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Physiological approach to future developments in therapy.

First, the multifactorial background of primary hypertension is outlined in principle, where particular attention is given to the early, sometimes even genetically reinforced structural "upward resetting" of the cardiovascular system, which soon dominates hemodynamics in both human and rat hypertension. On this basis, it is then discussed which modes of action that antihypertensive treatment could best achieve regression of the structural changes in heart and vessels. Since both the luminal and wall changes can be affected in a different manner, and since the growth processes may be reinforced by both genetic and neurohormonal "trophic" influences, there are potentially many ways by which regression could be accomplished via specific interferences, apart from the blood pressure lowering per se. As to the "hemodynamic profile" of drug interferences, reasons are given for an approach where a systemic resistance vessel dilatation is combined with a mild damping of the beta-adrenergic sympathetic drive on the heart.

Antihypertensive Agents↗

[Surgical treatment of scirrhous carcinoma of the stomach].

In surgical treatment of scirrhous gastric carcinoma, the important points are as follows: Extensive resection of the stomach should be performed. Left epigastric evisceration and extensive dissection of lymph nodes including the para-aortic nodes should be done for sufficient extirpation of the tissues around the stomach. Adjuvant therapy is recommended for intensive chemotherapy immediately after surgery and for postoperative long-term maintenance therapy. Development of a combined therapy which takes into account the characteristics of scirrhous gastric cancer is hoped for in the future.

Adenocarcinoma, Scirrhous↗