[Choice of surgical procedure in esophageal cancer].

In a retrospective study results of surgical treatment of esophageal cancer by transthoracic and abdominal transhiatal approach are compared with each other. 70% of the patients (n = 21) had tumor stage III. The overall 30-day-lethality is 9.

[Endoscopic resection of colorectal polyps].

In 766 patients, 1413 polyps of the colon and the rectum were resected endoscopically. 79% of the polyps were located in the rectum and sigmoid colon. The histological examination revealed adenomatous polyps in 60%.

Sclerotherapy for massive enterostomy bleeding resulting from portal hypertension.

Three patients with frequent and massive hemorrhage from enterostomy (colostomy 2, ileostomy 1) due to portal hypertension are reported. The hemorrhages were treated with sclerotherapy by submucous injections of polidocanol (Ethoxysclerol) or phenol (5 percent) almond oil. In one patient, a complete and long-term stoppage of the bleeding was achieved.

Diamine oxidase as a marker of intestinal integrity in acute appendicitis.

In the operative treatment of appendicitis the so called negative appendectomy is an important issue because of its increased morbidity. From the hypothesis that the intestinal diamine oxidase activity is a suitable marker of mucosal integrity, the distribution pattern of the enzyme in appendices histologically classified as inflamed or not inflamed was studied. Histologically apparent inflammation of the appendix was connected with a significant reduction of diamine oxidase activity.

Inhibition of human and canine diamine oxidase by drugs used in an intensive care unit: relevance for clinical side effects?

Three hundred and forty-one drugs, commonly used in intensive care units (ICU), were chosen for an investigation of possible activation or inhibition of the histamine metabolizing enzyme diamine oxidase (DAO). After examination of 164 substances, using both canine and human DAO in an in vitro screening test, 61 agents inhibited DAO activity to various degrees. Of these, 44 inhibited the enzyme from both species, 4 inhibited the canine enzyme only and 13 the human DAO only.

[Is the protective colostomy in left-sided resections of the colorectum necessary?].

In a prospective clinical study 100 left-side colon and anterior rectum resections were performed without a protective colostomy under standardized conditions: Whole gut lavage, oral and systemic antibiotic prophylaxis, parenteral highcaloric nutrition perioperatively, anastomosing technique end to end, single layer, with atraumatic sutures (3 X 0 Vicryl, Dexon) or EEA stapler. A clinically relevant insufficiency of the anastomosis was seen in 4%, wound-healing impairment in 7%, only one patient died. Due to careful preparation and operation technique the frequency of septic complications and mortality nowadays is very low.

Histamine content, diamine oxidase activity and histamine methyltransferase activity in human tissues: fact or fictions?

To understand the role of histamine in the aetiology and pathogenesis of human diseases reliable data are urgently needed for the histamine content and for the activities of histamine-forming and -inactivating enzymes in human tissues. In order to make a substantial progress toward this aim a tissue-sampling programme during surgical interventions was carefully conceived and conducted. From March 1982 until January 1983 106 tissue specimens were taken from 56 patients who underwent surgery.

Distribution and properties of human intestinal diamine oxidase and its relevance for the histamine catabolism.

High activities of diamine oxidase (EC 1.4.3.

[Antibiotic prophylaxis in colorectal surgery: is there a drug of choice?].

It is possible to reduce the rate of septic complications following colorectal operations by a prophylactic antibiotic regimen. After the evaluation of 67 controlled clinical trials a combination of antibiotics disintegrating aerobic and anaerobic bacteria was recognized as an effective antibiotic prophylaxis. Clinically proved combinations are neomycin/metronidazole and neomycin/bacitracin.

Intestinal diamine oxidase and histamine release in rabbit mesenteric ischemia.

It has been suggested that histamine contributes to lethal circulatory collapse after acute superior mesenteric artery occlusion. The activity of the histamine inactivating enzyme diamine oxidase, the release of the amine, and the effect of histamine receptor antagonists was therefore studied in rabbits. The main results were: (a) Diamine oxidase activity decreased by 60% after intestinal ischemia and reperfusion.

The start of a programme for measuring diamine oxidase activity in biopsy specimens of human renal mucosa.

In human subjects, apart from in the kidney, diamine oxidase occurs mainly in the gut. Therefore this enzyme can be used as an indicator of intestinal integrity. In biopsies of rectal mucosa the diamine oxidase activity was assayed in 55 patients, 41 having a histologically normal mucosa and 14 being diseased.

The influence of carcinoma growth on diamine oxidase activity in human gastrointestinal tract.

The distribution of diamine oxidase (DAO) activity was studied in patients having no carcinoma disease. Besides in gut DAO occurred in high activity only in kidney and mesenteric lymph nodes. In patients with adenocarcinoma of the large bowel or of the stomach the enzymic activity was reduced in the tumour tissue itself as compared with the adjacent mucosa in which part the highest activities were observed.

[Experimental occlusion of the superior mesenteric artery: further evidence of the influence of histamine and diamine oxidase in the development of shock (author's transl)].

In shock produced by temporary superior mesenteric artery occlusion the plasma histamine concentration was enhanced following release of the mesenteric blockade. Furthermore, an inhibition of the diamine oxidase catalysed histamine inactivation resulted in an aggravation of the shock development. These processes, already shown in dogs and mini pigs, were also observed in rabbits.

Comparison of alterations in the histamine-diamine oxidase system during acute intestinal ischaemia in pigs, dogs and rabbits; evidence for a uniform pathophysiological mechanism?

Among various vasoactive substances histamine was also suggested to induce circulatory arrest following superior mesenteric artery occlusion. Thus the involvement of the histamine-diamine oxidase system was studied in intestinal ischaemia using three animal species. In pigs, dogs and rabbits aminoguanidine, the specific inhibitor of diamine oxidase, shortened the survival time after mesenteric infarction.

Diamine oxidase activity in gastric and duodenal mucosa of man and other mammals with special reference to the pyloric junction.

In the gastric mucosa of human subjects and of various mammals methylation was accepted as the main pathway of histamine catabolism. However, augmentation of gastric acid secretion by aminoguanidine, the strong inhibitor of diamine oxidase, indicated an influence of diamine oxidase activity on this secretory process. Therefore a careful reinvestigation of the occurrence of diamine oxidase activity was started from the distal duodenum in the direction of the cardia.

Diamine oxidase activity and histamine release in dogs following acute mesenteric artery occlusion.

Following superior mesenteric artery occlusion and revascularization in dogs all animals died in a circulatory collapse state. However, pretreatment by aminoguanidine, the strong and specific inhibitor of diamine oxidase, accelerated the circulatory break-down significantly and increased the venous plasma histamine concentrattions up to levels which also in normal dogs are effective in the circulatory system. Furthermore, the haematocrit increased significantly more in the aminoguanidine-treated animals than in the dogs treated by saline.