[Marcello Malpighi (1628-1694) and the Terms Miliary and Tubercle]. / Marcello Malpighi (1628­1694) und die Begriffe Miliar und Tuberkel.

Today Miliary Tuberculosis in Central Europe is a rare disease, quite often with resulting diagnostic uncertainty. The terms "miliary" and "tubercle" are outlined with their up to now accepted historical roots. An analysis of Marcello Malpighi's quite unknown post-mortem reports by the Italian author L. Munster reveals an earlier use of both terms than described till now.

[Marcello Malpighi (1628 - 1694) and the terms miliary and tubercle. A completion of hitherto existing historical terminology]. / Marcello Malpighi (1628 - 1694) und die Begriffe Miliar und Tuberkel. Eine Ergänzung der bisherigen historischen Terminologie

Today Miliary Tuberculosis in Central Europe is a rare disease, quite often with resulting diagnostic uncertainty. The terms "miliary" and "tubercle" are outlined with their up to now accepted historical roots. An analysis of Marcello Malpighi's quite unknown post-mortem reports by the Italian author L. Munster reveals an earlier use of both terms than described till now.

[200 years of bronchitis--from 1808 to 2008]. / 200 Jahre Bronchitis--1808 bis 2008.

Because of the still growing importance of airway diseases, it should be worthwhile to remember Charles Badham's coining of the term bronchitis 200 years ago--in 1808. In the two editions of his book he reviewed historical names and concepts of tracheobronchial affections according to humoralism mainly under the topic of catarrh. Using his new term "bronchitis" he classified three forms (Br. acuta, asthenica and chronica). Analyses of clinical symptoms, case histories and therapeutic aspects form the central chapters of his work, always in relation to former ideas and authors. According to modern authors his characterization of chronic bronchitis conforms best with today's definitions, whereas the first two forms remain unclear even today. Early German medical reviews and comments uniformly concur with both editions of his book (1808 and 1814). Finally we present some important dates of his life and work.

Infections after pleuro-pulmonary surgery.

The incidence and causes of infectious complications after pleuro-pulmonary surgery occurring in our institution before 1968, from 1968 to 1975, and from 1978 to 1979 are compared. Soft tissue infections occurring in the operative region, in the pleural cavity and in the remaining lung tissue are assessed separately. From these data it is concluded, that infections of soft tissue have markedly decreased from 7 to 2% while secondary wound healing without purulent infection has fallen from 21% to 5%. The risk of infection thus has decreased below the average figures of general surgery. A comparatively high number of wound infections however, have to be expected after decortication of thoracic empyema. The incidence of postoperative empyemas predominantly related to postoperative bronchial fistulae after lung resection has decreased from 4% to one percent in segmental or lobar resections. Serious infections of the remaining lung with abscess formation have become rare indeed (0.2%). Inflammatory atelectasis caused by bronchial obstruction has remained at a constance level of one to 2% throughout the years. There were 2 cases of lethal bacterial sepsis in 1,566 pulmonary procedures before 1973, but none thereafter. Increasing attention will have to be paid to mycotic superinfections rather than to primary bacterial infections since such superinfections of the tracheo-bronchial tree and of the pleural cavity have increased from less than one percent to approximately 3% during the recent 10 years.

[Fiber bronchoscopy as an aid in placing and monitoring double lumen tubes in thoracic anesthesia]. / Die Fiberbronchoskopie als Hilfsmittel zur Plazierung und Uberwachung von Doppellumentuben in Thoraxanästhesie.

100 thoracic surgery patients were intubated by means of a left-hand Broncho-Cath PVC Double-Lumen Tube (DLT) and 10 further patients with a right-hand tube. In 76 of the 100 left-hand DLT's safe conventional placement of the tube was successful, oriented exclusively by auscultation findings and positive pressure respiration. However, fibre-optic control showed that only 44 of these tubes were correctly positioned (57.1%). 25 DLT's were too high and 24 too low, whereas the right main bronchus had been intubated in 6 cases. 1 DLT was endoscopically correctly placed although the positioning of the tube had been considered unsatisfactory during conventional examination. Only 2 right-hand DLT's fulfilled the conventional and endoscopic criteria for correct placement of the tube. All malpositionings could be corrected via fibre optics. Recurrent tube dislocations occurred both after lateral repositioning of the patients (so that they were now lying sideways) (27.3% of all patients) and intraoperatively (24.6% of all patients). Besides, intraoperative obstructions of the tube/bronchus lumen due to blood/coagulates (49.1% of the patients) and/or secretion (46.4% of the patients) could be demonstrated and eliminated by endoscopy. Fibre bronchoscopy proved to be a decisive help to reduce the possibilities of complications associated with the use of the Broncho-Cath PVC-DLT in thoracic surgery.