[Social structure and social behavior of elderly ambulatory surgical patients].

Geriatric surgery is getting more and more important. Rising expectation of life, improved pre- and postoperative therapy deferred the age limit for elective operations for about 20 years above the former average. In a chance control we examined the social structure and the social behaviour of older ambulant patients suffering from surgical complaints.

Utilization of blood recycling in nonelective surgery.

Intraoperative infusion of autologous shed blood is efficacious in elective vascular, cardiac, and orthopedic surgery. Blood recycling has also been advocated for emergency and trauma surgery. We examined 33 candidates for autotransfusion during emergency surgery.

Resection of pulmonary metastases from nonseminomatous testicular tumors. Correlation of clinical and histological features with treatment outcome.

Clinical and histological correlates of survival in patients undergoing complete resection of pulmonary metastases from nonseminomatous testicular carcinoma were determined in 25 Stage C patients aged 17-38 years treated from 1969-1978. All patients had orchiectomy and retroperitoneal lymphadenectomy. Nineteen patients received combination chemotherapy before resection, and all received chemotherapy after resection.

Prognostic significance of urinary antigen analysis by enzyme-linked immunosorbent assay in melanoma patients.

Urine samples collected from normal donors and melanoma patients were analyzed for the presence of tumor-associated antigen by competitive inhibition in the enzyme-linked immunosorbent assay (ELISA) using an allogeneic melanoma serum as the source of antibody and partially purified urine from the same donor as the target antigen. The results were expressed as antigen units (ng antigen protein/mg creatinine). The antigen levels in urine of melanoma patients (median = 56.

Relationship between circulating immune complexes and urinary antigens in human malignancy.

Urine samples obtained from patients with histologically proved melanoma and sarcoma were analyzed for the presence of tumor-associated antigens by complement fixation and enzyme immunoassay. Also, serum samples obtained during 24-hour urine collection from these patients were analyzed for circulating immune complexes by the complement consumption method and by the K562 radiometric assay. Of 36 cancer patients who were positive for urinary antigen (UA) by both assays, 28 (78%) were also positive for CIC in the two assays, six (17%) were positive in one of the two CIC-detection assays, and two (5%) were negative in both assays.

Application of cultured human myeloid cells (K562) for detection of immune complexes in human sera.

Cultured human myeloid cells (K562) are known to bear Fc receptors that bind with aggregated human IgG (AHG). These cells were used to develop a radiometric assay for detection and quantitation of immune complexes (IC) in human sera. The binding of AHG or in vitro-formed IC between keyhole lympet hemocyanin (KLH) and human anti-KLH to the K562 cells did not require complement.

[Lymphogranulomatosis and heart involvement].

In the early extralymphatic affection of the organs without relevant clinical and roentgenological findings the diagnosis of the lymphogranulomatosis makes difficulties. It is referred to the peculiarities of the extra-nodal manifestation. The case of a lymphogranulomatosis with early participation of the heart is described and it is gone more fully into the differential diagnosis.

Assessment of in vivo effectiveness of tumoricidal chemotherapy and radiation therapy by serial analysis of tumor-associated urinary antigen titers in patients with sarcoma.

Serial measurements of tumor-associated antigens in the urine of patients with sarcoma who received preoperative intra-arterial doxorubicin and radiation therapy were assayed by microcomplement fixation. Changes in urinary antigen titer as a result of therapy were compared to pretreatment samples and were correlated with clinicopathologic evidence of in situ tumor cell destruction. Of the 53 patients with sarcoma studied, 44 had clinicopathologic evidence of tumor destruction induced by the preoperative therapy, and all 44 had a fourfold or greater rise in the level of urinary antigens during the treatment period.

Development of an enzyme immunoassay to detect and quantitate tumor-associated antigens in the urine of sarcoma patients.

This study describes the development of an enzyme immunoassay (EIA) to quantitate antigen in the urine of sarcoma patients and compares its results with those of the authors' previously reported complement fixation assay. Three populations were studied for the presence of urinary antigen by EIA: (1) sarcoma patients who developed metastatic disease after resection of their primary tumor; (2) sarcoma patients who remain clinically disease-free two years after resection of their primary tumor; and (3) normal volunteers with no history of malignant disease. EAch group consisted of nine individuals.

Direct assay for creatine kinase by reversed-phase high-performance liquid chromatography.

A direct assay for creatine kinase (CK) activity was developed based on the separation and quantitation of adenosine triphosphate (ATP) by high-performance liquid chromatography. The total incubation time is 13 min and the elution time for ATP is 16 min. Using lyophilized CK as the sample, a sensitivity in the range of 8 U/l (units/liter) was obtained.

Pulmonary resection for metastatic sarcoma.

Surgical resection plays an important role in the treatment of sarcoma that is metastatic to the lung. Multiple bilateral metastases are not contraindications to surgery. The rapidity of growth and the response to chemotherapy can be accurately determined by the tumor doubling time.

Plasma thyrotropin-releasing hormone, prolactin, thyrotropin, and thyroxine concentrations following the intravenous or oral administration of thyrotropin-releasing hormone.

In a further evaluation of the use of oral thyrotropin-releasing hormone (TRH) in puerperally lactating women, a radioimmunoassay for its measurement has been developed. Its concentration in plasma as well as that of prolactin (PRL), thyrotropin (TSH) and thyroxine (T4) were measured following either intravenous or oral administration of TRH. Basal concentrations of TRH in 14 normally cycling women ranged from less than 5 to 17 pg/ml.

[Contribution to the differential diagnosis of lung infarct, pulmonary tuberculosis and lung neoplasms].

It is reported on the rare case of a symptom-free, atypically localised haemorrhagic pulmonary infarction without provable cause in a 52-year-old male. The patient became conspicuous on account of a plum-sized focal shadow in the right lateral upper field detected during a mass examination. The state was regarded as bronchial.

Nursing-mediated prolactin and luteinizing hormone secretion during puerperal lactation.

Alterations in plasma prolactin (PRL) concentrations in response to nursing in puerperally lactating women are often significant beyond the 90th postpartum day, yet the increment appears unrelated to the frequency or duration of the nursing stimulus. Tonic gonadotropin secretion is low, assuming a more episodic secretory pattern either when the frequency of breast-feeding is reduced or when weaning takes place. Significant increments in peripheral concentrations of luteinizing hormone can be seen in response to weaning coincident with a fall in peripheral plasma PRL concentration.

[Rare thoracic injuries (biomechanics, diagnosis and therapy) (author's transl)].

Thoracic injuries caused by direct or indirect power action involve various injury effects. The extent of injury depends on the force and the direction of the acting power, on the biomechanical properties of the partial structures of the thorax, and on genetically determined variations of form and structure. These correlations are demonstrated by special examples of rare thoracic injuries.

[Intra-and postoperative complications in pulmonary surgery (author's transl)].

The age of the patients, the causative diseases, and the extent of the surgical operation are decisive for the development of intraoperative and postoperative complications in pulmonary surgery. Restrictive and obstructive pulmonary changes of the older-age group involve the danger of postoperative complications. By our experience the critical age for pulmonary surgery is about 50 years.

[Methods and quality of information from myocardial scintigrams in the diagnosis of myocardial infarct].

There is an increasing importance of scintigraphy for the assessment of microcirculation in the myocardium. In animal experiments advantages and disadvantages of negative and positive representation of ischemic myocardiac areas were tried, after experimental infarction in particular. The results by computer scintigraphy prove that positive representation reveals an information on site and extent of an infarction.

[The management of bronchial hemoptysis - case study (author's transl)].

Two case reports exemplify, that in patients with massive hemoptysis occuring in the bronchial system and owing to known or unknown causes, the emergency surgery must not to be delayed. In the case of minor relapsing hemoptysis, especially in old-age patients or borderline operability, the minimum surgical procedure is indicated after diagnosing and finding the localization of the hemorrhage.