[Laparoscopic findings in aged patients (author's transl)]

A group of 165 geriatric patients is compared with a control group of 114 younger patients concerning different frequency of laparoscopic diagnoses. As it was suspected from the clinical view aged patients predominently suffered from posthepatic cirrhosis and from cirrhosis of unknown origin, from recurrent cholecystitis, obstructive jaundice, metastases and carcinosis of peritoneal cavity. Younger patients much more frequently showed toxic liver damage starting from fatty liver and ending up with fatty liver cirrhosis. Persistent acute hepatitis non associated with HBSAg was scarcely seen with the aged group. It was a frequent diagnosis with the younger control group. There are explanations given for the differing endoscopic results concerning aged persons and younger control persons.

[Cholestatic jaundice after azathioprine treatment (author's transl)]

Severe cholestatic jaundice occurred in two patients receiving prednisolone and azathioprine, one for chronic progressive hepatitis, the other for Wegener's granulomatosis. Reversible abnormal liver function, involving both elimination and synthesis, was in the foreground clinically. Signs of parenchymal-cell damage were only moderately severe. When azathioprine had been discontinued all previously abnormal values returned to normal within six to eight weeks. Azathioprine is an indirect optional hepatotoxin. If given over long periods there should be regular controls of blood count and liver functions.

Liver disease in drug addicts: clinical course-toxicological and clinical pharmacological aspects

Drug addicts admitted to the hospital had acute hepatitis in 44%, chronic hepatitis in 34%, toxic liver injury in 16%. About 50% of the patients with acute hepatitis were HAA positive. Patients with intravenous drug abuse acquired acute hepatitis after a mean period of 1.8 years. Acute hepatitis in drug addicts shows a prolonged course in the majority of the cases. Biochemically increases in serum bilirubin and transaminase levels are less pronounced as compared to non-addicted persons. 30-35% of the patients develop chronic hepatitis. Speed abuse promotes the tendency to cholestasis in acute episodes of liver disease. A toxic effect of the drug preparations upon the liver cells is assumed. Chronic hepatitis in drug addicts mainly develops from earlier acute hepatitis with prolonged course. In our material, the percentage of chronic hepatitis at present is 47.5%. Besides toxic effects, also repeated infections have to be discussed with regard the etiology and pathogenesis of the disease.

Report on internal fixation of the femur

During a recent survey of all cases involving fractures of the femur treated over a four-year period at the Ipswich General Hospital, it was found that a total of 78 were given operative treatment and had some form of metal fixation. This article will deal with these particular cases and summarize the treatment, time involvement and eventual rehabilitation, with consideration given to those which did not follow the general pattern, because of other complications.