[Hot air coagulator for the treatment of bleeding of parenchymal organs]. / Heissluftkoagulator zur Behandlung von Blutungen parenchymatöser Organe.

Experiences are described about the hemostasis in parenchymatous organs by means of a self-constructed hot air coagulator. Bleedings in liver, spleen, and kidney were caused experimentally in 15 dogs. A certain control of hemorrhage were carried out by hot air. The own hot air coagulator was superior to other coagulators by the little weight and the fast and noiseless working.

[Animal experiment studies of hemostasis using the fibrinogen adhesive system on the liver and spleen in coagulation disorders]. / Tierexperimentelle Untersuchungen zur Blutstillung mittels des Fibrinogenklebesystems an Leber und Milz bei Gerinnungsstörungen.

Fresh resection areas after partial resection of liver and lien in rabbits were repaired and sealed by a fibrin film on conditions of hemorrhagic tendency and increased fibrinolysis. A strong damage in the wound area in the same way as in organic injury originates from these pathologic conditions. A premature demarcation of the external wound strata especially in raised fibrinolysis takes place by reason of the parenchymal necrosis though the fibrinogen is cross-linked to an intact film independent of the common circulation and clotting relations. An abundant wound revision is recommended before using the fibrin adhesive to prevent an after-bleeding.

[Demonstration of dual liver systems after experimental auxiliary partial liver transplantation using the alternative of sequential hepatobiliary scintigraphy]. / Die hepatobiliäre Sequenzszintigraphie-Alternative zur Uberprüfung des Duallebersystems nach experimenteller auxiliärer Leberteiltransplantation.

Hepatobiliary sequential scintigraphies by 99m Tc-ROTOP-EHIDA were carried out for judging the dual liver system after experimental auxiliary transplantation of a part of the liver. A functional advantage of the host liver in contrast to the transplant was found in all cases investigated. Ischemic transplant damages could be detected in all experiments and were scintigraphically recognised at an early stage. In addition to transplants with a functioning entire parenchyma, the investigations showed transplants with functionally active parenchyma zones and such ones without any functional evidence. A quantifiable determination of the global functional capacity of the hepatobiliary system of both livers was possible and also the evidence on residual functions. The different behaviour of the kinetics of the radio-pharmacon with normal function and in case of hepatic ischemia is discussed.

[Selective proximal vagotomy with and without pyloroplasty--results of a randomized clinical study of duodenal ulcer 5 and 8 years after surgery]. / Selektiv proximale Vagotomie mit und ohne Pyloroplastik--Ergebnisse einer randomisierten klinischen Studie nach 5 und 8 Jahren beim Ulcus duodeni.

Selective proximal vagotomy (SPV) with pyloroplasty (n = 39) and without (n = 39) were compared five and eight years after surgery in a randomized clinical study. Pyloroplasty according to Finney had no effect on ulcer recurrence rates after both periods of time (7.9:7.9 or 10.8:8.3 per cent). Additional pyloroplasty, too, had no statistically significant effect on incidence and severity of post-vagotomy syndrome, dumping and diarrhoea, though some trend towards an increase was discernible in wake of pyloroplasty. Occurrence of the lactase deficit syndrome after SPV with pyloroplasty was increased with statistical significance. Lasting loss of senses of appetite and saturation was observed for the first time after SPV, on top of the lactase deficit syndrome. Clinical results recorded after five and eight years did not reveal any significant difference between both groups. These findings are likely to suggest that SPV without pyloroplasty is sufficient for surgical treatment of duodenal ulcer. However, pyloroplasty in combination with SPV has continued to be fully indicated for no-resection therapy of ulcerogenic pyloric stenosis.

[Results of functional scintigraphic studies of the hepatobiliary system following reconstruction of bile duct injuries with ring drainage splinting]. / Ergebnisse funktionell-szintigraphischer Untersuchungen des hepatobiliären Systems nach Rekonstruktion von Gallengangs-verletzungen mit Ringdrainageschienung.

Functional-scintigraphic examinations were conducted to establish liver functionality and kinetics of extrahepatic bile flow, using 99mTc-Rotop-Ehida, in 25 patients with bilio-biliary or bilio-digestive anastomosis calibrated by ring drainage. Checks were made with indwelling drainage in place or after its removal. Liver damage was detectable in 80 per cent of all probands. The method based on nuclear medicine has proved to be more suitable for quantitative functionality assessment than clinical examinations and enzyme activity tests. With ring drainage in place, it may provide useful information complementary to X-ray presentation of bile duct conditions. After removal of ring drainage, it should be preferred to invasive methods of examination.

[The auxiliary transplantation of a portion of liver in an animal experiment]. / Die auxiliäre Transplantation eines Leberteiles im Tierexperiment.

The authors inform about a model for auxiliary liver part transplantation in pig. Intra-abdominal narrowness which can lead to failure of the transplant can avoided by this model. In the transplant was carried out an extensive left resection with purse-string ligature of all visible vessels and cystic ducts. The resection surface is sealed by a tissue adhesive. An auxiliary transplanted part of the liver can also operate on a heterotopic location of the organism.

[Total pancreatectomy without duodenectomy--a model for studies in the dog without a pancreas]. / Totale Pankreatektomie ohne Duodenektomie--ein Modell für Untersuchungen am pankreaslosen Hund.

The authors report about their experiences with the total pancreatectomy without duodenectomy in the dog. The circulation of the duodenum can be preserved by subtle preparation technique and exact knowledge of the anatomy. The represented model is qualified for all investigations in the pancreasless dog because of its slight operation trauma.

[Oxygen supply and oxygen uptake by skeletal muscle in acute arterial circulatory disorders--an experimental study in the dog]. / Sauerstoffangebot und Sauerstoffaufnahme der Skelettmuskulatur bei akuter arterieller Durchblutungsstörung--eine experimentelle Studie am Hund.

The oxygen supply and the oxygen uptake of the ischemic skeletal muscle were defined in rest and by loading in experimental studies in dog. About 72% of the supplied arterial oxygen was taken up from the ischemic skeletal muscle in rest in opposite to 84.7% by loading. Therewith the authors found an essential higher value as supposed in literature so far. The absolute value of the oxygen uptake of the normally circulated skeletal muscle with 0.14 ml O2/min/100 g is small in contrast to the highly differentiated parenchymatous organs. An adaptation to an anaerobic metabolism is assumed by the authors in case of falling below the critical boundary value of 0.1 ml O2/min/100 g in skeletal muscle.

[Indications for appendectomy]. / Indikation zur Appendektomie.

While the statistical morbidity and mortality rates of appendicitis are high in the GDR, a declining trend has been recordable since 1970. The incidence of appendicitis in the GDR, as compared to figures in other countries, has supported the author's insistence on early indication and surgical action to prevent the occurrence of avoidable deaths. This is the reason why a liberal approach is taken to appendectomy in cases of appendicitis.

[pH measurement in tissue--a reliable criterion for the registration of acute arterial circulatory disorder in animal experiments]. / Die Gewebs-pH-Messung--ein verlässliches Kriterium zur Erfassung einer akuten arteriellen Durchblutungsstörung im Tierexperiment.

An arterial ischemia was carried out step by step in the right pelvic extremity of the dog. The ph level was measured continuously in the lateral vastus of the femoris muscle on both sides by means of a glass-one-rod measuring equipment. The pH value decreased to 6.43 ninety minutes after a total interruption of the arterial circulation. The initial value amounted to 7.20. The tissue-pH-values increase quickly during the following phase of recirculation.

[Therapy of acute poisoning with orthograde intestinal lavage]. / Therapie akuter Intoxikationen durch orthograde Darmspülung.

Orthograde intestinal lavage was successfully used in the treatment of eight patients with acute poisoning. Three had mushroom (Amanita pantherina) poisoning, five acute drug intoxication (attempted suicide: diazepam, dihydropyridine, crotylbarbital, phenobarbital, amitriptyline and glibenclamide). Within 5-18 hours the clinical signs of poisoning regressed in four patient in stage IV (after Reed), so that the patients became responsive. Detoxication by orthograde intestinal lavage is achieved by mechanical removal of nonabsorbed compounds from the gastro-intestinal tract and via intestinal dialysis across the intestinal mucosa.

[Reaction of the whole body to auxiliary liver transplantation]. / Die Reaktion des Gesamtorganismus auf eine auxiliäre Lebertransplantation.

Changes of hemoglobin, hematocrit, blood pressure, blood lactate concentration, and blood pyruvate concentration, as well as in the acid-base balance, the electrolyte metabolism, and the enzyme activities into the serum were investigated in auxiliary liver transplantation in 5 dogs. Transitory hypokalemia and hypoglycemia, a slight controllable acidosis caused by lactate accumulation, as well as a strong short-term increase of the enzyme activities in the serum are an expression of the functioning of the transplanted liver. Hyperkalemia, a massive increase of the blood lactate concentration with uncontrollable acidosis, a therapy-resistant depression in blood pressure, and a slow continuous increase of the enzyme activities in the serum are symptoms of the irreversible ischemic damage of the transplanted liver. The avoidance of an irreversible ischemic damage during the preservation, the maintenance of a normal blood pressure after the transplantation, as well as the compensation of acidosis, hypoglycemia, and hypokalemia are of decisive importance for a successful liver transplantation.

[Adenine nucleotides and metabolites of glycolysis in the liver in auxiliary transplantation]. / Adeninnukleotide und Metabolite der Glykolyse in der Leber bei auxiliärer Transplantation.

The metabolic state of the liver during preservation as well as in and after auxiliary transplantation was investigated in dogs. The biopsy was carried out by means of TRU-CUT biopsy needle. - The ATP concentration, the storage of energy, the amount of the adenine nucleotides, and the ATP/ADP quotient decrease in the preserved liver. The AMP concentration, the concentration of the hexosemonophosphates and the mass-effective quotient of the phosphofructokinase increase simultaneously. The energy supply is the glycolysis exclusively. A lactate accumulation is avoided by continuous perfusion. - The changeover of the anaerobic to the aerobic energy preparation took place by degrees after the recovery of the liver circulation. The ATP concentration, the ATP/ADP quotient, the storage of energy, and the amount of the adenine nucleotides increase in the transplanted liver. - An irreversible ischemic damage of the liver appears in the metabolic state of the organ by a massive decrease of the ATP concentration below 0.7 mmol/kg, the amount of the adenine nucleotides below 1.8 mmol/kg, and AMP concentration.