The efficacy of betanecholchloride in the postoperative treatment of bladder dysfunction is controversial. We therefore performed a comparative study on the effect of this therapy for the prophylaxis of detrusor hypotonia after Wertheim-Meigs operation. Forty patients with cervical cancer FIGO stage Ib/IIa were divided into two study groups. The control group (24 patients) only received betanecholchloride if the residual urine persisted above 50 ml after the 10th postoperative day. The study group (16 patients) received 50 mg betanecholchloride three times a day from the 3rd postoperative day onward. In this group postoperative catheter treatment, and consequently hospital stay, were significantly shorter (9.6 versus 13.3 days and 15.5 versus 18.6 days). The residual urinary volume normalized faster (8.0 versus 13.0 days) and the rate of cystitis was lower (18.8 versus 25%). According to our study, a prophylactic application of the parasympathomimetic drug betanecholchloride diminishes postoperative complications associated with bladder dysfunction after Wertheim-Meigs operation.

As holoprosencephaly without chromosome defect may be associated with other CNS-related anomalies such as mental retardation, mental illness, facial paralysis, endocrine disorders, deafness, spina bifida, and myelomeningocele, we present a family in which one girl had a myelomeningocele, a brother had orbital hypotelorism, facial and cerebral asymmetries, cerebral palsy, abducens paralysis, and inner ear deafness. A 3rd pregnancy was terminated at 16 weeks; the fetus had cyclopia. A common cause is discussed in these cases and in those families in which holoprosencephaly and additional malformations occur among different generations.

Bei 84 Mammakarzinompatientinnen wurde präoperativ die zelluläre Immunität untersucht. 47 Patientinnen waren frei von regionären und Fernmetastasen, 37 Patientinnen hatten bereits axilläre Lymphkno-ten- aber noch keine Fernmetastasen. Als Kontrollkollektiv dienten 32 klinisch gesunde Frauen. In bezug auf die Leukozytenzahl und den prozentualen T-Zell-Anteil an der Gesamtlymphozytenpopulation ergaben sich zwischen gesunden Frauen und den Mammakarzinompatientinnen keine Unterschiede. Die Karzinompatientinnen wiesen jedoch gegenüber dem Kontrollkollektiv eine signifikant erhöhte Lymphozytenzahl auf. Trotz quantitativer Zunahme der Lymphozyten konnte bei den Mammakarzinompatientinnen eine signifikant ernied-rigte Concanavalin-A-Stimulationsfähigkeit nachgewiesen werden. Bei den Mammakarzinompatientinnen mit regionären Lymphknoten-metastasen war auch die Stimulationsfähigkeit durch Phytohämagglutinin erniedrigt.

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