risk, a worse prognosis with regard to permanent healing and a higher rate of postoperative lethality.

Investigations of the course were performed by means of an antigenspecific rosette test using a poolantigen from tissue samples of approximately 100 pigspleens with the help of the model of allogenic renal transplantation in 26 female pigs. The animals received no immunosuppressive treatment. In our study with this test 75% all of the rejection episodes by clinical acute and chronic rejection were predictably. In acute rejection a maximum rosette forming cell response was examined in general 2-3 days before a pathological rise of serum creatinine or in the course of a bad clinical state. Under chronic rejection this reaction can be seen 5-14 days before the kidney function will go poor. In spite of the high individuality of original curves statistical analyses indicate a good correlation of the number of antigenbinding cells toward pathological deviation of serum creatinine, as long as blocking factors not protect the transplant against the attack of persisting immunocompetent cells or their effectors. These blocking factors can be monitored in a rosette inhibition test with autolog serum.

The angle between the annulus fibrocartilaginous and the superior crest of the petrous bone was measured with 14 (10 to 19) degrees. The height of the annulus was in our material 10.04 mm, the width 9.45 mm. Measured were also the length of the plicae malleares and the height of the recessus membrane tympani anterior, posterior et superior with (2.5, 3.0 and 1.5 mm). In about 74%, the chorda tympani was imbedded in different zones of the plicae malleares. Its entrance and exit areas, the length of its intratympanal course and its width were measured. Included are also values of the ligaments of the otic ossicles, measurements of the ostium tympanicum tubae auditivae, of the epitympanic recess, the aditus ad antrum, and the antrum mastoideum. The eminentia pyramidalis, the sinus posterior and the sinus tympani, ponticuli and subicula, the fossula fenestrae cochleae and the fenestra cochleae, the fenestra vestibuli and prominences of the facial canal in the lateral semicircular canal have been researched and measured. Also the tympanic nerve and its course on the promontorium have been estimated.

After allogenic renal transplantation in pigs kinetics of the immunological reactivity have been investigated in order to diagnose rejection crisis. In a first series of 26 transplants without any immunosuppression we secured the diagnosis of rejection in 95% of cases of acute or chronic rejection by a combination of antigen-specific rosette test, inhibition of this parameter by autologous serum, complement dependent cytotoxicity and antibody dependent cell-mediated cytotoxicity. The antigen-specific rosette test reacts very early, 2-3 days before a bad clinical feeling in the course of acute rejection or 5-14 days by chronic rejection. Under the therapy with prednisolone and azathioprine we could not reach any prolongation of survival by arbitrary donor-recipient-selection. Under immunosuppression antibodies have never been observed by acute rejection in CDC and ADCC. In every case of acute rejection an increasing rosette formation of specific antigen binding cells appeared 2-3 days before an increasing of serum creatinine. In the case of other complications like infection or thrombosis this test is not reacting. However, by thrombosis of arteria or vena renalis there can be an increased specific rosette formation either independent of this process by beginning of immune reaction or by causal connection of both processes (necrotizing thrombotic rejection). So we have given the evidence, that the antigen-specific rosette test on a high level meets all requirements of a specific diagnosis of rejection under immunosuppression in pig.

After a concise interpretation of the urea and creatinine values a new variant of the determination of the urea concentration in the serum, the plasma, the urine and other body fluids is described. The determination is done by means of Berthelot's reaction, requires 50 microliters serum and comprehends the concentration range of 0.1 to 100 mmol/l (0.6 to 600 mg urea/100 ml). The method has a good precision, is inexpensive and renders the determination of urea possible in less than one hour.

The existing possibilities to prepare colon and rectum for surgery are discussed, optimal nutrition just before operation is particularly stressed. The efficiency of oral and parenteral antimicrobial prophylaxis ist pointed out. Apart from contra-indications, orthograde lavage of the bowel is the method of choice.

After allogeneic renal transplantation in 26 female pigs the kinetics of the immunological reactivity against the graft have been investigated with a specific test, the antigen specific rosette test and an unspecific test, the active E-rosette test. In acute and chronic rejection the level of antigen specific rosette forming cells reflects very well the clinical signs of rejection. Because of early occurrence of immunological reactivity in the case of frequent (daily) testing this test is suitable for a relative sure prediction of rejection episodes. In spite of their relative good correlations to the increase of serum creatinine, posttransplant increase and decrease of active rosette forming cells are not always in an uniform temporal relation to the rejection process. For that reason this test alone is not suitable for diagnosis of rejection. However, high preoperative values (greater than or equal to 18% active T cells) refer to an increased readiness to immunological reactivity of recipient against the graft and reflect contraindication to transplantation. If active rosette forming cells (greater than or equal to 18%) and antigen specific rosette forming cells show maxima at the same time, than follow in high significance strong cell mediated rejections. On this way the active E-rosette test completes the values of the antigen specific rosette test.

In the era of selective vagotomy the gastric motility is increasingly important. Measuring methods are demonstrated as to electromyography, intraluminal pressure measuring, measuring of emptying using isotope labeled food, and serial X-ray technique with amplifier photography. Measurings were performed in 12 patients, before and 4 months after selective proximal vagotomy. The bioelectric gastric activity is hardly influenced by selective proximal vagotomy. Enhanced antral peristalsis (tonic and peristaltic contraction) and delayed emptying are observed in cases without pyloroplasty. The authors therefore recommend that preoperative examination of motility in combination with intraoperative findings should indicate the pyloroplasty.

In different intervals 220 patients were examined after a resection of the stomach with Billroth's second operation. 179 of them spoke about complaints of different degrees of severity. The cases in question were an early dumping syndrome in 83 patients, which, with the exception of 7 patients, could be removed by simple dietetic measures, such as the elimination of incompatible foodstuff. Again and again the symptoms could be evoked by provocation with it. The method described by Henley proved as correcting operation. Apart from a few exception the fitness for work was not restricted by Billroth's second operation. In shift work or severe physical work a change of the working place was striven for. The body-weight which was reduced already before the operation again increased after operation in 50%, but reached the normal only in 20%. Recidivation ulcera and anastomositis of a suture were rare findings. Stump gastritis is no own clinical picture. Also in this case in histologically still normal mucous membrane earlier histochemical changes develop in the sense of a chronic gastritis with a reduction of the adenosin triphosphatase, the acid tissue phosphatase and succinodehydrogenase.

A short-time-study (1 to 24 hours) and a long-time-study (1 to 96 hours) after a single alcohol intake were made in 23 healthy probands. The pancreas and liver parameters as alpha-amylase, bilirubin, ASAT, ALAT, gamma-GT and GLDH in the serum were determined at regular intervals. The pancreas showed a sensitive reaction to alcohol expressed by an early rise of lipase activity. The liver enzymes of young healthy probands remained unchanged. Older probands, on the other hand, react by a distinct increase of the gamma-GT and GLDH as well as a decrease of the ASAT and ALAT. Also the enzyme quotients gamma-GT/ASAT and (ASAT + ALAT)/GLDH be obviously well suited to recognizing very early stages of liver lesion by serum examinations. For this purpose only a definite alcohol intake (I ml ethanol per kg body weight) is necessary.