[Incidence study of endemic nephropathy among newcomers (immigrants) to endemic foci in Bulgaria]. The clinical-laboratory studies of 488 immigrants in 17 endemic settlements in Bulgaria are presented. The average age of the immigrants is 56 years and 31 years is the average duration of the sojourn in the endemic foci. From the total group of immigrants 30 per cent are "contact ímmigrants", i.e. immigrants that had lived together or are living at present with patients with endemic nephropathy or members of their families. The average duration of the sojourn of the contact immigrants in the endemic environment is the same as that of the whole group. Ten of the immigrants have come in their child-adolescent age into the endemic settlements. The average age of that group is 61 and the average duration of the sojourn in the endemic foci is 52 years. The following data are stressed upon: The total and renal morbidity of the immigrants in the endemic foci does not differ in structure from that of the country. No sufficient data are available about the existence of family domestic noxae or infections. No data indicating tumours in the urinary system were found in the immigrants examined. It is conculded that, at the stage of the examination, no definite data were established about the endemic nephropathy affection of the immigrants in the endemic foci which though indirectly support the genetic hypothesis of endemic nephropathy etiology. The dispensarization of the immigrants in the endemic foci favours the longitudinal examination which is the final aim of the authors.


Psychiatry and psychotherapy. Is a divorce imminent? Despite the long tradition of psychiatrists practicing psychotherapy, many psychiatric and medical leaders are predicting and urging a reorientation of psychiatry toward the medical model. They would leave psychotherapy to psychologists, social workers and the like. Many social, governmental and institutional factors favor such a change. The marriage of psychiatry and psychotherapy has always been an uneasy one, and the push for divorce may be irresistible. The author cautions that a divorce could be detrimental to medicine by substituting, in the name of "science," a dehumanized, technological psychiatry for the current "moral" treatment. One alternative to divorce is a broader approach to psychiatry, combining biological, neuromedical, socioenvironmental and psychodynamic factors. The divorce, though imminent, should be resisted.


Percutaneous radio-frequency rhizotomy in the treatment of trigeminal neuralgia. A percutaneous technique of selective partial trigeminal root coagulation was evaluated in the treatment of 38 patients suffering from trigeminal neuralgia, 1 patient with pain secondary to oral carcinoma and 1 patient with atypical facial pain. The pain of trigeminal neuralgia was relieved in 94.7 percent of patients. Pain was relieved in the patient with oral carcinoma, but not in the patient with atypical facial pain. There was no mortality and no permanent morbidity outside of the trigeminal nerve lesion. The procedure requires only a brief hospital stay without the time, expense and hazards of open cranial surgical procedures.


[Differential diagnosis between skeletal muscle lesions and myocardial damage in multiple injury by determination of myocardial-specific creatine phosphokinase (CK-MB) (author's transl)]. The serum level of the myocardial-specific isoenzyme of creatine phosphokinase, CK-MB was determined in 50 patients with severe multiple injuries or following extensive surgery. It is concluded that whenever the proportion of CK-MB exceeds 10% of the total creatine phosphokinase activity myocardial damage has occurred, especially since equivalent ECG changes were registered in this group of patients.


[Clinical efficacy of perhexiline maleate in stable angina pectoris (author's transl)]. The antianginal effect of perhexiline was evaluated in a placebo-controlled double-blind study of 20 patients with stable angina pectoris. Only patients with documented myocardial infarction of more than 6 months' standing and with ST-segment depression on exercise were admitted to the study. Objective parameters of bicycle stress tests at a submaximum level of 50 watts and a maximum exercise level were evaluated. Subjective data such as nitroglycerin consumption and incidence of anginal attacks per week were obtained from the patients' self-maintained records. No negative chronotropic effect of perhexiline was found at rest. At a submaximum exercise level with unchanged double-product, a significantly lower heart rate (p less than 0.05) and a significant reduction in ST-segment depression were observed in comparison with the placebo. At maximum exercise level an increase in exercise tolerance of 8.1% and in aerobic capacity of 8.3% resulted in a significant increase in the double-product (p less than 0.01), with a shift in the blood pressure/heart rate ratio. Discontinuation of exercise occurred at the same heart rate, but at a markedly higher level of exercise attainment. Heart rate on exercise proved to be the most valuable parameter in this study for the evaluation of the aerobic capacity of the individual patient. Nitroglycerin consumption and frequency of anginal attacks per week were reduced, but were not of statistical significance. Side-effects occurred in 6 patients, but these did not require termination or reduction of medication. The selective effect on heart rate during exercise opens a new field of application for perhexiline in comparison with beta-blocking agents.


[The mitral valve prolapse syndrome and its complications (author's transl)]. Out of 1800 patients examined for valvular heart disease, 19 were found to have the mitral valve prolapse syndrome (MVPS). The relevant literature is reviewed and the epidemiology and aetiology of the disease are discussed. 50% of the patients had a history of endomyocarditis. The special diagnostic value of echocardiography is emphasized. Sudden death (observed in 2 young patients) and the grave complication of bacterial endocarditis (observed in 3 patients and usually caused by Streptococcus viridans) can occur in this condition. Prophylactic therapy with beta-blocking drugs and antibiotics seems warranted. The case history of one patient with MVPS under observation for eight years, who developed bacterial endocarditis from a dental focus is reported in greater detail as a typical case.


[Haemodynamic response to antihypertensive treatment with atenolol in patients with hypertension (author's transl]. The antihypertensive effect of atenolol, a cardioselective beta-blocker, was examined in 8 patients with essential hypertension. The most important haemodynamic changes observed were a significant reduction in heart rate (reduction in maximum heart rate at the end of symptom-limited exercise by 23% p less than 0.01) and a moderate fall in systolic blood pressure (reduction at submaximum level of exercise by 22%, p less than 0.01). The antihypertensive effect was attributable in half the patients to a drop in peripheral vascular resistance and in the other half evenly to a predominant reduction in cardiac output or to a reduction in both parameters. In view of the compensatory rise in stroke volume a significant reduction in cardiac output was not found. Symptom-limited exercise tolerance was increased in all patients. These results lead to the conclusion that the antihypertensive action of the cardioselective beta-blocker, atenolol is based on a lowering of the increased peripheral vascular resistance and a reduction in cardiac output; the latter mechanism is predominantly found in patients with hyperkinetic features.


[Audiological evaluation of ototoxicity in gentamycin-treated children (author's transl)]. Audiological evaluation was performed on 36 children who had been treated with gentamycin for severe infections of the urinary tract and/or of the bronchopulmonary system. An average of three years had elapsed between medication and audiological testings. Only one child showed a slight degree of symmetrical sensoneural hearing loss in the high frequency range.


[Arterial embolic occlusion in tumours of kidney and bladder (author's transl)]. Arterial embolic occlusion is a comparatively new therapeutic method in urology. This procedure is performed now before operation of tumours of the kidney and as a palliative measure in the treatment of renal and bladder cancer. The procedure and mode of administration of the different materials for occlusion are described. The difficulties arising during embolic occlusion and the subjective response of the patient to this treatment are discussed. Furthermore, the advantages and disadvantages of this method and, in particular, undesirable side effects are pointed out.


[Exit block: a postoperative complication of pacemaker implantation (author's transl)]. Exit block occurs in 7% of cases following implantation of a pacemaker for the first time and appears to be a serious and unpredictable occurrence which cannot be prevented by the selection of a particular technique or type of electrode of pacemaker. Therapeutic measures in patients who are not dependent on a pacemaker consist primarily of exchanging the intracardial lead. In all patients, as well as in those cases with recurrence of exit block, a pulse width-adjustable pulse generator should be implanted without resorting to other methods of questionable efficacy. The implantation of such a pulse generator was successful in all our cases.


[Retention of anal sphincteric control following surgical treatment of 498 patients with rectal carcinoma (author's transl)]. 498 cases of carcinoma of the rectum were operated on at the Surgical Polyclinic of Vienna during the period 1966 to 1975. The optimum procedure ensuring retained combination between presphincteric control, the mortality rate and late results are discussed.


[Legal aspects of patient enlightenment (therapeutic consent) from a surgeon's point of view (author's transl)]. The doctor-patient relationship has undergone considerable changes over recent years. An increase in public discussion of real or supposed malpractice has led to an increasingly critical attitude in patients, who are no longer prepared to accept the doctor's instructions unquestioningly. Every doctor, surgeons in particular, should, therefore, strive to restore a satisfactory relationship with his patient, since this is an essential precondition for ensuring therapeutic success. The doctor is obliged to explain to his patients (or legal spokesman) the risks involved in therapy and give him adequate insight into his condition. Only then can the patient make an adequate decision as to acceptance or refusal of therapy, which is legally binding (written consent in the case of operations). Absolute priority must be given to uninhibited maximum efficiency of the doctor. Legal safety should be of only secondary importance.


[Induction of labour (author's transl)]. Labour can be induced by different methods: there are conductive, indirect and direct approaches. Conductive techniques are reversible and, as a rule, successful only in women approaching term. Indirect techniques, i.e. low and high amniotomy, are irreversible; they should be carried out only for a precise indication and are associated with certain hazards. Direct techniques, i.e. administration of oxytocin and, recently, of prostaglandins, need an intravenous infusion. The dosage of the drug per minute differs according to the obstetrical situation and the aim of the approach. Calculated statistical data of the tonus, the intensity, the frequency and the uterine activity were summarized in order to evaluate the effect of induction of labour. The induction of labour is associated with hazards and risk to the fetus and/or the mother. Labour induction must be avoided in obstetrical situations which preclude a vaginal delivery. The necessity of labour induction occurs primarily under circumstances in which the further continuation of pregnancy is associated with increased hazards to the mother and/or the child.


[Urological complications following radical treatment of carcinoma of the cervix (author's transl)]. Urinary tract infection, obstruction and fistulation are the three commonest urological complications following radical treatment of cervical carcinoma. Special trends in treatment are discussed. Long-term results confirm the value of using a bladder flap in cases of reimplantation of the ureter into the bladder. Formation of a unilateral or bilateral "psoastip-bladder" (bipartition of the bladder) is described and active surgical management is recommended in cases of operable recurrent cervical carcinoma involving the urinary tract.


[Prophylactic medication to prevent miscarriage in pregnant women with a history of sterility (author's transl)]. A report is given of the outcome of 451 pregnancies occurring among women who had previously attended the Infertility Clinic. General gestagen therapy was given prophylactically in 129 cases before the appearance of any signs of threatened abortion. Massive gestagen therapy was initiated in 41 cases in response to signs of threatened abortion. Gestagen was not given either prophylactically or therapeutically in the remaining 281 pregnancies. The incidence of abortion was 10.1% in women given prophylactic gestagen, whilst the overall rate of abortion in the entire series of 451 women was 13.3%. It transpired on closer scrutiny of the 129 cases given prophylactic gestagen therapy that the abortion rate was 12.0% in the 108 pregnancies in which prophylactic gestagen therapy had been initiated at the time of the first missed period or later, whereas not one single abortion was registered amongst the 21 women who had been given gestagen therapy in the immediate post-ovulatory phase. It can be concluded that commencement of prophylactic gestagen therapy at the earliest possible moment provides optimum conditions for successful implantation of the fertilized ovum, especially in cases with masked insufficiency of the corpus luteum.


[Prophylaxis and early diagnosis of cancer of the cervis (author's transl)]. As a means to early detection of cancer of the cervix Hinselmann invented the colposcope in 1925, Papanicolaon the smear technique in 1943 and Antoine and Grünberger the colpomicroscopy in 1949. A more detailed description of colpomicroscopy is given. The healing of a benign erosion by electrocoagulation or freezing is a prophylactic measure to prevent development of cancer of the cervix. With suspicious findings on routine examination (colposcopy, Papanicolaou, colpomicroscopy), the lesion must be checked by conisation. Removal of the entire lesion (basal hyperplasia, dysplasia, concer in situ) obviates the need for further therapy. Conisation is, therefore, also a prophylactic measure to prevent development of cancer of the cervix. A report is given of 2 series of cases treated at the Department of Obstetrics and Gynaecology, Kaiser Franz Joseph Hospital, Vienna.


[Glucocorticoid-induced effect of erythropoietin in haemolytic anaemia with uraemia and red cell enzyme deficiency (author's transl)]. The effect of 6-methylprednisolone (GCC) was studied on erythropoietin (ESF) levels and on the metabolic functions of erythrocytes (RBC). GCC (U mg/kg/day for 15 days) was administered to 6 patients with the haemolytic-uraemic syndrome (group B) and to 6 patients with non-spherocytic haemolytic anaemia due to hereditary pyruvate kinase enzyme deficiency (group C). 6 healthy persons served as control (group A). The metabolic functions of RBC were investigated by assaying HMPS activity, GSH/GSSG and lactate/pyruvate ratios, relevant glycolytic intermediates, 2,3-DPG, ATP, and key enzymes. A significant increase in ESF was observed in group B patients after GCC therapy, correlating with an improvement in the haemolytic state, and consequent rectification of the secondary disturbances of RBC metabolism. Group C patients already had raised ESF levels before GCC therapy; no further increase occured in response to treatment and no other clinical or haematological change was recorded. Hence, no harmonal influence of GCC on the disturbed RBC metabolic process was detectable in the cases.


[Measles antibodies in systemic lupus erythematosus (author's transl)]. 30 patients with systemic lupus erythematosus (SLE), 19 patients with rheumatoid arthritis (RA) and 34 controls were investigated with regard to measles antibodies (AB). The titres were compared with clinical and immunological parameters. As previously reported by several authors we found increased measles AB titres more frequently (kappa 2-test, p less than 0.05) in patients with SLE than in those with RA and controls. No significant correlation was found between immunoglobulins, antinuclear antibodies, CH50 or rheumatoid factor, and an elevation of the measles AB titre. A trend was noted, however, towards a positive correlation between measles antibodies and IgM. An elevated measles AB titre in SLE can be explained on the basis of several mechanisms. However, hyperimmunoglobulinaemia with non-specific, secondary AB elevation can be ruled out as a cause of elevated measles AB titre according to our results.


[Summer holiday camps for asthmatic children--an attempted assessment (author's transl)]. 118 schoolchildred (males:females = 2.5 : 1) with bronchial asthma--defined as recurrent allergic or non-allergic expiratory dyspnoea--were investigated as regards their clinical course, frequency of asthma attacks, exercise tolerance, anti-asthmatic drug requirements and spirometric changes during and after participation in specialized holiday programmes during the summer months in 1974, 1975, and 1976. Clear-cut improvement was observed with regard to asthma attack frequency (up to nearly 100%) and drug requirements (up to 76%). Steroid dependence was observed in most cases. No significant spirometric improvement was demonstrable. All data require critical evaluation and interpretation in view of seasonal variations in asthmatic manifestation and the influence of environmental factors. On reviewing the results it is concluded that treatment of the asthmatic child by supervised high altitude holidays (1400 m above seal level), combined with physical training and a respirator re-education programme, is still a justified therapeutic approach, but it cannot replace specific therapy laid down on the basis of careful diagnostic testing. Particpation of the asthmatic child in school gym classes is recommended. Abstention from physical exercis due to a misplaced protective attitude is not beneficial in most cases.


[Five cases of lactic acidosis (author's transl)]. Five cases of non-biguanide-induced lactic acidoses are reported. The key role of the liver and kidneys in lactate metabolism is stressed. The patients at risk are enumerated and the particular stress in connexion with surgical procedures and the dangers of fructose infusions are pointed out. The coagulation disturbances due to lactic acidosis are discussed. The different operative procedures and their effectiveness are discussed.


[Live influenza vaccination of military personnel (author's transl)]. A field study was performed on 118 members of army personnel with the intranasally-applied live influenza vaccine, RIT 4050. 91 subjects were revaccinated 7 days thereafter. The immune response was best in subjects with a low prevaccination titre and was better in subjects vaccinated twice than only once. An immune response was also detected in the nasal secretion measuring the secretory IgA antibodies. Live influenza vaccine can be regarded as a suitable alternative to other influenza vaccines, with the qualification that it lacks an influenza B component.


The fate of saccharin impurities: the excretion and metabolism of toluene-2-sulphonamide in man and rat. Oral doses (20 mg/kg) of [Me-14C]toluene-2-sulphonamide were rapidly eliminated by rats (92% of dose in 24 h). Most of the 14C (88%) was recovered in the urine within 7 days with litte (5%) in the faeces. Larger oral doses (125 and 200 mg/kg) were eliminated more slowly (70 and 43% respectively in 24 h) but the overall distribution of 14C between urine and faeces was unchanged. 2. Low oral doses (0.2--0.4 mg/kg) of [Me-14C]toluene-2-sulphonamide were excreted more slowly in man than in the rat, with about 50% recovered in the urine in 24 h and 80% in 48 h. Negligible 14C (less than 1%) appeared in the faeces. 3. The main metabolites of toluene-2-sulphonamide were 2-sulphamoylbenzyl alcohol and its sulphate and glucuronic acid conjugates (80% of the 14C in the urine of rats and 35% in man) and saccharin (35% in man and 3% in the rat). Other metabolities found in the urine were 2-sulphamoylbenzoic acid (2% in the rat and 4% in man) and N-acetyltoluene-2-sulphonamide (6% in rat and 2% in man) together with unchanged compound (5% in rat and 3% in man).


The fate of saccharin impurities: the excretion and metabolism of [3-14C]Benz[d]-isothiazoline-1,1-dioxide (BIT) in man and rat. 1. The 14C label of [3-14C]benz[d]isothiazoline-1,1-dioxide (BIT) (40 mg/kg) was rapidly eliminated (97% dose in 24 h), largely in the urine (92% dose in 24 h), after oral administration to rats. Larger doses (400 mg/kg) were eliminated more slowly after oral or parenteral administration (45--60% within 24 h) mostly in the urine (42--53%). Little 14C (2--3% dose) was present in the faeces after intraperitoneal (400 mg/kg) or low oral (40 mg/kg) doses, but the presence of larger amounts (12% dose) after larger oral doses (400 mg/kg) indicated incomplete absorption. 2. Metabolites identified in the urine of rats were saccharin (about 30% of urinary 14C), 2-sulphamoylbenzoic acid (about 35% urinary 14C) and 2-sulphamoylbenzyl alcohol (15% urinary 14C) in addition to unchanged compound (5--10% urinary 14C). The urine also contained a polar, labile metabolite that gave BIT on acid hydrolysis. The pattern of metabolism was not significantly affected by dose or route of administration. 3. In man, urine was the major route of elimination of 14C (93% dose) after administration of 14C-BIT (0.5 mg/kg). Negligible 14C was recovered in the faeces (less than 1% dose). Excretion was rapid (59% dose in 6 h; 80% dose in 12 h) and little 14C was eliminated on the second (3%) or subsequent days after dosing. 4. Identified metabolites in man included saccharin (about 50% of urinary 14C), 2-sulphamoylbenzoic acid (7% urinary 14C) and 2-sulphamoylbenzyl alcohol (8% urinary 14C unconjugated and 40% conjugated) with negligible unchanged compound. Only traces of the polar labile metabolite were detected. 5. the possible significance of metabolic interrelationships of toluene-2-sulphonamide and BIT to studies on the metabolism of saccharin are discussed.


The fate of saccharin impurities: the metabolism and excretion of 3-amino [3-14C]benz[d]-isothiazole-1,1-dioxide and 5-chlorosaccharin in the rat. 1. 3-Amino[3-14C]benz[d]isothiazole-1, 1-dioxide was prepared from [3-14C]-saccharin. IT was well adsorbed on oral administration to rats (25 mg/kg) with only 2% of the 14C in the faeces. The absorbed material was rapidly eliminated with about 87% dose in the urine in 24 h and 91% in 4 days. Little 14C (0.5% of dose) was present in the carcass 4 days after dosing. Most of the 14C in the 0--24 h urine (99%) was present as unchanged 3-aminobenz[d]isothiazole-1,1-dioxide, the rest being an unidentified metabolite. 2. 5-Chlorosaccharin was excreted unchanged after oral administration to rats (80 mg/kg) with 76% dose in the urine in 24 h and 81% in 4 days. Only 4% was detected in the faeces. There was no significance hydrolysis (less than 0.5%) to 5-chloro-2-sulphamoylbenzoic acid. 3. The extent of metabolism of these and other compounds related to saccharin showed good agreement with the extent of their partitioning into organic solvents.


Metabolism of the antimicrobial agent nibroxane, 5-bromo-2-methyl-5-nitro-m-dioxane, in the rat. 1. The metabolism of nibroxane, a topically effective antimicrobial agent has been studied in the rat after oral and dermal administrations. 2. Plasma level studies in vitro and in vivo showed nibroxane to be rapidly debrominated to 2-methyl-5-nitro-m-dioxane. 3. Nibroxane is rapidly absorbed and extensively metabolized in the rat regardless of the route of administration. 4. Enzymic hydrolysis of the m-dioxane ring was of major importance in the biotransformation of nibroxane. The major eliminated metabolite in the rat was 2-nitropropan-1,3-diol.


The identification of eight hydroxylated metabolites of etidocaine by chemical ionization mass spectrometry. 1. Eight hydroxylated metabolites of etidocaine have been identified in urine of man by g.l.c.-chemical ionization mass spectrometry, using methane and a mixture of methane and deuterium oxide as reactant gases. 2. The metabolites identified were N-(2,6-dimethyl-3- and 4-hydroxyphenyl-)-2-(N,N-ethylpropylamino)butyramides, N-(2,6-dimethyl-3- and 4-hydroxyphenyl)-2-aminobutyramides, N-(2,6-dimethyl-3- and 4-hydroxyphenyl)-2-(N-ethylamino)butyramides, and N-(2,6-dimethyl-3- and 4-hydroxyphenyl)-2-(N-propylamino)butyramides. 3. The eight metabolites represent about 10% of the oral dose of etidocaine.


Sex differences in the kinetic constants of ethylmorphine demethylation and type I binding to hepatic microsomal cytochrome P-450 in mice. The influence of castration and testosterone. 1. In the CPB-SE mouse strain sex differences were observed in the Km and Vmax of ethylmorphine demethylation and in the deltaAmax of its type I binding to cytochrome P-450. In the CPB-V strain a small sex difference in the Vmax of the demethylation was found, whereas Ks and deltaAmax of type I binding differed considerably. 2. Testosterone pre-treatment of female CPB-SE mice abolished all sex differences, as did castration of males, except in Vmax, which was partially decreased. In the CPB-V strain testosterone pre-treatment of females abolished sex differences in type I binding, but had no effect on ethylmorphine demethylation. 3. Km values exceeded the corresponding Ks in all cases and sex differences in deltaAmax far exceeded those in Vmax. It is concluded that the Km is determined not only by the Ks of type I binding and the reduction rate of the type I complex between ethylmorphine and cytochrome P-450. The larger sex differences in deltaAmax as compared with Vmax may be attributable to type I binding of ethylmorphine to cytochrome P-450 subspecies not involved in its demethylation.


Biotransformation of 3-(2',4',5'-triethoxybenzoyl) propionic acid, a new biliary smooth muscle relaxant with choleretic activity, in rats. 1. By the combined use of deuterium labelling and gas chromatographic-mass spectrometric analysis, the metabolite pattern of 3-[2',4',5'-triethoxybenzoyl) propionic acid (triethoxybenzoylpropionic acid), a new biliary smooth muscle relaxant with choleretic activity, has been determined in the rat. 2. The metabolites excreted in urine and/or bile were isolated and characterized as follows: the parent drug, 3-(2',5'-diethoxy-4'-hydroxybenzoyl)propionic acid (metabolite II),3-(2'-ethoxy-4'-hydroxy-5'-methoxybenzoyl)propionic acid or 3-(2'-ethoxy-5'-hydroxy-4'-methoxybenzoyl)propionic acid (III), 3-(2',4'-diethoxy-5'-hydroxybenzoyl)propionic acid (V) and 3-[2',4'-diethoxy-5'-(2-hydroxyethoxy)benzoyl]propionic acid (VI). 3. The primary route of biotransformation of triethoxybenzoylpropionic acid in the rat was either O-de-ethylation at the C-4' and C-5' positions or beta-hydroxylation of the ethoxy group at the C-5' position in the parent molecule. 4. All these excreted products except metabolite VI were eliminated both unconjugated and in conjugates (probably glucuronides and/or sulphates). 5. The rat excreted mainly metabolites V and VI in the urine and parent drug, metabolites V and VI in the bile.


Metabolic fate of 1-hexylcarbamoyl-5-fluorouracil in rats. 1. The metabolic fate of a new antitumour agent, 1-hexylcarbamoyl-5-fluoro [6-14C]uracil (14C-HCFU) in rats after oral administration was compared with that of 5-fluoro[6-14C]uracil (14C-FU). 2. Tissue radioactivity reached a max. 1 to 3 h after administration of 14C-HCFU and 0.5 h after 14C-FU. 3. Both drugs were excreted rapidly, mostly in urine. Expired 14CO2 from 14C-HCFU was significantly less than that from 14C-FU. 4. Unchanged FU was not detected in plasma 3 h after administration of 14C-FU, whereas FU was detected in plasma 5 h after 14C-HCFU. The pyrimidine ring of 14C-HCFU might be degradated more slowly than that of 14C-FU. 5. 1-(5-Carboxypentylcarbamoyl)-5-fluorouracil and 1-(3-carboxypropylcarbamoyl)-5-fluorouracil were identified as the major urinary metabolites of 14C-HCFU.


Taurine conjugation in metabolism of 3-phenoxybenzoic acid and the pyrethroid insecticide cypermethrin in mouse. 1. A substantial proportion of the radioactivity of an oral dose (1-20 mg/kg) of 3-phenoxy [14C] benzoic acid and the pyrethroid insecticide trans- and cis-[aryl-14C] cypermethrin (an alpha-cyano-3-phenoxybenzyl ester) is eliminated rapidly in urine of mice. 2. The major urinary metabolite of these compounds in two strains of mice is N-(3-phenoxybenzoyl)taurine. 3. Neither 3-phenoxybenzoic acid nor cypermethrin gives a taurine conjugate in rats. 4. Benzoic acid gives no taurine conjugate in mice.


The oxidative metabolism of alpha-chlorohydrin in the male rat and the formation of spermatocoeles. 1. The oxidative metabolism of [3-36C]chloropropan-1,2-diol (alpha-chlorohydrin, I) was studied in male rats. Two metabolites were isolated and identified as beta-chlorolactic acid (IV) and oxalic acid (V). 2. Neither alpha-chlorohydrin nor beta-chlorolactate was concentrated in any tissue. Traces of an intermediate metabolite, beta-chlorolactaldehyde (III) were detected in the urine within 4 h of administration. Studies in vitro indicated that the metabolic pathway is: alpha-chlorohydrin leads to beta-chlorolactaldehyde leads to beta-chlorolactic acid. 3. A comparative study of the metabolism of 36Cl- and 14C-beta-chlorolactate showed that oxalate was produced slowly and, as calcium oxalate, caused a type of renal glomerular nephritis. This pathological condition is responsible for the diuretic action of both alpha-chlorohydrin and beta-chlorolactate and, in higher doses, for their toxicities. 4. The role of oxalate, as a metabolite of alpha-chlorohydrin and of a number of related compounds, in inducing the formation of spermatocoeles in the male rat reproductive tract is discussed.


Stereoselective disposition of fenfluramine enantiomers in the rat. 1. Rats were treated with d-, l-or dl-fenfluramine. The two optical isomers and their metabolites were determined in plasma, red blood cells and brain areas such as striatum and brainstem. 2. In all cases, the levels of d-fenfluramine were higher than those of the l-enantiomer, while levels of the metabolite norfenfluramine were lower for the d- than the l-form. 3. When metabolism of fenfluramine was inhibited by pre-treatment with SKF 525-A, the concentrations of the enantiomers no longer differed.


[Selection and characterization of Penicillium cyclopium mutants with altered developmental program]. After treatment with NNMG, NaNO2 or UV-light of conidiospores of Penicillium cyclopium strain SM 72 variant strains (mutants) with altered developmental programme were selected. Additionally from a methionine-auxotrophic mutant of P. cyclopium prototrophic revertants were prepared. Investigation of the alkaloid metabolism and other idiophase processes has shown that these mutant strains can be divided into two groups (cf. table 1): a) Mutants with a depression of all idiophase features. The defects of these strains presumably affect central regulatory processes which, as in strain rev-met 83a, can be reversed spontaneously by an one-step mechanism and b) mutants defective in certain parts of the idiophase programme only, demonstrating that there is a certain autonomy in regulation of the individual parts of the programme.


Metabolism of fructose in Thiocapsa roseopersicina. Thiocapsa roseopersicina strain 6311 grew phototrophically in a mineral medium containing fructose as sole electron donor and carbon source with a doubling time of 11--13 h, provided the mineral medium contained vitamine B12 (50 ng/ml), not more than 20 mM phosphate, and the culture was preincubated in the dark for 24 h. In fructose-grown cells but not in autotrophically grown cells, the cell-protein content was strongly reduced when vitamine B12 was growth limiting, while the carbohydrate content was increased. Growth on fructose as sole carbon source was inhibited by the addition of sulfide or thiosulfate; growth inhibition was relieved in the presence of bicarbonate. No growth on fructose was observed anaerobically in the dark; aerobic growth in the dark was poor. Analysis of enzyme activities in fructose- and acetate-grown cells indicated that fructose was catabolized via fructose-1-phosphate and the EMBDEN-MEYERHOF pathway. The operation of the EMBDEN-MEYERHOF pathway was confirmed by incorporation of 1-14C-, 3-14C-, and 6-14C-fructose into the spirilloxanthin fraction and analysis of its specific radioactivity.


[Growth kinetics of thiamine requiring Candida lipolytica during thiamine limitation: the existence of a linear growth phase]. The growth kinetics of batch cultures of the thiamine requiring Candida lipolytica 695 was investigated. It was established that a phase of logarithmic growth is followed by a linear growth phase. The time length of the linear phase and the relative increasing of the biomass during the linear phase are nearly constant and independend of the concentration of thiamine. The existence of the linear phase is discussed in connection with a constant activity of one of the two 2-ketoacid dehydrogenases as a bottle neck enzyme which needs thiamine pyrophosphate as coenzyme. Critical intracellular thiamine concentrations were calculated necessary for transition from the logarithmic to the linear phase and from the logarithmic to the stationary growth phase. Without the existence of the second critical thiamine concentration the linear growth would continue infinitely.


[Use and application of aerosols on the upper respiratory tract including the paranasal sinuses (author's transl)]. A general view of actually situation of aerosol application in inflammatory affections of mucous membrane of upper respiratory tract is represented. Aerosol therapy problems of inflammation of the paranasal sinuses - sinus maxillaris and sinus frontalis - are accentuated and new experimental in vivo results are submitted.


An electroaerosol device for group vaccination against influenza. With the aid of an electroaerosol device a group of persons were vaccinated by inhalation of influenza vaccine. In a first trial 76 persons with a low antibody level (1 : 20 and less) were vaccinated against A2/Victoria/1/72 and B/USSR/69: Antibodies were reexamined 30 days later, Interferon at the 3rd and 10th day. This kind of vaccination caused an antibody increase statistically significant. In the course of an influenza epidemic 2,300 persons vaccinated by inhalation were compared with 2,195 not vaccinated. Among the persons vaccinated there were 13.7 +/- 0.7% diseases, among the non vaccinated persons 26.3 +/- 0.9%.


Vaccination by the aerosol method.

Vaccination by the aerosol method. After a review on vaccination by inhalation of aerosols the authors describe the group vaccination with the aid of an electroaerosol generator. 8 persons may be vaccinated simultaneously in a very short time. The vaccination by inhalation is without any hazards. The viability of the microorganisms in the aerosol is preserved. Interferon inhalation seems to reduce symptoms of intoxication in the first days after outset of influenza or acute airway infection. The efficiency of vaccination through aerosol inhalations against bacterial infections demands further researchs.


[The combined effect of ionizing radiation and smoking on the causation of bronchial carcinoma (author's transl)]. For the prevention of bronchial carcinoma the identification of its causes is of highest priority. Especial attention should be dedicated to the combined action of several factors. In this paper a review is given on the combination effect of simultaneous action of ionizing radiation and smoking observed by epidemiological studies in miners exposed to radon and its consecutive products. The amplifying action of both factors observed under working conditions brought about to refer to such combinations in smokers also outside their working life. This results from the natural loading by radiation of the respiratory tract, from radioactive material in the emmission of power stations on the base of fossil fuels, and from the contents of tobacco with 210Pb and 210Po. The combined action of radiation and smoking is regarded as another motivation to give up smoking strictly.


[Case finding of bronchial carcinoma in Czechoslovakia (author's transl)]. In Czechoslovakia obligatory registration of all cases of cancer is introduced in 1953. In this paper are informed of the most important results of the analysis of indexes which were find out in the whole country, of the results of epidemic studies in Prag, and of the epidemic studies in the district of Kolín. From 1959 to 1975 the rate of bronchial carcinoma has increased in men from 47 to 86 of the male population, in women from 6 to 9 of the female population.


[Definition of limits of bronchial reactivity with aid of bodyplethysmography (author's transl)]. Investigations for dose-effect relationship of acetylcholine-ultrasonic-aerosols (apparatus "TUR" USI3, duration of inhalation three minutes, control of the ventilation parameters five minutes after termination of inhalation) led to the result that the delimination of the bronchial hyperreactivity is already possible by application of a 0.01% test-concentration. In this way the ultrasonic-aerosol-method also leads to results which are comparable with the nozzle-aerosol-method used in GDR (0.5% test-concentration, duration of inhalation one minute). As a limiting criteria for the evaluation of a bronchial hyperreactivity analogous to the decrease in the FEV1 of greater than or equal to 15% in comparison with the starting position for the bodyplethysmography yield an increase of the resistance totalis of greater than or equal to 3.0 cm H2O/1/s.


Autoradiography of colonies of mycobacteria on membrane filters. Effect of tuberculostatics on incorporation of radioactive phosphorus. A technique for the autoradiography of colonies of mycobacteria on membrane filters has been evolved. The method enables studies on the effect of various factors on the incorporation of radioisotopes by mycobacteria. In this study the effect of INH, SM and RMP on the incorporation of 32P by mycobacteria cultivated in the form of microcolonies on membrane filters was examined. 30 minute incubation of Myc. phlei or 10 hour incubation of Myc. H37Ra with these drugs caused visible inhibition of 32P incorporation by drug-sensitive mycobacteria.


[A questionnaire with a special computer programme for the anamnesis of patients with suspicion of asthma bronchiale (author's transl)]. A questionnaire with a special computer programme is introduced for the anamnesis of patients with suspicion of asthma bronchiale. The questionnaire is filled in by the patient himself. It has proved of use in 750 patients during three years.


[Article in addition to the angioleiomyomatosis of the lungs (author's transl)]. The appearance of a spontaneous chylothorax is a rare case-taking. Chylous effusions are a cardinal symptom of the angioleiomyomatosis of the lungs. Symptomatics and diagnostics of this very rare disease occuring only in women are described by means of one casuistics. Referring to about 60 cases described in literature the probable pathogenetic mechanism and the possibilities of therapy are mentioned in the discussion.


[Drugs and vitamins].

[Drugs and vitamins]. Since most of the drugs are taken orally via the gastrointestinal tract, interactions with food ingredients may lead to alterations in the intake of essential dietary factors. With regard to vitamins the following effects have been demonstrated: early decomposition resp. inactivation, decreased absorption or a qualitatively and quantitatively modified metabolism. Examples of such changes are given with regard to water- and lipid-soluble vitamins.


An epidemiological and biochemical study on osteomalacia among pregnant women in Egypt. 230 pregnant women of low socio-economic standard were studied regarding the nutritional status and state of calcium and bone mineralization, social, environmental, dietary and biological factors of the women were also investigated to determine their possible role in such state. Results revealed a low nutritional status associated with biochemical abnormality denoting an impaired calcium state and defective bone mineralization. The low intake of available calcium and lack or inefficient supplements are suggested to be the main factors in causing the low state of calcium.


Microsomal enzymes inducers and serum minerals in carbon-tetrachloride hepatotoxicity. The effect of ten repeated doses of carbon tetrachloride, phenobarbitone and propionyl promazine when administered alone or simultaneously with CCl4 on serum minerals was investigated. Carbon tetrachloride resulted in a significant increase in serum iron, copper, zinc, calcium, potassium and sodium. A portion of this rise was due to increased permeability in damaged mitochondrial membrane as a result of the action of CCl4. Propionyl promazine when administered alone or together with CCl4 has no effect on serum minerals. Phenobarbitone when administered alone increased serum minerals except sodium, but to a lesser degree than CCl4, while phenobarbitone when given repeatedly together with small doses of CCl4 led to a normalization of serum iron, calcium and potassium. Also serum zinc and copper were lower than in case of CCl4. This may be due to some protective effect of phenobarbitone on liver mitochondria. Serum magnesium was not affected in all the experimental groups.


Effect of phenobarbitone and propionyl-promazine on serum enzymes in carbon-tetrachloride hepatotoxicity. The influence of phenobarbitone givenin ten repeated doses simultaneously with small doses of CCl4 on serum enzymes was investigated in albino rats. The same experiment was repeated to investigate the influence of propionyl-promazine (phenothiazine derivative). The results proved that SGPT is a more specific and sensitive index than SGOT of hepato-cellular injury. The activity ratio between serum GOT and GPT in the normal control group was 2.44. The activity of SGPT increased nearly 6.1 fold after CCl4 administration and thus the activity ratio between GOT and GPT is sharply reduced to 0.56. The activity of serum GPT when CCl4 and phenobarbitone were administered together showed value of about 1/2 of the value when CCl4 was administered alone, while it remained high when CCl4 administration was combined with propionyl-promazine. Serum GOT and alkaline phosphatase increased significantly in all the groups. Regarding the pathological examination of the liver it was found that marked fatty necrosis could be demonstrated when high values of SGPT was found, which is not the case with serum GOT. It is concluded that in the present experimental conditions phenobarbitone protected the liver from the hepatotoxic effect of CCl4, while propionyl-promazine did not.


[What emergencies arise from anticoagulant therapy?]. The antithrombotics (fibrinolytics, anticoagulants and aggregation inhibitors) belong to the most effective therapeutic methods and are used in all clinical specialties. The therapeutic mechanism of the fibrinolytics and anticoagulants is recognizable and can be regulated by hepatic parameters. Nevertheless, under this treatment patients undergo a potential risk of haemorrhage which not in every case can be estimated with the usual laboratory parameters. In addition to the factors increasing the potential risk false behaviour of the physician in charge and false behaviour on the side of the patient must be mentioned. In these two cases a treatment with antithrombotics should be omitted. If personal and technical insufficiencies are present the patient should be transferred to a centre for further treatment. In acute indications for discontinuing the treatment with antithrombotics depending on the clinical urgency a gradually different discontinuation by stages should be striven for, in order to avoid thromboembolic relapses.


[Gastrectomy patients--a retrospective study]. Of 39 patients with resected stomach the endoscopic and radiological findings as well as the anamnestic and paraclinical data were analysed retrospectively and compared. In contrast to the patients with recidivation ulcer and stump gastritis the patients with a gastric stump carcinoma had an essentially higher average age and, in general, a considerably longer postoperative interval. The endoscopy, including biopsy, achieved a considerably greater diagnostic security in the various groups of disease than the X-ray examination. Symptoms, such as decrease of weight, gastric pains and vomiting, were most frequently found in patients with carcinoma.


[Evaluation of weather-dependent dyspnea by means of body plethysmographic study of bronchial reactivity]. By body plethysmographic investigations including the test of the bronchial reactivity (ultrasound aerosol of a 0.01% acetylcholine solution) was demonstrated that in dependence on the degree of the manifest disturbance of ventilation the frequency of the bronchial hyperreactivity (increase of the total resistance by at least 3.0 cm H2O/l/s compared with the initial position) increases. The constellation of findings mentioned leads to a large increase of dyspnoea depending on weather.


[Psychologic guidance of the cancer patient]. Cancer belongs to these diseases threatening severely the lives of patients affected by cancer. Therefore, cancer is connected with psychic responses on the part of the patient. The response as a result of the disease is intensified by negative environmental experiences. The physician has to make due allowance for this fact in the patient's guidance. At the beginning the pros and cons of a truthful information of the patient are discussed. In the following an inhouse model of the care of patients is presented according to which the patient is faced with his diagnosis and prognosis. An attempt is made of helping the patient "to integrate" his disease and to cope with "his" cancer problem. This also includes the guidance of the relations.


[The behavior of albumin in acute and chronic liver damage. III. Intrahepatic and serum albumin concentrations in human liver diseases]. In 305 patients examined by liver biopsy albumin and the entire soluble protein in the liver puncture as well as albumin in the serum were estimated quantitatively. A significant decrease of the serum albumin level in active cirrhoses and biliary liver damages confirmed the importance of the hypalbuminaemia as facultative symptom of a liver damage. The lacking specifity was emphasized by the low albumin serum concentrations in malignomas and after the intake of contraceptive hormones. The hypalbuminaemia and the increased content of soluble liver protein in the bioptic material might enrich the diagnostics of the activity in cirrhoses. The diagnostic value of the decrease of the relative proportion of albumin is low, since of all liver diseases examined the active cirrhosis alone was accompanied by a significant decrease. The estimation of the albumin content in the bioptically got liver tissue had in contrast to the animal experiment no diagnostic value for liver diseases.


[Removal of a foreign body from the superior vena cava by means of a urinary calculus remover]. It is reported on a successful removal of torn off or knotted parts of a heart catheter, which were extracted without difficulties from the superior vena cava and from the right atrium via the vena saphena magna by means of the catcher of ureteroliths after Dormia. One case in question was a 27-year-old male patient with pentalogy of Fallot, in whom was the danger of embolisation into the greater circulatory system on account of the torn off catheter conducting wire. In the other 57-year-old patient with acute myocardial infarction after knotting of a subclavian catheter a mechanical irritation of the endocardium with repeated appearance of ventricular fibrillation developed. Before deciding on a thoracotomy for the removal of parts of a catheter from the central vessels and the heart it should be tried before a transvasal extraction with the help of special catheters.


[Cardiovascular radiography, changes in the thoracic aorta, ECG and clinical parameters in hypertension. 2. Changes in the thoracic aorta in hypertension]. In 142 hypertensives and a control group of 230 normotensives the measure of the aorta after Kreuzfuchs was estimated. In the two groups a significant increase of the width of the aorta was found with growing age. Whilst the width of the aorta concerning the degree of severity I of hypertension on an average were slightly below those of normotensives, they were increased in the degrees of severity II and III, but a further increase could not be ascertained at the transition from degree of severity II to III. On the other hand, the duration of hypertension is of particular importance when a dilation of the aorta is present. Also between deformation of the heart and measure of the aorta close relations which may conclude to a homogenous development are to be seen particularly in the younger patients. The influence of the sclerosis of the aorta in the sense of an additional dilation of the aorta could not be clearly confirmed on the basis of our material. On the other hand, the frequency of calcium depositions significantly increased with growing age in the region of the aortic arce and in the group of younger patients with the duration of hypertension, whereas the different degrees of severity II and III had a smaller influence. It is interesting that several patients showed normal widths of the aorta despite a duration of the hypertension of more than 5 years and a degree of severity III.


[Results of in vivo analysis of injected fibrinogen degradation products and factor VIII in patients with hemophilia A]. Seven patients with haemophilia A CP were injected in a dosage of 1 to 3 double units, which were stored for 127 days partly deep-frozen, partly lyophilized and after this time contained fibrinogen fission products (16--256 microgram/ml). Though in two patients after the transfusion positive WA of the injected fibrinogen fission products were established, a relevant influence on the fibrinogen fission product levels of the patients is to be expected only after administration of larger quantities of such preparations. The therapeutic efficacy of the stored CP was insufficient, since despite good in-vitro-activities of factor VIII the increase of factor VIII in four patients was slight and retarding and did not take place in three patients.


[Hemangioendothelioma--a case contribution]. By means of two casuistics the haemangioendothelioma is demonstrated. The malignant tumour may occur in all tissues and organs metastasizing in haematogenic and lymphogenic manners. The thorotrast or vinylchloride-caused promotion of the tumour formation is especially discussed because of its considerably prophylactic importance.


[Does abdoman cause ileus?].

[Does abdoman cause ileus?]. On account of its favourable pharmacological properties Abdoman has proved in the treatment of patients with uncomplicated duodenal ulcer. On the basis of its pronounced motility inhibiting effect on the gastrointestinal canal it may be additionally used for the treatment of diarrhoea. It is reported on 5 patients in which under Abdoman therapy a paralytic ileus developed as severe complication, so that it must be warned of an uncontrolled prescription of abdoman concerning this indication. Abdoman should be used above all in juvenile patients, in which case particular attention must be paid to obstipation as most frequent side-effect.


Segmental infrarenal aortocaval transposition. An experimental model for vascular research. The technique for transposition of infrarenal segments from the abdominal aorta and the caval vein, respectively, was described and morfological changes characterized. The vessel walls in the transposed caval segments became "arterialized" 1 month after the operation due to increased connective tissue in the media. Fibrin depositions were found on the intimal layer. The transposed aortic segments had no morfological changes. The described model was found to be a simple and valuable method for vascular research in small animals.


[Thrombogenic effect of direct current in the arterial circulation]. In 54 dogs thrombosis was induced in the femoral artery by means of continuous current. Macroscopic and microscopic and studies on the tensile strength of the vascular wall were carried out in order to clarify the thrombogenic effect of continuous current. Further the behavior of the blood flow during the formation of the thrombus was examined.


[Collecting methods for pancreatic juice in long-term research in the non-anesthesized dog]. Comparison of various methods of collecting pancreatic juice in long-term experiments shows that there is no ideal procedure. The authors themselves obtained the best results by help of the duodenal cannula according to Tuckermann and Thomas, which is implanted in the duodenum opposite to the duodenal papilla. Using this cannula it is often possible with sufficient skill and patience to cannulate the duodenal papilla from the outside and to gain pancreatic juice from the awake dog in an exact manner. Among the pouch techniques the best is the method according to Herrera.


[Discoid lupus erythematosus or lichen planus?]. A patient with atypical skin symptoms is described. The clinical symptoms as well as the histological ones showed the signs of both LE, and LP. The administration of antimalarial drugs had a good effect. The results of laboratorical examinations were such as in LP.


[RIST or PRIST?].

[RIST or PRIST?]. In 240 patients the radioimmunosorbent (RIST) and paper-radioimmunosorbent (PRIST) tests were used parallel for determination of serum IgE levels. Whilst the values achieved with PRIST generally were somewhat lower than those with RIST, a very good correlation was found between these two methods. Taking its procedural simplicity into account, PRIST thus appears better suited for routine diagnostic purposes than RIST.


[Action of the calciumantagonistic compound gallopamile on sinus node, atrioventricular and intraventricular conduction (author's transl)]. The influence of the calciumantagonistic agent Gallopamile (D 600) on cardiac conduction and sinus node function was studied by using His bundle recordings and atrial stimulation in 13 patients with normal sinus rhythm. Intravenous administration of a single dose of 4 mg produced a significant increase in the atrioventricular conduction time by 30 %. On atrial stimulation second degree a-v block occurred at lower stimulation rates in all patients after Gallopamile. The impulse propagation in atrial tissue and within the His-Purkinje system was not affected, even in patients with diseased conduction system. There was an impairment in sinus node automaticity, the sinus node recovery time was increased by 58 % of the control value.


[Echocardiographic normal data for premature and normal newborn infants (author's transl)]. Sufficient echocardiographic analysis of premature infants has not yet been presented. Therefore echocardiograms of 105 babies without cardiovascular disease weighing 0.6--4.0 kg were analyzed. Normal data for right ventricular dimension, diastolic left ventricular inner dimension, left atrium, aorta, septums left ventricular posterior wall, cardiac depth, amplitude and closing velocity of the anterior mitral leaflet have been established. All measurements are a linear function of bodyweight with a very good correlation.


[Echocardiographic diagnosis of thrombotic deposits in acute endocarditis (author's transl)]. This report describes the echocardiographic features seen in 6 patients with valvular vegetations as documented by autopsy or surgery. 4 mitral, 3 aortic and 1 tricuspid valves were investigated using M-mode echoscan(n = 8). Characteristic findings observed were non-uniform thickening of the typical valve pattern in sytole and diastole without restriction of valve motion. In 7 cases the exact echocardiographic localization of valvular vegetation was confirmed in situ, whereas localization of vegetation in tricuspid valve disease was uncomplete.


[New method of estimating x-ray magnification on angiographic volume determinations (author's transl)]. 1. The necessity of a precise determination of the magnification factor for angiographic volume determinations is described. Each error of the linear magnification factor influences in its third power the volume calculation. 2. For the magnification of linear cineangiographic magnification a method is used in which the tip of the catheter is filmed in two positions. The distance approximately resembles a normal ventricular diameter. The relationship of virtuel shifting of the catheter tip versus real shifting of the patient is the magnification factor. 3. For the practicable handling of this method a new developed mechanical device is described which allows the performance of the calibration procedure with an adequate high precision. 4. The method is simple and can be done within a short period of time.


[Pressure curves in the coronary arteries (author's transl)]. During catheterization of the coronary vessels two different pressure curves can be registrated. One curve looks like the aortic pressure while the other is similar the ventricular curve. The diastolic pressure of these curves lies below the aortic diastolic pressure but is higher than the diastolic ventricular pressure. The appearence of the different pressure curves is independent from the morphology of the coronary arteries. The different form of the pressure curves depends on the dynamic of the blood flow in the coronary system which is discussed.


[Effect of prostaglandin E1 on the hemodynamics in newborn infants with pulmonary atresia (author's transl)]. The effect of prostaglandin E1 (PGE1) on the haemodynamics during cardiac catheterisation was studied in 6 newborn infants with pulmonary atresia and ductus-dependent pulmonary perfusion. In 4 patients with initial arterial O2-saturations between 24% and 45% pulmonary blood flow increased from a mean value of 1.0 to 4.5 1/min/m2, 15--20 minutes after the infusion of PGE1 was started. At the same time the systemic blood flow decreased markedly, the systemic blood pressure varied only slightly, and a marked increase in systemic vascular resistance was calculated. In one further patient with a relatively high initial arterial O2 saturation the pulmonary blood flow increased only minimally, whereas in the remainder patient with low initial arterial oxygen saturation there was no change after PGE1 during the investigation.


Electron microscopy observations on Trypanosoma brucei: freeze-cleaving and thin-sectioning study of the apical part of the flagellar pocket. Observations on the apical part of the flagellar pocket of Trypanosoma brucei using the freeze-cleaving and thin-sectioning techniques of electron microscopy are reported. The flagellar pocket is shown as a flask-shaped depression in the body, continuous with the pellicle and flagellar sheath. The membranes of the apical part of the pocket on the flanged side of the body compress the flagellar sheath, forming part of a "neck region". This region is completed on the broad body side of the flagellar pocket when it embraces the flagellar sheath. The possible role of the neck region in the dynamic function of pinocytosis is discussed.


[Invasion of erythrocytes by toxoplasma gondii (author's transl)]. The in vitro-invasion of mouse erythrocytes by Toxoplasma gondii could be detected and analysed by electron microscopy. The sequence of events observed during erythrocyte invasion led to the assumption of an actively penetrating parasite into the non-phagocytic host cell.


Serial passages of larval Echinococcus granulosus from equine origin in mice. I. Infection with protoscolices. Starting with protoscolices from Echinococcus granulosus cysts of equine origin it was possible to isolate and maintain several "strains" of the parasite in mice through successive transfers of protoscolices. The most advanced strain is now in its 7th generation. Several criteria to evaluate the results are presented and discussed. It is concluded that serial echinococcosis of E. granulosus through passages with protoscolices is a practical method to maintain different strains for fundamental and applied comparative studies.


An automatic method for recording the emergence of cercariae of Schistosoma mansoni from the snail Biomphalaria glabrata. In order to study the pattern of emergence of trematode larvae from the snail hosts (S. mansoni from B. glabrata) an automatic apparatus was developed. This apparatus allows the snails, each suspended by a thread, to be transported at intervals of at least half an hour into different beakers into which the cercariae are shed. This "eclosion clock" is essentially a carriage driven on perlon wheels along steel bars.


Ultrastructural localization of basic proteins on the conoid, rhoptries and micronemes of Toxoplasma gondii. The ethanolic phosphotungstic acid (E-PTA) technique was used to locate basis proteins in trophozoites of Toxoplasma gondii, obtained from the peritoneal exudate of infected mice. The reaction was observed mainly on the conoid, rhoptries, and micronemes of both extracellular and intracellular parasites. The strongest reaction was observed on rhoptries. Nuclei and ribosomes from parasites and host cells also reacted. The role of basic proteins on rhoptries and micronemes is discussed with a view on host-cell penetration by the parasite.


[Simuliids larvae microsporidans: ultrastructural data (author's transl)]. This work is the summary of our present knowledge about the ultrastructure of Simuliids larvae Microsporidans, including several new data concerning: 1. Pleistophora simulii (Lutz et Splendore, 1904): reticulated or net-like plasmodial envelope, formation of pansporoblastic structures looking like short pipes. 2. Stempellia simulii Maurand et Manier, 1968: plasmodial envelope as Pleistophora simulii, granular-textured polaroplast. 3. Thelohania fibrata (Strickland, 1913): ultrastructural study of the sporogonic sequence nerve done so far. 4. Thelohania bracteata (Stickland, 1913): its relations with Thelohania minuta, T. canningi, Amblyospora bracteata, Pegmatheca simulii. 5. Tuzetia debaisieuxi (Jirovec, 1943): formation of pseudopansporoblasts by the host-cell membrane.


On factors possibly restricting the distribution of Schistosoma intercalatum Fisher, 1934. Two hypotheses have been postulated explaining the limited distribution of Schistosoma intercalatum. The first hypothesis is correlated with physical factors and behaviour of cercariae. Histochemical and ultrastructural studies have shown that in response to increased temperature change the cercariae of S. intercalatum form aggregates, unlike other schistosome cercariae of man, which are non-infective to the definitive host. The aggregates are formed by the release of the adhesive post-acetabular gland secretion which causes the cercariae to stick together. It is suggested that if S. intercalatum spread from streams within tropical rain forest to pools and laybys of streams in the savannah, cercariae would be subjected to greater daily temperature changes thus triggering the release of post-acetabular gland secretion, thereby impairing invasion of the definitive host. The second hypothesis is based on the natural occurrence of hybridisation between S. intercalatum and Schistosoma haematobium. With some strains of these two species there are no genetical isolating mechanisms. It is suggested that if S. intercalatum extended into a savannah environment from tropical rain forest, hybridisation between S. intercalatum and S. haematobium would eventually occur. Experimental studies indicate that probably, as a result of introgressive hybridisation, a new strain of S. haematobium would eventually supersede the original S. intercalatum.


The enhancement of tetrathyridial proliferation of Mesocestoides corti in mice by B.C.G. The effects of different doses of B.C.G. given at various periods before infection, on the development  of tetrathyridia of Mesocestoides corti was studied. B.C.G. administration was found to exert a complex influence upon M. corti infection in mice. Either enhancement or inhibition of parasite proliferation may occur, depending upon dosage level and the time interval between B.C.G. administration and parasite challenge.


Ultrastructural changes in the body wall of Schistosoma mansoni during the transformation of the miracidium into the mother sporocyst in the snail host Biomphalaria pfeifferi. The ultrastructure of the body wall of the free miracidium of Schistosoma mansoni and the changes occurring within 48 h after penetration into the intermediate host Biomphalaria pfeifferi are described. Within 2 h after penetration the ciliated plates are shed into the haemolymph of the snail and phagocytized by amoebocytes. At the same time the narrow ridges between the plates of the free miracidium expand to form the continuous outer layer of the sporocyst. Within 48 h the entire tegumental structure, consisting of a thin outer layer, connected with sunken nucleated areas, develops to its full extent. The observations are compared with those on Fasciola hepatica.


[The vulnerability of peripheral nerves and the somatic toxin linkage in tick paralysis of chickens, caused by Argas (Persicargas) walkerae (author's transl)]. Investigations on the impulse propagation and the pattern of amplitudes of toxically by Argas (Persicargas) walkerae larvae impaired peripheral nerves were carried out under oxygen saturated and anoxic conditions. It was demonstrated, that the maximum nerve conduction velocities of the isolated N. ischiadicus were slightly lowered in the first carbogenic and anoxic phase, in comparison with normal nerves. After the second incubation the conduction velocities were, however, almost the same or even higher. The survival times of the nerves after anoxic exposure, which were determined by the temporal persistence of the potentials, revealed that this neurophysiological parameter always resulted in a higher value for the damaged nerves after every two anoxic phases. The diseased nerves therefore tolerate anoxia longer and better than do healthy nerves in respect to their excitability and in their function of impulse propagation. From these in vitro investigations it is concluded that the noxious substance responsible for the paralysis is not cell-bound, but circulates humorally. The toxin possesses membranophilic properties, but its somatic linkage is very labile.


[Game approach to processing physiologic data with the study of human emotional responses as an example]. The paper presents a mathematical method of experimental data processing, using the study of human emotional reaction as an example. The method allows to process data of different signs containing a great uncertainty. Different signs of data observed in the studies of the dependence of degree of human emotional stress on need and uncertainty in goal reaching, emerge in the course of the experiment and classification of the emotional reactions by their intensity. Numerical models for two subjects are created on the base of the minimax Kolmogorov criterion, and the obtained results are discussed.


[Generalized transformation of subjective time assessment]. The subjects were given false information on the results of their estimation of time intervals in one of the experimental situations (they assessed time intervals filled up with different kinds of mental activity or free of them, as well as reproduced from memory 1-sec. interval). The observed changes in the accuracy of time estimation were typical of all situations, i.e. they were of generalized and coordinated character and pertained throughout 5 days. It is suggested that different specific forms of time perception typical of certain conditions form a unified system.


[Conditioned reflex autoregulation of human respiration during tachystoscopic presentation of cues]. The changes in external respiration were studied in humans during visual perception of test signals, as well as the changes in relations between the moment of signal presentation and the phase of respiratory cycle in the process of complication of experimental tasks and training. The method of temporal stereotype of test signals sequence permitted to reveal the process of self-regulation of cerebral functional state through the changes in respiration. This process is envisaged as a component of the entire structure of conditioned reflex to time. Its principal meaning is to prepare the functional level of the central nervous system providing for the stability of the given level of perception and processing of information in time.


[Conditioned reflexes to time and effective stimuli after extirpation of the parietal region of the cortex in dogs]. Experiments on unrestrained dogs performed by the alimentary method showed that extirpation of the parietal cortex (field P) does not affect the previously elaborated and well stabilized conditioned reflexes to time, their reversal and temporal differentiation. The operated dogs retain their ability for relative perception of temporal intervals. Switching over of conditioned reflexes to time is disturbed. The conditioned reflexes to successive complex stimuli with simultaneous differentiation of their components are disturbed for a long time (up to seven months). Less disturbed are the conditioned reflexes to a simultaneous polysensory complex with parallel extinction of their components (within one month after the operation). An assumption has been made that the parietal zone of the cerebral cortex plays an important part in the mechanism providing for successive connections.


[Effect of hippocampal damage on the appearance of trace reactions in dogs during ontogenesis]. The formation of trace motor and secretory alimentary conditioned reflexes were studied in dogs after injury of dorsal part of hippocampus at different stages of ontogenesis, 38--42 days, 3, 5, and 13 months. All animals with lesioned dorsal hippocampus formed non-delayed motor and secretory reflexes. Trace motor reflexes were elaborated in four out of nine animals, and trace secretory ones--only in one animal. The experiment emphasized the importance of the degree of hippocampal injury for the maintenance of the studied functions. Morphological analysis revealed that degeneration of thalamic nuclei is identical in animals operated at different age. No signs of brain tissue regeneration were observed.


[Interrelationship between the auditory, parietal and sensomotor regions of the dog cerebral cortex during a defensive conditioned reflex]. Interrelations between projection (auditory), associative (parietal) and integrative-triggering (sensorimotor) cortical areas were studied in dogs by EP parameters and localization during formation of defensive conditioned reflex to clicks. These interrelations were studied in intact animals and after ablation of either T3 areas or PI2 area of the auditory cortex. It was found that in intact animals auditory cortical areas are constantly involved in brain integrations whereas parietal ones show periodical participation (EPs in the parietal cortical area accompany some pairings of signal stimulus with reinforcement). Integrative-triggering cortical structures are involved in the systemic processes in the period of stabilisation of defensive reaction. After ablation of T3 area integrative-triggering cortical structures are turned on within a large exitation system from the beginning of the defensive reaction formation. After ablation of PI2 area parietal areas constantly participate in brain integrations. The nature of their participation in the forming of a given functional system is determined by the state of the auditory system or location of its injury.


[Behavior of cats after unilateral section of the brachii of the inferior colliculi]. In experiments on 13 cats a unilateral section of the brachii of inferior colliculi produced a stable interhemispheric asymmetry not only in the auditory system, but in other (vestibular, visual, somatic, olfactory) analysers as well, which led to a disturbance of adequate space perception. This was manifested in orienting reactions directed only to the side of brain lesion. Animals were no more able to distinguish between the right and left troughs either by spatial or by modal cues. A complete "disregard" by the animals of the trough contralateral to the side of lesion suggests a hemispheric lateralization of conditioned connections providing for an adequate direction of the animals' running.


[Role of intervals between "conditioned" and "unconditioned" stimuli during elaboration of a cellular analog of a temporary connection]. A cellular model of temporary connection was used to study the effect of intervals between stimulation of ventrobasal thalamic complex (conditioned stimulus) and local activating polarization (unconditioned stimulus) on plastic changes in the neuronal responses of sensorimotor cortex inalert rabbit. It was found that a prolongation of the interval between paired stimuli from 0 to 150 msec. produced a decrease from 60 to 28 per cent in the number of neurones in which after pairings the responses to the conditioned stimulus underwent significant plastic rearrangments. Inspite of the general trend each cell has its own optimal interval between combined stimuli where changes are most pronounced. The fact that rearrangments in cellular responses occur in a time interval corresponding to reinforcement in pairings supports the idea about a selective increase in the efficiency of those excitatory synapses that were activated simultaneously with the cell discharge.


[Plastic transformation of the activity of cortical neurons upon pairing a signal stimulus with microiontophoresis or electrocutaneous stimulation]. Substantial differences have been found in the plastic reorganizations of neuronal activity of the rat sensorimotor cortex at local and systemic reinforcements. In nineteen (95%) out of 20 neurones stable and one-type changes of response to CS (electrical stimulation of the cortex) developed in the course of pairings with local ionophoretic application of L-glutamate in the vicinity of the studied neurone. Twenty two units were studied during the pairings of electrical stimulation of the cortex with pain electrocutaneous stimulation: plastic reorganizations in response to CS were revealed only in eight (36.4%) units; they were, however, of long duration and were more diverse in pattern, than in the series with local reinforcement. It is assumed that different plastic reorganizations in these two model situations of learning depend on the number and reactive properties of the participating units.


[Effect of ethymisole on long-term memory]. Influence of ethymisol (bismethylamid of 1-ethylimidasol-4,5-dicarbonic acid) on learning and retention of habit was studied in experiments on rats by the method of active conditioned avoidance of electrical stimulation. At the same time optimal conformation form of the drug was determined by the method of proton magnetic resonance and by means of infrared spectra and theoretical conformation analysis. A single administration of ethymisol in the dose of 3 mg/kg reduced the deficit of the avoidance habit, when tested in 30 and 60 days following learning. A stable conformation of the ethymisol molecule with a planar arrangement of atoms of its heterocycle and amide groups was found in which the interaction of this substance with biological macromolecules was most active. The ethymisol effect on the long-term memory apparently results from a stable facilitation of synaptic transmission based on stabilization of spatial structure of biological macromolecules in the given conformation.


[Changes in the activation level in the EEG's of adolescents as a result of school work and its attendant hypokinesia]. The integral activity of main frequency ranges of the rest EEG was studied in two groups of schoolchildren at the end of the schoolyear. One half of each group consisted of boys, the other one of girls. The groups differed in the number of physical culture lessons per week (2 and 8). The boys of the two-lessons group manifested a higher integral oscillation activity over the whole EEG spectrum as compared with the boys of the eight-lessons group; this was considered as a drop of activation level. At the same time the girls of the two-lessons group revealed a higher integral activity within the theta range and a lower one within other ranges; this was estimated as an EEG manifestation of traces of tense alertness. Judging by the result of dispersion analysis, the influence of chronic hypokinesia on the recorded EEG components is much greater than that of the school activities.


[Evoked cortical potentials to simple and complex visual signals in children]. The analysis of steadily recorded components of evoked potentials (EP) in different areas of cerebral cortex during tachistoscopic presentation of a homogeneous square, checker-board pattern and schematic drawings of human faces (face-pattern) of 6 degrees size was performed in children aged from 6,5 to 7 years. During contour detection, characterized by significant EP differences between responses to a checker-board pattern and a homogeneous square, the most pronounced changes were observed in the visual projection area of the cortex. Reaction to a complex visual stimulus, characterized by differences of EP to fase and checker-board patterns, had maximal manifestation in the temporo-parieto-occipital area. The changes observed during both operations were noted for EP components appearing up to 250 msec following stimulation. It is suggested that they are connected with the activity of cortical receptive fields. The data obtained are discussed on the basis of hypothesis of a difference between cortical mechanisms of single operations involved in visual perception.


[Effect of a generator of pathologically intensified excitation in the orbital cortex on the sleep--wakefulness cycle]. In experiments on cats it was shown that the creation of generator of pathologically intensified excitation (GPiE) in the orbital cortex resulted in certain pathological changes of sleep. These changes were expressed in a shortening of the wakefulness period and prolongation of the sleep state, the relationship between slow-wave and paradoxical sleep phases remaining unchanged. The results of the investigations confirm the suggestion concerning the participation of the orbito-frontal cortex in sleep induction. The obtained data are analyzed with respect to the general concept about the role of determinant structures in the nervous system activity and the theory of generator mechanisms of neuropathological syndromes characterized by hyperactivity of the systems.


[Role of the frontal cortex in organizing emotional-behavioral reactions induced by hypothalamic stimulation and natural stimuli]. Study of the effects of a functional switching off the sensorimotor neocortex area in cats by means of cooling reveals its inhibitory influence on emotional-behavioral reactions to hypothalamic stimulation. Multiple (up to 12) switchings off of the frontal neocortex are attended with a gradual compensation of its inhibitory function by the activity of other brain structures. On the other hand inactivation of the sensorimotor cortex reduces the ability of natural provoking stimuli to lower the thresholds of goal-directed rage which develops when these stimuli are combined with an electrical stimulation of the hypothalamus. A conclusion has been made on the participation of the frontal neocortex in the systemic organization of estimation of biologically significant stimuli.


[Cytochemical characteristics of protein content in neurons from functionally different regions of the cerebral cortex in rabbits]. Interpherometric determination of proteins in neurones of the III, IV and V layers of the visual and parietal areas and of III and V layers of the motor area of the rabbit cerebral cortex has shown that functionally different neurones have their own morpho-chemical characteristics as well. Differences are revealed between neurones of individual layers within each of the studied areas, between neurones of individual layers of the projection (motor, visual) and the so-called associative (parietal) areas as well as between neurones within each layer. The latter is apparently determined, above all, by their belonging to mono- or polymodal neurones.


[Amplitude-frequency analysis of the total electrical activity of the cat cerebral cortex in the presence of mean dynamic pressure in the circulatory bed]. In the experiments on cats dumpfing of arterial and venous systems was carried out in order to study the functional state of CNS with blood supply under constant hydrostatic (mean dynamic) pressure. It was found that pulse oscillations of pressure in arterial and venous blood introduce marked distortions in ECoG. Blood supply under non-pulsatile pressure doesn't cause any considerable changes in the functional state of the cerebral cortex.


[Microsystemic organization of neuronal interactions in the central units of the visual analyzer]. Neuronal interaction in superior colliculi (SC) and visual cortex (VC) was studied in acute experiments on immobilized unanaesthetized cats with simultaneous recording of unit activity in both structures. Polarization of cortical neurones produced activational changes in the level of impulse activity of SC neurones. In a considerable number of neurone pairs (38.4 per cent), fluctuations of the mean frequency and moments of spike discharge generation were in marked correlation suggesting their synphasic modulations. The data obtained are discussed from the point of view of microsystemic organization of central mechanisms of the higher nervous activity.


[Nickel, cobalt, iron, manganese, zinc and chromium content of black tea and the distribution of these metals between prepared infusion and the extracted tea leaves (author's transl)]. Twentytwo samples of black tea were examined for nickel, cobalt, iron, manganese and chromium by atomic absorption spectro-photometry. The amounts of these metals in the tea beverage as well as the amount remaining in the tea leaf residue was determined in duplicate experiments. From these results the proportion of each metal extracted may be calculated, as well as its concentration in the tea beverage prepared under defined conditions.


[Mercury content of poultry meat (author's transl)]. The muscle and fatty tissue of 101 deep-frozen fattened stewing chickens was tested for Hg content. After wet digestion, the mercury content was determined by cold-flameless AAS (atomic absorption spectrometry). The average Hg content in muscle and/or fatty tissue was 0.004 and 0.001 ppm of fresh weight, respectively and thus was very low. The limit value of 0.08 ppm was exceeded in 2% of the samples analysed.


[On the metabolism of sulphur dioxide in apples (author's transl)]. Apples of the two varieties, Boskoop and Brettacher, were exposed to 35S labeled sulphur dioxide. After storage at several conditions the distribution of 35S-activity among the three fractions, sulphite, sulphate and sulphonate was examined. The major portion of the radioactivity was found in the sulphate fraction. The activity decreased remarkably from the peel towards the core. Appreciable differences in distribution patterns were found between the two apples varieties.


[Determination of aroma substances in Spalter hops by gaschromatography-mass spectrometry (author's transl)]. The volatiles of Spalter hops were concentrated by destillation-extraction, separated by liquid solid chromatography and characterized by capillary gas chromatography-mass spectrometry. 125 constituents (terpenes, sesquiterpenes, esters, alcohols, acids) were identified and semiquantified.


[Analysis of flavonoid glycosides by high pressure liquid chromatography (author's transl)]. The development of a qualitative and quantitative method of determination for glycosides of flavones, flavonols and flavanones and their aglycones by means of high pressure liquid chromatography is described. Silicagel LiChrosorb Si 60 is used as stationary phase, as well as various eluents at different temperatures. The compounds are acetylated. An extract of plum leaves serves as example of application.


Aflatoxin at several initial concentrations is degraded by different amounts of mycelium of Aspergillus parasiticus. Increasing amounts of a blendure of 9-day-old mycelia of Aspergillus parasiticus NRRL 2999 added to aflatoxin-salts reaction mixtures resulted in increased rates at which aflatoxin B1 and G1 were degraded. Similarly, increasing the amount(s) of aflatoxin B1 and/or G1 in the aflatoxin-salts reaction mixture resulted in increased rates of degradation of aflatoxins B1 and G1 by mycelia. This mycelial blendure degraded aflatoxin G1 approximately 1.6 times more rapidly than aflatoxin B1 when comparable amounts of the aflatoxins were initially present. When the same mycelial blendure was used to compared combined effects of size of inoculum and initial aflatoxin concentration on aflatoxin degradation, it appeared that increasing the amount of either inoculum or aflatoxin resulted in a comparable increase in degradation of aflatoxin B1 and G1. Hence, doubling the amount of inoculum or of aflatoxin resulted in approximately doubled rates at which aflatoxins B1 and G1 were degraded.


[A contribution to the analysis of Fusarium toxins (trichothecene toxins) (author's transl)]. The isolation of fusarium toxins (Trichothecene toxins) is described as well as methods using thin-layer chromatography and gas chromatography for their determination. An improved biotest with larvae of Artemia salina is outlined. Some toxins could be identified together as as group by preparing a common derivative.


Phosphatidylcholine as the main phospholipid within essential oil residues from the orange fruit. The essential oil obtained from oranges of different origin leaves a dark red oil after purification. The residue holds phospholipids. Phosphatidyl cholin has been identified as the main compound.


[Organization of occupational medicine in the Federal Republic of Germany]. The present organization and development of occupational medicine in the Federal Republic of Germany are presented. The main laws and regulations are summarized as well as their ways of enforcement. Then, the status of occupational medicine, the legal conditions to which it complies, the level of prevailing expertise and the education are discussed. Finally, the official introduction of this science to the University level, including the research and education needs, is studied.


Occupational safety and health: United States of America. The major legislation in the United States to implement safety and health in the workplace is the Occupational Safety and Health Act of 1970 (Public Law 91-595). The United States has enacted a number of laws to reduce the number and severity of work-related injuries and illnesses which, despite efforts of employers and government, were resulting in ever-increasing human misery and economic loss. The Act calls not only for enforcement of standards but for programmes of research, education and training. The Secretary of the Department of Labour Uniformly applies occupational safety and health standards which have been developed with the assistance of the Secretary of the Department of Health, Education and Welfare. A strong programme has been developed in research and application of research to problems in the special areas of mining, construction, and agriculture, as well as for general industry and other employment.


[Swiss federal work inspection in the light of a century of workmen's protection]. A hundred years ago, on March 24, 1877, the first federal law on factory workers protection was passed in Switzerland. It was updated in 1914, and in 1964 it was replaced by the present legislation which protects not only factory workers but also most other employees, such as in trade and commerce. The Cantons are responsible for the execution of the law, whereas on the federal level, four federal inspectorates and a medical division exercise supervisory functions. Their task is to see to it that there is countrywide uniformity in following the law.


[Remarks on hygiene and safety conditions in small and medium-sized firms]. The author reviews briefly the main ideas of the international program for improvement of working conditions presently recommended by the ILO. This program emphasizes a global approach to working conditions and environment. The swiss situation according to this program is briefly described and some suggestions are made to improve the lot of workers in small and medium-sized firms.


[What is the use of an occupational physician?]. In four occidental countries, an analysis of available statistics shows a decrease of industrial accidents, occupational diseases and tuberculosis during the last decades. However this decrease is correlated neither with the number of occupational physicians, nor with the spread of statutory annual medical examinations. Efficient prevention depends mainly on measures taken by the employers and employees themselves. If the medical examination in itself doesn't protect the worker, tasks of the occupational physician should be reassessed: a) to identify health hazards in industry by clinical and epidemiological surveys, b) to advise on safety at work, c) to control the effectiveness of the measures taken by medical examination and/or biological tests of workers exposed to well defined hazards. Occupational health could be developped in Switzerland, with limited cost, but sharing the tasks between the occupational physicians already working in the large industries and new occupational State-physicians in cantons or regions.


[Organization and tasks of occupational medicine in Switzerland]. Industrial health aims to harmonize man's relation to his work. In our country indusprial health is promulgated by the medical services of SUVA (Swiss Accident Insurance Institute) and BIGA (Federal Office for Industry and Labour) on one hand and by the lecturers of universities and at the ETH (Swiss Federal Institute of Technology) as well as by plant physicians on the other hand. Industrial health is a compulsory discipline with examination at medical faculties.


[Teaching of occupational medicine in Switzerland]. In this paper, the different training programs in the field of occupational health are described. It appears clearly that training programs differ widely from one university to another. A new step will be fulfilled with the development of a degree in occupational health for FMH specialists. It is mentioned that the lack of a valuable status for industrial physicians may adversely affect the evolution of training programs in Switzerland.


A review of the organization of occupational health and safety and occupational hygiene in Britain. Britain's Health and Safety at Work Act introduced in 1974 marked a change in approach to occupational health and safety which is having important long-term effects on the organization of occupational health and safety in Britain. The purpose of this paper is to outline the broad principles of approach to health and safety at work contained within the 1974 Act; highlight the implications of the new Act for employers, managers, employees, and representative organizations, and discuss the developments in the organization of occupational health and safety as a result of the 1974 Act.


[Is preventive medicine a government task?]. Health care of the citizens (sanitary police) belongs to the classical tasks of the public authorities ( = state). Primary prevention is a joint task of the state and the individual, but it only can be fully effective if the state participates in the organization and coordination. The most significant examples are immunization and prophylaxis of road accidents while preventive medical examinations can be left to the individual's own responsibility. It is no primary task of the state to carry them out and pay for them. The state creates the necessary basis for effective prevention by means of training and further education of the health personnel, continued evaluation of preventive measures, setting up statistical instruments, coordination of nationwide activities, active cooperation in publicity campaigns for preventive measures (mass media) and promoting research. Simultaneously, the citizen's own responsibility should be activated by persuasive measures. As little use as possible should be made of compulsory measures.


[Task of a cantonal preventive health officer]. Considerations from a point of view of health-policy as well as from an epidemiological standpoint reach the conclusion that the main tasks of a medical officer in preventive medicine at cantonal (state) level are on the field of primary prevention, in particular health-education. In the new health-law of the canton of St.Gall, early detection of diseases will be delegated to physicians in private practice. At the cantonal level, a health officer will thus have the following tasks: 1. Planning of programmes in primary prevention, mainly in the field of health-education, for state or private authorities. 2. Counseling of state and local authorities in questions of preventive medicine. 3. Support, evaluation an coordination of already existing activities on the field of public health.


[Preventive medicine in private medical practice]. The basis of preventive medicine for the individual is composed of health education, certain examinations and preventive treatments. A coherent approach is essential for efficiency of a program and avoidance of costly and nonessential expenditures. In the Swiss health system, the doctor's office could become more and more the center of preventive medicine for the individual. It would concern a large part of the population (in the United States, 80% of the men and 90% of the women consult a doctor at least once a year); offering a direct contact with the doctor of choice, advice specific for each case and the possibility of regular examinations by the same doctors. In many situations both public and private sources are involved in preventive medicine (public health services, doctors involved in the educational system, doctors involved in controll of security of working conditions, out-patient clinics, various health organizations). A collaboration among these sources should be organized and a reasonable division of the work established. A list of examinations and preventive treatments is presented.


[Preschool screening examinations in medical practice]. In most European countries systematic screening programs for infants and preschool children are being introduced or are already established as a routine procedure. The contents and the possible effects of such programs are discussed critically in this paper, which also describes the present state in Switzerland as well as a pilot project initiated by the Bernese Pediatric Association.


[Radiography services: old and new tasks]. At the beginning of mass-radiophotography campaign the main interest was the fight against tuberculosis. Today the point of view has completely changed. The detection of all the diseases of the chest, the evaluation of risk groups and the combination with other screenings such as blood pressure measurement have largely improved the efficiency of the campaigns.


[Preventive dentistry programs in the schools]. Dental caries and gum disease may easily be prevented. Based on experiences extending over twenty years several preventive programs for school children can be offered and the one best suited for the local circumstances may be selected. Two types of dental auxiliaries have proved very useful to realize preventive programs on the level of communities and/or cantons, requiring costs of only 3 to 7 Swiss fracs per year and child. Considering the excellent results already available it should not be very difficult to obtain cooperation even of those communities who have not yet introduced any preventive programs.


[Sex education in the schools. Inquires among the cantons]. During the last ten years most cantonal educational departments in Switzerland have tackled the problem of sexual education. With the exception of the canton of Schaffhausen all the cantons have decided not to introduce compulsory sexual education. In almost all the cantons the consent of the parents is necessary. They usually have the right to have their children excused from sexual education. Theoretically speaking, sexual education is not confined to a certain age, but actually it is only given in the middle and upper classes. All the cantons accept that the parents should give their own children sexual education; school has only a complementary function. Usually the form master is responsible for sexual education. A close intercantonal cooperation is not the case, because sexual education is too much dependent on local conditions.


[Extent of preventive medicine services of the canton of Basel-town]. The results of an analysis of all preventive services in the canton of Basel-Town for 1974 show, that there were 110,000 preventive examinations delivered (i.e. 374 per 1000 adults). Practizing physicians provided 73%, cantonal services 23% and occupational health services 4% of those exams. For primary prevention, the relationship is inverse: the weight of cantonal services is in this domain. Costs for cantonal services amount to 1.4% of the cantonal outlays for health.