[Aseptic bone necrosis in lupus disease]. Seven cases with aseptic necrosis in lupus disseminatus are presented being 9.70 per cent of 72 patients with confirmed systemic lupus, observed in the cours of 20 years. Six cases with lupus disseminatus are concerned--acute and subacute paroxysm a course and one case with chronic skin form--discoid lupus, complicated in the course of its evolution with aseptic necrosis of the right head of the femur. The cause for detection of the bone lesions in the cases presented, was the pain, especially manifested with the necrosis localized in the supporting bones of the lower limbs. The analysis of the state of the patients with systemic lupus reveals that all cases, are severe forms of the disease with multiorgan involvement, febrile reactions and the presence of vascular phenomena--Raynaud syndrome, coronary and cerebral arteriitis. High doses of corticosteroid preparations were used in the treatment of the disease due to its lasting progress (paroxysms of 8--12 months).


[Left atrial thrombi manifesting clinically as an annular thrombus]. The authors present a case diagnosed while still living, as an annular thrombus in the left atrium with the presence of a "pure" mitral stenosis. At necropsy, two thrombi were found, one of them "traveling", situated very close to each other, providing conditions for a complete obstruction of the mitral opening and imitating the respective clinical picture.


Fever of undetermined origin: role of cytomegalovirus and Epstein-Barr virus. Roles of various infections, neoplasms and granulomatous diseases in fever of unknown origin were studied in 22 patients. Bacterial infections were responsible in seven (32 percent), herpes viruses in five (23 percent), neoplasms in four (18 percent) and granulomata in two (9 percent) cases. Patients with herpes infections had initially no clinical or routine laboratory clues to viral involvement, and were given an intensive workup for 5 to 15 days. The diagnosis was made on the basis of cytomegalovirus or Epstein-Barr virus lgM antibody titers.


Rheumatoid hand deformities: pathophysiology and treatment. Rheumatoid disease, as it affects the hand, is a disease of the synovium lining the joints and sheaths of the tendon. The proliferating synovium destroys the articular surfaces of the joint, interferes with the gliding mechanism of the tendons and weakens the supporting ligaments of the joints. The degree and variety of deformities is multifold. Treatment of the rheumatoid hand is aimed at conservation and restoration of hand function, as well as prevention of future deformities. Rheumatologists, physical therapists and hand surgeons carry out important functions in the well-planned, integrated regimen. Surgical treatment of the rheumatoid hand deformity may alleviate pain, lessen deformity and improve function in selected cases. It should be integrated in the general medical management of a patient. Treatment of tendon ruptures includes tenorrhaphy, tendon grafting and arthrodesis in the case of mallet finger deformity. The wrist joint is improved by synovectomy and carpal tunnel release is accomplished by median nerve decompression. Metacarpal phalangeal joint deformities may be treated by synovectomy or silastic joint replacement when there is destruction of the articular joint surface, severe subluxation, or persistent painful motion.


Organophosphate pesticide poisoning.

Organophosphate pesticide poisoning. A total of 118 workers from a 120-person grape picking crew became ill in early September 1976. Of these (108 men and 10 women), 85 received medical attention and three of the 85 were admitted to hospital. The symptoms were typical for organophosphate poisoning. Average plasma and red cell cholinesterase values for the affected workers were depressed more than 60 percent. Most were treated with atropine and some were also treated with 2-PAM (pralidoxime). The exposure to residues of the organophosphate pesticides dialifor (Torak((R))) and phosalone (Zolone((R))) occurred in one grower's vineyards near Madera, California. It appeared that workers had been allowed into recently-treated areas before the expiration of the required 30-day safety interval for dialifor, and that excessive skin exposure to residues of this pesticide had resulted. The clinical management of these cases and the occupational surveillance of the workplace became quite complex. The grower sustained significant losses of grapes during the period in which some of his vineyards were under quarantine and he had to pay substantial medical expenses as well as a fine for violating state regulations concerning the proper use of pesticides. Organophosphate pesticides decay more slowly under hot, dry weather conditions than they do when rainfall is frequent. California has imposed a number of specific safety intervals to be observed after the application of these pesticides to certain crops. If, in violation of these regulations, workers are permitted to enter fields too soon, poisoning can occur.


Medicine in South India.

Medicine in South India. A three-month sabbatical allowed a superficial overview of Indian medical history and practice. As in Western nations, cost is a major determinant of health care delivery in India; poverty and fiscal shortages, however, deny care to many. The education of Indian physicians is similar to that in Western nations and a high level of clinical competence is seen. However, physician compensation is woefully low by Western standards. India possesses its own indigenous medical systems, purported to be the oldest in the world and predating Hippocrates by several millenia. Most Indians are cared for by native practitioners whose medical techniques are intricately related to the Hindu and Islamic religions. Many of their herbal medicines have been assimilated into contemporary Western practice. Diseases unknown to us except by textbooks are commonly seen and effectively treated. On the other hand, Western diseases such as coronary arteriosclerosis are not uncommon in a land of massive overpopulation and malnutrition. The humbling aspect of this experience is the realization that medical practice dating back several millenia can be made more modern and carried out competently by contemporary physicians. A Western physician working in India finds an unparalleled variety of disease in a totally different medical-religious environment allowing him to reorganize his priorities and to rediscover himself in the world within which he lives.


Nails and systemic disease.

Nails and systemic disease. Important diagnostic clues may be provided by changes in the nails. Because nail findings are easily observable and yield valuable information, attention to these features is often rewarding. Some of the nail changes that may be observed in systemic disorders are reviewed.


[Lymphocyte response to mitogens in serum-free and serum-containing medium in patients with rheumatoid arthritis (author's transl)]. Mitogenic transformation of lymphocytes from patients with rheumatoid arthritis (RA) has revealed divergent results in different laboratories. Since the sera used for medium supplementation in these previous studies might have influenced the results, we investigated lymphocyte transformation in serum-free medium in 28 RA-patients and 25 controls. It was shown that a majority of patients with RA responded weakly to PHA. Comparing some of these serum-free cultures with cultures that were set in parallel in 10% ABserum, no difference between patients and controls was observed after transformation in supplemented medium. It is concluded that lymphocyte reactivity to PHA (however not to ConA and PWM) is diminished in patients with RA and that this defect--at least partially--is reversible by addition of serum. The use of parallel cultures in serum-free and serum-containing medium is recommended for evaluation of the lymphocyte mitogenic response.


[Multi-organ specific autoimmunity in idiopathic adrenal insufficiency: autosensitization to steroid hormone-producing cells and antigens of the anterior pituitary gland (author's transl)]. Multi-organ specific autosensitization to endocrine active cells, with particular reference to steroid hormone-producing (STH) tissues and cells of the anterior pituitary, has been studied in 23 patients with idiopathic Addison's disease (IAD). Adrenal antibodies were found in 57% of the patients and antibodies reacting with StH-cells (thecal and interstitial cells of the ovarial stroma, placental syncytiotrophoblast and Leydig's interstitial cells) were detected in 22% of cases. A specific staining reaction with antigens of the anterior pituitary was obtained in 2 patients. Dense lymphocytic infiltrates were found in the anterior pituitary, adrenal and thyroid gland in one of the pituitary antibody-positive patients. In addition, dense IgG deposits were observed in some areas of adrenal tissue, which points to in vivo fixation of adrenal antibodies. On the basis of the clinical and immunological heterogeneity observed in patients with adrenal insufficiency a more precise differentiation of Addison's disease is suggested.


[The influence of metabolic control on chemotactic activity in insulin-dependent diabetes mellitus (author's transl)]. An increased incidence of infections, especially during periods of poor metabolic control is well known in patients with insulin-dependent diabetes mellitus. Therefore, we studied polymorphonuclear chemotaxis and its dependence on the degree of diabetic control in 49 patients with insulin-dependent diabetes mellitus in 46 controls. A modification of the chemotaxis assay described by Frei et al. was used as test system. The mean chemotactic activity observed in the total group of insulin-dependent diabetics did not differ from the values obtained in the controls. However, in patients with poor diabetic control and glucosuria exceeding 60 g/24h, a significantly reduced chemotactic leucoyte migration was found. These data indicate that normalization of leucotaxis can be achieved in insulin-dependent diabetes by means of adequate diabetes control.


[Indications for neuroradiological investigations using contrast media in patients with psychiatric disorders (author's transl)]. The results are presented of neuroradiological investigations using contrast media in 100 patients hospitalized in a psychiatric department. The existence of neurological disturbances or the psychoorganic syndrome, as well as the results of screening methods such as EEG and brain scan are important factors in the decision for or against the performance of cerebral angiography or pneumoencephalography. The significance of the "brain atrophy syndrome" accompanying psychotic diseases is discussed. In addition, some cases are demonstrated of organic neurological brain diseases with predominantly psychiatric features, where the diagnosis was reached on the basis of only neuroradiological methods using contrast media.


[Occlusion of the central retinal artery following injection of embolizing material (author's transl)]. The injection of a suspension of hydrocortisone into a keloidal scar of the nose of a 72 year-old man and of a foamy solution of hydroxypolyethoxydodecane into a little haemangioma situated above the right eyebrow of a 29 year-old woman was followed by sudden blindness of the homolateral eye in each case. This is basically explained by the involuntary injection of embolizing material into the anastomoses between the external and internal carotid arteries within the orbit. Therefore, the injection of embolizing material into the skin of the face should be avoided.


[Standardized protocol for radioimmunoassay evaluation and quality control (author's transl)]. Of several methods for constructing a radioimmunoassay (RIA) standard curve discussed in this paper the logit-log transformation emerges as the most favourable approach. In our hands, all RIA systems analyzed so far display a linear dose-response relationship after logit-log transformation. Truncating the standard curve to its operative range between effective dose 85 and 15, linear regression analysis can also be performed with the unweighted data, thus considerably facilitating computation. A standardized concept for RIA evaluation and quality control has been developed which can be executed by a low-cost desk-top calculator. A standardized protocol for RIA analyses should include the determination of total radioactivity added, the amount of both non-specifically and maximally-bound tracer hormone, 6 logarithmically-diluted standards specially prepared to cover the range between ED 85 and 15 and control samples with different levels of analyte. The RIA standard curve should be described by appropriate numerical parameters to keep a record of the intrinsic assay performance quality. Within assay variance is found on the basis of dose scatter of all unknown run in replicate, while between assay variance is based upon the observation of control sample variability. Control charts should graphically exhibit the variation of both essential assay parameters and control samples. Quality control should mainly be regarded as a means to assist in assay optimization which obviously is an important prerequisite for international standardization of RIA analyses.


[Sucrosuria following an oral sucrose load (author's transl)]. 44 male and 103 female subjects were given an oral load of 1 g or 2 sucrose/kg body weight. Glucose, fructose and sucrose were determined in capillary blood and urine samples before and after sucrose ingestion. Sucrose was detected in the blood only in 10 cases, but was present in the urine in each subject (max. 1132 mg sucrose/100 ml). Urinary excretion of sucrose is considered to be a physiological phenomenon since none of the subjects had any metabolic disorder.


[Therapeutic defibrination by arwin in unstable angina pectoris combined with hyperfibrinogenaemia (author's transl)]. Therapeutic defibrination by Arwin was induced in a group of nine patients suffering from unstable angina combined with hyperfibrinogenaemia and in a further six patients who developed hyperfibrinogenaemia accompanied by angina pectoris after thrombolytic therapy with streptokinase for recent myocardial infarction. In patients of the former group with unstable angina a mean pretreatment plasma fibrinogen concentration of 4.9 g/1 was lowered to 1.4 g/l over a period of four weeks, whilst in the latter group, the plasma fibrinogen was lowered from 5.7 g/l to 2.0 g/l over 10 days. In all cases a remarkable improvement in the severe anginal symptoms was achieved already at fibrinogen levels within the lower range of normal. This improvement outlasted the period of therapy in most patients. Two patients died following acute myocardial infarction; one of the patients with unstable angina died 15 months after Arwin therapy and the second patient discontinued therapy after one week and died three weeks later.


[Acute self-poisoning with arsenic and treatment with BAL (author's transl)]. A case of attempted suicide by ingestion of 4.8 g As2O3 (more than 20 times the estimated lethal dose) is reported. Absorption of arsenic caused elevated urinary levels over 5 days BAL treatment was started within three hours after arsenic ingestion. The patient did not develop any signs of polyneuropathy or other clinical changes.


[Sonography in traumatic rupture of the gallbladder and liver: a case report (author's transl)]. The practicability of using ultrasonography in the evaluation of traumatic rupture of the gallbladder and liver is demonstrated on the basis of a case report. The presence of a subphrenic fluid collection was detected by means of this procedure and the increase in fluid was accurately determined by regular follow-up control examinations. This report eventually led to successful operation. Sonographic postoperative follow-up control examinations showed extensive perihepatic scars in the subdiaphragmatic region.


[The effect of ethanol on the deformability and the rheological properties of erythrocytes (author's transl)]. The rheological properties of human erythrocytes were investigated after incubation in ethanol-containing suspensions. Ethanol concentrations were adjusted to the blood ethanol level reached in severe alcohol intoxication. Red cell deformability was measured by the filterability and by viscosimetry of suspended erythrocytes. Red cell deformability becomes significantly decreased by ethanol addition to the suspending media in close connection with the increased osmolarity of the solution. The influence of these alterations on blood viscosity and microcirculation in shocked and non-shocked patients suffering from alcohol intoxication is discussed.


Differences in the availability of d- and l-enantiomers after administration of racemic amphetamine to rats. 1. Rats were treated with racemic amphetamine or separately with the single enantiomers. The two optical isomers were determined in several brain areas, in plasma and urine. 2. The concentration of d-enantiomer significantly exceeds that of the l-enantiomer in brain and plasma but not in urine, following administration of racemic amphetamine. In contrast, when the two isomers are given separately, their brain concentrations are similar. 3. Such a difference does not appear in the brain of mice treated with racemic amphetamine or in the brain of rats pre-treated with SKF 525-A, an inhibitor of amphetamine hydroxylation. 4. The possibility that the l-isomer can interfere with hydroxylation of d-amphetamine is discussed.


Disposition of a new alkylating agent [14C]mitoclomine (N,N-bis(2'-chloroethyl)4-amino-2-methyl-1-methoxy-naphthalene). 1. The absorption, distribution and elimination of a new alkylating agent, N,N-bis(2'-chloroethyl)4-amino-2-methyl-1-methoxynaphthalene (mitoclomine), labelled with 14C either in the dichloroethyl group or in the methoxy group, have been studied in mice and rats. 2. Expired 14CO2 of rats given [chloroethyl-14C[- or [methoxy-14C]mitoclomine amounted to 1.0 and 35% dose respectively, indicating that O-dealkylation occurs. 3. The part of the molecule carrying the cytotoxic group displayed a high affinity for lymphoid organs (thymus, spleen). This could explain some biological properties of this drug, especially the selective effects of mitoclomine on circulating lymphocytes.


Metabolism of 3, 4-dihydroxyphenylalanine, its metabolites and analogues in vivo in the rat: urinary excretion pattern. The metabolism and interrelationships of orally and intraperitoneally administered L-dopa, related amino acids and their metabolites have been studied 2. Amino acids were decarboxylated. N-Methyldopa formed dopamine but not epinine. D-Dopa was absorbed from the intestine and metabolized by a series of reactions which resulted in greater decarboxylation than was observed after L-dopa. Transamination was a minor pathway. 3. m-Hydroxylated phenylpyruvic acids were poorly reduced, but vanilpyruvic acid was reduced fairly readily. Lactic acids were largely unchanged. Lactic and pyruvic acids formed phenylethylamines and their metabolites. Small amounts of phenylpyruvic acids may be decarboxylated to phenylacetic acids. 4. Glycine conjugates were formed from phenylacetic acids, a partially reversible change 3,4-Dihydroxyphenylacetic acid was metabolized to homovanillic and m-hydroxyphenylacetic acids, especially when given orally. Little 3-hydroxy-4-methoxyphenylacetic acid was oxidized to 3,4-dihydroxyphenylacetic acid but some increase in m-hydroxyphenylacetic acid excretion was observed. 5. 2-Phenylethanol analogues were largely converted to the corresponding acids. 3,4-Dihydroxyphenylethanol was partially m-O-methylated before oxidation. 6. beta-Phenylethylamine analogues were oxidized mainly to phenylacetic acids. but a variable amount of analogous phenylethanol was also formed, especially from m-tyramine. Dopamine was O-methylated, a process not readily reversible. It was also p-dehydroxylated following oral and intraperitoneal administration but not after oral neomycin; biliary excretion of amines may be involved in this sequence of events. N-Methylated amines were oxidized less readily than the parent amine. 7. Differences in route of administration resulted in quantitative changes in degradation pathways, an effect deriving, to some extent, from p-dehydroxylation and O-methylation in the gut.


Ultrastructural characterization of stable L-form cells from Erysipelothrix rhusiopathiae and of accompanying artifacts. The stable L-form of Erysipelothrix rhusiopathiae is a typical protoplast type L-form. Cells are surrounded by a trilamellar cytoplasmic membrane only. They grow in form of aggregations in liquid media and their diameters vary between 0.1 and 2 micrometer. Always a large portion of cells undergoes lysis. It seems to be characteristic for L-form cultures of E. rhusiopathiae that always many artifact structures are formed. The artifacts are spherical particles with diameters of 0.1 micrometer to more than 3 micrometer. They can be differentiated from L-form cells only by electron microscopy. The artifacts consist of electron dense amorphous material and their surface is irregular without a clear boundary line. Obviously, these artifacts are produced from protein components of the medium and from cytoplasmatic components of the lysing L-form cells.


[Uptake of labeled zinc by Chlorella containing different amounts of zinc]. Chlorella fusca was grown asynchronously for 2 weeks in media with different Zn concentrations up to 10(-3) M. Growth was optimal at 10(-5) M Zn. The Zn contents of the algae were followed by activation analysis. They increased with increasing Zn concentration in the media, and, except with the lowest Zn concentrations, with time. Further, the uptake of labelled Zn (65Zn) from 5 . 10(-6) M solution by cells of known Zn content was measured at 30 degrees C during one day in minimum and optimum conditions (dark/nitrogen or light/air, respectively). The rate of uptake showed a maximum with algae grown in a medium with 10(-5) M Zn. However, algae exposed to a lethal Zn concentration (10(-3) M) also absorbed much Zn; this anomalous uptake is ascribed to a breakdown of the cell membrane as a permeability barrier.


[Surgical management of stenosis of the trachea (author's transl)]. 16 cases of stenosis of the trachea treated by resection and anastomosis are reported. The essential features of the technique of anaesthesia and surgery are described. It is stressed that the best results are to be obtained from end to end anastomosis. Results are analysed according to indications. In 13 cases normal function could be restored, one case improved and two remained carriers of tracheostomy canuls. 12 further cases have undergone surgery for large retrosternal thyroids causing stenosis of the trachea. Details of indications, technique and results are analysed.


[Tracheobronchopathia chondro-osteoplastica (author's transl)]. Clinical, roentgenological and histological findings in two cases of tracheobronchopathia chondroosteoplastica are described in detail. Characteristic features of this rare disorder are calcificated, cartilaginous and osseous deposits in superficially parts of tracheobronchial mucosa. The clinical picture and x-ray changes are not very characteristic. Final diagnosis is possible by bronchoscopy with histologic examination of bioptic material (excision from tracheobronchial mucosa).


[Danger of silicosis in pottery (author's transl)]. The trade of pottery was practised already in antiquity. This very old art had culmination points of its artistic performance in several epochs. The ornamentation of the body of the ware by glazing came in use in Germany (Rhine Territory) in the 12th century. The raw material applied were plastic argils baking with colour, at that time just as now. After dressing with water the plastic material was shaped to the most different objects. It was done, either off-hand or by the aid of the potter's wheel. Dust is developing when the argils are crushed representing a danger to health if technical control of the dust is not made effective. Wearing respiratory protection apparatuses is sufficient in shorttime work but must be regularly checked according to our experience. In the production of earthenware relatively high concentrations of dust occur only temporarily, but in very few cases they may cause silicosis. Among the 35 cases of silicosis in potters observed by the different special services for prophylaxis and control of dust 25 developed by exposition in plants of the GDR. 8 of the 10 diseased persons with exposition in plants outside the GDR had worked as potters in Bunzau (Silesia). The danger of silicosis is by for less than in the porcelain industry; it can be prevented by keeping clean the places of employment. This low danger is proven also by the very long exposition time of 30--40 years in average.


[Experimental findings after application of Kveim antigen. I. Sensibilization of guinea pigs by mycobacterium avium (author's transl)]. Guinea pigs were injected intraperitoneally with different types of mycobacterium avium (serotypes 1, 2 and 3). 4 weeks later followed the injection of Kveim antigen into the foodpats. Beside a high rate of non-specific foreign body reactions in all groups, histological pictures resembling a positive Kveim test were found only in the group of animals which received Mycobacterium avium serotype 1.


[The assessment of invalidity in bronchial asthma (author's transl)]. In contrast to the assessment of the vocational activity there are no fixed principles with regard to the application of defined methods of examination and the interpretation of its results. The assessment cannot be based only on the results of pulmonary function testing but has to take into consideration also the frequency and severity of the troubles, their dependence on vocational influence and their therapeutic management. The result of the function test using all given possibilities is essential. Sometimes are of decisive importance the arrangement of a mitable place of employment, the patient attitude to his disease and his vocational activities. In this paper proposals are given for a complex assessment of the physical capacity and invalidity in bronchial asthma.


[Suggestions for therapy with glucocorticosteroids in obstructive airways diseases (author's transl)]. Glucocorticosteroids are an integrating component of complex therapy in severe obstructive airways diseases. The well known risks of this treatment may be minimized by observing the following rules: 1. Rigorous indication for long term therapy 2. Careful attention to certain concomitant diseases and contraindications 3. Control of therapy by continuous specialized supervision in a dispensaire. On the basis of modern literature and personal experience with glucocorticosteroid therapy in 1210 patients with bronchial asthma and chronic obstructive bronchitis during the years 1972 to 1977 (34.9% of all patients in this group of diagnoses) are given some recommendations for practical handling of glucocorticosteroid therapy in obstructive airways diseases.


[Suggestions for allergological diagnostics in outpatients' departments for lung diseases and tuberculosis (author's transl)]. In increasing number of patients suffering from bronchial asthma are being examined by outpatients' departments for lung diseases and tuberculosis. The early confirmation of an allergic genesis is of main importance for therapy and prophylaxis. Primary allergological diagnostics in outpatients' departments are therefore desirable with special emphasis on allergological anamnesis, intracutaneous allergen tests respectively prick tests. Sufficient experience of the physician especially in the evaluation of results and consecutive measures is necessary. It is recommended to confine cutaneous testing to the usual antigens of airways allergy after careful elucidation of anamnesis. Testing with professional allergens and with allergens leading to strong reactions should be restrained to certain clinical centres. In addition to the recommendations of the Society for Clinical and Experimental Immunology of GDR for allergological and clinical immunological diagnostics the presented publication gives some hints to practical handling and to the evaluation of results.


[The radiological appearances of caustic burns in the upper intestinal tract (author's transl)]. Seventy-nine caustic burns of the upper gastrointestinal tract were divided into early and late effects. The radiological findings were analysed and discussed. The central role of radiology proved to be indisputable, particularly for demonstration of a perforation and for the control of treatment. Endoscopy is of particular value in the diagnosis of caustic burns if the radiological findings are negative, for following treatment and for clarifying atypical late changes.


[Behavior of papillary capillaries in initial common psoriasis]. The capillary pattern of the papillary body in early psoriatic lesions was compared with that in normal skin and in full developed psoriatic lesions. In contrast to the normal skin, dilated and occasionally tortuous capillaries were already to be seen in early lesions. Furthermore, the density of the capillary network showed a significant increase, which may have been due to neovascularisation. Our histological examination of fully developed psoriatic lesions revealed the characteristic capillary pattern. The increased capillary density is most probably caused by coiling of the capillaries; it is also possible, however, that the difference between early and advanced psoriatic lesions is due to further vascular proliferation.


[Mast cell numbers in initial psoriasis vulgaris]. Using sections from 10 early and five fully developed psoriatic lesions, we counted the mast cells in the papillary body. The results were evaluated statistically and compared with the findings of other researchers. The number of mast cells in the papillary body beneath the basal membrane shows a significant difference between early psoriatic lesions, fully developed psoriasis, and normal skin. Even in the very early lesion, the number of mast cells per mm3 is increased compared with the normal skin, though it is less than in fully developed lesions.


[Aspects of anxiety-fear differentiation]. By exposition of philosophical and general psychological aspects of the differentiation of anxiety and fear an heuristic differentiation according to the following criterias becomes possible: 1. attributes of a (threatening) stimulus constellation, 2. personality specific cognitive and emotive-motivational processes, and 3. reactive rehaviour and action patterns. By means of a model which considers the functions of especially the hippocampus as well as the problems of orientation the differences are to be exemplified neuropsychologically.


[The "inter" and the role (conditional analysis of endogenous psychoses)]. The relations of the individual to others and to the family are understood by the concepts "intersubjective" and "interfamiliar". This "inter" is always the origin of the relations of subjects. The "inter" is a reality which is of an atmospheric pneumatic nature respectively. Its creative power and its primateship for the word is clarified by a selection of examples from oriental and occidental cultures. On the other hand, the relations of the individual is determined by norms, in which the "objektive Geist" (Hegel) of a time is manifested. The individual is in this relation first of all a carrier of roles. A conditional analysis of psychotic disturbances has to proceed from a conception that the individual's psyche in both spheres, is not a "tabula rasa" (Locke), but always already conveys a selection of that which has been offered in the situation (Leibniz). Out of this result constellations of a conditional nature for the development of endogenous psychoses, exhibiting themselves in the Inter-shere and Role-sphere. These can only develop where a coherence of specific personality-structures with specific situations are present. What makes such situations pathogenic, is all a specific inference of meaning from peristatic precipitations. It is this that makes a situation into what it actually is for a certain type.


[Social behavior and psychosis induction in manic-depressives]. The social behavior of manic-depressives shows a specific structure of identity, whose consequences for the onset and course of manic-depressive psychosis are investigated. Besides in interactional conduct, group behavior, orientation in values etc. we are mainly interested in the behavior of manic-depressives in social roles. From the point of view of role theory the social behavior especially of monopolar depressives could be described as hypernomic, as it shows an extreme conformity with norms. Situations of opposing or competitive role demands, opposing norms and values therefore are very difficult for manic-depressives to handle. The preponderance of their role identities results in an atrophy of ego-identity and in an increasing dependence on their social roles. This explains why not only the loss but even the endangering of their social roles may result in psychotic states that here are interpreted as crisis of identity.


[Criteria of heart rate response measurements in psychosomatic diagnosis]. The central function of the cardiovascular system in the internal homeostasis of the human organism and in the externally directed adaptive and transformative processes explains the importance of this system in psychophysiological investigations. At the same time it is apparent, that the functional complexity leads to methodological difficulties in the analysis of stimulus-response relationships. Using heart-rate-response to acoustical stimuli a variety of factors influencing form and extent of cardiovascular responses are discussed as there permit an explanation of varying results in psychophysiological studies on this topic. Two habituation experiments with a total of 100 subjects were used to analyse the depending of heart-rate upon type and intensity of stimuli and associated systemic variations with varying states of activation. An alternative method of measurement is presented which consideres the timing of heart-rate reaction, thus avoiding to undue the temporal coherence of the components of heart-rate response. This method offers the possibility for a real-time-comparison between different autonomic functions.


[Personality profile of asthmatics and its changes in the course of various treatment methods]. Our study of 30 Asthmatics showed an increase in the neurotic triangel (MMPI-Saarbrücken) and good agreement with the personality profile of neurotics with psychosomatic tendencies. To measure the effect of a 4-week- treatment-course on the personality structure of the patients, the FPI-scale was used, where only a slight change was found in the scale "Nervosität" (FPI 1 measures psychosomatic conflicts). Part of the patients who were also treated with "autogenes Training", the change was somewhat larger but not statistically significant, as compared to the group of patients without "autogenes Training". The treatment-course itself, judging only by the medical evaluations, was proved to be highly effective with statistical significance. A possible explanation for the discrepancy between the two findings could be the difference between the methods of investigation and/or the attitude of the patients to their Asthma because many of them emphasize the somatic aspect of their illness, wishing to ignore or deny a possible psychosomatic explanation.


[Infleunce of heart cycle length on left ventricular ejection fraction in normals and patients with coronary artery disease]. The ejection fraction is a clinically valuable index of left ventricular pump function. We investigated the influence of a change in heart cycle length in normals (gr. I) and in patients with coronary artery disease without (gr. IIa) and after myocardial infarction (gr. IIb) (atrial pacing 80 and 120 min-1). In all subjects ejection time decreased by ca. 17%. There was no statistical difference between the groups. Ejection fraction (mean absolute values): gr. I (n = 7): - 3.4% (n. s.), gr. IIa (n = 8): - 8.4% (p is less than 0.01), gr. IIb (n = 12): - 6.5% (p is less than 0.01), Gr. IIa + IIb: - 7.2% (p is less than 0.001), gr. I +IIA + IIb: - 6.1% (p is less than 0.001). Compared to the control value the relative decrease for all subjects was -12.3 +/- 12.0% (n = 27). When left ventricular performance is evaluated by ejection fraction using invasive and noninvasive methods (contrast medium ventriculography, echocardiography and scintigraphy) heart cycle length has to be taken into account. The data cannot be normalized by a simple mathematical procedure.


[The influence of afterload on the normal and ischemic myocardium in the dog]. The influence of an instantaneous increase in afterload on the hemodynamics and regional myocardial function was studied in five anesthetized dogs before and after occlusion of the left anterior descending coronary artery. By inflation of an intaaortic balloon during single ejections, an instantaneous increase in afterload was obtained. From biplane cineventriculograms, the following parameters were calculated: left ventricular volumes (EDV, ESV), stroke volume (SV), ejection fraction (EF). Mean circumferential fiber shortening (V CF) was calculated in three ventricular diameters in the RAO projection. Simultaneously PLV, PLVED, PAo, and LV dp/dt were obtained. In the control ventriculograms, an increased afterload (delta PLV 16.4 +/- 8 mm Hg) caused only a minor decrease of SV (2.6 +/- 2.5 ml), EF (4.2 +/- 2.4%), and V CF (0.20 circ . s -1). After coronary occlusion (delta PLV 14.5 +/- 6.7 mm Hg),the reduction of SV (5.9 +/- 2.7 ml) and EF (8.2 +/- 2.6%) was more pronounced. This was caused mainly by a significant reduction of V CF in the center of ischemia (delta V CF -93%). For the evaluation of regional myocardial function by ventriculography, the marked influence of afterload in ischemic areas must be taken into consideration. This is of special interest in comparative ventriculograms, such as those before and after coronary bypass surgery.


[The new calcium antagonist Ro 11-1781 in the treatment of ventricular tachycardia due to atrial fibrillation]. In 9 patients with tachyarrhythmia and atrial fibrillation the effect of the i.v. application of the calcium antagonist Ro 11-1781 on the av-conduction was investigated. All patients received 1 mg/kg during 2-3 minutes. A significant decrease of the ventricular rate at the end of the injection period was noted. The maximal decrease of the av-conduction of 10-32 % of the initial ventricular rate was observed 5-10 min after the injection. During 60 min the initial heart rate before application of the drug was not yet reached again. The registrations prove the inihibiting effect of Ro 11-1781 on av-conduction in atrial fibrillation, which was sufficient for therapeutic use in our cases concerning the reduction of heart rate and duration of the effect. No serious side effects were observed.


[Antegrade catheterization of the aorta with a flow-directed balloon catheter following transseptal left atrial puncture: a new technique]. The described heart catheterization technique allows the antegrade catheterization of the aorta from the left ventricle with a Swan-Ganz-flow-directed catheter via the saphenous vein and subsequent puncture of the intact atrial septum. The transseptal Brockenbrough-technique is modified by the use of a long thin polythene sheath which is fitted over the transseptal left heart catheter and can be advanced over the catheter after atrial septal puncture. A Swan-Ganz-flow-directed catheter can be passed directly to the left ventricle toward the outflow tract before it enters the aorta. This technique was used successfully on 18 children. By avoiding the retrograde arterial catheter technique additional information will be obtained.


[Epidemiological study on the demonstration of precipitating antibodies against Micropolyspora faeni in agricultural workers]. The authors report on the frequency (as determined by the double diffusion test according to Ouchterlony) of circulating precipitating antibodies against thermophil actinomycetes of the genus Micropolyspora faeni in 1666 blood samples from 1376 agricultural workers. These workers belonged to the main professional categories in two districts of the German Democratic Republic and were examined by members of the Research Group on Occupational Medicine in Agriculture of the Ernst Moritz Arndt University during the years 1972-1975. 290 workers were examined twice or three times in a longitudinal study. Positive serological findings were obtained from 5.1% of the subjects under investigation. There were no statistically significant differences with regard to occupational category, sex, age, and season. Nevertheless, there were marked regional differences. The results obtained show that there is no need for special medical supervision of the agricultural workers with regard to thoracic actinomycosis (farmers' lung). Further examinations are of course necessary in case of suspected or clinically manifest affection.


[Investigation of gait of patients with idiopathic scoliosis and the influence of the Milwaukee brace on gait (author's transl)]. We investigated 42 juvenile patients with idiopathic scoliosist, 37 of them were provided with a Milwaukee brace and treated physically. The electromyographic activity of the musculi erectores trunci and the musculi glutaei medii were recorded during walking and standing on one leg. Simultaneously the motions of the trunc and the pelvis in the frontal plane were registered and calculated. Results without the brace: During walking the activity of the erectors trunci predominates on the convex side of the curvature of the spine. This applies as to the functional curve. The M. glutaeus medius shows an increased activity on the contralateral side of the overhang of the trunc. The priodical shifts of the trunc to the right and to the left during walking decrease with increasing activity of the M. glutaeus medius. In this way, we show the stabilizing influence of this muscle upon the statics of the spine. This should be especially considered with regard to the physical treatment of the patients. Results with the brace put on: There is only little influence of the brace upon the electrical activity of the musculi erectores trunci: we could not detect any activating ore inactivating effect of the brace. The amplitude of the periodical shifts of the trunc and the perlvis during walking is reduced by the brace. At the same time we found a greater activity of the musculi glutaei medii than with the brace taken off. We suppose that the reduced shifts of the trunc and the pelvis involved by the brace force a greater activity of the glutaeus medius.


[Atelectases as part of the convex-sided lungs in thoracic scoliosis (author's transl)]. In 4 patients with juvenile idiopathic thoracic scoliosis an atelectasis as part of the convex-sided lungs was found. In all cases there was a small sagittal diameter of the chest; the atelectases were situated in the right lower and middle lobe and caused by the close topographical relation of large bronchi and scoliotic spine (sometimes compression of the bronchus) demonstrable by tomography, bronchoscopy and bronchography. The therapeutic approach of these atelectases is discussed. Thoracic casting either for conservative correction and treatment of scoliosis or as postoperative immobilisation after fusion was done. In all cases, it may influence the occurrence of an atelectasis.


["Physiological" healing and development of coxa valga in congenital dislocation of the hip (author's transl)]. At the University Orthopaedic Clinic Bonn, congenital dislocation of the hip has been treated since 1969, using the Hanausek-Apparatus. In this study the results of "physiological healing" and the development of coxa valga are compared with the results of our previous combined treatment regimen (traction in extension, followed by manual reduction, and initially fixation in the Lorenz position in plaster of Paris and then in Lange position). The term "physiological healing" is explained. The diagnosis coxa valga was made using the criteria of the DGOT working party on hip dysplasias. The problem of femoral head necroses is not considered; this has been reported previously. From this study we see a definite advantage of the functional treatment over the combined method. The "physiological healing" rate was substantially higher, and the development of coxa valga greatly reduced. The clinical results are further supported by animal studies from several authors.


[The effectiveness of pes anserinus transfer for old anteromedial knee instability (author's transl)]. Old anteromedial instability of the knee joint causes an increased external rotation of the tibia against the femur. To actively control this tendenoy to increased external rotation, Slocum and Larson advocated the pes anserinus transfer (1968). An increase of rotatory muscle function of 39% after this transfer could be demonstrated experimentally (Noyes and Sonstegard 1973). Contrary to these reports, an increase of rotatory muscle power was rather the exception than the rule in our dynamometric examinations of 49 patients after transfer of the pes anserinus for old anteromedial instability. The reasons for the lack of clinically effective increase in muscle power are discussed. The advancement of the tendon of the semimenbranaceus muscle seems more advantageous as an alternative measure.


[Etiology of dislocation of the patella (author's transl)]. Using a new method for measuring the distal femoral torsion (Janssen a. Prüssner 1977) it is possible to determine the encreased medial torsion of the distal femur in most of the patients with dislocation of the patella. A group of patients with dislocated knee-cap was studied for this purpose. The characteristic clinical and x-ray features are listed and weighted according to their value. They throw a new light on the pathogenesis and pathomechanics of patellar luxation, and point to the need to reclassify the different types of luxations according to etiological aspects.


[Studies on the presence of metal traces in tissue surrounding A.O. angle plates, based on neutron activation analysis (author's transl)]. Using instrumental neutron activation analysis, 11 samples of tissue in contact with A.O. angle plates and 8 samples of fascial tissue were examined for their content of trace elements, half a year to 5 1/2 years after hip joint intertrochanteric osteotomies. Significant increases in the concentrations of the elements Cr, Fe, Co, Ni and Mo, all of which are contained in the A. O. steel plates (V4A steel), were found both in the contact tissue and in the tissue of the fascia lata femoris about 4--8 cm away from the angle plates, whereas the levels of concentration of elements not specific for the alloy in question, namely, Zn, Se, Rb and Cs, were normal or just subnormal. It was possible to prove by means of element correlations that the elements Cr, Co, Ni and Mo are present in constant ratios in those tissue samples which are loaded with traces of metals foreign to the body. However, only the Mo:Cr ratio corresponds to that of the angle plates. The authors considered Ni to be a useful indicator for the degree of metal loading of a tissue, since Ni will normally occur in human tissue in very low concentrations (less than or equal to 10(-6) g/g dry substance) and was identified by the authors--contrary to previous studies--even in the fascial tissue located up to 8 cm away from the contact tissue. Non-linear correlations were found between iron and the other components of the steel, reflecting the complicated regulatory mechanisms governing the presence of iron in the organism. The results of the analysis are discussed in respect of possible long-term action of the implantate components liberated by corrosion, which, in case of long-term implantates might place an overall burden of foreign ions on the body.


[Examination of the extension of the osseous facies lunata. A functional study (author's transl)]. In 30 human acetabula the osseous facies lunata was examined and measured. It was found that the acetabular notch is inclined ventrally against the vertical line for an amount of 18,3 degrees (mean value). It was further found that the widest region of the facies lunata is not situated in the acetabular roof (which is usually visible in X-ray photographs), but about 15 degrees in front of it. The outer margin of the osseous acetabulum corresponds to a parallel of latitude of 11,5 degrees, that means that it is situated distinctly above the equator. The cornu anterius is always narrower than the cornu posterius; the similarity between the sockets examined was so great, that a division into different types did not seem to be necessary and an "average acetabulum" was calculated. The width of the facies lunata is interpreted as an equivalent for the amount of stress brought upon; now and then existing indentations of subdivisions of the joint surface are correspondingly understood as places of reduced stress.


[Paraplegia due to sports and bathing accidents (author's transl)]. An analysis of 2346 paraplegics treated in the Heidelberg University orthopaedic hospital showed that 194 of the lesions (= 8,3%) were caused by accidents during sports and bathing. Of 123 bathing accidents, 98.4% produced a lesion of the cevical part of the medulla, the site of paresis being mostly below C 5 or C 6. The predominant accident mechanism of the most frequently occurring luxation fractures was hyperextension and hyperflexion. 71 of the 194 cases (= 36,6%) were genuine sports accidents. 35 cases of tetraplegia occured preferably during gymnastics, jumping on the trampoline, and high-tower diving, whereas 36 paraplegias were due to accidents during riding, skiing and mountaineering. Flexion and compression fractures mainly concern the pelvic region of the vertebral column. Only 4 of the 194 injured patients (= 2.1%) died as a result of their accident.


[Results of the treatment of congenital dislocation of the hip by "extentions repositioning" and "Hanausekretention" (author's transl)]. Since 1969 all our patients below the age of three years, suffering from congenital luxation of the hip-joint, were treated conservatively. The "Extensions-reposition" and "Hanausekretention" were just slightly modified in providing the "Lorenzposition" by reducing the abduction. The rate of necrosis of the femoral head (4.3%) did not change significantly. In only one case we did not succeed in repositioning a completely luxated hipjoint conservatively. Children up to the age of 3 years can be treated conservatively by this method.


[High tibial osteotomy for gonarthrosis (author's transl)]. Tibial osteotomy proximal to the tuberosity is a successful method of treating osteoarthritis of the knee joint with a axial deformity. The clinical results of 54 osteotomies carried out between 1971 and 1975 show significant pain relief after correction of the deformity. There were only a few complications. Internal fixation by plates or other devices is superflous. A single staple is sufficient to allow early movement and weight-bearing because of the broad contact of cancellous bone at the osteotomy site. So this operation is the method of choice especially in the elderly patient with cardio-vascular disease. In the case of failure of the osteotomy other salvage procedures as well as joint replacement are still possible.


[Studies on thermoregulative performance of disabled persons with congenital maldevelopment of the limbs and acquired loss of limbs during defined physical work and passive heat load (author's transl)]. Comparative studies were conducted in 20 persons without hands (amputated a long time ago) and in fifteen juveniles (12--15 years) with dysemlia (phocomelia or ectromelia), tested in each case against groups of non-disabled persons of corresponding age. All persons under examination had to perform the same, graded treadmill work under thermoconstant condition (30 degrees C, 45% rel. humidity). These tests pointed towards the existence of a particularly economic mode of thermoregulation in persons with dysmelia obviously involving adaptive processes of energy metabolism as well, whereas such adaptation does not take place--not even in the course of many years--in disabled persons with acquired loss of limbs. The persons with congenital dysmelia showed lower temperatures of the interior of the body, less sweat loss, and on the average a lower uptake of oxygen than non-disabled persons of the same age, whereas higher temperatures of the interior of the body, greater sweat loss, and a higher oxygen uptake were measured in the persons whose arms had been amputated a long time ago (ie persons without hands). Under passive heat load (40 degrees C, 30 min.) the amputated persons showed a corresponding thermoregulative performance as during physical work, in comparison to the non-disabled persons.


[Acute course of arthropathia syringomyelica. A case history contribution to the differential diagnosis of acute affection of the shoulder joint (author's transl)]. Basing on own observations of a typical base, the article presents the clinical and X-ray symptoms of an acute arthropathia syringomyelica of only 3 weeks' duration. Differential diagnosis of inflammatory or tumorous processes of the shoulder joint is performed and it is pointed out that accurate diagnosis is possible despite the rare occurrence of the condition. Contrary to the opinion held by other authors, the present study seems to permit the interpretation that destruction of the joint originates from the bony joint mouse.


[Differential diagnosis of tumors: plasma cell osteomyelitis--Ewing's sarcoma (author's transl)]. Radiographical changes of the left humerus, diaphysial, partly subcortical partly periostal suspect for Ewing's Tumor alarms the surrounding of a 15-year-old boy. By a rapid and exact examination as well as by an therapeutical punction the severe suspect of Ewing's Tumor could be eliminated. The tumore symptoms similarity of the plasmazellular Osteomyelitis is discussed.


[Functional differentiation of different portions of the the rat neocortex]. The effect of uni- and bilateral ablation of rostral and caudal parts of neocortex on conditioned avoidance reflex was studied on naive and pretrained albino rats. Maximal impairment of the reflex was seen after bilateral ablation of the caudal region of neocortex, minimal one--after unilateral neocortex ablation. The rats without rostral cortex showed medium impairment. After extirpation of caudal cortex the number of positive reactions to light was greater in pretrained rats than in naive ones. After total cortical extirpation the previously elaborated conditioned reflex disappeared irreversibly. The conclusion is made on functional heterogeneity of the rostral and caudal cortex.


[Alteration of the hypothalamic electrical stimulation disconnection reaction in rats during chronic morphine administration]. Rats with electrodes implanted in the hypothalamus were trained to switch off the central stimulation. Animals were administered 12--30 injections of morphine in increasing doses (from 20 up to 120--180 mg/kg/injection). The drug exerted a dose-proportional suppressive effect on the escape response. During repeated injections an absolute or relative tolerance to the suppressive action developed in the responses both to central and to peripheral painful stimulation. The suppressive action seems to be specific and does not correlate with the catatonic reaction and changes in general motor activity. The activation of gnawing response was noted after the morphine injections in doses of 60 mg/kg and higher. In one of the animals the transformation of the negative effect into ambivalent one as well as self-stimulation were observed. "Antiaversive" effect is considered to be one of the determinants of morphine abuse and addiction liability.


[Evoked brain potentials and perception errors]. Visual evoked potentials were studied in a psychophysical experiment based on discrimination of two phtoic flashes of different brightness. EP were summarized in accordance with the four experimental results: correct detection, misses, false alarms and correct rejection. It was found out that EP parameters are in a rather precise correspondence with the perceived brightness of stimuli. The subjective brightness depends in its turn, on two factors: intensity of stimulation and sensitivity of sensory input. Maintenance of sensitivity at a constant level provides for the precision of perception. On the contrary, the changes in sensitivity lead to errors in detection. The data obtained show that these changes may result from the shift of brain DC potential.


[Multiple sensory projections in the dolphin cerebral cortex]. The paper presents characteristics of evoked potentials appearing in response to afferent stimuli in the dolphin visual and auditory cortical areas. Both the visual and auditory areas are divided into zones which generate evoked potentials different in form and temporal parameters. They may be regarded as multiple projection zones of the visual and auditory analysers respectively.


[Mechanisms causing repeated pedal pressing during self stimulation of the brain]. Mono- and polymodal histograms of pauses duration were obtained in rats during self-stimulation (SS) through electrodes implanted in the lateral hypothalamus. Changes in motivational state (deprivation--satiation) did not markedly affect the histogram pattern. It is concluded that the SS drive mechanism is not connected with natural motivations. In all experiments, a high negative correlation between "optimal criterion" parameters and model pause duration is obtained. It is suggested that one and the same mechanism underlies both the SS-reinforcement and drive. Reinforcement is probably connected with current excitation of reinforcing structures during stimulation, whereas the drive is caused by trace activation of the same cerebral structures after the stimulation.


[EEG activity of symmetrical points of the cerebral cortex during unilateral cooling of the temporal neocortex in cats]. A study of ten alert cats has shown that inactivation with cold of the temporal neocortex elicits a sharp drop in EEG activity in all the examined points of the homonymous hemisphere, which actually points to a temporary switching off of its function. At the same time a unilateral switching off of the temporal area brings about an increase in EEG activity of the contralateral hemisphere. Functional asymmetry sets in not only in the system of the auditory analyser, but also in other sensory systems. Systematic cold switching off of the temporal cortex in one hemisphere results in a reduced contrast in the EEG of the brain symmetrical regions.


[Trace processes in the neuronal activity of the rabbit cerebral cortex following rhythmic photic and electrocutaneous stimulation]. Trace unit activity in the visual and sensorimotor cortical areas was studied in alert rabbits after photic and electro-cutaneous stimulation. The ability of the sensorimotor area to preserve temporal stimulation pattern in the afteraction interval was higher than that of the visual area. Maximal rhythm preservation and a higher level of distant correlation in cortical unit activity were seen after synchronous bimodal stimulation. The data obtained suggest some diversity of the mechanisms of trace and evoked activity of cortical neurones.


[Instrumental conditioned reflexes to salt and acid stimuli in carp]. In experiments on unrestrained carps, a comparative study was made of the analysis of different concentrations of NaCl and HCl (starting with threshold ones) by means of instrumental conditioned reflexes, aimed at eliminating harmful chemical stuffs from water medium. Salt concentrations, in response to which the formation of a conditioned reflex is possible (3--9 mM) are by an order higher than those for the acid (0.3--0.85 mM). The intensity and duration of manifestation of the defensive conditioned reflex depend directly on the strength (concentration) of the chemical stimulus. Cessation of motor conditioned reaction providing for restoration of the optimal conditions of the surrounding takes place when initial concentration of the stimuli in experimental reservoir is reduced to values close to threshold ones, namely to about 2 mM for NaCl and to about 0.2 mM for HCl, i.e. to a minimal concentration compatible with normal vital activity. After extirpation of the forebrain, the fish lose the capacity for active elimination from the surroundings of both salt and acid components.


[State of cerebral neuronal nuclear chromatin during multimodal stimuli to the body]. The state of nuclear DNA, revealed by the microfluorometric method, changed unequally in conditions of dissimilar afferentation in different classes of the neurones in the neocortex and the hippocampal dentate fascia. It may be assumed that the examined classes of cells (large pyramids and stellate neurones of the sensorimotor zone of the cerebral cortex and the granular cells of the dentate fascia of the hippocampus) possess a different structural functional organization of genome. This probably accounts for the peculiarities of their functioning.


[Physiological and genetic ways of studying the extrapolation capability of mice]. Elementary reasoning--the ability of mice to extrapolate the direction of alimentary stimulus movement--was investigated in gentically different groups of animals. It was shown that mice possessing. Robertsonian translocation Rb(8,17) 11EM were superior in the extrapolation task solving than mice with normal kariotype, or mice with Robertsonian translocations of other types (RB(5, 19)1Wh, Rb(6, 15)1ALD, Rb(9, 14)6Bnr, Rb(16, 17)7bnr). Mice selected for low brain weight were superior in the extrapolation task solving than mice with high brain weight in 3--11 generations of selection. In F12--F14 this difference was absent. Mice with Robertsonian translocations and mice selected for brain weight are perspective models for physiological and genetic study of elementary reasoning.


[Conditioned reflex leg placing reaction induced by stimulation of brain structures]. The mechanogram of fore-leg movement and evoked potentials in the leg cortical motor area this as well as biceps EMG were recorded in 4 cats in chronic experiment during conditioned placing reactions, elicited by tactile stimulation of the paw tip and by electrical stimulation of several cortical and subcortical brain structures. Mean latency of the conditioned movement and its dispersion were of the same order of values during reactions caused both by tactile stimulation and by electrical stimulation of the cortical motor area. During placing reactions to the stimulation of the sensory cortex, ventral posterolateral nucleus of the thalamus and the cerebral peduncles these values were significantly higher than in the first case.


[Dynamics of conditioned reflex preservation in young and adult rats]. Experimental data are presented on the formation and retention during 24 hours of a motor alimentary conditioned reflex (MCR) in a T-maze, in rats 4--5 months and 1,5--2 months old. In adult rats the formation of MCR required a significantly smaller number of runs and less time, than in young ones. In young animals reflex retention is better as compared to adults. Traces of MCR change regularly throughout 24 hours in both animal groups which may be due to development of memory in several stages, in young animals this process being slower.


[Rhythmic activity of central portions of the cat visual analyzer during different forms of behavior]. Synchronized EEG activity of visual cortex and some other parts of the brain was recorded in cats during milk licking. The frequency range, cortico-subcortical topography and some conditions of its appearance and blockade were analyzed. It was found, that this activity consisted of two rhythms with frequencies of 6--9 and 9--15 c/s and was strongly influenced by visual conditions. By come parameters it also differed from EEG of drowsiness and light sleep. Possible mechanisms and localization of pacemakers of this activity was discussed as well as its similarity to human alpha rhythm.


[Possible role of conformational changes in synaptic proteins in mechanisms of temporary connection formation]. Possible mechanism and the role of structural changes in the proteins of synaptic membranes in the process of formation of the temporary connection is discussed on the basis of existing assumptions and experimental data. Our experimental data suggest that during learning the structural changes occur in the synaptic membrane which are due to the conformation changes in the external and the integral proteins of membranes. Low-molecular proteins of synaptoplasma may play the role of the "carriers" and connectors and at a certain stage promote a conformation changes in synaptic proteins.


[Forward and reverse connections in the presence of a combination of indifferent stimuli]. In pairing of auditory and photic stimuli, the first stimulus caused an orientation reaction typical of the second stimulus even before its action, while the "proper" reaction to the first stimulus was reduced. Difference between orientation reactions to "positive" and "differentiation" stimuli was revealed. If the "positive" stimulus evoked the orientation reaction typical of the second stimulus, and the proper reaction was weakened, then the differentiation stimulus elicited mainly the proper reaction or no orientation reaction at all. This seems to be due to the specialization of reactions of performed by means forward connection.


[Neuronal organization of a focus of unconditioned excitation in the cat sensomotor cortex]. The impulse activity of sensorimotor area neurones, situated near the point of its direct electrical stimulation used as a reinforcing stimulus, was studied in cats. The rearrangement of impulse activity during reflex elaboration consisted in the reduction of frequency of background activity, in changes in the character of neuronal reactivity and of the pattern of response to the signal and reinforcing stimuli. During the reflex elaboration the percentage of polymodal neurones increased. Tonic response to the conditioned sound stimulus changed into a phasic one. The inhibitory component of responses to direct electrical stimulation of the sensorimotor cortex became more protracted.


[Defensive dominant detected by an unconditioned blinking reflex]. Multiple stimulation of rabbit leg with short DC pulses of both threshold and subthreshold intensities creates in corresponding areas of CNS a focus of excitation with dominant properties: summation, inertia et al. When an unconditioned reflex (blinking) was used as in agent exposing defensive dominant, it was found that summation in the dominant focus may occur without a conjugate inhibition of the subdominant center. During summation the dominant center is not uniform. Depending on the level of excitation in the dominant focus, the subdominant focus may be both in inhibitory state (no blinking in response to the subdominant stimulus) and in a state of enhanced excitation (the reflex to its proper stimulus increases). Multiple pairings of two subthreshold stimulations (of leg and eyelid) result in the establishment of a temporary connection with two-way conductivity.


[Conditioned motor-alimentary reflexes in cats following ablation of the body of Luys]. Alimentary conditioned motor reflexes in cats were elaborated in special chambers. Subsequently, the subthalamic nucleus was damaged, first on one and then on the other side. After its unilateral destruction, temporary disturbance in the cat behaviour was observed disappearing within 2--3 weeks. Bilateral destruction of the subthalamic nucleus led to a stable disturbance in the reaction of choice of reinforcement side in conditions of uncertainty.


The effect of human serum in vitro on Trypanosoma (Trypanozoon) brucei species trypanosomes and its relationship to infectivity in the blood incubation infectivity test. All attempts to identify Trypanosoma (Trypanozoon) brucei species trypanosome strains by their sensitivity or resistance to human serum in vitro have so far been unsuccessful. Wet-film examination of T.(T.) b. brucei, T. (T.)b. rhodesiense and T. (Nannomonas) congolense trypanosome strains, both before and after in vitro incubation in fresh human blood for 5 hours at 37 degrees C showed that serum-sensitivity or serum-resistance is not a constant and reproducible property of a trypanosome strain and is totally unrelated to infectivity.


Blood transfusion--a review of the literature. The dangers of using whole blood and its disadvantages are pointed out and the place of crystalloid or colloid transfusion as an adjuvant or substitute is discussed. The use of blood fractions for treatment of anaemias and clotting disorders is stressed. This means a reduction in amount of blood used for transfusion and hence reduction in cost and morbidity due to blood transfusion.


Determination of nitrite at low level without prior extraction. A method has been devised for the determination of nitrite at low level that is directly applicable to food or other dried matrices without prior extraction. Nitric oxide released from nitrite through the action of acetic acid is determined using a chemiluminescence analyser. The limit of detection is approximately 0.02 microgram, the coefficients of variation being 5.7 and 8.2% using 0.1 and 0.05 microgram of sodium nitrite, respectively. The chemiluminescence analyser response is diminished when water in excess of 0.5 ml is present in the assay system unless hydrogen bromide in acetic acid is used instead of acetic acid alone. The application of the method to the direct determination of nitrite in freeze-dried cod fish has indicated a content of 0.25 mg NaNO2 per kg, equivalent to 0.050 mg per kg of the original undried material.


[A rapid method for the isolation and quantitative analysis of 3,4-benzpyrene [benzo(a)pyrene] in food (author's transl)]. A method for the isolation and the quantitative determination of benzo(a)pyrene in food is described. The material is suspended in petroleum-ether. Benzo(a)pyrene is extracted from the organic phase as a water-soluble caffeine-complex. After re-extracting and purifying by column chromatography on silica gel the quantitative evaluation of benzo(a)pyrene is carried out by thinlayer chromatography and fluorimetric scanning of the cellulose acetate plates. To test the method benzo(a)pyrene was added to several products in concentrations of 100 to 1000 ng. A recovery of about 80% was achieved. Each analysis takes a total of 5 h.


Evaluation of lysinoalanine determinations in food proteins. A comparison is made between lysinoalanine (LAL) determinations both with an automatic amino acid analyzer (AAA) and with thin layer chromatography-densitometry (TLC) in different types of food and food ingredients, taken from the Dutch market. Generally there is a reasonable agreement between the LAL content obtained by both methods. However, some results indicate that a single technique is not always conclusive about the real identity of the ninhydrin-positive compound at the same position as LAL on the chromatogram. By TLC for instance, in yeast a content of about 800 mg of LAL/kg in protein is found, but according to the AAA method no LAL is present. In heated milk and milk products the LAL content determined by the TLC method is also higher than that found by the AAA method. This is caused by a preceding unknown ninhydrin-positive compound in TLC, occurring in all heated milk products and practically coinciding with LAL. In the AAA technique similar interferences of unknown ninhydrin-positive compounds could be avoided by choosing a suitable elution temperature; however, application of this temperature modification to foaming agents gave no satisfactory results.


Chlorohydrins in protein hydrolysates.

Chlorohydrins in protein hydrolysates. Four samples of neutral fractions of protein hydrolysates were separated by gas chromatography and the individual components were identified from the mass spectra obtained. Some of the identified compounds were not previously reported as volatile components of foodstuffs. Three of these compounds namely 3-chloropropan-1-ol, 2,3-dichloropropan-1-ol, and 1,3-dichloropropan-2-ol, were toxic chlorohydrins. 1,3-Dichloropropan-2-ol was present in samples in concentrations 0.17 to 0.94 mg/kg. To check the possibilities of the formation of these chlorohydrins and to find their precursor, glycerol, and hydrochloric acid mixtures were heated under conditions of producing protein hydrolysates. All three chlorohydrins, formerly found in protein hydrolysates have been identified.


Phaeochromocytoma in pregnancy: report on two cases and a review of the literature. Two cases of phaecochromocytoma in pregnancy are described. One case was diagnosed at autopsy and in the other case the tumour was successfully removed. The world and particularly African literature on the subject is briefly reviewed. The clinical feature diagnosis and management are discussed in the context of the reported cases.


A case of cryptococcoma producing tracheal obstruction during anaesthesia. A case of cryptococcoma of the right upper lobe producing tracheal obstruction during anaesthesia is reported. Whilst conscious the patient breathed spontaneously with little difficulty. The reasons underlying complete tracheal obstruction during anaesthesia are discussed.


Bacterial liver abscess--a diagnostic problem. Two cases of bacterial liver abscess presented to a hospital during an 18 month period. Both involved male caucasians who had been resident in Zambia for many years. The cases are recorded with a review of the recent literature. The difficulty in diagnosis and importance of adequate surgical drainage are stressed.


[Quick residue control of plant and animal food, tobacco, and tobacco-products by Sweep-Co analysis. 1 (author's transl)]. Control of Pesticides residues in imports and on market-places are only practicable, if a true statement is possible very quickly. The multi residue methods, which determinate a great number of pesticides in one analysis are well known, but very costly in time and material and cannot be automated completely. The Sweep-Co-Method can improve the present situation.


Goodpasture's syndrome in a Zambian woman. The clinical and pathological characteristics of Goodpasture's syndrome are described and a case reported in which there were classical clinical and pathological manifestations of this condition. This is the first report of this entity in an indigenous black African.


The influence of water activity on the stability of vulgaxanthin I. The stability of vulgaxanthin I at 100 degrees C is dependant on the water activity of the system. The half-life of vulgaxanthin I was found to be three times greater at aw 0.20 than at 1.00. The rate constants for vulgaxanthin I degradation varied exponentially with respect to water activity and below aw = 0.50 the stability was not improved.


[Detection of trenbolone residues in meat by thin layer chromatography and fluorimetry (author's transl)]. An new method for the qualitative and quantitative determination of trenbolone residues in meat, liver and kidney is described. The analytical procedure consists of the following steps: comminution of the meat sample; homogenisation with tetrahydrofurane; liquid-liquid partition first between acetonitril and hexane then between sodium hydroxide solution and petroleum ether/benzene; chromatography on a silica gel column. The detection on the TLC-plate is performed with 366 nm ultra violet light. The quantitative determination is carried out by means of a remission spectral fluorimeter directly on the plate. The detection limit in meat extracts was 5 ppb.


[The indication of radiation treatment for irradiated chicken on the basis of the radiation--induced loss of protein sulfhydryl groups (author's transl)]. A spectrophotometric technique for the identification of irradiated chicken (gallus domesticus) and doses ranging between 0.1 and 2.5 Mrad is described. Spectrophotometric determination of the sulfhydryl content in the animal tissue before (control) and after using 6,6'-Dithiodinicotinic acid is applied. Ionizing radiation causes a permant loss of sulfhydryl groups in the animal tissue such as chicken. Irradiation at room temperature and storing at -18 degrees C over a period of approximately one month does not show restitution or repair of the sulfhydryl loss. The dose-effect relation for this radiation-induced decrease of the sulfhydryl content can be described best by a double exponential function. Irradiation conditions, preparation of protein suspension from chicken, spectrometric investigations and other experimental details are reported. The results of all will be discussed in detail.


[Effect of chemotherapy on kidney function in pyelonephritis due to calculi with kidney insufficiency]. In patients with stone pyelonephritis the behaviour of the renal function under the influence of chemotherapy was examined at the stage of the compensated retention. 24 cures carried out on clinical conditions on 10 patients with an average age of 52 years (14--71) were evaluated. By means of chemotherapy in connection with the treatment of anaemia and the compensation of acidosis the renal function could favourably be influenced and the terminal stage of the renal insufficiency could be shifted. The author adopts a definite attitude to the long-term prophylaxis.


[Correlations between the metastable solutions of calculus-forming salts and crystals from coexistent insoluble urinary components]. The correlations between the individual stone-forming systems, expecially the induction of heterogeneous crystallization from metastable solutions of one stone-forming system by preformed crystals of the other stone-forming system, were measured semiquantitatively by the Coulter-Counter-Size Distribution Analyzer technique. It has been found out that Ca-oxalate crystals may represent potent triggers and accelerators of the phosphate precipitation from metastable Ca-phosphate solutions. The importance of this phenomenon could be attributed especially to the induction of crystal rich phosphate crystalluria at moderate pH values (6,5--6,8) by the preceding Ca-oxalate crystalluria (,,starter "resp." primer "crystalluria). The favouring, promoting influence of uric acid on the stone formation and growth of Ca-oxalate crystals could be observed with the same experiments under changed conditions. This mechanism could be of some importance in the case when Ca-oxalate precipitates from the urine, saturated by uric acid, at low pH values (5,0--6,0). Uric acid resp. sodium urate crystals showed a moderate by clear favouring effect on the formation of Ca-phosphate crystals from metastable solutions. The influence of Ca-phosphate crystals upon the growth of Ca-oxalate crystals proved to be very limited.


[Our experiences with urate I in bladder stones]. It is reported on the experiences with the electrohydraulic lithotripsy in 122 patients. The indications, contraindications and regulations for the intervention are shown and it is referred to their significance for a successful and dangerousless operation. This fact is emphasized by two own cases with intraoperative complications. In the opinion of the authors the electrohydraulic lithotripsy is the method of choice in the treatment of vesicular calculi in an adequate indication and in the department of the authors it has fully restricted the mechanical lithotripsy.


[Frequency of pathological liver changes in biopsy and autopsy samples (author's transl)]. It is the purpose of this study to point out the epidemiological importance of pathoanatomical records. In this connections, it is necessary to pay attention to different prerequisites for documentation, especially to an agreement on diagnostical nomenclature. Liver alterations and liver diseases are given as an example for valueing the relevance of both bioptic and autoptic materials for epidemiological purposes. By means of about 8,500 liver biopsies and 1,000 autopsies from the same territorial region the type and frequency of the different pathological alterations of the liver are compiled. Their frequency differs about ten fold. The epidemiological value obviously lies in specially aimed investigations; on the other hand, autoptic examinations are more representative and therefore of higher general reliability and greater epidemiological value.


[Primary leiomyosarcoma of the liver (author's transl)]. The occurrence of leiomyosarcoma was demonstrated in a tissue cylinder obtained by liver biopsy in a 68-year-old woman with unclear hepatomegaly. The patient died 8 months after she had experienced first signs of illness. Autopsy revealed a primary leiomyosarcoma of the liver with metastases in the lungs, bilaterally in the pleura, in the kidneys, and in the periportal and spleno-pancreatic lymph nodes. The occurrence of a primary tumour in the urogenital system or in the gastrointestinal-tract could be excluded. The diagnosis of leiomyosarcoma was based on the microscopical demonstration of smooth muscle fibres with enlarged red-like and partially atypical cell nuclei and atypical mitoses. Furthermore, we observed extensive necroses and haemorrhagia in the tumour tissue. Preexisting tumours of the liver as, e.g., teratoma or hepatoblastoma were not found. No cirrhosis of the liver could be detected. Obviously, the leiomyosarcoma had its origin in the smooth muscle fibres of the liver vascular system.--According to the literature primary leiomyosarcomas in the liver are only rarely found.


[State after pancreatitis--as a clinico-pathological term (author's transl)]. Up to now, little attention has been paid in the clinical as well as in clinico-pathological systematics to the fibrotic "state after pancreatitis" (in its severest form called "cicatrical pancreas"). This state is of interest not only as an increased risk of a recurrent pancreatitis (including acute haemorrhagic pancreatitis), but as well as because of the severe pancreatographic changes, as they occur in (chronic) pancreatitis. In biopsy diagnoses of the pancreas the "cicatrical pancreas" also has to be taken into consideration as a life-long frequently inactive pancreatic disease. With respect to these questions 264 pancreases, among these a series of 144 random autopsy cases, were examined histologically and pancreatographically.


Systemic angioendotheliomatosis (author's transl). Two cases of systemic angioendotheliomatosis are reported. The first patient was a 20-year-old pregnant Negro woman from Ghana; the diagnosis was established in the biopsy of the skin lesions; the follow up of the patient is unknown. The second patient, a 70-year-old man, presented repeated but transitory loss of sight and speech, later on associated with unconsciousness and convulsions. He died of severe epileptic status two months after the onset of the symptoms. Systemic angioendotheliomatosis was found in the brain as well as in other organs and tissues.


[Coronary atherosclerosis, coronary thrombosis and myocardial infarction in autopsy cases. 9th communication: relationship of coronary thrombosis and myocardial infarction (author's transl)]. The autopsy reports of the Pathological Institute Erfurt of the period from 1.1.1951 until 31.12.1969 were scored for cases of myocardial infarction and coronary thrombosis. Among 2,393 morphologically analysed myocardial infarctions 454 coronary thromboses (18.97 per cent) were found. Males were significantly more affected than females. Fresh infarcts showed significantly more thromboses than callous infarcts. We found fresh and occluding vessel thromboses more frequently in fresh infarctions. The analysis of age distribution yielded an increase of the rate of thrombosis in cases with myocardial infarction. On the other hand, the frequency of infarctions in cases with a coronary thrombosis was decreasing. It is suggested that the risk for infarctions is larger in younger people with coronary thrombosis than in older ones. No infarctions were detected in 165 cases of thrombosis. Preferably this group includes those cases in which the patients deceased within 6 to 8 hours and, therefore, the infarction was not morphologically detectable.


[Cysts in the villous stroma of the placenta in maternal diabetes mellitus (author's transl)]. Edemateous placentae of diabetic mothers have been examined by light as well as electron microscopy. In addition to typical fetal capillaries there were observed thin-walled cysts containing Hofbauer-cells rather than blood cells which, unlike the capillary system, cannot be filled up with intraarterially injected ink. Derivation and significance of these cavities are discussed. They are considered to be a possible expression of frustraneous extracapillary formation of new vessels. The changes, while not specific, are characteristic of the placenta in maternal diabetes mellitus.


[Operations on vertebral bodies by anterior approach (author's transl)]. The origin of most pathological affections of the spine is situated in the vertebral bodies and the intervertebral disks. There have been established standard manners for the anterior approach to all parts of the spine in the last years which allow us to reach every vertebral body from the front. The authors describe the anterior approach to the different parts of the spine and discuss the indications for interventions on the vertebral bodies separately for the cervical, thoracic and lumbar spine. The experience with their 144 own cases is briefly reported.


[Treatment of hip joint fractures and their sequelae (author's transl)]. Present state and own experience in surgical treatment of different fractures of the acetabulum are reported. Primary insufficient treatment of those cases and delayed treatment impair the results considerably.


[First treatment of compound fractures of the tibia (author's transl)]. Omission of primary closure of the wound after debridement on the day of admission may delay the in hospital time for some days or even weeks, but does not interfere with the healing of the open fracture. On the other hand, primary closure endangers the patient with wound infection and osteitis. Experience shows that this complication can be diminished considerably by delayed wound closure when planned systematically.


[Functional treatment of fractures of the calcaneum (author's transl)]. 62 fractures of the calcaneum treated by functional therapy have been reviewed. Good results were observed in 63 per cent of the cases, whereas 37 per cent showed satisfactory results. Fractures of the Typ A and B and those of Typ C without other injuries demonstrated good results. Therefore functional therapy can be recommended. Although Typ C fractures combined with other injuries have poor end-results, operative therapy should be delayed because of the over-all risk of the patient. A trial of functional therapy should be initially instituted.


[Insufficient treatment of fractures of the hand (author's transl)]. The treatment of fractures of the hand cannot be standardized, the procedure to be used has to be determined from case to case. Besides age and profession the patients intelligence and his readiness to cooperate are of importance. Sometimes osteosynthesis is not successful because these factors are disregarded. In some cases immediate amputation will not only shorten the time of treatment considerably but also prevent an inept psychic attitude (pension neurosis). Correct assessment of the injury during the first treatment may be decisive for failure or success, because a second operation will not yield a good result.


[Permanent damage after frontobasal fractures of the skull; its evaluation according to medical reports (author's transl)]. Frontobasal fractures of the skull may cause cosmetical disfigurement, impairment of nasal airflow, anosmia, brain lesions, liquor dripping, dysfunction of the eyes and trigeminal neuralgia. This is followed by social problems. The percentage of compensation is dealt with.


[Tracheostomy--late complications and their treatment (author's transl)]. The number of late complications after tracheostomy has increased due to new indications especially reanimation. Tracheal stenosis is the most severe complication. Its treatment by resection and end to end anastomosis, tracheopexy, plastic reconstruction or by endotheses is discussed. The operative technique of these procedures is difficult, the result not always satisfying.


[Achalasia of the oesophagus. Operative treatment by abdominal myotomy and fundoplication (author's transl)]. Achalasia is a neuromuscular functional disturbance with dystonia and dyscinesia of the entire tubular oesophagus of unknown aetiology characterised by loss of cardial opening reflex. In the usual functional state dysphagia and moderate stenosis are observed, but occasionally an organic form with marked mega-dolicho-oesophagus will develop. Therapeutically an attempt is made to reduce the hypertonus of the terminal oesophagus. In mild or moderate cases this may be achieved by dilatation alone. If conservative treatment fails or in severe forms an operative correction is mandatory, we advise preoperative dilatation together with an extramucous myotomy of the distal anterior oesophageal wall and a fundoplication to prevent the gastro-oesophageal reflux. This abdominal procedure demands great care but is not traumatising and ensures satisfactory early and late results even in patients with considerable surgical risks. Operative indication and technique in 63 cases are demonstrated.


[Heterologous and alloplastic grafts for haemodyalisis (author's transl)]. In cases of the malfunction of av-fistulae for haemodialyses a kind of prosthetic graft has to be used. Since 1973 alloplastic protheses (Sparks-Mandril) have been used in 7 patients, since 1976 heterologous (Solko-graft-calf-carotis) ones in 12 patients. In an average follow-up period of 18 months the heterologous prostheses proved to be more suitable because of longer patency-rates, simpler handling during surgery and earlier use for dialyses. As a major late complication only one case of an aneurysmatic enlargement was observed in one of the heterologous protheses. Long-term results have still to be waited for.


[Splenectomy; its results (author's transl)]. 270 patients underwent splenectomy for different indications. The rate of complications amounts to 18,8%. Prognosis after splenectomy depends on the basic disease, accompanying illness and the quality of pre- and postoperative care.


[Surgical treatment of carcinoma of the pancreas (author's transl)]. 147 cases of carcinoma of the pancreas are presented excluding cancer of the ampulla and endocrine tumours. Only 21 (14,9%) radical pancreatectomies could be performed with 3 deaths. 83 (56,4%) patients were treated by palliative procedures with 16,8% deaths. 21 (14,9%) patients had explorative laparotomy with a 27,2% mortality rate. The mean survival time is 11,5 months after duodeno-pancreatico-resection and 16 months after total pancreatectomy. The mean survival time in palliative surgery is 14,8 months. There was no survival at all after 5 years. Our surgical indication depends on local extension, but above all on lymphnode metastases: if there are more than 3 metastased nodes in the frozen section, radical surgery seems to be useless. On the other hand, total pancreatectomy gives better results for morbidity, operative mortality and survival rates than segmental resection.


[Combined operations for cholecystitis (author's transl)]. An analysis of 60 operations for cholecystitis includes interventions accompanied by simultaneous procedures on various organs of the abdominal cavity, on the abdominal wall, the kidney and the heart. The problems of preoperative examination of patients with cholecystitis are discussed along with the surgical tactics when concomitant pathology requiring surgical management is revealed, and with indications for one-stage combined interventions in cholecystitis.


[Trouble after cholecystectomy (author's transl)]. Unsatisfactory results after cholecystectomy are mostly due to complications of the disease not realised under surgery and to technical blunders. Only intraoperative cholangiography, exploration of the common bile duct and inspection by choledochoscopy build the sound basis for an adequate surgical procedure.


[Effect of hormonal contraception on the fibrin-stabilizing factor (factor XIII)]. The plasma activity of fibrinstabilizing factor (factor XIII) in 27 women treated with Non-Ovlon an anticonceptive agent, were investigated. It was found significant differences of levels plasma activity. Conclusions from isolated observations are not possible.


[Progesterone-induced changes of the endometrium and cervix mucosa in glandular, cystic hyperplasia of the endometrium]. In a period of 5 years 116 specimens were collected with various techniques from patients with the homologous type of cystic-glandular hyperplasia of the endometrium. These were systematically studied with a view to identifying a potential progesteron effect on the morphology of the endometrial and, given sufficient material, cervical mucosa. While the endometrium was examined for discrete areas with signs of secretion, attention in cervical specimens was directed to the potential presence of focal alveolar proliferations of cervical glands with basal cell hyperplasia (socalled cribriform polypoid hyperplasia). Progesteron-induced changes of major endometrial areas were found to be present in 6,9% of cases; the "cribriform polypoid hyperplasia" involving the cervical mucosa was seen in 9 of 43 cases (20,9%) with adequate cervical specimens. In 2 of the patients with progesterone-induced cervical changes luteinized follicular epithelium in the ovaries was indicative of effective endocrine activity. The different action of progesterone on the endometrial versus the cervical mucosa is discussed on the basis of katamnestic studies.


[Corpus luteum function in the middle luteal phase following treatment with prostaglandins]. The corpus luteum of the mid-luteal phase was examined concerning of the signs of functional and morphological regression after treatment with Prostin F2alpha and 15(S)-15-methyl-PGF2alpha. By 8 patients who were operated upon out of various uterine indications steroid hormone levels were determined during the treatment with prostaglandins and corpus luteum was judged by electron-microscopy. Morphological changes in the temporary decrease of the progesteron concentration could be found.


[Changes in treatment results of 5279 cervix tumor patients between 1946 and 1972]. Results of the treatment of 5279 cervix tumour patients between 1946--1972 are reported. The assessment was performed by computer analysis of the material. There was a parallel rise in the 5 years survival of patients with the growth of radiotherapeutical equipment, mainly in extensive cases. Regarding all stages, the 5 years survival was 44,36%.


[Laurence-Moon-Bardet-Biedl syndrome and endometrial carcinoma]. Report on a classical Laurence-Moon-Bardet-Biedl-syndrome (LMBB-Syndrome). After a 9 (to 10) year-period of irregular bleedings caused by proved monophasic menstrual cycles and Stein-Leventhal-syndrome an endometrial adenocarcinoma arose in the 23 old patient. The possible carcinogenesis by virtue of an extraglandular oestrogen-(oestron-) production is discussed. The frequently observed nephropathy is often a decisive factor in morbidity and letyality of the LMBB-syndrome.


[Self-examination of breast under personal and psychologic aspects. (Psychometric studies of 533 women)]. A psychometric study conducted among 533 women tested for statistical significance of personality traits (FPI) between selfexaminations of the breast and the attitude to examinations performed by physicians. --I. Introverts (FPI-E) performed selfexaminations with only half the frequency of extroverts (p less than 0,01). One fifth of the women with personality traits of introversion believed that screening examinations for detection of breast cancer performed by physicians are of lesser importance as did women with personality traits of extroversion (p less than 0,01). The later group believed that breast has significance in cosmetic appearance (p less than 0,05) and sexual value (p less than 0,05). Introverts are mostly of lower education (p less than 0,05) and their intelligence quotient is usually below 100 (p less than 0,1) when compared with that of extroverts. For selfexaminations of the breast this finding is of special importance to preventive medicine to provide effective instructions and guidance. --II. Emotional labile women (FPI-N) produce expected results of being especially fearsome (p less than 0,01) regarding breast change appearance produced by an conscious fear of cancer (p less than 0,05). Upon discovery of a painful lump in the breast labile women delay the visit to the physician longer as emotional stable women (p less than 0,05). Labile women stay single twice as often as emotional stable women (p less than 0,01). This produces a lower possibility to be activated by ones spouse to seek the aid of a physician for treatment of the breast. --III. In women with personality traits of depression or low selfesteem is a longer delay period apparant as in women with high selfesteem. Upon noticing a lump in the breast--if painful or not--women with high selfesteem immediately pay a visit to their physician (p less than 0,05) but the others delay. Here should be mentioned that depressed women deviate from the lot in regard to family status (p less than 0,05) and obtained education/intelligence niveau (p less than 0,01). These results are debated viewing preventive-medical and psychosocial aspects.


[Premature rupture of fetal membranes].

[Premature rupture of fetal membranes]. Our investigations on premature rupture of the fetal membranes (PROM) show that prematurity represents a higher risk for the fetus than infection does. Therefore we tend to be expectant in case of PROM combined with prematurity. On the other hand latency between rupture of the membranes and onset of labor should not exceed 24 hours for a mature fetus (gestational age greater than 37 weeks, estimated weight greater than 2500 g, L/S-ratio greater than 2). Antibiotics are applied only in case of manifest infection and at the onset of labor following a latency longer than 24 hours.