This study was designed to compare the clinical efficacy of a single dose of ceftriaxone with cefoxitin given 3 times a day for 3 days. Methods: Patients had to have a penetrating injury to only one part of the body, reach the hospital within 2 h and be operated on within 16 h after the trauma. Patients were excluded if it appeared likely that they would require mechanical ventilation for more than 24 h. The same applies to open or grade II/III craniocerebral trauma. The end point was the occurrence of infections within 10 days. The costs of antibiotic treatment were also calculated. Results: 96% of the ceftriaxone patients (n = 97) and 95% of the cefoxitin group (n = 98) remained infection-free. In neither treatment group was deep infection, abscess, phlegmon or sepsis seen. No additional surgery or intensive care due to infection was required. At $41.83 vs. $172.16, the average total cost of delivering antibiotic treatment was significantly lower in the ceftriaxone group (p < 0.001). Conclusion: Prophylaxis in penetrating trauma with a single dose of ceftriaxone is safe and has considerable practical and economic advantages.

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Summary. Using optimal preservation and Calnffs technique, we have observed few bile duct complications after liver transplantation. In the initial phase, renal insufficiency was observed as a result of cyclosporin medication. In the first 10 days, we therefore use azathioprine. Infections and fungus infections were the main complications and causes of death. The hepatic graft is immunologically beneficial. We assume that the ischemicaily damaged donor liver liberates immunosuppressive factors that could stimulate the formation of suppressor cells. Both components are responsible for maintenance of graft function in the early phase and in humoral transferable factors later. Schliisselwiirter: Lebertransplantation -Immunologie-Cyclosporin. Der Bilirubinspiegel und seine Kinetik beim extrahepatischen Verschluflikterus H. R6dingChirurgische Klinik, Bezirkskrankenhaus Potsdam, Wilhelm-Pieck-StraBe 72, DDR-1500 Potsdam The Bilirubin Level and Its Kinetics in Obstructive JaundiceSummary. In 40 of 284 patients the preoperative elevation and in 180 of 284 patients the postoperative normalization of the bilirubin level in obstructive jaundice were followed up. The preoperative elevation can be described by a logistic function and the postoperative slope by exponential functions, with a mean halflife of 7.5 + 3.7 days for the 3rd to 20th postoperative day. The methods of operations and causes have no influence, as the variance is mostly explained by the preoperative level of plasma albumin. Sehliisselwrrter: Verschlul3ikterus -Bilirubinspiegel -Kinetik. Key words:

Mass disasters are exceptional situations, requiring exceptional efforts of medical services and institutions, to overcome the problems and consequences of those affected. According to a commonly accepted definition, a disproportion between objectively required and actually possible aid is the main distinguishing mark. In such a situation, the target function of health systems must change as much as possible to help save injured persons lives and to avoid severe consequences, because simultaneous aid for all is temporarily impossible.

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