[Frequency, diagnosis and dependance of duodenitis upon the morphological status of the gastric mucosa (author's transl)]. In a attempt to prove the dependence of duodenitis upon the morphological status of the gastric mucosa, a biopsy of the corpus, antrum, and duodenal canal had been made of 354 patients. In 56 cases, a superficial duodenitis was histologically verified; however, this infection had not contaminated the Brunner' glands. A duodenitis was found to be more often associated with surface gastritis of the corpus and antrum than it was with atropic gastritis. A duodenitis was discovered by a biopsy in 16 patients possessing a normal antrum mucosa and in 25 patients having a normal corpus mucosa, thus proving the possibility of isolated duodenitis.


[Liver diseases with microsomal antibodies. Frequency, clinical and immunological findings and course observations (author's transl)]. Microsomal antibodies (LKM-antibodies) differ in the indirect immunfluorescence by use of rat organ sections (kidney, stomach, and liver) from mitochondrial antibodies by there reaction with proximal renal tubules and hepatocytes while parietal cells usually fail to stain. In contrast to other humoral autoantibodies LKM-antibodies are rare. In a prospective study on 930 adults and 33 children with two third chronic hepatitis resp. cirrhosis frequency in the first group amounts to 0.38% and in the latter to 6.9% of all liver diseases. Among six patients with LKW-antibodies and chronic active hepatitis there were three children aged 4-13 and three adults between 45-55 years. On common results two children showed beside LKM-antibodies by absence of other immunphenomenons a rise of gamma-globulins in the electrophoresis and immunglobulin G as well as a chronic active hepatitis with necrosis leading in spite of initial rapid progression and persistent antibodies into inactive postnecrotiv cirrhosis. The other four patients showed no common course in respect to clinical, histological and immunological findings.


Inclined or conventional supine position in ultrasonic examinations in late pregnancy. Ultrasonic examinations were made on 22 patients in late pregnancy both in the conventional supine position and in an inclined position. The findings give rise to the following conclusions: 1) The inclined position prevents the development of the vena cava inferior syndrome. 2) The examinations can be made as easily and accurately in the inclined as in the conventional supine position. 3) In cases where the head is in the occipito-posterior position the inclined position may increase the reliability of the measurement of the biparietal diamter. The authors consider it recommendable to use the inclined position instead of the conventional supine position in ultrasonic examinations to maintain both maternal and fetal well-being during the procedure.


[Delivery and post partum period associated with surgical closure of the cervix (author's transl)]. The course of delivery and the post partum period of 211 gravidae with closure of the cervix during pregnancy were compared with a compatible collective of another 221 gravidae without surgical closure. There were significant differences in some respects: The duration of labor (primiparae: 9,2 hours, multiparae: 6,7 hours) was longer than in the control-group (primiparae: 8,1 hours, multiparae: 5,0 hours); the necessity of administration of drugs and the frequency of dystocia (primiparae: 13%, multiparae: 9,2%) was higher than in the control-group (primiparae: 1,0%, multiparae: 0%). These and the higher incidence of lacerations of the cervix (13,4% respectively 1,7%) will be due to the scar, caused by the suture in the cervix. The rate of caesarean section was significantly higher (9,5% respectively 4,1%). There were more complications in disconnecting of the placenta. These and the higher rate of dystrophic newborn could be correlated with anamnestic dispositions of the gravidae. The higher rate of perinatal mortality (9,9%) than in the controlgroup (3,6%) is associated with the higher rate of prematurity (22,1%) than in the control-group (8,5%). A higher incidence of malformation was not observed, but a higher rate of neurological complications in the newborn. The post partum period of the mother was not significantly different than those of the control-group


[Maternal hemoglobin AIc (HbAIc) and diabetic pregnancy (author's transl)]. Third trimester HbAIc was determined in 57 pregnant women according to the TBA-reaction, first discribed by Flückiger and Winterhalter (1976). Simultaneously oral glucose tolerance tests (GTT) were performed in 52 patients; in 5 insulin dependent diabetic women dayly blood sugar profiles 2 to 5 times per week were done throughout the third trimester. HbAIc, when expressed as per cent of total hemoglobin, was 6.14 +/- 0.56% (m +/- SD) in women with normal GTT (n = 40) and found to be significantly (p less than 0,001) elevated in 7 women with abnormal GTT (7.54 +/- 0.61%; m +/- SD) and in the 5 women with insulin dependent diabetes (7.59 +/- 0.92%; m +/- SD). In patients with abnormal and boarderline GTT a linear relation between HbAIc and mean blood sugar, as determined from individually summarized 60 and 120 minutes GTT values, was observed. Insulin dependent diabetic women with higher mean blood sugar (as calculated from the total profile values throughout 4 weeks prior to HbAIc determination) showed a tendency towards higher HbAIc values.


[Amniotic fluid tests for fetal lung maturity (author's transl)]. Amniotic fluid specimens of 30 pregnant women were examined for the evaluation of the fetal lung maturity. Three assays were used in parallel: the determination of the lecithin concentration, the estimation of the lecithin/sphingomyelin ratio and the shake test. The results were compared together and with the fetal outcome. The shake test has proved to be sufficient for the exclusion of an immature lung. To avoid failure from false-negative results of the shake test an additional determination of the lecithin/sphingomyelin ratio is recommended, whenever clinical dates give rise to expect a mature lung. The determination of the lecithin concentration has no advantage compared to the lecithin/sphingomyelin ratio. Pathology as candida infection or anecephaly falsifies.


[The evaluation of cortisol in amniotic fluid and in maternal blood as parameter for foetal lung maturity (author's transl)]. The lecithin/sphingomyelin-ratio (L/S-ratio) in amniotic fluid has become established in recent years as a valuable laboratory parameter for determining foetal lung maturity and has thus helped to avoid the neonatal respiratory distress syndrome. Since glucocorticosteroids are a decisive factor in stimulating foetal lung development, we were prompted to investigate whether the determination of cortisol in amniotic fluid or maternal blood could also serve as an indicator of foetal lung maturity. The cortisol concentration was measured by radioimmunoassay in amniotic fluid (n = 91) and in maternal venous plasma (n = 70) from normal and complicated pregnancies and was compared with the L/S-ratio. A significant correlation between gestational age and cortisol in amniotic fluid (r = 0.711) and in maternal venous plasma (r = 0.625) was observed. There was also a significant correlation between the L/S-ratio and amniotic fluid cortisol (r = 0.701). However, compared to the L/S-ratio, measurements of cortisol yielded 10% false positive and 11% false negative results. A significant correlation between the L/S-ratio and the maternal plasma cortisol could also be demonstrated (r = 0.631). Here the comparison with the L/S-ratio gave even poorer results: 16% false positive and 6% false negative. The high percentage of false results, especially false positive results yielded by cortisol estimations in both fluids leads to the conclusion that the L/S-ratio remains the superior diagnostic parameter in determining foetal lung maturity.


[Treatment of house dust allergies with tyrosine-adsorbed house-dust-mite vaccine]. Desensitization treatment of house dust allergies with L-Tyrosine adsorbed house dust mite vaccine is described. It is stressed that the success of the treatment depends on an exact diagnosis and sufficiently long treatment period.


[Clinical variations of keratoacanthomas]. Clinical variants of Keratoacanthomas are, besides the very frequent crateriform types, and the plate-shaped ones, Keratoacanthoma marginatum centrifugum, aggregated Keratoacanthomas, successive multiple Keratoacanthomas, and rare special forms like multiple eruptive Keratoakanthomas and Keratoacanthomas combined with Hyperplasia of sebaceous glands and epitheliomas. A detailed description of the different types is derived from their growth and their origin from supraseboglandular epithelium of hair follicles.


[Illness concept responsible for illness]. With a certain heuristic exaggeration, the author dares to demand from psychologists a biographic phenomenological diagnosis without prejudicial influence by the medical diagnosis. Needless to say, the psychologist has to deal with " sick" people quite often. His task as a diagnostician however is not to find a category which would discriminate the patient but to describe him in his biographic and social perspective. The psychological diagnostician should not forget that psychic illnesses imply isolation and that medical diagnosis in this case makes isolation even more apparent. In any case, the psychologist and especially the psychoanalyst must be self-critical and avoid prejudice in diagnostics.


[Boundaries of medicine: throughts on the role of the orienting behavior in the therapist-patient relationship]. The author shows that from the organismic of point of view the question for the limitations of the medical discipline has to be transformed into a question for the limitations of the doctor himself. The concept of organismic self-reference is put into relation to the contents of narcissitic logic. In this context the symptomatology of depression is elaborated upon in a paradigmatic way. Using a model of a systemtheoretical communication theory (orienting-behavior) the basic hypothesis of this article is discussed.


[Introduction to a structural psychopathology]. Structural psychopathology maintains that the psychiatrist finds himself in a situation similar to that of the literary critic. The objects of their critical analysis are marked by a high degree of linguistic complexity, reflecting social as well as personal interrelationships. The structural method which developed in the course of this century is thus applicable to psychopathological relationships, if careful attention is paid to their unigueness. The structural method is illustrated by a schizopasic text. Those typical stylistic and rhetorical structures which lead to the impression of schizophasia are isolated. The structural method can also be used to examine the pathogenesis of an illness or to extrapolate information from medical histories. Finally, through the analysis of the book "Mary Barnes, two accounts of a journey through madness" it can be shown how the structural method can illuminate critical problems of a literary science which are disguised as psychiatric ones.


[Feeblemindedness and its treatment].

[Feeblemindedness and its treatment]. The problem of feeblemindedness has been approached from a social point of view. Newer researches in socialisation have increasingly pointed out mental retardation not to be only a matter of hereditary factors, but largely determined by social environment. If it is true that one is born a retardate, it is true in a social sense. Not so much determined by genetic deficiency, but due to social environment efficient so early as in utero the retardate is born with the stigma of a "Paria". Possibilities of improvement are discussed, more attention should be given to largely unemployed areas of personal development and interpersonal communication.


[Spatial orientation with regard to short-term memory, age and cerebral dominace]. Though orientation in acoustic space frequently has been the subject of investigations, sound was offered as a rule only in one or two dimensions of the subjective polar system of coordinates. In an earlier paper a test-situation was presented in which the offering of sound is varied in all three dimensions (horizontal and vertical angle as well as distance); the mistake also is calculated in these three dimensions separately. In this paper the investigations are continued by examinating the influence of age, the cerebral dominance and the short-term memory (offering of two different noises with following indication). Our results show that 1) age has no significant influence; 2) the relation of mistakes of the right and the left side is significantly more inhomogen in all three dimensions in left-handed persons; 3) the influence of the memory does not enlarge the mistake significantly.


[Hemodynamic effects of aldosterone antagonists in patients with mitral stenosis (author's transl)]. In 12 patients with mitral stenosis of a severity that surgery was required, some hemodynamic parameters after intravenous injection of 400 mg Kaliumcanrenoat were studied. The hemodynamic changes were noted after 15 min and reached maximal values after 60 min. The increased values of pulmonary wedge, pulmonary artery and right atrial pressures were significantly reduced and the cardiac index and stroke volume index augmented, with unchanged systemic arterial pressure. Thus, a remarkable relief from pulmonary congestion followed, accompanied by an increase of the left-ventricular working index.--These results encourage the use of aldosterone antagonists in certain cases suffering from severe mitral stenosis.


[Hemodynamic effects of intracardiac diatritoic acid and their dependance on left ventricular function and severity of coronary sclerosis (author's transl)]. In 16 patients with coronary heart disease (n = 13) and cardiomyopathy (n = 3) heart rate, left ventricular pressure and contractility (max dp/dt, min dp/dt and Vpm) were measured prior during and after three consecutive left ventricular angiograms. Heart rate decreased during angiography and increased slightly but significantly after angiography. Systolic and diastolic left ventricular pressure, max dp/dt and min dp/dt increased after angiography, whereas Vpm remained unchanged. Any hemodynamic changes occuring were moderate and only of short duration. No significant differences were found a) between patients with angiographically proven normal and reduced left ventricular function, b) between patients with normal or increased left ventricular filling pressure or c) between those with slight or severe coronary heart disease. The investigations point to a good tolerance for the sodium methyl glucamine salt of diatrizoic acid (Urografin 76) even in patients with progressed coronary heart disease. Severe side-effects described in animal experiments indicate a poor comparibility between animal models and human studies. Moreover animal experiments are mostly done with high doses not used clinically.


[Coronary artery reserve in patients with hyperlipoproteinemias (author's transl)]. The coronary reserve was measured in 119 patients with different types of primary hyperlipoproteinemia. Cardiovascular diseased with clinical manifestation were excluded. 90 patients of same age with normal serum lipids served as controls. The groups did not differ in other risk factors as blood pressure or overweight (the latter excluded in hyperlipoproteinemia type IV). The controls showed decreased coronary reserve in 8%, type IIa patients in 36%, IIb patients in 18% and type IV patients in 23%. The frequency of restriction in coronary flow increased with age: in hyperlipoproteinemic patients of 50 years and more it was found in nearly 40%. Further interesting results were the significantly higher systolic and diastolic blood pressures reached during exercise in our hyperlipoproteinemic patients.


[Significance of pulmonary artery diastolic pressure after myocardial infarction for physical training (author's transl)]. Functional disorders of the left ventricle after myocardial infarction at rest and with exercise can be evaluated with right heart floating catheter by measuring pulmonary artery diastolic pressure. 45% of 200 patients with myocardial infarctions did not tolerate bicycle exercise test with a work load of 50 Watt during 6 minutes. A routine digitalisation of these patients without strict indication did not improve the results. The upper borderline to admit a physical training program is a pulmonary artery diastolic pressure of 20 mm Hg; this should be realised otherwise additional complications have to be expected in long term follow up. The effects of digitalis should be controlled with floating catheter observations in these patients too. There are some indications, that it is possible with the same technique to evaluate hemodynamic responses on psychological strain. Measurements of pulmonary artery diastolic pressure after myocardial infarction open a wide field for individual therapy from drugs to physical training and even to behaviour therapy for stressfull situations.


[Echocardiographic detection of a left ventricular tumor after myocardial infarction (author's transl)]. A mobile left-ventricular tumor was detected by echocardiography in a 28-years-old patient, who has sustained an anteroseptal infarction four years before. The patient was admitted to hospital because of arterial embolism. The echocardiographic finding was validated by left-ventricular angiography. In open-heart surgery a pedunculated tumor was excided, in microscopic study the tumor revealed the findings of an organized thrombus. The echocardiographic and angiographic findings are shown, the echocardiographic differential diagnosis is pointed out.


[Congenital partial defect of the pericardium with herniation of the left atrial appendage (author's transl)]. Congenital partial pericardial defect with herniation of the left atrial appendage presents a rare anomaly. Clinical appearance of a 25-year-old man with this anomaly combined with adherance to the left lung hilus and the pericardial sac is described. He suffered from cardiac arrhythmias and dyspnea during exertion. The chest X-ray film at unremarkable physical examination and routine laboratory data within normal limits showed a prominent shadow of the left cardiac border, the cineangiocardiographic findings revealed that the prominence was due to a large left atrial appendage. Since strangulation of the left atrial appendage is a well-known and described potential hazard, thoracic surgery was performed without any complication.


[Investigations on tribology and strength of aluminium-oxide-ceramic--hip endoprostheses (author's transl)]. The nature of friction and wear of ceramic material and ceramic hip endoprostheses by different manufacturers has been investigated by means of model test equipment and gait-simulators. Thus the aptitude of ceramics to be frictional partners for artificial joints can be attested, the results give the hope of a long usability. Anyway there is the demand to the manufacturers to give a garantee for the breaking strength of the cone--plug-in-connexion and a highest productional quality of the sliding faces. The long-term testings are carried on.


[The new rotatory hip-joint endoprosthesis according to the unit construction system after Weber. Experience and results of follow-up checks after five years (author's transl)]. The new rotatory hip-joint total prosthesis after Weber with rotating metal head and polyethylene socket has yielded a very high percentage of good results to date, according to experience collected in the course of five years and a comprehensive followup study. It was possible to prove that the metallic rotatory joint does not entail any disadvantages, and that it is extremely resistant to wear. The almost complete absence of shaft fractures is remarkable (two cases after 2,500 operations) as well as the low incidence of loosening after primary operation. Complications occur much more frequently following exchange operations. The unit construction principle on which this type of prosthesis is based, offers great advantages in respect of surgical technique. It appears that the rotatory prosthesis is superior to other concepts with regard to wear and to stability of fixation.


[Standardization of implant materials shown by "bone cement". Comparative investigations in consideration of antibiotic admixtures (author's transl)]. Test methods for acrylic based bone-cements proposed by a draft international standard are approved by investigation of different bone cements. The cements showed different qualities and different mechanical properties. Added antibiotics slow down the polymerisation, possible influences to mechanical properties are covered by handlingcaused deviations. Pressure test and impact test are leading to different strength statements.


[Surgical treatment of the congenital femural defect by means of rotation plasty (author's transl)]. Experiences made in 5 cases with Borggreve's rotation plasty have shown that in cases of congenital femural defects and exceptionally also in malignant bone tumors of the distal femur this method should be suggested to the patient as a possible therapy. By rotating and shortening of the leg, the ankle joint is converted to a new knee joint. With this method an active movement of the knee joint can be obtained, so that the fitting with a below knee prosthesis becomes possible.


[Investigations concerning the extension of the cartilage surface of the femoral head (author's transl)]. The extension of the cartilage surface of 30 human femoral heads was measured from the center of the fovea capitis. In ventrolateral direction of the fovea the largest extension of cartilage was observed, in the medical direction the lowest extension. The different arrangement of the cartilage distribution pattern on the medial head area resulted in three types: whereas type A had a continuous cartilage margin, type B showed an inlet in the direction of the fovea capitis, which, in type C, extended right up to the fovea as an area free of cartilage. The findings are considered under functional aspects and are related to the stress of the hip joint. A calculation of the cartilage area proved that the morphological geometric conditions for an enarthrosis are not fulfilled in all cases. These calculations were performed assuming both a spherical and a small ellipsoidal curvature of the head surface.


[Progressive slipping in severe spondylolisthesis-long-term observation (author's transl)]. In total consolidated dorsal fusion it is possible that the decreased intervertebral distance as well as the displacement can increase. 50 patients treated in the period from 1925 till 1977 with a spondylolisthesis of more than 50% have been reviewed. 36 of them were treated by a dorsal fusion, the 14 other patients without operation. Increased displacement was found in 43 cases. This phenomen will be brought about the deflective deformation of the dorsal fusion. Depending on the elasticity bone rebuilding under substinent biomechanical conditions is possible. In the course of time, total intercorporal consolidation leads to a difinitive stability and relief of pain.


[Problems of the little people (author's transl)]. The problems of the dwarfs are often not very well known. After reexamining 30 patients, we distributed an extensive questionaire to many other patients. The answers of 136 patients--examinated by punchcards--have given the information about the reason of their limited growth, their troubles and to questions of their familiar and professional integration. As expected most of the patients were those with achondroplasia. In babyhood the most important problem is the diagnosis. On the other hand the adult dwarfs come to the doctor for their complaints. The mostly seen complaints are backpains. It will be reported over postoperative reversible cases of paraplegia in case of narrow lumbar spinal canal and kyphosis. The most frequently carried on opperations are corrective osteotomies of the lower leg. The long-term results were mostly satisfactory. Apart from the medical problems were the social ones which were often as prominent. The patients are frequently lonely and in their profession overtaxed.


[Experiences with temporary epiphyseal stapling by Blount (author's transl)]. After an epiphyseal stapling (Blount 1949) on 93 patients a control was carried out in 87 cases. In this control age, growth prognosis and the growth after removing the staples were taken into consideration. The result shows various complications so that the patient will have to undergo a second anf finally a third operation. Through these repeated operations the difference of the leg length could be shortened, but the results were not up to expectations. On the whole, a clear prognosis was difficult to determine and on nearly a third of the patients the difference of the length could not be corrected under 2.0 centimeters. The epiphyseal stapling is connected with too many risks and complications. It may be carried out in seldom special cases. For the treatment of the difference of the leg length there are today safer and less complicated operating-methods.


[Epidermoid cyst of the tibia (author's transl)]. Case report on a large epidermoid cyst in the proximal tibia in a 42-year old woman. Scrutiny of the available literature shows that this is the first recorded case of an epidermoid cyst in a long bone.


[On translocation surgery of the tendon of the musculus peroneus brevis (M. fibularis brevis) in clubfoot (author's transl)]. The paper reports on the basis of long-term observations on an old surgical method which used to be practised in infants before arthrolysis around the anklebone (pantalar arthrolysis) was employed in the treatment of insufficient lifting of the outer edge of the foot in clubfoot recidivation. This old surgical method consisted of translocating the tendon of the m. peroneus brevis (m. fibularis brevis) before the outer ankle bone. The method is described, and its mode of action is discussed. Results obtained with 14 operations of this kind, are presented.


[A rare type of block formation of lumbar vertebrae in a top-performance sportswoman (author's transl)]. The article reports on a block formation in the lumbar vertebrae of a woman athletic. In the authors' opinion, such an anomaly has not yet been described. The article demonstrates on the basis of a detailed descussion of developmental anatomy that the block formation extended from L 3 to L 5, L 4 being merely a "quarter vertebra". The findings and the complaints resulting thereform prompt the authors to demand that in persons aspiring to become top-performance sporstmen. The locomotor system must be subjected to a thorough examination.


[Development and functional anatomy of the human elbow joint (author's transl)]. According to the general function of the upper limb the importance of the human elbow joint is discussed including phylogenetic aspects. The ontogenesis of this joint is analysed by serially sectioned human embryos of different stages. The important period is at the end of the second month, as the articular elements are formed at this time. The density distribution of the subchondral bone of the elbow joint corresponds to the results from photoelastic models. They are compared with the stress diagrams calculated by Pauwels. The density distribution of the articulating elements corresponds to the local stress. The analysis of the elbow joint of children of different ages shows, that there is no basis connection between the shape of the different formed articular surfaces of the ulna and the orientation of the epiphyseal plate. For the structural changes of the articular surfaces in the incisura trochlearis ulnae functional explanations are given with regard to Pauwels' deductions on the mechanical stress and the hypothesis on the causal histogenesis.


[The fixing shoe with rolling sole (arthrodesis shoe) with interchangeable built-in-element (author's transl)]. The fixing shoe with rolling sole (arthrodesis shoe) serves to ensure pain-free or at least tolerably painless walking in case of changes due to arthrosis or lesion sequelae in the ankle joints or the tarsus. This is achieved by means of a high shaft of adequate strength, an accurate bedding of the foot, and a rolling sole with sufficient lift at the tip. This shoe is indicated in cases where the load alone is well tolerated whereas load in conjunction with movement produces pain. Several types of these orthopedic shoes have been developed. Of these, the model with interchangeable built-in element has proved most successful in the authors' experience. This built-in element consists of a drummed (milled) cap reinforced with cast resin, and a cork bedding. This removable or interchangeable unit is advantageous compared with a firmly integrated system insofar as any changes or repairs can be effected easily and at a lower cost.


[Functional treatment of beginning hallux valgus with a special sandal (Schlaufensandale) (author's transl)]. A special sandal for the early treatment of hallux valgus is described. The deviation of the hallux is corrected by traction and brought to a middle position. Active correction is effective with every step.


Medical self-care: an old remedy recurs. Beginning in the 1960s, Virginia was the site of pioneering efforts in medical self-care education. The author traces the history of this concept, the reasons for its current popularity, and the benefits it can yield to both physicians and patients.


Hypertensive crisis and phencyclidine abuse. This report of a case in Virginia suggests linkage between the abuse of a "street drug" by a young woman and an acute episode of hypertension resulting in coma and blindness. The authors warn of the potential dangers of phencyclidine and describe its mechanisms.


Ectopic pregnancy and the intrauterine contraceptive device. The incidence of ectopic pregnancy is greater among patients with IUD in situ than among women in general. Four cases are reported, and the clinical implications are discussed.


The uses of myelography in the diagnosis of disc disease. "There are three main advantages in the preoperative myelogram for disc lesions: It confirms the diagnosis of disc lesion, excludes tumor, and defines the exact level of the pathologic lesion."


Degradation of aflatoxin by lactoperoxidase. Three concentrations of lactoperoxidase, 5, 50, and 500 units/ml of reaction mixture, degraded aflatoxin in the presence of 225 micrometer NaCl and 50 micrometer H2O2 at 28 degrees C. Increasing the amount of lactoperoxidase from 50 to 500 units/ml of reaction mixture resulted in increasing the rate of degradation of aflatoxin B1 from 3.6 to 5.1%/24 h. When comparable amounts of lactoperoxidase were present, aflatoxin G1 was degraded approximately 1.5 times faster than was aflatoxin B1. At a given concentration of lactoperoxidase, aflatoxin degradation was independent of initial aflatoxin concentration. Derivatives that cochromatographed with aflatoxin B2a and derivatives that were water soluble were the major degradation products of aflatoxin B1. Similar derivatives, but in greater proportions, were noted as degradation products that resulted from activity of a blendure of mycelia of Aspergillus parasiticus.


Evaluating the inhibitory action of honey on fungal growth, sporulation, and aflatoxin production. Unprocessed honey was inoculated with toxigenic strains of Aspergillus flavus NRRL 5862 and A. parasiticus NRRL 2999. The fungi grew and sporulated in varying amounts of honey diluted with water, but none of the cultures produced detectable levels of aflatoxin. Growth and subsequent sporulation were seen only in media containing up to and including 60% of honey. Media having 40% of honey showed growth and sporulation by day two. Neither species of Aspergillus produced toxins even in 10% honey. These results confirm our earlier observations that pure honey inhibited fungal growth and now even diluted honey seems capable of inhibiting toxin production or possibly neutralizing it. The general procedures recommended by the AOAC for extraction and thin layer chromatography were applied successfully in analyzing the honey substrate for aflatoxin.


[Detection of estrogen residues in meat by thin layer chromatography and fluorimetry (author's transl)]. A new method for the qualitative and quantitative determination of six anabolic substances is described. The analytical procedure consists of the following steps: comminution of the meat sample; homogenisation with tetrahydrofurane; liquid-liquid partition between sodium hydroxide solution and petroleum ether/benzene; chromatography of the estrogen containing fraction on Sephadex LH-20; derivatization with Dansyl chloride; and finally thin layer chromatography. The qualitative estimation on the TLC-plate is performed with 366 nm ultra violet light. The quantitative determination is carried out either by fluorimetry after elution of the substances from the plate, or by means of a remission spectral fluorimeter directly on the plate. The detection limit of the qualitative estimation in meat extracts was 5--10 ppb. A minimum concentration of 20--50 ppb is necessary for quantitative determination.


[The particular solution state of processed casein (author's transl)]. Processed casein manufactured with melting salts has properties which are not consisted with a solution of casein in water. The specific partial volume of the water VW = 1.061 cm3/g is clearly increased compared with pure water (VW = 1.00177 cm3/g). The activity of the water aW is greater than 1 instead of less than 1. The irregularities are explained by a solution state which is comparable to an inverted solution. That means that by melting salts in the melt water is absorbed from casein. Water now becomes the solute, whose cohesive forces are decreased. The result is an increase of the partial volume and a higher water activity.


[The application of numerical toxonomy for the classification of wines (author's transl)]. Monovariate and multivariate methods for clustering of wines according to origin, grape variety and vintage year (representing) climate are compared. The multivariate method which is described makes it possible to find similarities especially related to origin and is superior to a monovariate analysis.


[The microscopical identification of fruits from Gevuina avellana Molina (author's transl)]. The fruits of Gevuina avellana Molina, which in Chile are eaten like hazel-nuts, were subjected to microscopic examination. There are several anatomical characteristics, useful for differentiation. The anatomy of these nuts was then compared with that of hazel-nuts (Corylus avellana L.) is added.


[Principles and problems of evaluation of results in health education]. The goals of health education are the following: 1. Increase of knowledge about physical and psychological health; diseases and their causes; and possibilities of prevention. 2. Favorable influence on attitudes concerning health problems. 3. Influence on health behavior (nutrition, smoking, way of life, exercise). In school health education and in particular in adult health education, emphasis is usually put on communication by means of lectures, brochures, newspaper articles, radio and television. However, the effectiveness of such measures is not well known. Especially, it is not clear whether the transmission of knowledge in the particular fields brings along a lasting effect on attitudes and behavior of individuals or society. Outcome evaluation in health education requires short-term, but mainly long-term studies designed according to epidemiologic principles. The groups of persons suitable for testing in accordance with the health education programs have to be compared with groups not exposed to these health education measures. Not only immediate but also long-term outcome should be evaluated. Among the difficulties inherent in such a design are the precise execution of the health education programs, the surveillance of the test and comparison groups, long-term follow-up, and especially the identification and investigation of person groups suitable for study or comparison purposes. The problems inherent in health education evaluation are illustrated by practical examples.


[Health services as a study object: preconditions, principles, applications]. The call for more research in health care delivery has increased with the rising cost of medical care. Since the end of the fifties, a new research direction is identifying itself primarily in the Anglo-Saxon literature: Health Services Research. Examples discussed include results of Health Services Research regarding the diffusion of medical technology and the mechanisms to control costs of health services. These and similar results from special studies on average length of stay and utilization of hospital beds show that Health Services Research should develop from primarily descriptive studies into an analytical and experimental discipline in order to provide clues to the pressing problems of the delivery of medical care.


[Studies on health services--European outline]. Health Services Research is the systematic investigation and evaluation of the health services with respect to their availability, accessibility, coverage, effectiveness, efficiency, utilization and costs. Although some important developments like the introduction of national health insurance or the creation of a national health service led in given European countries to limited efforts in Health Services Research it has only been recently that the need for such research has become recognized. The cost explosion in health care and growing doubts about the effectiveness of given health care interventions provide leverage for a greater effort in Health Services Research. The World Health Organization created in 1977 the European Advisory Committee for Medical Research and Health Services Research. This Committee has identified five priority areas for research: 1. standardization of methods, measurements and terminology in biomedical and health services research 2. prevention, prophylaxis and early detection 3. evaluation of drugs and other therapeutic and diagnostic substances 4. problems in health care delivery 5. economic aspects of health care Adressing these problems will call at the national level for the development of a critical mass of capable health services researchers. It will also require substantial financial resources.


[The notion of effectiveness in the health field]. The author emphasizes the necessity of an interdisciplinary approach in the field of exploring efficiency of the health system. He attempts to show how the notion of efficiency depends on the degree of aggregation of the considered components of the health system.


[Scientific theory and planning in the health fields]. One of the most important function of philosophy of science is to elucidate terms and to discuss the possibilities to decide about values--both problems have practical relevance for the interaction between science, policy and politics in planning. Within planning theory it is striking, that in most cases the critical point of rationality is not treated adequately. Organization, functions and norms in the field of science and administration decide upon the forms of cooperation of social medicine in planning.


Polymorphism of the red cell acid-phosphatase in Tuscany by starch-gel thin layer electrophoresis and fluorogenic substrate. The red cell acid-phosphatase types were determined in 495 individuals from Tuscany, Italy. The observed frequencies of the three alleles are: ACPA1 = 0.271; ACPB1 = 0.665 and ACPC1 = 0.064. The results obtained by starch-gel thin layer electrophoresis and 4 methyl-umbelliferyl-phosphate as fluorogenic substrate are very satisfactory for forensic purposes also.


[Hemobilia--a contribution to vital reaction (author's transl)]. In 60 autopsies, with and without ante- or postmortem liver injuries bile was analyzed for its blood content, by UV-spectrophotometry. A microhemobilia was found in 20 cases and a visible macro-hemobilia in one case. The aetiology and pathogenesis of the hemobilia are discussed. If artefacts are taken into account, the two forms of hemobilia can be regarded as a vital reaction.


[About the polymorphisms of esterase D and glyoxalase I and their forensic application (author's transl)]. Phenotypes of esterase D and glyoxalase I were determined electrophoretically in samples from Northern Germany. Gene frequencies: EsD1 = 0,889 (n = 1430), GLO1 = 0,415 (n = 865). The data of 295 (EsD) and 153 (GLO) mother/child combinations were in full accordance with the genetic model of two codominant alleles at an autosomal locus. Esterase D typing has proved successful in bloodstains up to three weeks old. The forensic scope of serological systems is discussed intensively. According to our own data and the results presented in the literature esterase D and glyoxalase I have proved to be useful additional markers for use in cases of disputed paternity.


[Highly different values for the plausibility of fatherhood and for the exclusion chance (author's transl)]. More than 1800 HLA-typed mother-child-putative father triplets were biostatistically analyzed on the basis of the Essen-Möller principle. 14 of them had W-values (= probability of paternity) of less than 50%, the lowest value being 4,4%. Using a specially designed computer program, exclusion probabilities between 68 and 96% were calculated. This demonstrates (a) that nonexclusion is not necessarily in every case a positive indication of the paternity of the man involved; and (b) that the probability of exclusion as a biological method of establishing paternity is not a suitable piece of evidence. The W-value (= "probability of paternity"), obtained on the basis of the Essen-Möller principle, provides complete information, and is alone conclusive.--The high proportion of non-fullhouse children among the 14 cases allows the conclusion that the more comprehensive the specificity spectrum of the antiserums used in the typing is, the fewer the number of such cases.


[Spontaneous pneumothorax and tension pneumothorax as causes of sudden death (author's transl)]. Report on the pathological--anatomical findings on 4 persons, having died suddenly with a spontaneous pneumothorax. The relative frequency of cases and the clinical picture of the illness, stress the importance of this not unusual, but only by post-mortem examination verifyable, cause of death.


[On two cases of lethal trichloroethylene intoxication (author's transl)]. Two lethal cases of inhalation of vapors containing trichloroethylene are reported. The results of autopsy and of histological and toxicological examinations indicated a long lasting exposure and survival time.


[Traumatic thrombosis of the carotis artery (author's transl)]. The case of an 51-year-old man, who died about 24 hrs after having tried to commit suicide by hanging is reported. Death was caused by rupture of an arteriosclerotic layer in the left carotis communis artery with consecutive intramural bleeding and thrombosis of the left carotis communis, carotis interna and carotis externa arteries. In this respect another case of an injury of the neck and thrombosis of the carotis interna artery is reported. On the basis of these two cases the clinical and legal importance of diagnosis and causal connexion are discussed.


[The influence of alcohol on central nervous compensating mechanisms following labyrinthic lesions (author's transl)]. The influence of alcohol on mechanisms compensating for labyrinthine lesions was studied in 180 guinea-pigs. The animals were subjected to either unilateral or to successive bilateral labyrinthectomy which was induced by an injection of chloroform into the middle ear. No significant influences of alcohol on vestibular compensation were found up to alcohol levels of 1g/kg. Dosages higher than 2 g/kg exerted inhibitory effects on compensation after unilateral labyrinthectomy. Compensation after successive bilateral labyrinthine lesions could not clearly be influenced. In animals which had achieved natural compensation after labyrinthectomy alcohol dosages of 0,5--1 g/kg re-elicited some of the formerly present symptoms. The data presented are interpreted with regard to their significance for the action of alcohol patients with cerebral dysfunction.


[The polymorphism of human erythrocytic esterase D. Phenotype distribution and gene frequency in Northern Germany (Schleswig-Holstein); description of an Es D 4 family (author's transl)]. A good correlation between the actual phenotype distribution of esterase D and the expected distribution was found in the analysis of a random sample of 2028 unrelated persons, 54 umbilical cord blood samples, 406 mother/child comparisons, 24 family investigations, one fraternal and 32 identical twin investigations. The assume gene frequencies in Northern Germany were calculated for Es D1 =0.8935 and Es D2 =0.1065 for an aggregate sampling. Gene defects were not observed, and one family exhibited the variant Es D4 in the father (Es D 4--1) and son (Es D 4--2). Likewise, these phenotypes distinctly distinguish themselves by electrofocusing from the phenotypes Es D 1, Es D 2--1, and Es D 2.


[Pituitary changes after craniocerebral injuries and their correlation to localisation and time of surviving (author's transl)]. 62 pituitary glands were examined after craniocerebral injuries of different seriousness. Primary and secondary changes of the pituitary gland depend on localisation and direction of violence, dimension of intracranial haemorrhage and other cerebral changes, therapeutical measures and time of surviving. Primary pituitary lesions occur likewise with isolated fractures of the calvarium and facial skull, but also without fractures of the skull. On the other hand fractures of the base of the skull including the sella do not necessarily result in traumatic pituitary lesions.


[Lesions of the cervical spine caused by suicidal hanging (author's transl)]. In 107 cases of suicidal hanging the CVC was investigated systematically. A frequency of lesions at a rate of 65% was found. There were only soft-tissue-lesions with the maximum in C 5/6. The 2nd maximum was the occipito-atlanto-axis-region (C 0/2). This distribution depends on traction. Particularly in the dorsal part the loss of lordosis results from traction. The lesion of C 0/2 is caused by tension due to the weight of the head or by hyperextension due to submental position of the node. 20% of cases showed additional lesions in various locations, which are thought to be results of terminal convulsions.


[Deadly scald or Lyell syndrome? (author's transl)]. The changes of skin of the Lyell Syndrome have an extreme likeness with those of a 2nd degree scald. As this illness is more frequently observed as of late, it may get forensic importance. Based on the case of a man, 48 years of age, who suddenly died without previous diagnosis and therapy the aetiologic and morphological problems are discussed.


[Monitoring of the clinical and morphological course of glomerulonephritis]. It is reported on the clinical and morphological course of 50 patients with glomerulonephritis. The period of observation extended from 6 months to 10 years. The judgment of the clinical and morphological course was done on the basis of the laboratory findings or by means of the control biopsy. In the period of observation 36 patients were treated with different medicaments, whereas 14 patients were observed without treatment. A positive success of the therapy could not be recognized in the group of patients described the clinical and morphological course in the patients is described and the author adopts a definite attitude to the necessity of control biopsies.


[Treatment of intracapillary-proliferative glomerulonephritis]. It is reported on 137 patients with chronic intracapillary-proliferative glomerulonephritides. Of them 101 patients were treated with prednisolone, 36 patients remained untreated. The control biopsies and the observations of the course after on an average 1.8 years showed that the treated patients clinically and histologically had no better results than the untreated patients. A relatively high number of urinary tract infections and pyelonephritides was evident in patients treated with prednisolone. These diseases did not occur in patients who were not treated.


[Importance of the purine components in preserved-blood stabilizers in uremic patients and their study on the basis of serum-UV-spectroscopy]. The presence of adenine and guanosine, respectively, disturbs the detection of metabolites carried out with the simple total UV-spectrum as well as with the separation chromatographic technique. Since these investigations are used more widely, attention should be paid to this point of view. The stored blood taken with the ACD-AG-stabilisator has its full value for four days, also on the basis of the investigations mentioned, but it is advisable to avoid its application in the period of the diagnostic methods using the UV-absorption technique.


[The current state of spinal anesthesia in urologic interventions]. It is reported on the experiences of several years in 9,400 spinal anaesthesias in the urology in patients at an advanced age. Still at present the spinal anaesthesia has a dominating position in the urological intervention. Despite modern and differenciated anaesthetic methods the importance of the spinal anaesthesia is by no means reduced for most urological interventions, particularly for the transurethral operation technique, but it rather increased during the last years by the new local anaesthetics, by the development of thinnest spinal needles, but also the increased knowledge of the dangers of general anaesthesia. In urological diagnostics and therapy the spinal anaesthesia has still its full right and is less toxic for the patient and has less severe complications than the general anaesthesia. However, prerequisites for its use are: a) mastery of technique b) full assent of the patient c) psychic guidance of the patient during the whole duration of the intervention and d) balanced pre-, intra- and postoperative substitution of the volume e) overcoming of the established opinion that the spinal anaesthesia has a particular depressing effect on circulation and frequently causes post-spinal headache.


[Effect of D-penicillamine on zinc levels in blood and urine of patients with chronic polyarthritis]. In 6 female patients with classical rheumatoid arthritis D-penicillamine was administered in a daily dose of 250--500 mg for 3 weeks. The only additional antiphlogistic treatment was Indomethacin (100--150 mg daily). At the beginning and during the trial blood levels and the urinary excretion of zinc were determined using both neutron-activation analysis and atomabsorption. The results showed an increase of the urinary zinc excretion during the whole trial, a decrease of blood concentration of zinc until the 2nd week of treatment followed by an increase during the 3rd week above the level of the controls obtained before D-penicillamine therapy was started.


[Clinical and socio-medical aspects of long term uricostatic treatment of primary gout (a 5-10 year study)]. In 60 patients (48 cases were evaluated) with primary gout a longterm therapy (5--10 years) with Allopurinol was performed. Without treatment 4.4 sudden onsets of gout per patient and year were registrated; under Allopurinol only 0.062 (p less than 0.001) onsets were observed. This resulted in a large decrease in hospitalisation time from 44 days to 0.62 days per patient and year. In the majority of cases involution or diminuation of the tophi was found. In 7 cases of nephrolithiasis no further renal colic took place. In 8.3% a skin rasch and in 12.5% a slight gastrointestinal side effect was observed. Together with the clinical results the socio-medical aspects are discussed and the importance of gout in respect to the socioeconomic point of view is pointed out.


[Clinical aspects and treatment of pericardial tamponade in uremic pericarditis]. On the basis of four cases with chronic glomerulonephritis in the terminal stage of renal insufficiency with uraemic pericarditis and tamponade of the pericardium, which in one patient developed before and in three patients under therapy of haemodialysis the author adopts a definite attitude to the problems of development, treatment and prognosis of uraemic pericarditis. For the treatment of the tamponade of the pericardium a suction drainage of the pericardium is recommended. Apart from this a particularly intensive haemodialytic treatment is necessary. After overcome uraemic pericarditis must be reckoned with a constriction of the pericardium as late complication which should early be treated operatively.


[Effect of cyclophosphamide (Endoxan) on experimental arthritis in rabbits]. The experimental investigation is divided into 3 parts: Firstly, it was assessed that cyclophosphamide (Cp) in different dosages was well tolerated locally when injected into the knee joint of normal rabbits as compared to saline controls on the basis of histology and cell count determination of the injected joints. In a second series of experiments a hyperimmune arthritis (HIA) was produced in rabbits by systemic administration of albumin, complete Freund's adjuvant and intraarticular stimulus by ovalbumin. Histological examination of synovial membranes reveal alterations similar to those of human rheumatoid arthritis on the 7th day after stimulus. Further experiments were aimed at assessing if Cp exerted an inhibitory effect on the 7 day old HIA. Cp in a dosage of 10 mg has been applied intraarticularly in various intervals prior, simultaneously and after the elicitation of HIA. It could be demonstrated that Cp led to a reduction of the number of lymphocytes, plasma cells and fibroblasts in the synovial membrane, the inhibitory effect on fibroblasts was bound to its administration around the point of HIA elicitation, an even stronger inhibition of lymphocytes and plasma-cells was only to be expected when Cp was applied 48 hours after ovalbumin challenge. Unwanted reactions in the course of Cp administration such as superficial and deep necrosis as well as damage of blood vessels in the synovial membrane combined with minor inhibition of lymphocytes and plasma cells were encountered when Cp was injected 120 hours after HIA elicitation. These new experimental results lead to the conclusion that efficacy and unwanted reactions during Cp administration are related to a local activation of the substance in the inflammatory milieu of HIA. Furthermore we were able to demonstrate that even the sole application of Cp if injected shortly before immigration of lymphocytes into the synovial tissue led to a marked suppression of almost all histological parameters of HIA. Our experimental findings strongly support the importance of lymphocytes and plasma cells being inactivated for the successful treatment of adult rheumatoid arthritis. They grow to consider the formation of necrosis and damage of blood vessels as sequelae of too fast a local activation of Cp in the inflammatory tissue.


Microbiological production of acetone-butanol by Clostridium acetobutylicum. Trials succeeded in raising the efficiencies of the fermentation medium, used in the fermentative production of acetone-butanol by Clostridium acetobutylicum. Egyptian black strap molasses (50.0% sugars) was suitable as carbon source in the fermentation medium, and (NH4)2SO4 was utilized with great success as inorganic nitrogen source. 140.0 g/l black strap molasses (about 7.0% sugars) and 3.0 g/l (NH4)2SO4 were the optimum concentrations for obtaining good yields of acetone and butanol. Molasses and (NH4)2SO4 were preferred because they are cheaper than the other carbon and organic nitrogen sources, used in the fermentative production of acetone-butanol. The percentage increase of the total solvents produced in the fermentation (production medium) was increased by 64.0. The slop (by-product of the acetone-butanol fermentation after distillation) was re-used in the fermentation medium as organic nitrogen source and supported the microorganisms for a good production of acetone and butanol, while when stillage was used in the production medium, the total solvents output was less than that produced in the medium containing slop.


Investigation if inorganic and organic nitrogenous compounds on microbial nitrogen fixation with respect to the fixation cycle. The effect of inorganic and organic nitrogenous compounds on microbial nitrogen fixation with respect to the fixation cycle was investigated. Various nitrogenous compounds were added to the nutrient solution in concentrations of 2.5 mM and 5 mM. After incubation with the bacteria for fifteen days, the nitrogen and carbon contents were estimated.


Effect of uranyl and molybdate ions on microbial fixation of nitrogen. The addition of molybdate in presence of uranyl acetate causes a considerable increase in nitrogen fixation in all the species of nitrogen-fixing Azotobacter, studied in this paper, as compared to the case in which these ions are taken separately (4, 3).


Effect of Fusarium isolates and their filtrates on respiratory rate and chemical analysis of squash plants. The highly pathogenic isolate stimulated the emergence of the squash seedlings first, caused, however, the highest death rate of the seedlings finally. Fusarium isolates and their culture filtrates inhibited the respiratory rate of squash plants significantly. However, F. oxysporum isolates inhibited respiration more than F. solani isolates. Seasonal changes of respiration decline show that the respiratory rate decreased with plant growth in the case of infested soil and of plants injected with culture filtrates. However, spraying Fusarium culture filtrates on the foliage gave opposite results when the plants grew older. Fusarium solani isolates decreased nitrogen content of squash stems and leaves, while F. oxysporum isolates gave reverse results. Injecting Fusarium culture filtrate into the plant decreased nitrogen content of both stems and leaves, while spraying the foliage with the filtrates increased nitrogen content more than that of the control. Phosphorus content of the stems of squash plants, sown in infested soil, was less than in the control when the plants were treated with F. solani and higher when they were treated with F. oxysporum isolates. On the other hand, the phosphorus content of squash leaves was higher than in the control. In the case of injected plants, however, the phosphorus content in stems and leaves was equal to that of the control or less, and with sprayed plants it was higher than in the control. Infesting the soil with Fusarium isolates and spraying the foliage with their culture filtrates increased potassium content of squash stems and leaves, while injecting the filtrates into the plants decreased potassium content of both stems and leaves.


[On the effect of some morpholinium compounds on the multiplication of RNA viruses (author's transl)]. In the present paper the authors report about the effect of N,N-dimethylmorpholinium chloride (DMMC), N,N-dimethyl-2-oxomorpholinium chloride (DMOMC), and N,N-diethyl-2-oxomorpholinium chloride (DEOMC) on the multiplication of tobacco mosaic virus (TMV), potato virus X (PVX), and cucumber mosaic virus (CMV) as well as the plaque formation by the RNA phages M 12, f 2, and Qbeta. The used morpholinium compounds do not influence strikingly the multiplication of phytoviruses. The results found by serological procedure and by bio-assay are indicated concordantly by the two methods. The plaque formation by bacteriophages is not influenced by DMMC, but enhanced significantly by DMOMC and DEOMC. These effects might be caused by the different hydrolytical behaviour of the morpholinium compounds tested.


[Continence of anus praeter -- a problem solved? Erlangen magnetic stoma seal (author's transl)]. Primary or secondary implantation of the Erlangen magnetic stoma seal in case of colostomy or ileostomy is technically simple, although it requires a critical selection of patients and careful surgical technique. The best follow-up of the operated cases should be in the special protological clinics in the hands of stoma therapists. About 15% of the cases meet local complications and therefore the magnet-ring is explanted. An ideal continence is not always achieved. We hope that these patients can be better helped with magnetic stoma seal through further development.


[Ambiguous and obscure problems of liver resection (author's transl)]. On the basis of the authors personal experience of 155 liver resections, including 79 anatomical and 76 atypical ones, the paper presents various aspects of indications, choice of procedure and of various technical measures. The author demonstrates the indisputable advantages of anatomic liver resections over the atypic ones, since they permitted to increase the range of surgical aid to the liver patients.


[Primary tumours of the small bowel (author's transl)]. In a period of 21 years we observed 28 tumours of the small bowel (14 benign, 14 malignant), what comes up to 0.85% of all tumours of the GI-tract seen at our hospital. The low rate of incidence of malignomas of the small bowel is supposed to be in relation with the carcinogenic indifference of its contents. 60% of the cases underwent operations for acute complications, such as ileus or peritonitis. Early diagnosis of these tumours is difficult due to their uncharacteristic symptoms and the lack of radiographic signs. Only 4 out of the 14 cases with malignomas underwent radical surgery. The prognosis of malignant tumours of the small bowel is not a good one due to delay of diagnosis, early metastising and local involvement of the mesentery. The 5 year survival rate was 22%. Solitary benign tumours of the small bowel after their removal have an excellent prognosis.


[Prognosis and treatment of obstructing carcinoma of the colon and rectum (author's transl)]. From 1955 up to 1976 we observed 1140 patients with cancer of the colon and rectum. Out of these 134 patients had obstruction. Only in 40.3% radical resections could be done; mortality rate (22.0%). 54.7% underwent palliative procedures, 8% were inoperable. The primary mortality rate of this group came up to 62%. Causes were: peritonitis (44.5%), pneumonia (17.3%), pulmonary embolism (12.44%). The 5-year survival-rate for patients under 60 years was 31%.


[Vocational rehabilitation after lung resection due to bronchial carcinoma (author's transl)]. Problems of vocational rehabilitation after radical operation of 307 patients with bronchial carcinoma, who are still living 3 years after the operation are analysed. Preoperative relation of professional groups: Employees 46%, industrial workers 28%, independent professions 15%, agricultural professions 11%. The success of rehabilitation is dependent on profession extent of resection, and other concomitant diseases.


[Failure of pacemakers (author's transl)]. The number of pacemaker patients is permanently increasing. In case of dysfunction of the pacemaker they are demanding emergency care. All doctors should be informed about first aid in those cases.


[Controlled drainage of the thoracic duct (author's transl)]. The technique of the thoracic duct drainage is described. The importance of preserving the natural lymph outflow is emphasized. A method of controlled thoracic duct drainage is introduced that permits dosaged exteriorization of the lymph and additional internal drainage of the lymph into the veins via an external bypass for a long period of time. The results of the employment of controlled thoracic duct drainage in 33 patients are presented. A clear clinical effect was received in 65% of the cases. The authors conclude that controlled drainage of the thoracic duct is an effective method of treatment.


[Subcutaneous mastectomy (author's transl)]. Problems of indication (premalignant disease, difficult check-up, carcinophobia), of resection (incomplete, unilateral, compromises) and of breast reconstruction (one- or two stage procedure, capsular fibrosis, difficult follow-up) are discussed.


["Carcinoma in situ" of the mammary gland (author's transl)]. The paper summarizes the available knowledge on the so-called "cancer in situ" of the mammary gland. In 1960 to 1975 61 patients were operated on at the Institute. The diagnosis "carcinoma in situ"--was not established before a microscopic study of the removed specimen was conducted. Following sectoral resections of the mammary gland für "carcinoma in situ" two patients developed cancer in other quadrants of the gland: one--after 45 years, the other after 15 years. The authors believe the term "carcinoma in situ" to be improper for clinical practice due to its inherent contradiction, which not infrequently results in diagnostic, therapeutic and organisational errors.


[Revascularisation in peripheral vascular occlusions (author's transl)]. The 240 reconstructions of the femoral artery, performed within the last 4 1/2 years, involved 26 patients (27 bypasses) with combined femoral and peripheral vascular occlusions. The bypasses were connected with a segment of either the popliteal or the tibial artery. There was no operative mortality. The mean period of follow-up was 13 months: 18 of the bypasses were patent (2 patients died with open bypass), while 7 bypasses occluded (3 patients died). The authors feel, that isolated artery segment should always be explored. Only an autogenous vein graft should be implanted.


[Diabetic angiopathy (author's transl)]. Clinical findings of diabetic antgiopathy are usually caused by micro- and macroangiopathy and neuropathy. Predominant in this disease is the acral lesion. Differentialtherapy of diabetic angiopathy needs experience and patience of the attending physician and the patient.


[The problem of infection in alloplastichip-replacement (author's transl)]. The total hip protheses implanted (THP) in two different operation periods (156 THP till September 174, 577 THP from October 1974 till December 1976) is evaluated under the aspect of infection and the influence on the rate of infection by different factors is emphasized. The rate of infection could be decreased from 7.1 per cent to 2.4 per cent adaquate measures.


[Blunt abdominal trauma.--analysis of 201 cases (author's transl)]. 201 blunt abdominal traumata treated clinically at the surgical department of the Medical Academy in Erfurt from 1967 to 1976 are reported: No increase of blunt abdominal traumata within the period of the report in spite of considerable growth of trafficdensity and industrialization could be observed.--The percentage of severe secundary injuries remained approximately constant, too.--Intestinal lesions, combined hepatolienal ruptures caused the highest mortality  especially in combination with severe craniocerebral lesions.


[Intrauterine diagnosis of fetal sex from maternal peripheral blood]. Authors worked out on basis of previous investigations the possibility of prediction of fetal sex from maternal blood smear. The security rate of their method is 88.3 percent. The further progress of the exactness of their technique seems to be solvable.


[Effect on the cardiovascular system of a 3.5% gelatin infusion solution Gelafusal in hypertensive women in late pregnancy]. Using the method of quantitative sphygmometry with bloodless graphic recording of the arterial blood pressure and direct electronic timing of the pulse wave velocity the behaviour of the cardiovascular system in 10 hypertensive late pregnant women was examined before, during and after the intravenous infusion of 500 ml of a 3,5% gelatinous infusion solution (Gelafusal) given within 30 minutes. There is a mild and transient expansion of the plasma volume. Arterial blood pressure, stroke volume, cardiac output and total peripheral resistance remain constant nearly. Consequently the employment of Gelafusal in hypertensive late pregnant women is possible without making worse the arterial hypertension.


[A rare form of oscillation].

[A rare form of oscillation]. Two clinical pictures of a serous fetal distress are represented. The oscillations, registrated by means of phonocardiography, showed a so far no described automatism. The corresponding CTG's are discussed.


[Fetal retardation and its diagnosis].

[Fetal retardation and its diagnosis]. Cerebral malnutrition as well as a markedly increased rate of lethal malformations constitute the major problems of retardation. During the daily routine the question "retardation of growth or premature birth" poses itself time and again. Different methods of determining the period of gestation are being discussed: Two of the best methods used in combination during the last trimester of gestation are: 1. L/S-ratio-creatinine-ultrasonics, 2. creatinine-ultrasonics. But none of these methods is as efficient as the ultrasonic diagnosis in the first trimester of pregnancy (amniotic cavity, length of the foetus). The earliest possible examination of all pregnancies by ultrasonography is highly recommended. This method generally allows for a differentiation in symmetrical assymmetrical retardation of fetal growth. The author introduces different ultrasonic parameters and their limit of error for the middle and last trimester. The exclusive measurement of the biparietal diameter should belong to the past, one should strive to obtain the combination of two measurements. He recommends the combination of head and abdominal measurements as well as the combination index including the hight of the truncus; the determination of the measurements of the placenta is to be rejected. The author is hopeful that by improved technology the thickness of the subcutaneous fatty tissue can be measured in the future.


[Intrapartal retrograde jejunogastric invagination after gastrectomy]. This is a case report on a rare intrapartum complication consisting of a jejunogastric invagination 17 years after gastrectomy. The clinical systoms such as pain and tender mass in the epigastric region as well as vomiting are similar to an ileus. Immediate interdepartmental consultation is essential because of the very high mortality rate in case of diagnostic failure. Several possible reasons for the invagination are being discussed. The increased intraabdominal pressure during labor is most probably responsible for this life threatening event.


[Use of the inhalation anesthetics nitrous oxide and halothane in obstetrics]. By means of the literature of the latest years the advantages are discuss of nitrous oxide as analgesic and base anesthetic and of Halothan in the obstetrics.--Nitrous oxide can be regarded as especially favourable under consideration of a high PO2 proportion of the mother and under to the avoidance. Halothan is known as an optimal inhalation anesthetic for the inhibition of the intensive pain activity with the danger that can tear the uterus and is used successfully when intrauterine operations with desirable relaxing of uterus.--It has to be perferred the beta-adrenergicum Partusisten under the birth in danger because of its good manageableness.


[Value of ultrasonic fetometry for fetal monitoring in diabetes mellitus]. Evaluation of ultrasonic fetometry in diabetic pregnancy. In 51 cases we have carried out 134 ultrasonic investigations. The diabetes we classified to the score of White A--F. To evaluate the increase in fetal weight and the maturity in a qualified sense, we measured the biparietal diameter, the transversal and the sagital diameter of the thorax and the trunk length. The findings were registered into diagrams of our percentiles of development.--The fetopathia diabetica will be diagnosed right, if it is joint with fetal hypertrophy. The beginning of the macrosomia of the fetus is possible to recognize from the 32th week of gestation.


[The question of the innervation of the umbilical cord]. By supravital Methylenbluestaining a dense network of vegetative nerve fibres is demonstrated in the adventitia arround the arteries of the umbilical cord. Some of these nerve fibres are of cholinergic nature.


[Measurement of intrauterine pressure during extra-amnial induced abortion with prostaglandin F2 alpha]. There was given Pg F2 alpha extraamnially and intracavitary to thirty firstgravid nulliparae of the eleventh, twelfth, thirteenth or fourteenth week of pregnancy and there were taken through measurements of the intrauterine pressure in labour. The uterine activity was measured in Montevideo-Units. We registered labour duration, number of labours, amplitude and basal tonus. During the time of observation we attained a basal tonus of 30 +/- 10 mm Hg, a number of labours from 8 to 13 within 10 minutes, Montevideo-Units of 600 +/- 100 and a labour duration of about 45 seconds in 65% of the cases. The types of labour number 1 and 2 were predominant. In these cases we were able to demonstrate optimal clinical results in cases of Pg F2 alpha induction.--The meaning of Pg F2 alpha (extraamnially) for the induction of abortion will be discussed.


[Large paraumbilical hernia and pregnancy. Case report]. A case of big parumbilical hernia in pregnancy is reported. The hernial sac was filled out by the corpus of the uterus. In the second half of pregnancy the abruption as well as the hernial operation is indicated only in case of need. At term the primary caesarian section with the supracervical amputation of the uterus and the operative correction of the hernia were performed.


[Relationship of time interval between steroid therapy and labor to the incidence of respiratory distress syndrome]. The authors used Dexamethasone before delivery in 577 cases of pregnancy. There were 460 prematurities. Occurrence of RDS was significantly lower in cases, where delivery took place more than 48 hours after the steroid treatment. Where the steroid effect was not optimum (48 hours), the RDS was similar to that of the control group, although mild in form. In their studies they found no connection between the tocolysis (Partusisten) and the occurence of RDS. They emphasize that in the cases where respiratory insufficiencies are predisponated (elective caesarean section, diabetes mellitus etc.) the steroids significantly reduce the frequency of the disease. Neither the number of apoplexy nor that of death due to infections increase in dexamethasone treatment.


[Amniocentesis with free needle guidance following pinpointing using ultrasonic compound scan]. There is reported about 106 amniocenteses between 28th and 40th week of pregnancy after previous investigation and marking of the point of puncture on the abdomen of the pregnant woman by means of investigation the point with ultrasonic compoundscan. The angle of puncture method is found out and the maximum and minimum infiltration intensity. Complications have not been observed. That technique makes possible a high security for puncture and excellent puncture results.


[Dexamethasone-induced fetal lung maturation and the simultaneous control of MPL secretion of the placenta]. 24 mothers were given 4.0 mg. of dexamethasone one times daily for 3 days during the last trimester of pregnancy. Serial serum human placental lactogen (HPL) determinations were made by radioimmunoassay before, during and post the treatment. Dexamethasone did not change the HPL level.


[Experimental contribution on the biochemical study of normal and pathologic (diabetes) lung maturation in the Wister rat]. This is a research on the pulmonary normal and pathological (Diabetes) maturity of the WISTAR's Rat. To do that we have chosen 6 lots of rats. The animals were sacrificed by killing them up to 15., 18. and 21. days of pregnancy, then we removed the amniotic liquid from each rat to know or find out the lecithin/sphingomyelin and creatinin relations or reports.


[Determination of the prospective time of labor using ultrasonic fetometry]. The prediction of the date of delivery by ultrasonic fetometry.--On the basis of the biparietal diameter the accuracy of the prediction of the term amounts to 87.3% within +/- 15 days in patients with unknown last menstrual period. The result can be improved by examination in the second trimester, controls of progress and by truncometry.


[Delta pH F changes sub partu and their clinical relevance]. Investigations of delta pHF-changes in labor led to the opinion, that there exist no agreement between this changes and the fetal or neonatal condition. Nevertheless they represent an important criterion--together with electronic parameters--for estimation of placental function. By achievment of limiting values (delta pHF greater than or equal to 0,10) and persistent pathological fetal heart rate patterns the termination of labor is necessary. A pHF less than 7,25 should no be reached. That ist of great importance for a low acidotic morbidity.--In this connection the determination of pHF to begin of the fetal monitoring is requisite. This is meaningful for the dynamics of pHF-values in labor in accordance with the fetal monitoring.


[Relationship between social characteristics and behavior in pregnancy]. From 1973 to 1975 five hundred Berlin women have been questioned in puerperum. The authors seeked for possible differences in pregnancy behaviour during planned and unplanned gravidity. 40% of the women had an unplanned pregnancy. A higher fraction of unplanned pregnancies was found in young, unmarried women being under education, women without profession, plurigravids, and those who had never taken the anti baby pill.--In 5 of 8 parameters there were no differences in behaviour between planned and unplanned pregnancies (nourishment, use of drugs without doctor's order, coffee, alcohol, cohabitation near term).--In the group of planned pregnancy more mothers drank sufficient quantities of milk, read books about pregnancy and delivery, and smoked less. But the differences are small. Therefore the authors don't believe that fact of unplanned pregnancy is a considerable factor of risk for fetus and newborn.


[Curettage during puerperium and its late consequences]. The authors examined data of 160 cases of puerperal curettage. The histological examination proved placental residue in 15,61 per cent, decidual residue in 65,61 per cent of the patients. It was a very important finding that the histological examination proved the presence of acute (66 patients), subacute and chronic (23 patients) inflammation, but the patients had no symptoms that would indicate endometritis. 71,86 per cent of the curettage were performed in the 2nd to 4th week of puerperium. Follow-up examinations were made in 69 patients in a period up to 1--5 years after the post-partal curettage. Out of the 69 patients only 14 were free of complications, 32 of them had amenorrhoe or hypomenorrhoe, 20 suffered from Asherman's syndrome (intrauterine synechiae).--49 of the patients intended delivery, but 22 were infertile. The authors' own principles on the treatment and prevention of puerperal hemorrhage are also summed up.


[Abortion induced by prostaglandin F 2 alpha in risk patients]. For 245 cases of risk the intermittend extraamnial Prostaglandin F 2 alpha application was used for medicamentous dilatation of the cervix when carrying out the legal abortion in the I. trimenon. The low morbidity rate of 3% in cases of legal abortion as well as the preventive method of dilatation are able to prevent disturbances of fertility. Especially for all the young primigravidae we hope for a diminution of the cervix insufficiencies in the following desired gravidity.--In contrast to this, the danger of bacterial contamination as well as the burden onto the cervix' holding and supporting function up to the complete abortion are much higher with Prostaglandininductions.--The low doses of 3 mg Prostaglandin F 2 alpha for medicamentous dilatation of the cervix and economical advantages let this method be recommended as a method of selection for cases of legal abortion with risk.


[Dermatitis as an expression of progesterone hypersensitivity (autoimmune disease)]. By means of a report on a 39-years-old woman with cyclic eruption of dermatosis in praemenstruum, was caused by progesterone-sensitivity. The problem is discussed of this autoimmune-disease. It is supposed that this autoimmune-progesterone-mechanism may be of importance in gynecology.


[Experiences with clomiphene therapy of endocrine sterility]. Two hundred seventy-three infertile women with disturbances of the menstrual cycle were treated with clomiphene citrate a level of 50 or 100 mg daily for 5 days, or even--in cases of therapeutic failure--of 150 or 200 mg daily. According to the experiences of other authors the results indicate that conception can be obtained in a rate between 35 and 40%. The frequent occurence of additional factors diminishing fertility, however, reduces this relatively favorable pregnancy rate to a level of 30% under the conditions of practice. Patients with ovulatory failures, secondary amenorrhoe associated with sufficient endogenic estrogen secretion, and luteal insufficiencies respond most favorably to clomiphene citrate. If the preovulatory cervical mucus reaction is missed, the additional application of an estrogen preparation, in cases of repeated luteal phase defects the combination of clomiphene with HCG is recommended.


[Prevention of thromboembolism in surgical gynecology]. It is reported on the prophylaxis of thromboembolic diseases with acetylsalicylic acid (Micristin) in gynaecological surgery. The number of thromboembolic complications clinically ascertained was diminished from 3,25% (without Micristin) to 0,82% (with Micristin). Side effects were rarely observed, laboratory control was not necessary, Low-dose-heparin-prophylaxis were executed on contraindications and incompatibilities of Micristin. The perioperative use of low doses of heparin combined with postoperative use of oral anticoagulants on patients with increased risk of thromboembolism are discussed.


[Combined infarct of the brain in the basin of the middle and anterior cerebral arteries]. The report contains a description of the morphology, pathogenesis and clinical picture of combined brain infarctions in 16 cases developing in the basin of the middle and anterior arteries. The mechanisms of their development are discussed: thrombosis, thrombembolia of the middle and anterior brain arteries and their branches, pressure of the cortical branches in the anterior brain artery by the lower edge of the large crescentic process of the dura mater.


[Atherosclerosis of the major extra- and intracranial cerebral arteries in persons engaged in physical and intellectual work]. The authors conducted a visual-planimetric study of the magistral arteries, supplying the brain in 152 deceased individuals, where the intensity of atherosclerosis was studied in comparison to people of physical and intellectual work. The compared groups were identical for sex, age and the main disease. In people of physical work the intracranial arteries demonstrate either no changes or only lipoid spots in them. In people of intellectual work there were fibrous plaques. In extracranial arteries there were no differences in the frequency of atherosclerotic changes in the compared groups. The general area of atherosclerotic changes (as well as the area of eminental lesions and fibrous plaques) in the arteries of the Willisi circle was significantly larger in people of intellectual work than in people of physical work. There were no significant differences between the two compared groups according to the area of atherosclerotic lesions in the extracranial brain arteries.


[Clinical picture and several histochemical changes in the brain in cerebral rheumovasculitis]. A clinical study of 70 patients with cerebral rheumovasculitis permitted the author to distinguish 3 forms of the disease: with a diffuse, mild focal and crude focal neorological symptomatology. Their dependence upon the somatical signs is demonstrated, a successional development of nervous system lesions, treatment and its effectiveness. The histochemical studies in different brain areas in patients with crude focal neorological symptomatology demonstrated allergic, metabolic and inflammatory changes in the vascular walls, accompanied by hemodynamical changes and deep dystrophy of the neurons and nervous fibres, as well as productive reaction of the astrocytes, oligodendrocytes and microglial elements.


[Lesions of the central and peripheral nervous systems in rheumatoid arthritis]. Using morhological, neurohistological and histochemical methods the author studied different areas and anatomical structures of the central and peripheral somatic and vegetative nervous system in 4 patients who had died during different periods of rheumatoid arthritis at the age of 27, 48, 51, and 60. The studies demonstrated symptoms of disorganization of the connective tissue in the sheaths and walls of vessels (mainly in the microcirculatory bed), lymphoid histocyte infiltrates, rheumatoid nodules and nonspecific changes of neurocytes and conductors. The paper contains a description of the main form of lesions in rheumatoid, arthritis of the nervous system.


[Clinico-morphologic features of subacute anterior poliomyelitis]. The paper deals with clinical and morphological studies of 2 cases with subacute anterior poliomyelitis. The authors attract special attention to the development of flaccid pareses with a simultaneous inhibition of tendinous and periosteal reflexes, the absence of any pyramidal signs during the entire disease and a clear prevalence of degeneration in spinal cord motoneurons in the cervical and thoracel parts and their preservation in the brain cortex. These symptoms are distinctive signs from the poliomyelitic variant of the amyotrophic lateral sclerosis.


[Changes in the central nervous system in acute viral respiratory infections]. On the basis of a clinico-morphological analysis of 50 cases with acute respiratory viral infections, developing clinically with brain symptoms, the authors distinguish 2 main factors, influencing their development. The main factors consist in a evicious circles of respiratory disorders which causes the appearance of toxico-hypoxic encephalopathy. Encephalitis of an immuno-allergic nature are seen less frequently and may appear soon after acute respiratory viral infections. Histologically there are 2 forms of allergic encephalitis: 1) with perivascular lymphocyte infiltration and 2) hemorrhagical. The second form differs clinically from the first by apoplectic-like development with a coma and rapid short course. Both forms of poctinfluenza allergic encephalitis differ from encephalopathy in the fact that they develop not during the crucial phase of acute respiratory infection, but follow 1-2 weeks. The morphological differences of hemmorrhagical forms of poctinfluenza allergic encephalitis from from encephalopathy are characterized by intensive perivascular hemorrhages with a tendency towards their fusion; by changes in the vascular walls; by an appearance of small foci of colliquative necrosis and demyelinization.


[Endocrine myopathies. Muscular lesions in thyrotoxicosis]. The authors studied 42 patients with endocrine myopathy. In thyrotoxic myopathy prevalent muscle lesions of the pelvic girdle and femur were found. EMG studies (with the aid of point electrodes), histological and histochemical studies of the muscles in patients with thyrotoxicosis indicate a primary muscular character of the atrophies. The report contains descriptions of pathomorphological and histochemical changes in the muscles in experimental thyrotoxic myopathy.


[Ultrastructural features of cerebral synapses in schizophrenic patients]. The paper is concerned with ultrastructural traits of synapses in the frontal lobe, supraoptical nucleus of the hypothalamus and caudal nucleus of the brain in 12 schizophrenic patients and 8 normals (the period of autopsy was 4 hours following death). The results demonstrated 2 types of changes: 1) slightly expressed changes (a decrease of the extent of active zone contacts, changed forms in the synaptical vesicles); 2) extremely expressed or degenerative changes in the synapses (an appearance of fibrillar structures, glycogene granules, degeneration of synaptical endings of a dark type).


[Pathologic anatomy and pathogenesis of focal pneumonias in mental patients of late middle and advanced age]. The author studied 128 postmortem cases with focal pneumonia in mental patients (74 cases) and normals (54 control cases) at old age. In the main group there was a significant lesion of the bronchial tree, a polysegmental nature of pneumonia with a frequent localization of the process in the 10, 9, 6 and 2 segments of the lungs, expressed changes in the fibrillar structures, a drop in the immunological reactivity, atypical clinical development. Pneumonia in old age and especially in mental patients has an important thanatogenetical significance. In its pathogenesis special attention should be paid to the state of defensive mechanisms in respiratory organs, to the etiology of pneumonia and the level of immunological reactivity in such patients.


[Several characteristic senile dementia morphologic changes in the brain and their corresponding neuropsychological syndromes]. A pathohistological study of the brain in 23 cases of senile dementia detected that the loss of a significant amount of neurons of the II and III layers in the cortex of the frontal and occipital lobes was accompanied by foci of destruction in the knee and intumescentia of the corpus callosum as well as by a destruction of the long associative connections in the fascicles, connecting the frontal and occipital lobes of the same hemisphere. Such phenomena were not found in normal individuals of old age nor in mental patients with other diseases. A neuropsychological study of 21 patients with senile dementia demonstrated that a lesion of these brain structures may correspond to dynamical apraxia, visual agnosis and a disturbance of bimanuel reciprocal coordination.


[Pathologic anatomy of the neurolipidoses]. The authors give a description of 2 cases (sibs) with neurolipidosis of the group of amaurotic idiocy. There was an atypicity of the clinical and pathomophological picture: prolonged development of the disease (24 and 29 years, with an onset at 3-4 years), the absence of ocular changes, a massive lesion of the cortex in relative preservation of the subcortical areas, brain stem and cerebellum. The perspectiveness of a comprehensive clinico-morphological study is discussed in the interpretation of the genesis of different forms of neurolipidosis.


[Distribution of acetylcholinesterase in different regions of the human brain according to light and electron cytochemical findings]. On the basis of cytochemical studies the author presents some data, concerning the distribution of acetycholinesterase in the structures of human brain nervous tissues on the photo-optical and ultrastructural levels. There were some differences in the distribution of enzymes in the different brain areas. There were also some special traits in the cytochemical reactions to acethylcholinestherase in connection with the processes of postmortal autolysis and the state of the brain taken for studies. It is assumed that there are 2 forms of acethylcholinestherase in the cells--connected and not connected with the membranes. The author discusses some problems of the synaptical and barrier functions of acetylcholinestherase in the brain as well as the functional significance of the cholinergic system of mediation in relation to its distribution in different brain areas.


[Dynamics of changes in the ultrastructure of hypothalamic nerve cells in acute morphine poisoning]. In order to study the dynamics of submicroscopical changes in the paraventricular and supraoptical nuclei of the hypothalamus the authors studied with the aid of electron microscopic methods 12 white rats of the Wistar line. Such studies were performed in different periods after acute intoxication by middle toxic doses of morphine. Following 30 min after the injection the nervous cells demonstrated moderately expressed ultrastructural changes of a chromatolytical type. Chromatolysis after 60 min was increased and it was accompanied by focal destruction of the cytoplasma. After 48 hours following acute intoxication the changes of the nervous cells were characterized by a prevalent increase of the granular components, that formed the picture of a functional hyperchromatosis. These changes indicate to a tendency to rehabilitation of damaged structures.


[Ultrastructural changes in capillaries of the cerebral cortex during ischemia]. Electron microscopic studies of dynamic capillary changes demonstrated a tendency towards a progressive decrease of the diameter or a complete occlusion by thrombs. Acute disorders of microcirculation due to a bilateral ligation of common carotid arteries lead not only to different reactions of the capillaries, but to destructive changes in the capillary endothelium. As a result of the developing ischemia, hypoxia has an important pathogenetical significance in disorders of circulation, inasmuch as it exerts influence not only on the nervous tissue, but on the capillaries leading to their dysfunction, an increase of the wall permeability and oedema. The easily developing oedema in conditions of hypoxia, evokes further lesions of the brain tissue which concerns the ultrastructure of cell elements in the whole system: capillaries, glia, neuron.


Stimulation of L-ornithine and S-adenosyl-L-methionine decarboxylases by beta-(p-chlorophenyl)-gamma-aminobutyric acid in mouse tissues. Injections of beta-(p--chlorophenyl)-gamma-aminobutyric acid caused a monophasic stimulation of the activity of neural L-ornithine decarboxylase, to reach a maximum of 9-fold compared with the control values 3 h after treatment. Stimulation of hepatic L-ornithine decarboxylase was biphasic, the activity reaching its first peak, 48-fold compared with the control values, similarly at about 3 h after administration, and returning to its initial level by 4 h, and rising to a second peak, about one-third of the magnitude of the first, about 25 h after the injection. The effect in the adrenal gland of the mouse was multiphasic, reaching its maximum, 94-fold enzyme activity compared with the control values, 7--8 h after treatment. There were also marked fluctuations in the activity of S-adenosyl-L-methionine decarboxylase in the tissues examined.


Immunological and binding studies on chloroform--methanol extracts from electroplax of Torpedo marmorata and from rat brain cortex. Comparison of the material solubilized by organic solvents with the receptor proteins solubilized by detergents. We have investigated a chloroform--methanol extracted material from electric organ of Torpedo marmorata with respect to binding of [3H]-acetyl-alpha-neurotoxin and [3H]-acetylcholine. No binding was observed which is in contrast to observations with detergent extracted receptor. Further, no crossreactivity could be demonstrated between the chloroform--methanol extracted proteolipid and antibodies against the detergent extracted receptor. Labelling in the membrane with [3H]-acetyl-alpha-neurotoxin before extraction with chloroform--methanol gave a very low yield of extracted labelled compound. The protein yield is about 0.3% of the total in the homogenate and only 0.04% of the specifically bound neurotoxin. Using the alkylating affinity label [3H]-N-propylbenzilylcholine mustard (1) and also [3H]-atropine, which both bind, at low concentrations, specifically to the muscarinic acetylcholine receptor, binding was studied to the chloroform--methanol extracted proteolipid from rat brain cortex. No specific binding could, however, be demonstrated. Prelabelling in the membrane with 1 and subsequent extraction with chloroform--methanol gave a protein yield of about 1% and an extraction of 26% of the specifically bound label.


Effect of lead poisoning on the thiamine status and function in liver and blood of rats. Three groups of Sprague-Dawley rats were fed a thiamine deficient diet, which was supplemented by daily subcutaneous injections of a minimum requirement of thiamine, and treated with lead(II) acetate in different molar ratios to thiamine (1:1, 2:1, 10:1) for 5 and 9 months, respectively. The prolonged administration of lead(II) acetate decreases the thiamine level in lead-treated rats and diminishes the enzymatic activity of pyruvate dehydrogenase as well as that of transketolase. The thiamine level in the liver decreased by 30 to 40% compared with a reference group and the activity of the erythrocyte transketolase diminished by 5 to 40%. The level of the blood pyruvate increased by about 20% and the rate of the oxidative decarboxylation of pyruvate by liver mitochondria decreased.


[Sudden cardiac death in patients with pacemakers]. The risk of sudden death in our material, is 13.6% of all deaths. 2. In 5 patients (1.6%) death was caused by failure of the pacemaker (PM), or the electrode. 3. Patients with an asynchronous PM have no higher risk for sudden death, than patients with demand PM. 4. In 9 of 44 patients, a dysfunction of the PM or electrode, can not be excluded. Thus, it must be strictly advised in all patients with an implanted PM, that an autopsy and control of the explanted PM and electrode should be performed. 5. Patients who have a higher risk for sudden death (total AV-Block, Adams-Stokes-Attacks) should be kept hospitalized at least 4 weeks after implantation, controlled more frequently than others, and should be labelled as high risk patients in their PM passport. 6. Control of the resistance in the patients circuit can detect impending failure of the electrode and prevent life threatening complications.


[Control studies on retired lead workers]. Nine lead-workers, with an exposure time of 26 years, are investigated 10 years, after they had retired. There are no differences in the blood-count, hemoglobin, blood-lead level, urin-delta-aminolevulinic-acid, urincoproporphyrin and delta-aminolevulinic-acid-dehydratase-activity in their blood, upon comparison with a control group without lead-exposure. The mean urinary excretion of lead (0.119 mumol/g Kreatinin = 24 microgram/g Kr.) was 8 times higher than of reached by the controls (0.014 mumol/g Kr. = 2.7 microgram/g Kr.). The injection of CaNa2-EDTA increased the lead excretion to 0.197 mumol/g Kr. = 40.8 microgram/g Kr., in the control group 0.123 mumol/g Kr. - 25.7 microgram/g Kr. (62%). Therefore these two investigations are recommended for detection of previous lead exposure.