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The influence of native collagen-solutions on the cell cycle of human-fibroblasts was investigated. The results point out that the phase of cell-specific function is distinctly lengthened to the debit of a reduced rate of mitosis. That seems to be desirable, because the cells of the implantation-layer would produce more rapidly and augmentedly their cell-specific product--usually collagen--and incorporation of the implanted material would occur quite earlier. This effect seems also to be responsible for the promotion of granulation of "Dermodress", a fleece of collagen I for temporary covering of debrided areas (5).

We evaluated the free-plasma amino acid patterns of 156 patients with various gastrointestinal carcinomas at different tumor stages. As a control group, the plasma amino acid pattern of 73 healthy volunteers at different ages was determined. From out results we were able to compute a linear model of seven amino acids using computer-based stepwise discriminant analysis. This formula in the form of a Tumor-Index can be used as a prognostic indicator for the presence or absence of a gastrointestinal carcinoma.

In order to compare different groups of intensive-care patients and therapeutic interventions a measuring system is needed reflecting the patient's pathophysiologic status with great accuracy. The APACHE-system designed by Knaus et al. (APS) meets the requirements when comparing groups of patients. This prospective study was undertaken to determine whether APS is useful to forecast survival and death of 764 individual patients of a surgical ICU. The results were compared to daily statements obtained from the head surgeon of the intensive-care department. Both the physician and APS gave true judgements in 95% of the cases. Overestimation of the operative procedures by the physician was revealed to be a major source of error in wrong statements. When a combination of APS and physician's judgement was used the forecasts were found true in 99% of the patients. The authors conclude that APS by itself is not able to give a sufficient prognosis in an individual ICU patient but is an excellent tool to assure or modify the physician's opinion.

The outcome of esophageal perforation is determined by the cause and localisation, but mainly by the time lapse between trauma and therapy. Spontaneous and intraoperative ruptures are most dangerous. Treatment of choice is direct closure and drainage. If this is not possible, esophagectomy or exclusion and diversion in continuity should be considered. The injury may present itself with rather unspecific symptoms. Pathological findings in the plain chest roentgenogram and gastrographin study will confirm diagnosis in nearly all cases.