[Mesenteric vascular occlusion]. / Mesenterialgefässverschlüsse.

This report concerns 70 cases of occlusion of the mesenteric vessels, 32 arterial and 38 venous. Clinical symptoms and possibilities of therapy are discussed. Operative therapy was carried out in only 19 patients, 5 of whom survived. The time between the first symptoms and the operation essentially influences the prognosis. Postoperative anti-coagulation seems to be significant. The value of a 'second-look' operation is dubious.

[3 years experiences with the dynamic hip compression screw]. / Drei Jahre Erfahrungen mit der dynamischen Hüftkompressionsschraube (DHS).

The authors report on 140 cases of fractures near the hip joint, which had been treated by applying a dynamic hip compression screw (DHS). DHS is an ideal method for stabilising pertrochanteral stable and lateral fractures. In unstable pertrochanteral fractures it is recommended to use a 130 degrees or 150 degrees DHS, depending on the age and the patient's preoperative ability to walk. In medial fractures of the neck of the femur the use of DHS offers no advantage compared with screwing or total endoprosthesis. The article reports on the postoperative results. In respect of these results DHS appears to be superior to fracture nailing according to Ender.

[Para-articular fracture of the hip joint in the aged--an indication for immediate operation?]. / Die hüftgelenksnahe Fraktur des alten Menschen--Eine Indikation zur Sofortoperation?

177 patients with fractures near the hip joint were operated on between January 1983 and December 1985. The fractures were treated with Ender pinnings, total endoprostheses and dynamic hip screws (compression screw fixation). Up to June 1984 surgery was performed after the patients had been allowed a stabilisation phase of 4 days on the average, but from July 1984 onwards we aimed at performing immediate surgery within 12 hours. The second group was compared with the first group in a retrospective study in respect of recumbent period and mortality (hospital mortality and mortality after 8 months). The period during which the patients had to remain recumbent in the hospital was found to be considerably shorter, but there were no statistically significant differences in respect of mortality. The causes and consequences are discussed.

Interlamellar tight junctions of central myelin. I. Developmental mechanisms during myelogenesis.

The process of myelination in the central nervous system (CNS) of the rat (optic nerve) was studied with the freeze-fracturing technique and ultrathin sectioning to obtain information on the developmental mechanisms of interlamellar tight junctions. Using a tilting cartridge for analysis of thin sections, it could be demonstrated that during the initial phase of wrapping a tight junction formation develops between the joining tips of the oligodendrocytic process. In tannic acid-stained samples these junctions appear as typical quintuple-layered membrane fusions, while in potassium permanganate-stained material membrane thickenings between the apposing glial tips are prevalent. The latter configuration represents the characteristic feature of the so-called radial component of central myelin. Using the freeze-fracturing technique, a biphasic mode of the myelinic tight junction assembly was detected. It is suggested that tight junctions represent a prerequisite of the myelination process.

[Comparative studies of local recurrence following sphincter preserving anterior rectal resection and primary rectal excision 1980-1983]. / Vergleichende Untersuchungen der løkalen Rezidive nach sphinktererhaltender anteriorer Rektumresektion und primärer Rektumexstirpation der Jahre 1980-1983.

From May 1980-May 1983, 57 patients suffering from carcinoma of the distal part of the sigmoid colon and the rectum located 7 to 20 cm above the anus had anterior resections, with continuity being restored. 19 local recurrences could be demonstrated by a follow-up made in November 1983. In a group of 23 cases where the tumour was located between 7 to 10 cm above the anus 12 recurrences (56%) were found, which were not caused by the degree of malignancy or carcinous invasion of the intestinal wall. In the other group of 27 cases with the tumour located between 11 and 15 cm above the anus we found 6 local recurrences (22%), mostly in high risk tumours. Comparing the total recurrence rate of 36% within 34 months after anterior resection with a mortality rate of 18% after exstirpation of the rectum (18% within 36 months from 986 patients between 1960 to 1981) we came to the conclusion that tumours situated lower than 15 cm from the anus should only be extirpated, not resected.