[Changes in radical surgery of breast carcinoma in the last 20 years]. / Wandel der Radikaloperation des Mamma-Carcinoms in den letzten 20 Jahren.

UNLABELLED: The retrospective analysis of 383 female patients with breast cancer of all tumor stages from the department of surgery (323 patients since 1979) and the department of gynaecology (58 patients since 1993) shows the abandonment of the radical mastectomy according to Rotter-Halsted (116 patients until 1989), acceptance of the modified radical mastectomy (178 patients since 1979) and introduction and rise of the breast conserving operations (67 patients since 1983). In 1992 there was an extension of breast conservation treatment from T1 N0 to T2 N1-2 tumors (tumor diameter till 4 cm). Operation technique: 1. Circular incision above the tumor, 2. tumor excision in histologically healthy tissue, 3. lower axillary dissection (level I and II with > or = 10 lymph nodes), 4. no suture of the gland and drainage without suction, 5. postoperative computerised high energy radiotherapy of the conserved breast (Clinic of radiotherapy of the University of Leipzig). Because of the high operation risk a simple mastectomy without axillary dissection was performed in 22 of 383 patients. RESULTS: 3 of 383 patients died = 0.78% postoperatively due to tumor independent complications. One local tumor recurrence was observed 6 years after breast conserving therapy in 25 patients operated until 1992. In 42 patients operated since 1993 a tumor recurrence did not occur so far. The 5-year-survival-rate in 153 patients of all tumor stages amounted to 64%, in node-negative patients 80.3%, in node positive patients 51.7%. RECOMMENDATIONS: Breast conservation will be always recommended if the relation between tumor diameter and breast volume permits a cosmetic attractive result.

[Relation between corpus luteum function and serum prolactin concentration in early pregnancy]. / Zusammenhang zwischen Gelbkörperfunktion und Serumprolaktinkonzentration in der Frühschwangerschaft.

In 20 patients between the 6.-8. week of pregnancy serum prolactin concentration could be decreased successful by administration of a single dose bromocriptine. Coincidentally the steroid secretion of the corpus luteum has been monitored by measurement the serum concentration of progesterone and estradiol. There are no prolactin related changes in the corpus luteum function under these conditions.

[Relation between corpus luteum function and serum prolactin concentration early in pregnancy]. / Zusammenhang zwischen Gelbkörperfunktion und Serumprolaktinkonzentration in der Frühschwangerschaft.

In 23 patients between the 6.-8. week of pregnancy the serum prolactin concentration excessively increased by bolus injection of 10 mg metoclopramide. Coincidentally the steroid secretion of the corpus luteum has been monitored by measurement the serum concentration of progesterone and estradiol. There are no changes in the corpus luteum function caused by hyperprolactinaemia under these conditions.

[Bromocriptine treatment of hyperprolactinemia]. / Bromocriptin-Behandlung bei Hyperprolaktinämie.

In 36 female patients with microprolactinoma was carried out a primary therapy and in 19 patients (10 males, 9 females) with a postoperatively persisting hyperprolactinaemia a secondary therapy with bromocriptine. In close correlation between the PRL-levels and the bromocriptine dose we achieved a normalisation of the hormone levels in the microprolactinomas. A normalisation of the cycle was observed in 80%, a persisting of the galactorrhoea in about 90% and a conception in nearly two thirds of the women. Also in those patients who underwent a secondary therapy in nearly 80% a decrease of the PRL-levels into the normal region developed. In a longterm therapy with bromocriptine a reduction of the dose may become possible, so that controls of the hormone levels are necessary in larger intervals. Most side effects of a bromocriptine treatment are transitory.

[Kidney function and arterial acid-base status during continuous stimulation of the carotid chemoreceptors in vagotomized cats]. / Nierenfunktion und arterieller Säure-Basen-Status bei anhaltender Reizung der Karotis-Chemorezeptoren an vagotomierten Katzen

In spontaneously breathing, chloralose narcotized and bilaterally vagotomized cats under mannite saline diuresis, the isolated carotid sinus were perfused for 1 hr with arterial and then for 1 hr with venous blood, and subsequently again with arterial blood for 1 hr. Either measure d or calculated were the parameters of arterial acid-base status, the arterial systemic bl-od pressure, the p-aminohippuric acid (PAH), inulin (IN), and osmolar clearance, the filtration fraction, the tubular reabsorption of oxmotically free water, the urinary time volume, and fractional excretions of the kidneys. Stimulation of the carotic chemoreceptors increased respiration, slightly enhanced the CPAH, and caused a minor fall of CIN with little altered filtration fraction. The renal resistance increased. The absolute and fractional excretions of urine, sodium, potassium, and of osmotically active particles rose significantly. Tubular reabsorption of osmotically free water showed a singificant increase. Urinary osmolarity remained constant in general. The changes of water and electrolyte excretion did not correlate with those of renal hemodynamics. The results argue against natriuresis being caused on chemoreceptor stimulation by increased filtrate volume of the whole kidney, or by decreased osmolarity of the renal medulla. The results are discussed with regard to the renal function in arterial oxygen deficiency.