Eighty patients undergoing total gastrectomy for malignant disease were entered into a prospective randomized study, comparing anastomoses constructed mechanically (staples) with hand-sewn (single layer Maxon) anastomoses. The groups were matched with respect to clinical features, medical risk factors and were staged for tumour. Only one anastomotic leak was observed after operation and this was in the group of stapled anastomoses. One patient died in each group (owing to cardiac infarction and multiorgan failure). Operating time, morbidity and hospital stay showed no significant differences between groups. These results indicate that hand-sewn and mechanically stapled oesophagojejunostomy anastomoses allow the same high standard of performance.

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To reduce the risk of severe infections in splenectomized patients, new methods for splenic preservation or heterotopic autologous spleen implantation have been established. In the latter case, the immunological and functional benefits are still under discussion. In this study we compared immunological parameters in 16 splenectomized patients with and without heterotopic autologous spleen implantation with a nonsplenectomized control group. The total lymphocyte counts--T-cells, CD4+ -, as well as CD8+ - lymphocytes, CD16+ - and B-cells--were highly elevated in both groups, whereby the B-cells were relatively and absolutely higher in the implanted group than in the nonimplanted group. Splenectomized patients had a significantly reduced serum IgM level. The serum IgM of patients with splenic autotransplantation was not significantly lower than that of the controls. In contrast to the impaired in vitro immunoglobulin synthesis in the splenectomized group, the autotransplanted patients showed a normal PWM-induced IgG and IgM synthesis and an increased IgA production compared with the controls. The latter results support the findings of elevated serum IgA levels in this group. The mitogenic-induced proliferation with PHA, ConA, PWM, and OKT3 was not clearly different within the tested groups. The results may indicate a benefit of autologous spleen implantation in regard to the humoral immune response.

Background and question: Malignant cells characteristically possess high levels of proteases (e.g. plasminogen activator, cathepsin etc.), which should induce fibrinolysis. The DR-70™ immunoassay quantifies the amount of fibrin degradation products (FDP) in the body. This test system has successfully been used for the detection of a number of cancers including lung, stomach, breast, rectum, liver, colon and uterus cancer. In this paper we tested the diagnostic validity of DR-70™ relative to CA-125 as a tumor marker for the detection of ovarian carcinoma. Methods: We have simultaneously investigated the serum activities of DR-70™ and CA-125 from 61 preoperative patients with histologically confirmed ovarian carcinoma. One hundred healthy blood donors served as control group. We measured the FDP utilizing the DR-70™ ELISA as per test instructions of its manufacturer AMDL (Tustin, CA, USA). Results: Low levels of FDP measured by DR-70™ have been detected in the serum of 100 apparently healthy persons (mean ± S. D., 0.41 ± 0.19 μg/ml). Among the 61 ovarian carcinoma patients, DR-70™ mean value (± S. D.) was 7.0 ± 10.5 μg/ml in a range of 0.6 to 58.5 μg/ml. The cutoff level for DR-70 ® was set at > 1.2 μg/ml. The specificity was 100%, whereas the sensitivity was at 83.6 %. Relative to CA-125 a cutoff level of > 65 U/ml was applied. The comparable sensitivity of DR-70™ was higher by 13.1 %. Conclusions: Malignant cells with Zusammenfassung Fragestellung: Tumorzellen weisen häufig einen hohen Gehalt an Proteasen auf, die entscheidend an der Fibrinolyse beteiligt sind. Der DR-70™-Immunoassay misst mit hoher Spezifität Degradationsprodukte des Fibrins. Dieser Test ist, wenn auch an kleinen Fallzahlen, erfolgreich eingesetzt worden als Tumormarker zur Erfassung einer Reihe von Tumorentitäten. In der vorliegenden Arbeit wird dieser Test beim Ovarialkarzinom mit CA-125, dem "Goldstandard" beim Ovarialkarzinom, verglichen. Methoden: Im Serum von 61 Patientinnen mit histologisch gesichertem Ovarialkarzinom, aber auch im Serum von 135 Patientinnen mit entzündlichen Erkrankungen bzw. anderen Malignomen bzw. benignen Tumorerkrankungen wurde die Aktivität von DR-70™ im Serum gemessen. Als Kontrollgruppe dienten 100 Blutspenderinnen, die als tumorfreie, gesunde Frauen eingestuft wurden. Der DR-70™ ist ein ELISA, der nach den Vorgaben des Herstellers (AMDL, Tustin, CA, USA) eingesetzt wurde. Ergebnisse: Als Mittelwert ± S. D. in der Kontrollgruppe wurde 0,41 ± 0,1 μg/ml für DR-70™ ermittelt. Im Vergleich dazu lag der Mittelwert der Serumproben von 61 Patientinnen mit Ovarialkarzinom bei 7,0 ± 10,5 μg/ml, bei einer Schwankungsbreite von 0,6 bis 58,5 μg/ml. Wird der Cutoff -Wert für DR-70™ auf > 1,2 μg/ml festgelegt, beträgt die Sensitivität des Testes 83,6%, und der Wert für die Spezifität liegt bei 100%. Verglichen mit

652Wissenschaftliche Ausstellung position of incision ventral to the upper thigh and the exact placement of the trephine at the medial cortex of femur. The nail harmonizes with the architecture of the femoral neck. Results after 1-16 years in 130 survivors were good in 121, fair in 6, and poor in 3 cases. We have operated on a total of 600 cases.