Real-time ultrasonography: a new tool for the intraoperative localization of renal calculi (preliminary communication).

A B-scan real-time ultrasonic equipment providing three-dimensional information was used for intraoperative localization of renal calculi. Simplicity, non-invasiveness and ability to demonstrate radiolucent calculi or matrix are stress as the main advantages of the method. Its current use on a larger scale is expected and regarded as desirable.

[Perioperative treatment after esophagogastric surgery]. / Tapasztalataink nyelócsó- és kiterjesztett gyomormútétes betegek perioperatív kezelésében.

Extended gastric and esophageal resection is still associated with high postoperative morbidity and mortality. We performed a retrospective analysis of the perioperative management of 72 patients who had undergone such operations during a one-year period. Patient and management variables were analyzed by multivariate statistical methods to identify pre-, intra-, and postoperative factors which influence the results. The investigation of preoperative data revealed an increase of esophageal cancer among younger (< 55 years) patients (12 patients underwent gastrectomy and 22 esophageal resection). The intensity of smoking was significantly higher compared to the elderly (11.27 vs. 7.4 cigarettes/day; p < 0.05); and the same applies to alcohol consumption. In older patients (> 55 years of age), the duration of postoperative artificial ventilation was significantly longer (10.1 vs. 4 hours, p < 0.05) and the prevalence of septic complication was higher, than in younger patients. All three postoperative deaths recorded in this series occurred in the group of elderly patients. A preoperative weight loss exceeding 10 per cent of body weight was associated with significantly longer postoperative stay (21.6 vs. 17.4 days; p < 0.001), as well as with need for longer parenteral feeding (13.05 vs. 10.06 days; p < 0.005). Operations longer than 6 hours were associated with significantly longer postoperative ventilation period (14.44 vs. 5.31 hours; p < 0.02), need for longer stay intensive care unit (10.56 vs. 6.55 days; p < 0.001) and longer postoperative stay (21.56 vs. 17.64 days; p < 0.05). The prevalence of pulmonary complications was connected to the duration of the operation (10/16 vs. 3/55). We also describe and analyse two contemporary methods designed for monitoring circulatory parameters (PICCO) and tissue oxygenation (gastrotonometry). The analysis of postoperative data demonstrates that postoperative pain control with continuous epidural analgesia is superior to methods as it shortens the length of stay on the intensive care unit (7.15 vs. 10.67 days; p < 0.05) and postoperative hospitalisation (18.06 vs. 23.50 days; p < 0.05). Nutritional support is essential after esophageal anastomosis till oral feeding can start. Enteral nutrition was given through a jejunal tube that had been inserted intraoperatively. Calorie intake was built up step by step to a maintenance level of 31.2 kcal/day, which was administered until oral feeding could be started (mean duration 10.94 days; maximum duration: 42 days). We conclude that careful selection of patients, appropriate intra- and postoperative management, with adequate postoperative pain control can reduce postoperative morbidity and length of inpatient stay.

Antimicrobial activity of Mentha piperita and Saturenja hortensis in a murine model of cutaneous protothecosis.

BACKGROUND: To date there is no defined pharmacologic treatment protocol available against cutaneous protothecosis, which is difficult to combat using conventional drugs. OBJECTIVES: Our experiment aimed to comparatively investigate the effect of two essential oils (Mentha piperita and Saturenja hortensis) against cutaneous protothecosis experimentally induced by Prototheca zopfii in mice. MATERIALS AND METHODS: Immunosuppressed BALB/c female mice, were divided into six experimental groups, infected with P. zopfii, and then treated for 21 days against the infection. The effectiveness of the different treatments was assessed clinically and histologically by quantifying the degree of inflammation (immunohistochemical quantification of macrophages, T lymphocytes and neutrophils) and fibrosis. RESULTS: Skin lesions in experimental protothecosis from non-treated mice were more severe as compared to the four groups of treated animals. Both M. piperita and S. hortensis have proved to be efficient in vivo in the treatment of cutaneous protothecosis by reducing the clinical signs and significantly reducing the degree of inflammation (P<0.05 for the number of macrophages, T lymphocytes and neutrophils) and fibrosis as compared to untreated animals. CONCLUSION: Interestingly, our study shows that M. piperita and S. hortensis could represent a potential source of natural antimicrobial products in the treatment of cutaneous protothecosis.

[Our experiences with uroflowmetry]. / Unsere Erfahrungen mit der Uroflowmetrie.

The uroflowmetry is an essential part of the complex urodynamic examinations. One of its advantages is the non-invasive behaviour; the patient does not suffer any inconveniences. It is suitable for the evaluation of the success in surgical interventions due to obstructions in the lower urinary tracts, for control of results of the medicamentous therapy or after operative procedures, which have as their purpose the improvement of the function of the detrusor and for the general differentiation of diseases which are accompanied by dysuric symptoms. The technique renders possible the registration, the preservation of date and means an unlimited repeatable methody.

[Clinical aspects of urethral diverticula]. / Uber das Klinikum der Harnröhrendivertikel.

Experience with the treatment of 39 cases of urethral diverticula between the years 1954 and 1974 is reported. The patients were 32 women and 7 men. In 7 cases (3 women and 4 men) the condition was congenital in origin. In 30 patients the first symptoms appeared between the 31st and 60th year. In a 12 months old infant a hazelnut sized diverticulum in the posterior urethra caused complete ischuria. In two-third of the patients symptoms of cystitis dominated, dyspareunia in women (8%) and prostatitis in men (16%) had a lower incidence. 80% of the diverticula were infected; they contained stones in 3 cases. In one case the diverticulum recurred and histology revealed in its wall a planocellular carcinoma. Thirty-five patients were subjected to operation. Postoperative fistula developed in 3 cases which had to be re-operated. In cases of recurring urethritis, cystitis and prostatitis, urography is recommended, since the symptoms might be due to the presence of urethral diverticula.

Diagnosis and treatment of adult polycystic kidney disease.

The methods applicable to the diagnosis of polycystic kidney disease are reviewed. By assessing the clinical data of 314 patients suffering from adult polycystic kidney disease who had been treated in the 30 years between 1950 and 1979, the importance of conservative therapy and nephrological care is emphasized. The significance of hemodialysis in therapy and the special circumstances of transplantation are discussed. The indication of surgical treatment can be extended in complication-free cases.