Overfeeding-induced obesity in spontaneously hypertensive rats: an animal model of the human metabolic syndrome.

Background/aims: The metabolic syndrome (MS) has become an epidemiological problem in Western countries. We developed a diet-induced obese rat model that mimics all the symptoms of MS in humans, but whose insulin resistance, hyperphagia and hyperleptinemia are caused by nutrition rather than genetic modifications.

Methods: Spontaneously hypertensive rats (SHR) were allowed for 12 weeks to choose between a cafeteria diet (CD, 20.

[Therapy and course of disease in spontaneous esophageal perforations].

Introduction: Esophageal perforations occur spontaneously or as a complication of endoscopic procedures. Especially in spontaneous perforation there is ongoing debate regarding the best treatment options.

Methods: 24 patients that were treated at two surgical centers (University Halle, City-hospital Bielefeld) after spontaneous esophageal perforations between 1996 and 2005 were analysed retrospectively.

[Barium sulfate and water-soluble contrast medium--a suitable mixture for contrast radiography in acute small bowel obstruction].

Experiences with a mixture of two different contrast media for radiography in acute small bowel obstruction are reported. Due to different physical and chemical properties, barium sulfate and a water-soluble, high-osmolar contrast medium provided high contrast density in all segments of the small bowel and a shortening of the transit time to the colon. This method proved to be effective and accurate in predicting which patients with suspected small bowel obstruction required surgical intervention.

[Recurrent laryngeal nerve paralysis after thyroid gland operations. Etiology and consequences].

In the period of 1 January 1990 to 31 December 1996 the thyroidectomy cases we performed were immediately followed by vocal cord evaluation using a flexible bronchoscope while the patient was still on the operating table. If an obvious cord paralysis was discovered, an exploration of the recurrent laryngeal nerve, to the level of the larynx, was performed. If the nerve was found to be intact, no further measures were taken.

[Incidence of carcinoma in follicular neoplasia of the thyroid gland].

Within four years 1376 thyroid operations were performed. In 152 = 11% a follicular or oncocytic tumor was found, 20 = 13% of these were classified as carcinoma. Seven of these were of the grossly invading type, raising suspicion of malignancy already pre- and intraoperatively while 13 encapsulated tumors were found by the pathologist only.

[Possibilities and limits of reconstructive surgery of the recurrent laryngeal nerve].

The authors report on possibilities and borderlines of reconstructive microsurgery of the recurrent laryngeal nerve. When paralysis of the vocal cord is proved after thyreoidectomy exploration and control of the nerve should be done immediately. This must be done as fast as possible, latest at the 7th day after thyreoidectomy.

Endoscopic placement of a prosthesis for benign anastomotic stenosis after oesophagectomy and colonic interposition.

After oesophagectomy for oesophageal carcinoma and retrosternal colonic interposition, a benign stenosis developed at the collar anastomosis. Bouginage was unsuccessful. Therefore, a prothesis was placed endoscopically, which enabled the patient to swallow without problems until his death as a result of diffuse metastasis 9 months later.

[Mediastinal lymphadenectomy in bronchus carcinoma--techniques and problems].

Mediastinal lymph node dissection in bronchial carcinoma patients means an additional procedure to the tumor resection. The en-bloc dissection is only possible if an upper lobe resection or a pneumonectomy is performed; otherwise, an isolated lymph node mapping is necessary. According to the different anatomical structures, mediastinal lymph node dissection is more easily performed on the right than on the left side, where mobilisation of the aortic arch or a longitudinal sternotomy is mandatory to sample the pre- and paratracheal lymph nodes.

The importance of surgery as the first step in multimodality treatment of small cell bronchial carcinoma. The ISC Lung Cancer Study Group.

For patients with small cell lung cancer (SCLC) in their early stages (TNM I, II), surgery for cure was used to eliminate the primary tumour and its regional lymph-nodes followed by intermittent chemotherapy and radiotherapy within the first six postoperative months. After the pathohistological examination of the operation-specimen a two-arm-randomization was performed: standard chemotherapy (1000 mg/m2 cyclophosphamide, 50 mg/m2 doxorubicin, 1.4 mg/m2 vincristine) compared with sequential chemotherapy using three different drug-combinations (A: 1500 mg/m2 cyclophosphamide, 100 mg/m2 lomustine, 15 mg/m2 methotrexate; B: 1000 mg/m2 cyclophosphamide, 40 mg/m2 doxorubicin, 1 mg/m2 vincristine; C: 5 x 1.

Efficacy and benefit of mediastinal computed tomography as a selection method for mediastinoscopy.

In 95 consecutive patients with proven or suspected bronchial carcinoma, computed tomographic evaluation of the upper mediastinum for N2 disease was performed prospectively. Patients with positive results underwent mediastinoscopy. Patients with perinodal N2 or N3 disease at mediastinoscopy were not considered candidates for operation.

The role of ifosfamide and cyclophosphamide in the multi-modality treatment after surgery for cure for small-cell bronchial carcinomas (SCLC).

For the optimisation of the therapy for small cell bronchial carcinomas (SCLC), surgery is used to eliminate the primary tumor and its regional lymph nodes and chemo- and radiotherapy for the general treatment of micrometastasis. After patho-histological examination of the operation specimen, randomization for two arms is performed for a standard chemotherapy (CAV) or a sequential chemotherapy using three different drug combinations. Thereafter all disease-free patients receive prophylactic cranial irradiation (PCI).

Surgery for cure followed by combined modality treatment for small cell bronchial carcinoma. ISC Lung Cancer Study Group.

For patients with small cell lung cancer (SCLC) at early stages (TNM I, II) surgery for cure is used to eliminate the primary tumour and its regional lymph-nodes followed by intermittent chemotherapy and radiotherapy within the first six postoperative months. After the pathohistological examination of the operation-specimen a two-arm-randomization is performed: standard chemotherapy compared with sequential chemotherapy using three different drug-combinations. Thereafter tumour-free patients only receive prophylactic cranial irradiation.

[Oxygen supply of the human small intestine in mechanical ileus].

In 16 patients operated on for mechanically caused ileus and in 12 control patients (cholecystectomy) local PO2 of the small bower wall was determined by means of a multiwire Pt surface electrode constructed by Kessler and Lübbers. The ileus patients showed an increased pulse rate of 110 (90-115) vs 90 (80-110) beats/min and creatinine levels of 1.06 (0.

[Etiology and therapy of spontaneous pneumothorax. Discussion of conservative or surgical procedure based on personal results].

The treatment of spontaneous pneumothorax is discussed on the basis of the experience we have gained in 78 patients. Therapy is determined by the pathophysiology and aetiology of the condition. The treatment and follow-up results are compared with those reported in the literature, and the rationale of our own procedure is explained.

Evaluation of tomography and mediastinoscopy for the detection of mediastinal lymph node metastases.

In a prospective study of 88 patients seen consecutively with proven or suspected bronchial carcinoma, the validity of x-ray tomography and routine mediastinoscopy was tested for the detection and evaluation of mediastinal lymph node metastases. Positive mediastinum was defined as malignant tissue found in the mediastinum and negative mediastinum as mediastinoscopy with negative results plus a negative intraoperative mediastinal lymph node dissection. Thirty-four patients were eliminated from the analysis because carcinoma was not found or because mediastinal evaluation was incomplete by these criteria.

Surgically treated bronchial carcinoma patients--results of systematic follow-up.

A systematic follow-up was carried out on 63 patients treated surgically for bronchial carcinoma. Thirty-four patients died within 2 years after the operation. No evident benefit was noted when comparing their preoperative and postoperative physical status.

[Rhabdomyosarcoma of the pulmonary artery (author's transl)].

A case of a 55-year-old man with the histological diagnosis rhabdomyosarcoma of the left pulmonary artery has been seen. Lung scanning and pulmonary arteriography are the clues for the diagnostical procedure. 55 cases from the literature are reviewed and clinical findings of the early and late stages of the diseases are discussed.

[Validity of retro- and prospective data analysis (authors' translation)].

Retrospective chart analysis of 88 operated patients with bronchial carcinoma showed grave deficiencies. In 15% the reason for admission to hospital was not available and the exact smoking habits of 74% were not known. Retrospective TNM-classification was possible in only 59%.