[Early diagnosis of rheumatoid arthritis]. On the basis of own observations of courses the author adopts a definite attitude to the early symptomatology of the rheumatoid arthritis. During the first weeks of the rheumatoid arthritis the following symptoms are found: articular syndromes, more frequently in form of obstinate polyarthralgias, mono-oligoarthritis, accompanied by morning rigidity and accelerated BSR as well as impairment of the general condition. In the majority of the patients only the tentative diagnosis rheumatoid arthritis may be made. After a one to three months' course of the disease the diagnosis becomes more probable. It is above all based on constancy and symmetry, characteristic localisation of the articular process, morning rigidity, radiologically paraarticular loosening of the structure and morphological symptoms of an acute and subacute synovialitis. 6 to 12 months after the beginning of the disease a clinical picture forms which allows to make the diagnosis of a certain or classical rheumatoid arthritis in accordance with the criteria of the ARA. The occurrence of a high activity of multiple affection of the joints (permanent symmetrical polyarthritis including the small joints of the hands and feet), distinctive morning rigidity, high fever and much accelerated BSR, beginning with the first weeks of the disease, speaks for the possibility of the development of an arthrovisceral form of the course of rheumatoid arthritis.


[Early diagnosis of spondylarthritis ankylopoietica]. For the early recognition of the ankylopoietic spondylarthritis subjective and objective criteria are explained and the importance of X-ray-morphological, cytological, biochemical, immunogenetic and coagulation-physiological investigations are explained. By accentuation of two types of constellation of the course the possibility of an early diagnosis is given still before the appearance of severe irreparable X-ray-morphological changes in about half the cases of disease. Further observations and controls of courses are necessary for the confirmation of evidence.


[Diagnostic problems of gout].

[Diagnostic problems of gout]. The arthritis urica is defined as a relatively rare, at the same time facultative symptom of different metabolic and other disturbances (primary and secondary gout). As a rule it is observed only several years of the beginning of the hyperuric-anemia nearly exclusively in males and is only one form of manifestation of the wide-spread complex gout syndrome. It is proposed to supplement the criteria for gout or arthritis urica of Rome 1961 and New York 1966 by new knowledge on the uncharacteristic gouty arthropathy. It is particularly referred to method problems of the determination of uric acid in the serum.


[Reiter's disease].

[Reiter's disease]. In the Reiter syndrome apart from the symptomatology on the part of the urogenital tract, the changes of eyes and joints a series of further diagnostically important participations of organs appear. In most cases is at the beginning an intestinal infection which, after characteristic latency periods, is followed by urethritis, arthritis and changes of the eyes. Characteristic is further an affection of skin and mucous membrane; facultatively a participation of the heart appears. Different types of course render the diagnosis difficult. The investigation for the occurrence of HL-A 27 is useful.


[Use of compartment models in the pharmacokinetics]. A survey is given on the most important theoretical methods which are necessary for the analysis of pharmacokinetic data in clinic and experiment. According to their importance in practice the stress is on the description of the analysis of linear pharmacokinetic systems. Issuing from the general multicompartment theory the one- and two-compartment models important in clinic are dealt with more in detail. The problems of the model identification in models with three and more compartments are explained. With the help of the example of the one-compartment model the authors deal with the problems of the non-linear kinetics, which may appear in drugs with high plasma concentration. Summarizing are finally some hints given at the use of these theoretical methods in practice.


[Intestinal microbial flora and resorption]. An abundant microbial growth in the small intestine is called "overgrowth syndrome". The dysbiosis existing hereby is to be characterized by the prevailing of certain sorts of germs. A series of typical symptoms is explained by the metabolic activity of microorganisms, in which case disturbances of absorption are uppermost. Morphological and histochemical changes of the intestinal mucous membrane as well as disturbances of the bile acid metabolism and the absorption of carbohydrates, fats and vitamin B12 are explained. Finally the author deals with the microflora in conditions of malabsorption.


[Experiences in the use of the so-called M-mode method in the clinical diagnosis of heart diseases]. Since formerly only the diastolic phase of the curve of the mitral valve was in the centre of interest for diagnosing the mitral stenosis, nowadays the systolic area is more taken into consideration, the changes of which apart from the hypertrophies of the heart walls increasingly gains significance for the diagnostics of the idiopathic hypertrophic cardiomyopathies, the floppy valve syndrome, the aneurysm of the heart wall, the atrial septum defect as well as for systolic murmurs of different genesis. The registration of the movement of the posterior wall and the septum give the possibility of determination of the volume. Thus mean values of the stroke volume, the minute volume of the heart and the cardiac index showed a conspicuously good correspondence in persons with healthy heart compared with former determinations by dye dilution technique. As formerly (dye examinations) we found significant differences between normals and values of patients with mitral stenosis in stroke volume, ejection fraction, cardiac output and cardiac index, when we used the echocardiographic technique.


[Comparative allergologic studies in treated antihypertensive patients with vasomotor rhinitis]. In order to solve the problem, whether in anti-hypertensively treated patients with the symptom of the obstructed nose allergologic mechanisms play a role, comparisons with the transformation test of lymphocytes, the serologico-nephelometric two-step method after Hoigné and the mast cell degranulation test in rats were carried out. The proof of the sensitisation to the applied medicament by the transformation test of the lymphocytes was successful in all 7 patients who complained about the symptom mentioned. These findings were supported by the positive results in 5 patients, which we achieved by means of the other two methods. By comparison with the treated and untreated control patients the question of the clinically relevant connection between sensitisation and symptomatology was discussed.


[Determination of the renal clearance in combination with isotope nephrography]. The possibilities of a determination of the renal clearance including the separation of sides with the help of simple nuclear-medical examination and measuring techniques are described. In 50 patients the determination of the effective flow of renal plasma was carried out with 131J-labelled iodohippuric acid. Methodic variants were compared. The examinations of the patient last one hour. They can be carried out in the outpatient department within the isotopic nephrography. In addition to this only several takings of blood samples are necessary. A catheterization of the urinary bladder as it is necessary for the classical determinations of the clearance is no more to be done. The results show that with the help of the methods described valuable quantitative informations about the function of the kidneys are to be got.


[Importance of continuous recording of vascular resistance]. The behaviour of resistance in the periphery of the circulation and in the organic regions underlies different influences. Depending on the function of the organs, on the situation of heart and circulation and on the therapeutic influences the vascular resistance changes. To the study of the dynamics of the behaviour of resistance particularly the continuous electronic recognition is suitable. The gain of time and information is great. Especially for the determination of the coronary perfusion in different functions of heart and circulation the continuous registration of the vascular resistance is necessary. Its importance was as an example demonstrated for the left-ventricular ejection resistance and for the left- and right-coronary influx resistance.


[Assessment of granulopoietic function reserve of the bone marrow by means of the Pyrecol-test in granulocytopenias, immature-cell leukoses and patients under antineoplastic agent therapy]. By injection of the irritating substance Pyrecol the granulopoietic reserve of the function of the bone marrow can be judged. In normal test persons the result is after 8 hours an increase of leucocytes to 176%, when the granulocytes increase to 216%. On the other hand the rate of increase in patients with undifferentiated cell leucosis is statistically highly significantly lower (2alpha = 0.01) with 115 or 132%, respectively. A higher ejection function of the bone marrow correlating with the clinical improvement is to be found after a successful therapy with cytostatics. By this the test informatively contributes to dosage and effectiveness of the therapy with cytostatics and to the course of the disease. In 6 patients with granulocytopenia of unclear genesis examined in the result of the Pyrecol-test 5 passager granulocytopenias with favourable clinical course unambiguously distinguished themselves from a pan-myelophthisis with exitus letalis. The test is easily to be performed and has no essential concomitant a-pearances. By the integral functional evidence it represents a rational supplementation of the locally demarcated morphological substrate of the sternal puncture or bone marrow biopsy, respectively.


[Studies on the influence of glucose infusion on parameters of hemostasis]. In continuation of previous in vitro experiments the influence of glucose infusions on the following haemostatic functions was investigated: bleeding time, platelet count, platelet aggregation, release reaction, fibrinogen concentration, partial thromboplastin time. Five volunteers with normal metabolism a glucose infusion (100 g) was given for two hrs. Before, 1, 2, 3, 4 and 5 hrs after the beginning of the infusion blood sugar, insulin level and haemostatic parameters were determined. Apart from an increase in the glucose and insulin level, a prolonged bleeding time, increased platelet count, inhibition of platelet aggregation and release reaction occurred. Simultaneously, fibrinogen concentration increased and partial thromboplastin time shortened. The possible causes of these changes in haemostasis during glucose supply are discussed.


[Reaction of the rabbit brain to locally applied deep temperature (light- and electronmicroscopy findings)]. Investigations by light and electron microscopy showed more details of potential patterns of injuring after application of low temperatures to rabbit brain. The authors were actually concerned to transforming the intensity of cooling into exact and reproducible degrees of necrosis. According to these experimental results, the application of cryotechnique to human central nervous tissue is just permitted on special premises (size of probe, low-level of temperature, and period of application).


[Problems in the intravital demonstration of specific excitation-conducting structures of the heart]. A new method for x-ray visualization of essential parts of ventricular conduction system is reported, which was tried in vitro and in vivo on animals. Further a prospect is given as to the visualization of specific musculature, basing on the electrophysiologic course of excitation.


[Thromboelastography and inhibitors of aggregation]. The effect of maintained treatment with salicylo-acetic acid (1.5 g/day) on the thrombelastogram was examined in the venous blood from 18 accidental patients. In the prevention of thrombembolia, resulting values of the thrombelastograph are not sufficient to show functional changes of platelets. Some of the patients revealed prolonged times for reaction and formation of coagula, thus discreet influencing the thrombelastogram might be supposed.


[Role of the antrum in the etiology of stress ulcers in the rat]. In rats, antrectomy results in a decrease of ulcer rate by immobilization without statistic significance. Stress ulcer rate is also lowered by antral vagotomy, with statistically significant decrease of acid production. By antrectomy as well as by antral vagotomy just the acid production but not the circulatory disturbance in the mucosa of corpus is influenced, which is primarily responsible for the development of stress ulcers. This fact gives an explantation for the relatively high ulcer rate, compared with the conduction in rats after truncal vagotomy. Unclear remains whether antrectomy with consecutive total gastrin elimination is merely working by inhibiting the secretion, or if gastrin has a circulatory effect too.


Experimental investigations on the possibility of transplantation of venous grafts stored at low temperatures. At the Laboratory of Experimental Surgery, Institute of Haematology in Warsaw 13 dogs received homografts of venous patches stored at low temperatures to fill defects in the wall of the lower caval vein. Venous patches were prepared from segments of femoral veins and were placed in 1.41 M DSMO and stored at the temperature of liquid nitrogen. The authors describe the methods of obtaining venous patches, the technique of freezing and defreezing of grafts, and details of operations. Full healing in of grafts took about 15 days. The results of histological examinations of grafts obtained during planned autopsies between 12 and 29 days after application of the graft are discussed.


[Changes in the activity of lysosomal enzymes in experimental ileus]. After inducing experimental ileus in albino rats, the authors found changed lysosome enzyme activities in liver homogenizate. In the same kind "free" activity of acid phosphatase and acid ribonuclease is elevated by strangulation ileus. According to literature, these alterations result from changed permeability of lysosome membranes, resp. from rupture of lysosomes. Ileus by obstruction causes no significant changes of the "free" lysosomes activities in liver homogenizate. Increase of acid phosphatase and ribonuclease in blood serum by strangulation or obstruction is equally considerable in both kinds of ileus. The results of these experiments suggest the developing of hepatic damage under both kinds of experimental ileus, the extent of which can be assessed by determination of lysosome enzyme activities.


[Decontamination tests of heart valve grafts with cialit]. After exposure of contaminated xenogenous aortic valve grafts to 0.5 g% Cialit solution for 30 minutes, to 0.1 g% solution for 24 hours, or to 0.02 g% solution for 288 hours, growth of germs on the graft had stopped. Cialit has bacteriostatic and fungistatic effectiveness and fair stability of solubility; nevertheless it ought to be used with reservation. No safe destruction of microbes- spores and viruses in particular- can be guaranteed at acceptable Cialit concentrations of 0.1 g% and below.


[Hemodynamics, metabolism and function of the perfused pancreas under normal temperature]. The canine pancreas-duodenum has been perfused for 3 h with a membrane oxygenator, a pulsatile pump and a heat exchanger at a temperature of 37 degrees C. Among the criteria used in this study, the insulin output into the venous blood in response to glucose administration, as well as pancreas secretion after secretion stimulation were those found to be the most reliable indicators as to the viability of the pancreas. This is further supported by an average oxygen consumption of 0,77 ml O2/100 g at a constant flow of 80 ml/min and a perfusion pressure of 75 mm Hg. The pressure/flow relationship as for any other perfused organ was a safe indicator as to the viability of the perfused pancreas. The functional viability correlated with our anatomical findings.


Oxygen consumption by hepatic tissue after transfusion of a stroma-free haemoglobin solution. The ability of stroma-free haemoglobin solutions to transport oxygen was investigated by determining the oxygen consumption by the liver using Warburg's microrespirator. 50 ml of blood were removed from the rabbit under general anaesthesia and replaced by an identical volume of a non-oxygenated or oxygenated haemoglobin solution. The control rabbits received no transfusions. It was found that arterial hypotension produced by blood-letting caused a significant rise in oxygen consumption by the hepatic tissue. The rise was increased even more when the rabbits received no transfusions. Transfusion of non-oxygenated haemoglobin solutions caused likewise a rise in oxygen consumption immediately after transfusion. This rise was, however, not so significant as in the control group. On the other hand, transfusion of oxygenated haemoglobin solutions produced no rise in the oxygen consumption by the liver as compared to its value after blood-letting.


[Preservation of articular cartilage. 1. Chondrocyte vitality depending on the preservation method (autoradiographic studies)]. Vitality of chondrocytes of articular cartilages of adult Alsatian dogs was autoradiographically examined in vitro after different kinds of preservation. All preserving methods that require freezing-in result in dying of cartilage cells, immediately or after one day. On the other hand, chondrocytes survive dry preservation at +4 degrees C. for 14 days, and even for 28 days when stored in 5 per cent glucose solution.


[Preservation of articular cartilage. 2. Behavior of glycosaminoglycans (GAG) in the intracellular substance of preserved articular cartilage (histo- and biochemical studies)]. Glucosaminoglucanes (acid mucopolysaccharides) were assessed by means of histochemic and biochemic methods in differently preserved articular cartilages of adult Alsatian dogs. Immediately after lyophilization, resp. 14 days after preservation at --196 degrees C., the glucosaminoglucanes decrease, whereas they are present in undiminished concentration after deep-freezing preservation (--18 degrees C. and --78 degrees C.) up to 30 months, and at +4 degrees C. up to 100 days. No more destruction of glucosaminoglucanes occurs after dying of chondrocytes, obviously depending on blocking the glucosaminoglucanes destructing enzymes during the freezing. With regard to the investigations on the vitality, deep-freezing preservation at --18 degrees C. to --78 degrees C. is recommended for storage of avital articular cartilage. Preservation of vital articular cartilage is possible for 28 days at +4 C. in 5 per cent glucose solution.


[Experimental skin replacement by means of absorbing alloplastic material]. In 15 rabbits skin defects of various size were induced. The defects were covered with blood-soaked Surgicel which at the margin was attached with Histoacryl adhesive. Gradually under this cover the epithelization proceeds. The authors recommend this emergency procedure in severe cases of burns of other extended skin injuries.


[Morphological and angiographic studies on mammary artery in coronary sclerosis]. Macroscopic and microscopic studies on the anterior interventricular ramus of left coronary artery, internal thoracic artery, and great saphenous vein were carried out 50 dead, aged 21 to 60 years. The internal thoracic artery was always normal whereas in 40 cases stenosing coronary sclerosis was found. At mammography, 25 patients  with operable coronary obstruction also showed no degenerative alterations of this systematic artery. With a diameter of 1.5 mm in the 5th intercostal space the internal thoracic artery was fit for performing an anastomosis.


[Lyophilized vein as an arterial substitution]. The use of homologous preserved veins for replacing seems to have special importance in the surgery on peripheric and coronary arteries. Preliminary results from animal experiments are discussed in which lyophilized veins replaced arteries. Within 8 weeks after implantation into dog aorta develops a functionally satisfactory substitute. No immune reactions can be found histologically. The destruction of the graft and its replacement by host's tissue are temporally balanced. The experiments are to be continued.


[Studies on the immunologic behavior of standardized virus-induced rat tumor after cryosurgical and surgical treatment]. The authors report on the behavior of a virus-induced tumor in the rat after cryosurgical and surgical treatment and re-implantation of different tumor suspensions. No specific "immune-cryothermic response" could be demonstrated. The principle of the lysis of the re-implantate lies in devitalizing the primary tumor.


[Experimental and clinical use of the mini-size bubble-bag thermooxygenator by the Rygg-Kyvsgaard method]. The authors report on experimental and clinical use of the Mini-size-bubble-bag-thermooxygenator according to Rygg-Kyvsgaard. The advantages and possible applications are demonstrated. The Mini-size-bubble-bag-thermooxygenator is recommended for routine cardiosurgery on infants. The authors point at possibilities to use it in systems of extracorporeal circulation beyond cardiac surgery.


[Determination of lipids in serum and erythrocytes during surgery with extracorporeal circulation]. The changes of the lipids in serum and erythrocytes inclusively the fatty acid pattern of the phosphatids were registered at 16 patients of whose congenital heart defects were corrected with extracorporeal circulation. The differently evident changes of the lipid fractions are to relate to heparinization, hemodilution and injury of erythrocytes which is increasing in the duration of perfusion. They are discussed in their importance for clinical essential phenomenous as disturbances of the coagulation or hemolysis. From these preliminary studies is to conclude that the substitution of phosphatids is necessary at the end of or after the extracorporeal circulation.


[Function of the liver reticuloendothelial system in hemorrhagic shock in dogs]. The function of hepatic reticulo-endothelial system at normal circulation and during hemorrhagic shock was examined in 13 dogs. The results were as follows:1.198Au-colloid liver scintigraphy demonstrated no essential alterations by shock. A trifling diminution caused by the diminished blood amount in the liver was found at heavy blood loss. The spleen was opcified in no case. 2. The elimination rate, resp. the blood clearance, of 198Au-colloid remained constant during the first 2 hours, proving that the vital clearance function of hepatic reticulo-endothelial system is completely maintained in this phase of hemorrhagic shock. After longer duration of hypovolemic shock (5 hours) elimination rate decreased. 3. It can be concluded that hepatic circulation at first alters according to the blood volume. 4. Consequently, functional testing of hepatic reticulo-endothelial system is not fit for early diagnosis of shock.


Measurements of oxygen tension from the canine gastric mucosa under the influence of vasoactive and acid stimulating agents and following vagotomy. Implications on the pathophysiology of peptic ulceration. By the use of a multiwire platinum electrode mucosal tissue pO2 from the canine gastric antrum is continuously recorded. Injection of norepinephrine causes a short, steep fall of mucosal pO2, naftidrofuryl elevates mucosal pO2 for several minutes in spite of reduced arterial blood pressure, pentagastrin produces a biphasic response, a temporary rise of mucosal pO2 is followed by a longer lasting decrease, vagotomy causes a considerable and more persistent drop of mucosal pO2. These experimental findings are discussed in their possible relations to the clinical problem of ulcer formation and therapy of gastroduodenal bleeding.


[Influence of cholestasis due to duodenal ligation on the secretion of gastric juice in the rat]. In the rat stasis of duodenal and pancreatic juice, and of bile by ligatures at the duodenum with potential reflux into the stomach causes an inhibition of gastric secretion. The strongest effect presumably has the bile in connection with the distension of the duodenum. Moistening of the mucosa of gastric corpus with these juices seems to be unimportant.


[Induction of standardized burns in animal experiments]. A burn stamp is described that was designed in cooperation with the Institute for Biophysics. It is capable to induce standardized reproduceable burns in experiments on guinea-pigs.


[Limitations of and criteria for a coronary thrombosis model]. The increasing frequency of cardiac infarction and its close correlation with coronary thrombosis urge to seek for new therapeutic approaches to coronary thrombosis. Proper models are necessary for that. The principles hitherto published are reported as well as the limits of their reliability, and the demanded criteria of a pattern of coronary thrombosis are demonstrated.


[Experimental model of coronary thrombosis in the closed thorax in swine]. Coronary thrombosis was induced in 14 miniature pigs by means of direct current. The induction electrode was introduced via the common carotid artery into the coronary artery. The intensity of current (1 mA) and the duration of current flow (60 min) were kept constant in all the experimental animals. 6 miniature pigs survived the period of observation (48 h). In all instances, an injury to the intima was the morphopathological location factor. With the exception of one animal, which died after an induction time of 60 min, coronary thrombosis was stated in all the miniature pigs. The experimental arrangement which produces closed-thorax coronary thrombosis is suited for cardiosurgical, physiopathological and pharmacological experiments, especially because the anatomy and the degree of development of the porcine heart are most similar to those of the human heart.


[Studies on the mechanical resistance of human erythrocytes under in-vitro conditions]. Hemolysis and resistance of erythrocytes were studies in-vitro in experiments on human ACD fresh blood and on heparinized fresh blood after oxygen dispersion, resp. mixed oxygen and carbon dioxide dispersion, and subsequent treatment in the hemoresistometer. Blood alkalinity increases under oxygen dispersion, acidity increases under dispersion with mixed gases. The length of the period of dispersion is more important for hemolysis than the change of pH. The hematocrit value influences the behavior of blood resistance. High values imply enhanced hemolysis. There is no significant difference of actual hemolysis values between oxygen and oxygen/carbon dioxide dispersion. A different behavior appears in the calculation of difference value of hemolysis after treatment in resistometer and the respective actual hemolysis.


[Ulcer location in the stomach and pylorantral hypertrophy: problem of correlation of the ulcer location and wall hypertrophy in ulcus ventriculi]. Relationship between gastric ulcer (n = 100) site and antropyloric wall hypertrophy was examined in a prospective study. Irrespective of ulcer multiplicity most ulcers were found to be located at the lesser curvature and at the posterior wall (p less than 0,001); men had significantly more ulcers at the posterior wall than females (p less than 0, 001). Single ulcers and those connected with pyloric stenosis were more distant to the pylorus than multiple ulcers (p less than 0,001). Ulcer location did not relate to hypertrophy of the pyloric channel wall. Observed differences between single and multiple ulcers were limited to wall parts only: the musculature of high located single ulcers was significantly less hypertrophied 2,5 cm orally of the pylorus (p less than 0,02) and that of high multiple ulcers was more hypertrophied at the pylorus (p less than 0,02) than in the other parts. These findings suggest that ulcer variations do not influence the diffuse antropyloric disease in gastric ulcer patients and suggest that the generalized antral changes are prior to gastric ulcer occurance.


[Influence of small intestine shunt and small intestine resection on gastrin secretion]. In 10 healthy controls, in 3 patients with subtotal resection of the small intestine and in 7 patients with jejuno-ileal bypass gastric ackd secretion and serum gastrin were determined in the basal state and after stimulation. The patients with short bowel revealed basal and pentagastrin stimulated gastric acid secretion in the lower normal range. Hypergastrinaemia, however, was present in these patients in the basal state and after food stimulation of gastrin release, while in patients with jejuno-ileal bypass basal and postprandial serum gastrin concentrations were within the normal range. These data suggest, that hypergastrinaemia in patients with short bowel is due to dimished gastrin catabolism and that the small intestine plays a significant role in gastrin inactivation.


[Fat resorption: current concepts and micromophology]. Recent concepts in the physiology of intestinal fat absorption are reviewed and the intraluminal formation and the role of the mixed lipid micelle, the concept of the unstirred water layer and the role of the fatty acid binding protein in the intracellular transport of long chain fatty acids are particularly emphasized. It is pointed out that only little information is available on the exact mechanism of the synthesis of intestinal lipoproteins and their export from the intestinal epithelial cells. Finally, preliminary results are presented of an electron-microscopical investigation of the intestinal mucosa of rats at different intervals after intraduodenal injection of an emulsion of lipids.


[Combined radiomanometric and histological studies in the surgery of Vater's ampulla]. In 34 patients a transduodenal sphincteroplasty was performed for benign stenosis of the papilla of Vater or stones in the area of the papilla. The combined intraoperative radiomanometric investigations as well as the histological examinations of intraoperative biopsis of the liver and the papilla of Vater suggest that in most cases with elevated pressure values of the common duct pathological changes of the liver with signs of cholostasis as well as of the papilla of Vater either with pathohistological alterations or with stones in this area can be detected. Constantly, histological changes of the papilla of Vater lead to pathologically elevated pressures in the common duct. In these cases transduodenal sphincteroplasty is recommended instead of only treating with a bougie or dilating the papilla. The indication for this procedure can be objectified by intraoperative radiomanometry.


[Epidemiolgical significance of HBs-antigen subtypes D and Y in the Heidelberg area]. The HGsantigen subtypes D and Y were determined radioimmunologically in 220 HGsAg-positive patients from the Heidelberg area. The subtype D was significantly more frequent (D = 68%) in patients with chronic liver diseases (n = 45) and in healthy HGsAg carriers (n = 32) than in patients with acute viral hepatitis B (n = 143, D = 41%). The subtype distribution in patients with acute viral hepatitis was not constant in the years 1970--1974. An antigen drift from subtype D to subtype Y was shown in healthy HBsAg carriers from 1971 to 1974. The differing distribution of subtypes in persons with transient and persistent HGsAg finding can be explained unequivocally by the altered epidemiological situation at the time of the infection.


[Treatment of hemostasis disorders in liver diseases:prothrombin-complex concentrates]. A short review about indications, dosage, effectiveness and possible complications of prothrombin complex concentrates in liver diseases is presented. In particular the combined "low dosis heparintherapy" is discussed.


[Nevus eruption following thyroidin with spontaneous involution]. Report on a young girl with eruptive manifestation of multiple nevuscell nevi following unnecessary treatment with thyroid extract at the age of 13. When this treatment was stopped at age 19, most of the nevi diminuted. Many of them disappeared within a short time, some with halo formation. This case report shows a new side effect of thyroid extract therapy. It is also interesting with regard to pigment cell regulation.


[Data processing system for laboratory and hemodynamic heart catheterization measurements]. In cooperation with the Department of Electronic Data Processing Systems we have developed a data processing unit for the analysis of hemodynamic data at the Department of Internal Medicine I. The aim was to design a computer-system for the daily routine in heart-catheterizations as well as for the solution of scientific problems during hemodynamic studies. In the on-line-mode besides the ECG up to four pressures can be analysed simultaneously. Analog and digital tapes can also be processed off-line on demand. The concept of the whole system and the individual steps of computer-handling are adjusted to the problems of data-analysis in praxis from the viewpoint of the examining cardiologist. Since the system is interactive after each measurement and each given command the computer-results are displayed on the video-scope. Because of the modular structure of the program new medical criteria can easily be implemented at any time. Since the computer-system is not effectively used with only one cath-lab other units possibly of different hard-ware configuration can be connected simultaneously to the computer. Each cath-lab shares 16 K out of the total 32 K core-memory. The results are displayed graphically and alpha-numerically on video-scope, x-y-plotter and line printer. The sampling-rate for fluid-filled catheters is 200 Hz and for catheter-tip-manometers 400 Hz. Smothing and differentiation-procedures are adapted to the respective catheter-material. The computer-program calibrates the different pressure amplifiers automatically. After defining the catheter-position the pressure-signals are sampled for 10 s and immediately afterwards analyzed by the computer. The ECG and the corresponding pressure-curves are displayed on the video-scope. The automatically selected representative beat as well as each of the identified and numerated other beats of the sampling-phase can be displayed selectively together with its numerical results. The computer marks the positions within the pressure-curves, where the individual measurements were taken. Besides the systolic and diastolic pressures in valvular stenosis the maximal and mean systolic or diastolic gradients, ejection- or filling-period, valve-flow and valve-area are calculated autonomously. The calculation of cardiac-output, different volume-indices and stroke-work-index are based on Fick-method, thermo- or indicator-dilution technique. The contractility-parameters max dp/dt, t-max dp/dt, max dp/dt/DP, max dp/dt/P, VPM, V40, min dp/dt and the stiffness are computed for the left and on demand also for the right ventricle. Data of the patient and the operating-team, catheter-technique, complications and free comments are transmitted to the computer via terminal together with the actual time. The computer-system was drafted for permanent use. Therefore possible technical defects have been anticipated in the design of hard- and soft-ware. In cases of failure suitable steps allow the immediate restart of the system without loosing information...


[Relationship between frequency components of phonocardiography, vectorcardiography parameters and anatomic data]. Regarding heart volume, fundamental frequency of the first and second part of first heart sound (SI), vectorcardiographic parameters and constitutional data, the formerly found strong correlation between fundamental frequency of the first part of SI and heart volume was re-established. Heart volume guess got even better utilizing certain VCG-parameters, whereas constitutional measurement data gave no further approach. Correlations between VCG-data and fundamental frequencies of both parts of SI are referred to.


[Risk factors of arteriosclerosis in patients with severe bradycardia arrhythmias]. The frequency and distribution of risk factors of arteriosclerosis were determined in 405 patients with implanted cardiac pacemakers and compared with the corresponding results of patients with cardiac infarction. The most frequent risk factors were smoking (43,5%), hypertension (35,2%), and diabetes (34,3%) in males, hypertension (52,3%) and diabetes (49,7%) in females. The frequency of cardiac infarction was in average 19,5%. In the infarction group diabetes was lower in both sexes (23,5% and 35,8%), respectively), hyperlipoproteinemia and smoking were more frequent. From the different distribution of risk factors it is suggested, that coronary arteriosclerosis is not the most important etiologic factor in the development of bradycardic dysrhythmias. The higher percentage of diabetes in the pacemaker group could point to metabolic disturbances or specific diabetic vascular disease as harmful factors to the conduction system.


[Experiences with 87 permanent atrial electrodes of various types and emplacement technics]. Between March 1972 and December 1975 87 atrial leads were implanted into 85 patients. In 37 cases the transmediastinal retrocardial approach was preferred. In all the other cases the electrodes were introduced transvenous endocardially. The results showed: 1. There exist techniques of atrial lead emplacement which, when applying suitable lead designs, guarantee an anatomic stable positioning either on the left or in the right atrium. Especially the new transvenous J-shaped electrodes of type Medtronic TJL can be positioned easily. The dislodgement ratio of these leads amounts of only 6%. 2. Retro- as well as intracardially very high action voltages were found. The ones sensed by the J-tip-electrodes from the endocardial surface of the right appendage even run up to 5,4 mV. 3. In spite of relatively high initial thresholds, no exit block was seen in any of the 34 cases, in whom atrial leads were inserted transvenous endocardially for permanent atrial pacing.


[D-transposition in situs inversus, atrial septal defect, open foramen ovale and tricuspid valve insufficiency]. This paper reports on a rare case of a so-called corrected d-transposition of the great vessels of a 62-year old woman with situs inversus. In addition the patient had a VSD, a patent foramen ovale, and a tricuspid-valve insufficiency. The topography of the ventricular cavities, the great vessels and the coronary arteries is described in detail. There is pointed to the surgical treatment of additional abnormalities to improve the prognosis.


The fine structure of the endogenous stages of Eimeria labbeana. 4. Microgametogenesis. The fine structure of the microgamonts and microgametes of Eimeria labbeana from the columnar epithelial cells of the ileal mucosa of experimentally infected pigeons, Columba livia, has been described and compared with that of similar stages in other species of Eimeria. The microgamonts averaged 8.0 X 10.0 mum (6.7-8.4 X 9.0-11.4 mum), had a maximum number of 27 nuclei each (0.8-1.0 X 1.0-1.3 mum), and showed various stages of mitotic nuclear divisions without the appearance of detectable mitotic spindles. Modification of the membrane of some of the nuclei into spirally coiled structures containing granular bodies resembling autophagosomes were observed. One pair, and occasionally two pairs of centrioles with the typical (9 + 1) microtubular composition were seen in association with some of the nuclei. Polysaccharide granules were seen in only about 5% of the more than 2,000 microgamonts studied. Cytomere formation was not observed but development of microgametes in association with intra-cytoplasmic spaces, and surface invaginations was frequently seen. Microgametes were elongate to slightly curved, averaged 3.1 X 1.2 mum (2.8-3.3 X 0.8-1.3 mum), and each was composed of an apical perforatorium, 2 basal bodies, 2 flagella, 4 microtubules located representing a third but rudimentary flagellum, a row of more than 15 short microtubules located laterally in the apical region, a large nucleus (1.7 X 0.8 mum), and a mitochondrion. Subfibrillar composition of the basal body and basal-plate region was observed. The microgametes of E. labbeana are the shortest and stoutest ever reported from the genus Eimeria. The maximum number of microgametes detected from any one section was thirty.


Genetic recombination of precociousness and anticoccidial drug resistance in Eimeria tenella. Two strains of Eimeria tenella differing in decoquinate-resistance and developmental rate were crossed. Strain Wis-F was decoquinate-sensitive (DS) and precocious (P+), while strain 368 was decoquinate-resistant (DR) and had a normal developmental rate (P-). Cultures of the parent strains and a culture derived from a mixture of parent strain oocysts were propagated through drug and developmental barriers to select parasites with the respective parental phenotypes (DS/P + and DR/P-) and the recombinant phenotype (DR/P+). The ability of a portion of the population in the strain-cross culture to reproduce in the presence of simultaneously imposed drug and developmental barrier showed that they were the recombinant phenotype (DR/P+), which had been produced through fertilization by gametes of opposite parent strains of E. tenella.


Life cycle studies with Eimeria magna Pérard, 1925. Excystation of Eimeria magna required exposure to CO2 at body temperature followed by trypsin and bile. Incubation in the presence of CO2 produced marked effects on the inner layer of the oocyst wall. The evidence suggests that CO2 stimulates enzymic activity from within the oocyst rather than exerting a physico-chemical effect on the oocyst wall from the outside. Released sporozoites measured 19.65 X 3.33 mum. In the rabbit, E. magna undergoes at least 5 cycles of asexual schizogony before gametogony takes place. First-generation schizonts were observed at 30 hr, measured 15 X 11 mum and contained 4, 6, 8 or occasionally 12 merozoites; the merozoites were characterised by two very large and prominent refractile granules. As the infection progressed, schizont size and merozoite numbers became more variable; some schizonts contained 2-8 fat merozoites, many probably multinuclear, while other schizonts contained 12-100 thinner merozoites. First generation schizogony took place in the glands; all subsequent stages developed in the upper parts of the villi of the small intestine. Sexual forms have been seen as early as 96 hr, but maximum sexual activity was noted at 120-192 hr. Oocysts measured 35.87 X 24.05 mum. The first oocysts were passed 6-7 days after inoculation, with peak production at 8-9 days. Sporulation was optimal at 30 degrees C; higher temperatures inhibited sporulation, and were in time lethal, while sporulation would take place normally after suppression by cold for at least 11 months. Single oocyst inoculations indicated a maximum reproductive potential of 26.15 million. Pathogenic effects were mostly mild, amounting to growth depression over days 4-7 and softening of the faeces; occasionally diarrhoea and/or death occurred.


Ultrastructure and light microscope appearance of Blastocystis hominis in a patient with enteric disease. The patient reported had a fulminant, refractory diarrhea of unknown etiology producing about 81 of diarrheal fluid daily which required continuously large volumes of intravenous fluid therapy. No protozoon other than Blastocystis hominis was present. Bacterial counts were very low in the fecal material because of continuous antibiotic therapy. Blastocystis hominis was present in large numbers, averaging for a 5-day period, 8.3 X 10(6)/ml of diarrheal fluid. Treatment with metronidazole for 12 days had no effect on either the diarrhea or the numbers of B. hominis present. The patient died from aspiration pneumonia without a firm diagnosis of his underlying disease. Identification of an unusual form of B. hominis seen only in diarrheal fluid was confirmed through cultivation, specific fluorescent antibody staining, as well as by transmission electron microscopy and light microscopy using hematoxylin staining and Nomarski interference contrast. The most significant result of this study is the description of ultrastructure of the in vivo trophozoite form of B. hominis. The persistence of certain morphologic features of the in vivo and in vitro forms of B. hominis is described. In vivo, B. hominis has a larger nucleus than in vitro, more prominent, well structured nucleoli, and hundreds of mitochondria with numerous delicate saccular cristae in a clear electron-lucent matrix and complex internal structure. Many cytoplasmic vesicles lined with ribosomes are present. The in vivo structure differs from the granular culture form of B. hominis, which has a smaller nucleus (nuclei), no distinct nucleoli, mitochondria characterized by a uniform structureless electron dense matrix, and few cytoplasmic, ribosome-lined vesicles. A feature retained in both in vivo and in vitro B. hominis is a distinct crescentic band of nuclear chromatin.


Origin, structure and function of subcuticular cells of Fasciola hepatica. In the present paper the ultrastructure of the subcuticulare zone of the tegument of Fasciola hepatica and the distribution of thimidine-H3 for establishing the localization of DNA-synthesis in the tegument was studied. There were two types of subcuticular cells: 1) non-differentiated cells with presence of incorporated labelled thimidine in nuclei presented by DNA non-stable macromolecules, and 2) differentiated or definitive subcuticular cells without aggregates of silver grains. The results showed a high level of DNA replication leading to mitotic activity of the non-differentiated cells and absence of mitotic activity in the definitive cells. There was a morphological similarity between non-differentiated cells and the cells from the medular zone, supposing a relationship in their origin.


[Oribatids (Oribatei, Acari) as intermediate hosts of Ctenotaenia marmotae (Frölich, 1802), a tapeworm parasitic in marmots (author's transl)]. Out of 30 species of Oribatids (from 23 genera), which were provided with eggs of Ctenotaenia marmotae in the laboratory, 24 proved to be potential intermediate hosts. The course of development of the parasite in the intermediate host could be followed up as far as to the cysticercoid (Figs. 2-8). It largely corresponds to the development of other Anoplocephalidae. After 113 days p.i. (test temperature 18-20 degrees C) the cysticercoid stage was reached. In the Pölla valley (Carinthia), at sea level of 2,200 m, the droppings of marmots scattered on the grass andmingled with proglottids of C. marmotae were marked. 9 months later 24 grass samples were taken and examined as to infected Oribatids. Out of a total of 12,100 specimens 49 turned out to be infected with cysticercoids; these specimens, however, belong to the species of Trichoribates incisellus (Kramer) and Trichoribates trimaculatus (C.L. Koch). They were taken from 16 samples with a total of 8,400 Oribatids. This is the first evidence under natural conditions of Oribatids acting as intermediate hosts to C. marmotae. It is presumed that 2 seasonal invasion peaks occur in the final host Marmota marmota (L.).


Observations on the histogenesis of nervous tissue in Diphyllobothrium dendriticum Nitzsch, 1824 (Cestoda, Pseudophyllidea). The mode of growth of the populations of cells within and immediately surrounding the main lateral nerve cords in the actively growing, immature Diphyllobothrium dendriticum was studied by the use of 3H-thymidine autoradiography. The population of nerve cells within the nerve cord grows only on account of cell migration from the surrounding parenchyma. No mitotic figures were observed in the nerve cords. The rate of growth is high. Within a period of cultivation for 2 days in hamster 34% of the nerve cells within the nerve cords have arrived from the parenchyma. These cells can be considered as cells at the starting point for differentiation into nerve cells. The protective layer of binding cells around the nerve cords also grows on a-count of cells migrating from the parenchyma. The binding cells actively move from the outer regions of the layer inwards close to t-e nerve cord. As stem cells for these types of cell differentiation serve the highly basophilic, actively dividing germinative cells.


Studies on cytodifferentiation in the neck region of Diphyllobothrium dendriticum Nitzsch, 1824 (Cestoda, Pseudophyllidea). Cytodifferentiation in the neck region of adult D. dendriticum was studied. The highly basophilic germinative cells were found to differentiate into glycogen-containing parenchyma cells and three types of muscle cells. The cytodi-ferentiation was followed with the aid of 3H-thymidine. The differentiation potential of the germinative cells is discussed.


Antibodies sequestered in the liver granulomata of 8-week infections of CF1 mice by Schistosoma mansoni Sambon, 1907. With our methods IgM, 7Sgamma1 and C3 were detected in the egg-induced liver granulomata of 8-week infections of CF1 mice by Schistosoma mansoni. It is speculated that, in addition to sequestration of antigens within these lesions by these antibodies, 7Sgamma1 may be associated with the Hoeppli phenomenon, and IgM in combination with C3 may be responsible for the ultimate death of the embryo or miracidium within the egg shell.


Stereoscan observations of the miracidium and early sporocyst of Schistosoma mansoni. Whole miracidia of Schistosoma mansoni, miracidia vibrated in an ultrasonic cleaner, and the miracidium-sporocyst transition were studied in the stereoscan electron microscope. After vibrating, the cilia broke off near the bases and the epidermal cells, intercellular ridge and sensory structures were revealed. The apical papilla had a folded surface with penetrating sensory cilia. The number of epidermal cells varied between 17 and 22. The lateral papillae appeared as bulbous projections on either side between the first and second tiers of epidermal cells. There was a ciliated pit nerve ending close to each lateral papilla. A few ciliated pits were found between the cells in the first tier, and up to twelve ciliated pits with long cilia could be found between the second and third tiers. Miracidia placed in haemolymph from Planorbarius corneus cast off the apical ciliated part of the epithelial cells, and large scars appeared where the ciliated plates had been. Later, the syncytial intercellular ridge dispersed throughout the surface of the mother sporocyst, and small cytoplasmic knobs appeared on the surface. The apical papilla and the lateral papillae were still observed a few hours after shedding the ciliated plates, but the ciliated pits disappeared shortly after the ciliated plates were lost.


[Age dependent possibilities for healing in cartilage injuries (experimental investigations with animals) (author's transl)]. Regenerative and degenerative changes of cartilage were studied in animals by micromorphological methods and autoradiography. Cartilage lesions of defined size were set in the femoral condyle of rabbits of variing age by means of an electrical drill developed by us. We used juvenile animals, 3 months old, and senile animals 4 years old. The lesions were studied by lightmicroscopy, electronmicroscopy and scanning electron microscopy. In young animals we were able to demonstrate prevailing reparative changes after injury and the potency for genuine regeneration originating from cartilage. Isolated chondral lesions develop reactive tissue originating mainly from superficial parts of the cartilage. When subchondral bone is exposed we see granulation tissue filling up the defect and change by metaplasia. The replacing tissue originating from superficial cartilage as well as from subchondral bone is able to fill the defect within 3 months. In the replacing tissue originating from cartilage we find fibroblasts and fibrocytes with many mitoses. Consecutively the cells are rounding increasingly. Finally chondrocytes are developing. At the same time as these reparative changes occur we see degenerative changes with decreased mucopolysaccharide synthesis, cell necroses with consecutive decrease in number of cells and singular small cluster. In old animals we could not demonstrate any reparative or regenerative changes after injuries; the artificial defect in cartilage persists. Instead, degenerative changes with signs of arthrosis are developing rapidly: chondroitin sulfate synthesis is decreased, there is ample cluster formation, cell necrosis, decrease in number of cells, and incorporation of paraplasmatic substances in cartilage. We could not demonstrate any mitoses. The causes for the inability of cartilage of aged individuals for reparative changes are discussed.


[Investigations regarding the pathogenesis of fibromatosis of the palmar fascia (Dupuytren's contracture) (author's transl)]. The palmar aponeuroses of five patients suffering from Duputyren's disease were examined by means of light and electron microscopy. In all cases myofibroblasts could be found in the alterated regions of the palmar aponeuroses. The role of the fibroblasts for the pathogenesis of the disease is discussed.


[A comparative investigation of acetylsalicyclic acid and indirect anticoagulants for the prophylaxis of venous thromboses in patients with an orthopedic-traumatologic case history (author's transl)]. The efficacy of acetylsalicylic acid as a general prophylactic for thromboembolic complications in bedridden adult patients with bone injuries and osteotomies was investigated. The results were compared with a control group and a group of patients receiving indirect anticoagulants. A statistically significant difference in the frequency of thromboembolic complications between the group receiving acetylsalicylic acid and the control group could not be established. The group receiving indirect anticoagulants showed a tenfold decrease in phlebothromboses and a fourteenfold decrease in pulmonary complications when compared with the control group. Even in high doses, acetylsalicylic acid is less reliable than anticoagulation therapy for the prophylaxis of venous thromboses and embolic pulmonary complications.


[Proximal tibial osteotomy for osteoarthritis of the knee (author's transl)]. One hundred and seventeen cases of osteoarthritis of the knee-joint, were treated with tibia osteotomy. The result of the different types of the osteotomy are discussed. The proximal tibial osteotomy without metal-fixation has the best results.


[Patterns of localization and process in age induced bone atrophy and pathological osteoporosis (author's transl)]. Dennert and Münzenberg recommend comparative examination of x-rays of the spine and coxal end of the femur both for the differentiation of physiological bone atrophy and pathological osteoporosis and for the gradual evaluation of osteoporosis. The systematic bone deterioration in the proximal section of the femur in physiological osteoporosis is absent in the pathological forms of osteoporosis where only the skleletal trunk is usually involved. Since quantitative examination procedures for the exact differenciation of osteoporosis are generally not available for the practice, the comparative examination represents an essential help for diagnosis and the gradual evaluation of osteoporosis. To support the interpretation of the findings from this procedure which is well suited for the practice, the chronological and local process of physiological and pathological osteoporoses (obtained by quantitative radiological measurements) are compared.


[Side reaction after lumbar myelography with dimer-x (author's transl)]. The existence of several very impressive spinal paroxysms after lumbar myelography with Dimer-X1 caused us to make a retrospective investigation of 327 patients with 355 myelographies. In 7.1% of the investigations we have found partly heavy, but mostly reversible neurological complications. The latter cannot be classified, contrary to prevailing statements, in spinal, meningeal or cerebral reactions, since mostly all 3 anatomical structures are being concerned. Corresponding casuistical information are being presented and with their neurological symptomatic discussed. The spinal paroxysms appeared approximately 6 hours after the myelography and lasted over 8-10 hours, in spite of intensive therapeutical efforts. The pathogenesis points to a multifactorial occurrence caused by the coincidence of an increased dosage of the contrast media, too bed rest time, rising of the contrast media in the spinal cord zone and disturbed liquor fluid circulation and contrast media resorption. Pathophysiologically is in connection with spinal cramps an epileptic mechanism probable. Additional spinal reflexive components could be an explanation for the little therapeutical effect of Diacepam (Valium), which is contrary to the statement in the literature. We have seen a better effect in particular cases with Phenothiazine. With strict observance of specific precautionary measures, the Dimer-X seems to be a good media for the presentation of the lumbar subarachnoid space. A further development in this field is desirable.


[A muscle activated dynamic repair of lateral instability of the ankle (author's transl)]. A muscle activated dynamic plastic reconstruction of the fibular ligaments of the posttraumatic weak ankle is presented and the operative technique is described. The most important advantages of this operation are compared with known methods.


[Factors influencing the results in the treatment of patients with femoral neck fractures (author's transl)]. The results of 213 consecutive operatively treated patients with fractures of the femoral neck were evaluated. Especially the effects of improved operative technique, careful pre- and postoperative care and intensified rehabilitation were observed. The series consisted of 151 women and 62 men, 111 femoral neck fractures and 102 trochanteric fractures. Nailing was performed on 54 femoral neck fracture patients and endoprothesis operation on 57 patients. No statistically significant differences were proved when the two consecutive two years series were compared with one another concerning the nailing results and the frequence of thrombosis and infection. However, by means of early weight-bearing and improved pre- and postoperative care the 6 months mortality decreased statistically significantly (chi2 = 6.58, p less than 0.05).


[Restitution of lunate bone necrosis in a child (author's transl)]. We reported a case of aseptic bone-cartilage necrosis of the os lunatum in a child. All indications for constitutional disposition, anatomic variations in the wrist joint or a traumatizing of the wrist joint were absent. Etiologically, a disturbance in vascularization could be assumed. The increased repair potential in children apparently led to a restitution which has not been observed in adults.


[Arthrosis of the first ray of the hand in geriatric patients (author's transl)]. The frequency of arthrosis in the first ray of the hand increases with the age of the patient, particularly in the saddle joint of the thumb and in the joint between the trapezoid bone and the navicular bone of the hand. The finding is frequently bilateral and is accompanied by kinesalgia, periarticular swelling and restricted movement. A relationship between arthrosis of the first ray of the hand and certain occupations can be assumed. While the arthrosis in the saddle joint of the thumb demonstrates the usual radiological symptoms of arthrosis, the sclerosing of the joint surfaces between the os naviculare and the ossa multangula is the most pronounced.


[Contribution toward determining the inner equilibrium of the spinal column (pivotal point as temporary pole) (author's transl)]. The estimation of the centre of rotation of a spine segment can be shown as a transient pole, which follows the polar curve of the movement of the upper segment of the spine, relative to the lower one. With the help of X-ray, it is possible to evaluate two separate positions of the pole, from the normal position to the medium flexion and from the medium to the extreme flexion of the lumbal segment. Based on these expected values, as well as their intervals, pathological cases can be recognized, which is also shown in an example.


[Can the human posture be explained by biomechanics? (author's transl)]. Up to now, lacking a bio-mechanical model, human posture has only been examined morphologically, although the physics of posture respond to simple laws. With the help of a physical model, based on the hypothesis of a minimal rotating movement of the trunk and head from the spine, this report gives a description of a normal posture. The model can be extended mathematically to establish a computer simulation of each case examined by X-ray, showing which posture would use the smallest amount of ligamentary and muscular force. The above bio-mechanical analyses of the spine as a whole is being further examined and improved mathematically.


[Pictorial documentation in orthopaedics (author's transl)]. The experiences of 60 years of pictorial documentation in an Orthopaedic Clinic are presented. Whereas the evaluation of patient's progress by photographs dominated formerly, nowadays the main interest is frequently centered on scientific illustrations and documentation for teaching, lectures and publications. The paper describes, how these two demands can be met economically by effective utilization of the technical possibilities.


[Report of a lateral collum femoris fracture in childhood with observations spanning a 32-year-period (author's transl)]. On the basis of a 32-year-observation-period (radiologically controlled) of a lateral collum femoris fracture which occurred when the patient was 8 years of age, it could be ascertained that surprisingly good results were achieved in the sense of self healing in spite of basic treatment errors, pseudarthrosis of the collum femoris and traumatic loosening of the femur head with subsequent alterations.


[Investigations of the normal stability of Chopart's joint (author's transl)]. The stability of the so-called Chopart-joint was evaluated in 50 healthy and asymptomatic patients by x-ray examination under strain. Complete stability was found in 38%. Widening of the lateral joint space up to 4 mm in the remaining patients could be demonstrated. Greater instability must be regarded to be a ruptur of the Lig. calcaneocubiodeum.


[Transverse lesion of the cord syndrome in chondrodystrophic dwarfs (author's transl)]. More than 70 transverse lesion of the cord syndromes in chondrodystrophic dwarfs have been described in the literature. 43 of these were adequately described and/or accessible for the authors. In 22 cases, a mechanical cause (including 14 lesions of the intervertebral disk) was directly responsible and, in 14 cases, no direct spinal cord suppression was found. In the latter group, 10 had a negative myelography, 3 positive and 1 case myelography was not performed. Of the 12 laminectomized cases, only 3 made a good recovery, 4 showed severe deterioration and 2 conservatively treated cases (including the case described here) were clearly improved. Of the 16 laminectomized cases with limited mechanical impediment, 8 showed good results, 3 indifferent and 5 unknown. The cause of the vascular myleopathy was assumed to be a combination of the narrowness of the bony vertebral canal and an increasing kyphotic process. The authors suggest that laminectomy for tranverse lesion of the cord syndrome in dwarfs should be made only after several controls and an established stop correlating with the location of the neurological lesions. We reject decompression laminectomy for vascular myleopathy because of the already endangered vascular situation and the poor results. We prefer orthopedic measures.


[Electrogalvonic inflammation as the cause of aseptic implant loosening in alloarthroplasty of the hip joint (author's transl)]. The appearance of pronounced cavity formation and erosion of the cortex layer in the area of the prosthetic shaft following total endoprosthetic implantation, without signs of an acute bacterial inflammatory activity, was investigated in specimens from the Orthopedic Hospital, Würzburg. The causes of these alterations, in most cases, could be electrogalvonic tension which produces inflammatory processes with lacunar disintegration of the cortex layer. In this process, the metal implant is loosened. In vitro experiments have shown that an average difference in potential of 290 mV can be established between both electrodes of the metal implant.


Mirror image aneurysms of the ulnar artery in the palm. A case of sequential bilateral ulnar artery aneurysms in the palm is reported. Thirty-five unilateral true aneurysms in the hypothenar area are reported in the literature and most have been associated with repeated trauma to the palm. The diagnosis is easily established from physical examination. Definition of the anatomic relationships of the aneurysm is by selective arteriography. Surgical excision or ligation of the communicating arteries is curative.


Mural thrombosis after experimental carotid endarterectomy. The incidence of mural thrombosis following three types of experimental intimal injuries at common carotid arteries, was investigated in a series of 12 dogs. Mural thrombosis was obtained at each of the intimal lesions. Moreover, obstructive thrombosis occurred in three instances. Further investigation of thrombi revealed that partial fragmentation occurred when exposed to hydrodynamic forces. These results suggest that mural thrombosis following carotid endarterectomy in humans, is possibly more frequent and significant than it is generally appreciated, thus leading to the consideration of postoperative anticoagulation after endarterectomy, as a means to minimize the incidence of postoperative embolic cerebrovascular accidents.


The effect of postural changes upon the ankle arterial perfusion pressure. The normal arterial blood pressure at the ankle, (AP), right brachial arterial pressure (RBP) and pressure index (PI) were investigated in 50 healthy young volunteers under basal conditions and during certain positions of the legs, utilizing Doppler ultrasound flow determination and standard size blood pressure cuff. The mean AP was 10 mm Hg higher than the mean RBP in 76 instances but AP was smaller than RBP in 24 out of 100 investigated lower extremities. Mean PI was 1.069+/-0.158. There was no statistically significant difference between PI of heavier and leaner patients although increased weight was associated with a significantly higher brachial and ankle arterial pressure. Departure of the lower extremity from the horizontal position resulted in AP changes explained by gravitational effects. If the new posture was maintained, the new AP persisted, thus indicating an absence of significant corrective circulatory adaptation to the posture changes. Extreme flexion of hip and knee joints resulted in a marked decrease of AP and PI, suggesting arterial kinking. This change was not affected by the weight:height ratio of the subject. It is concluded, therefore, that the presence of a greater amount of periarterial soft tissues does not significantly prevent arterial kinking. These tensional shifts indicate changes of flow pattern occurring in normal subjects during extreme flexion. Even more marked shifts can be anticipated in arteriosclerotic patients under similar circumstances.


Surgical treatment of partial extraluminal occlusion of first part of vertebral artery. This report presents the clinical concept of hindbrain ischemia due to partial extraluminal occlusion of a segment of the first part of the vertebral artery, and submits a definite method of surgical treatment. Thirty one patients with vertebral artery insufficiency are presented who had operations with striking post-operative symptomatic improvement. Operative selection of patients is dependent on aortic arch angiography with visualization of the neck vessels. There was no mortality and no significant morbidity in this series.


Congenital carotid to jugular arteriovenous fistulae. Congenital carotid to jugular arteriovenous communications are rare lesions presenting a challenging surgical problem. Including our case, five cases have been reported so far and all were female. The communications represent the persistence of embryonic arteriovenous channels and consequently they are usually multiple. Ligation of the external carotid artery or the use of multiple ligatures should be avoided as a recurrence usually ensues. In addition, both methods render secondary complete excision more difficult and hazardous to the patient. Primary complete resection is recommended as the procedure of choice.


Arteriovenous fistula for revascularization of the ischemic extremity. The basic considerations in the use of an arterio-venous fistula for revascularization of the ischemic extremity have been summarized. Retrograde flow of arterial blood entering the venous system by way of an arteriovenous fistula has been demonstrated in acute and chronic animal experiments. While evidence of significant reversed flow in humans has been shown in a few small series, its occurrence is still controversial. The significance of venous valves in impending retrograde flow is not yet adequately investigated. Since a peripheral arteriovenous fistula is one of the most potent stimuli to arterial vessel formation in the extremity, its application may be worthy of consideration in certain selected patients with advanced and otherwise "inoperable" arterial occlusive disease.


[Effect of adaptation to high altitude hypoxia on fixation of temporary connections]. Parameters of preservation of conditioned defensive reflexes elaborated in one combination and of reflexes elaborated in many combinations in a T-maze varied as a function of time in animals preliminarily adapted to hypoxia and in control ones. Adaptation to altitude hypoxia raised the degree and duration of preservation of temporary connections and did not influence the course of conditioning. The degree of preservation in animals adapted to hypoxia was enhanced both during continued adaptation and in ten to twenty days after its cessation. It is probable that adaptation considerably intensifies the process of fixation of temporary connections. It is suggested that the effect results from activation of the synthesis of nucleic acids and proteins in the brain, due to adaptation to altitude hypoxia.


[Spatial relationships of electrical activity during reproduction of verbal signals in children]. The study of intercentral correlations of the brain biopotentials in five-to six year old children revealed considerable differences in the spatial distribution of interrelations of the neocortex projection and associative zones during reproduction of familiar and unfamiliar words. Reproduction of familiar words was accompanied by the greatest enhancement of interrelations of associative structures (infraparietal, frontal areas and Broca speech centre) with projection zones of the motor and acoustic analysers in the left hemisphere, while reproduction of unfamiliar words was attented with closer connections of the projection motor zone with the temporal and the anterior associative (frontal and speech) zones in the right hemisphere. The facts obtained testify to the existence of the interhemispheric asymmetry and to the different involvement of the neocortex projection and associative zones in the organization of motor speech in children.


[Phenomenon of masking in the reproduction of tactile signals]. The study of central masking and of its mechanisms is of interest in connection with the problem of transmitting information through the cutaneous communication channel. The subjects were children aged from seven to eight and from thirteen to fourteen with normal hearing, as well as deaf children. Latency and errors to localizing signals from isolated or paired action of four vibrators were determined in three series of experiments, using three, six and ten altenatives. A dependence of the precision of localization on the amount of information has been found: deteriorated identification is more pronounced in junior schoolchildren and in those with abnormal development. Matrices of the errors provide material for plottingildterial for plotting charts of convergence of afferent inputs. To elucidate the mechanisms of central masking, a comparison was made between the results of psychophysical and microphysiological experiments. Data analysis leads to the conslusion that the phenomenon of masking is determined by two factors: (1) the nature of the convergence of afferent inputs on the neuronal brain structures; (2) the level of formation of psychic operations which provide for singling out distinctive characteristics of signals, with subsequent decision regarding the certain class to which they belong, and with their recognition.


[Effect of serotonin on self stimulation and conditioned avoidance reactions in rats]. It has been shown that serotonin influences self-stimulation and avoidance conditioned reactions in rats in a different way. Serotonin administration caused a reorganization of self-stimulation process and enhanced its frequency; the avoidance reaction grew weaker and was achieved with a longer latency. Alternation of stages of activation and inhibition was observed in the EEG of the neocortex, hypothalamus and hippocampus as well as shifts in the heart rate. These changes did not always correlate with the animals' behaviour. Unidirectional, yet different serotonin effects on various behavioral reactions, brain electrical activity and vegetative processes testify to a relative independence of their mechanisms.


[Bilateral mechanisms of interference resistance in the parastriate cortex]. The influence of photic interference is manifested in animals (in cats) with an intact callosal body mainly in EP depression. The extent of EP depression depends directly on the strength of the interference and is inversely related to that of the determined stimulus. In some cases yet another effect, facilitation of EP may be manifested during the action of a weak interference. These facts are considered to result from postrevely. Section of the callosal body is followed by a weakening of the depressing influence of photic interference on EPs elicited by a certain stimulus, as well as by an enhancement of the facilitating influence on EPs of weak photic interferences. A stronger influence of a binocular photic interference, as compared with a monocular one, has been established in intact and callosotomized animals. A conclusion has been drawn that the interference resistance of a split brain is stronger than that of an intact one. A comparison of the interference resistance in the primary and secondary cortical visual projection zones has shown that after callosotomy interference resistance in the striate cortex increases to a greater extent than in the parastriate area.


[Effect of inhibitors of RNA and protein synthesis on audiogenic epileptiform reactions in rats of the KM line]. Injection of actinomycin D, puromycin and cycloheximide change the genetically determined reaction of rats to acoustic stimuli up to the appearance of resistance to sound. The change in the nature of audiogenic epileptiform seizures correlates with the disturbance of the RNA and protein synthesis in the experimental animals brain. The appearance of sound resistance does not correlate with the degree of inhibition of protein synthesis in the brain. It is assumed that the antiseizure effect of the drugs used is possibly due to their action on the neuromediator systems of the brain.


[Formation of neuronal activity in the association area of the cortex in developing cats]. Background spike activity as well as activity evoked by photic and acoustic stimulation in units of the associative cortex (field PMSA) was investigated in experiments on curarized kittens aged from four to six hours up to 60 days. Background activity of single PMSA cells appears from the first day of the animal's life. The mean frequency of impulsation is low; it changes but slightly during the first two weeks. Evoked spike activity in response to light is recorded from the end of the first week of the animal's life. Responses to sound appear somewhat later. During the second week the number of monosensory cells increases. Later ther is a diminution of the relative number of monosensory units and an increase in the number of bisensory ones. The results are discussed in the aspect of heterochronic systemic maturing of cortical cells in ontogenesis.


[Regulation of complex forms of animal behavior on the basis of electric stimulation of the emotionogenic structures of the brain]. The paper considers the possibility of controlling animal behaviour by acting on the positive emotional centres. It has been shown that in an experimental chamber under certain conditions of stimulation it is possible to control the motor-serach behaviour of dogs. This emphasized the possibility, in principal, for evolving biotechnical control systems of the "technical facility-bioobject" class.


[Postsynaptic mechanism of habituation of turtle cortical neurons to moving stimuli]. An investigation was made into the change in the amplitude of evoked potentials and intracellular slow potentials of the turtle general cortex units in response to a periodic movement of a monotonous stimulus, a black band, across the visual field. The recorded depression of responses possesses all the properties of habituation. The first presentations of the monotonous stimulus produce a generalized habituation, gradually replaced by a selective habituation to the monotonous stimulus, as the number of stimulations increases. It has been shown that it is possible to disinhibit the amplitudes of the evoked potentials and intracellular slow potentials of cortical neurones to moving black bands which form part of the monotonous stimulus. A conclusion has been drawn that habituation of the turtle cortical units to moving stimuli is due to a postsynaptic mechanism.


[Analysis of an instrumental motor act]. Different instrumental conditioned reactions were elaborated in dogs which suffered simultaneously from thirst and hunger. During the elaboration, not only external agents and the animal's own movements become conditioned stimuli but also any objects linked to these movements whose positive signal meaning is compared in the course of reinforcement with negative signal meaning of other objects and becomes differentiated. To achieve one and the same aim, different instrumental habits may be used, while the same habit may be used for achieving different aims. During instrumental conditioning any habit may acquire a generalized positive biological significance as a means of procuring.


[Characteristics of the cortical input of the hippocampus. Functional differences in the lateral and medial entorhinal cortex]. Extracellular investigation in unanaesthetized rabbits revealed low reactivity of the lateral entorhinal cortex neurones (lEC, field 28b) to visual and auditory stimuli. Only 25% of cells responded to them by diffuse long-latency reactions, while in medial EC (mEC, field 28a) 70% of neurones responded to these stimuli with short-latency patterned reactions. The neurones of lEC were selectively responsive to different somatosensory stimuli. Among reactions short-latency on-effects were observed. In some cells application of these stimuli switched on rhythmic bursts of spikes (frequency about 3-4 Hz) or regular activity of pacemaker type. The lEC neurones responded by short-latency driving to electrical stimulation of prefrontal cortex, while mEC neurones were responsive to stimulation of posterior non-primary neocortical areas. The data are discussed in the light of recent morphological findings on cortico-cortical connections of EC.


[Modulated electromagnetic field as a factor of selective influence on animal mechanisms of goal-directed behavior]. Proceeding from P.K. Anokhin's theory of the functional systems, the paper considers the action of a modulated electromagnetic field (MEMF) on different stages of the central architectonics of purposeful behaviour of rats: afferent synthesis, decisions making, acceptor of the action results. The action of MEMF was studied in different experimental situations: choice of an alimentary or defensive reaction to one conditioned stimulus in different situations; extinction of conditioned alimentary reactions; elaboration and extinction of alimentary conditioned reactions in animals group contacts; choice of the side of reinforcement in a T-shaped maze, and, lastly, self-stimulation reactions. The experiments have shown that MEMF has a selective effect on the animals' emotional reactions. Greater disturbances are observed in the mechanisms of the animals' appraisal of the action of situational and trigger stimuli or surrounding individuals of their species and, hence, of decisions making and anticipation of future results of the action, the acceptor of the action results.


[Impulse activity of visual cortex neurons at successive stages of instrumental behavior]. Dynamics of spike activity of 62 units was studied in the projection visual area of the cerebral cortex in unrestrained cats during their performance of a conditioned alimentary instrumental reaction. Analysis of the activity of each unit was made at intervals from the beginning of the conditioned signal (light or sound) to the beginning of lapping milk which appeared in the feeding trough after the cat pressed the pedal. It has been found that the form of activity of the cortical unit greatly depends on the modality of the conditioned stimulus (light or sound). As to the final stages of instrumental behaviour and the achievment of the positive result, the degree of participation of cortical visual units in their formation does not depend on the modality of the conditioned signal.


[Slow potentials and the impulse activity of cerebral cortex neurons following elaboration of internal inhibition]. The development of all studied kinds of internal inhibition in rabbits is accompanied by an enhanced phasic state, alternation of activation and inhibition in the responses of the visual area neurones, and enhanced late components of evoked potentials to flashes. During further intensification of inhibition, generalized polyrhythmic potential oscillations develop, which are in correspondence with chaotic or irregular group discharges of units in the visual and sensorimotor cortical areas, separated by inhibitory pauses. It has been concluded that enhanced hyperpolarization plays a considerable part in the development of internal inhibition; it may be local, predominantly in the conditioned stimulus analyser, or generalized in the case of a stronger inhibition comprising many brain structures.


[Rol' of the frontal lobe in synchronizing biopotentials in different regions of the dog brain]. The role of the frontal cortex in formation of neocortical systemic processes has been studied by the method of sign correlation of the summate electrical activity. A distant EEG synchronization in the temporal and occipital zones sets in following strychninization of F2 zones (but not of Prc2 zones) in anaesthetized dogs or in cerveau isolé preparations. In dogs with elaborated conditioned reflexes a statistically significant distant synchronization of the neocortical EEG sets in during the delay period only in case of well expressed motivation (of hunger in case of food reinforcement, and of thirst in case of water reinforcement). No distant conditioned EEG synchronization was revealed in lobectomised dogs. The role of the frontal cortex in the intracerebral integration is discussed which is necessary for achievement of the forthcoming signal activity.


[Role of natural sensory factors in organization of feeding behavior using fledgling development as an example]. A change in the composition of natural sensory stimuli, triggers of the alimentary functional system of Muscicapa hypoleuca nestlings, was studied throughout their nest life. In the first five days the alimentary reaction is elicited by a complex of acoustic stimuli. From the fifth to the eighth day the reaction appears in response to a momentary change of illumination. From the ninth to the thirteenth day two stimuli are involved in the organization of the alimentary reaction: a trigger stimulus-a momentary change of illumination, and a directional stimulus-a mobile silhouette of the bird. On the thirteenth to the fifteenth day the alimentary reaction appears only in response to the bird's movement. It is assumed that the successive change of trigger stimuli in one and the same alimentary functional system is determined by a successive involvement of increasingly complicated sensory mechanisms. The time periods of involvement may vary with a change of environmental factors.


[Evoked potentials in the dog sensomotor cortex during an avoidance reaction]. Elaboration of avoidance reaction (conditioned reflex of the second order), based on a preliminarily elaborated escape (conditioned reflex of the first order) from pulse electro-cutaneus stimulation of the paw, led to a well-defined reorganization of the activity of the cortical limb projection structures. By excitability parameters (EP and motor reaction thresholds) and by changes of parameters of EP to electro-cutaneous stimulation, in escape reactions the sensory functions are drastically enhanced. Judging from the EP pattern, in response to the first pulses of the series (intensification of late components, appearance of an additional late negative wave), these pulses act as signals. With the introduction of distant stimuli (clicks), the electric current loses its signal significance, and the EP produced by it are sharply depressed and simplified. In the somatosensory projection of the paw, EP to clicks observed before conditioning, decrease or disappear completely. But they appear in the motor projection of the paw. In conjunction with excitation parameters, these data suggest the predominance of efferent functions of the paw in avoidance reactions.


[Biomechanics of the motor act following destruction of the somatic feedback connections]. By means of cyclography method developed in detail by N.A. Bernstein for disclosing the changes in the physical parameters of jumps it was shown that as compared with intact animals, the speed of movements of the distal parts of the fore and hind limbs significantly decreases in animals with electro-coagulated medial lemnisci. The swing of flexion-extension in the ulnar and knee joints likewise diminishes, and the trajectory of the centre of gravity movement changes significantly. In the course of jumping from one platform to another the operated animal experiences difficulties in changing movement phases. It is suggested that the system of medial lemnisci exercises the function of internal somatic backward connection, which is necessary for the succession of micromovements within the general program of the motor act.


[Conditioned reflexes in relation to temporal intervals]. The paper outlines the results of experiments on twelve rats aimed at studying conditioned reflexes of discrimination of both absolute and relative characteristics of time intervals (30 and 180; 10 and 90; 5 and 45; 5 and 40; 5 and 35; 5 and 30 sec). The data obtained are discussed in the light of I.P. Pavlov's hypothesis regarding the physiological mechanism of conditioning to time.


[Plasticity of reactions of the sensomotor cortex to sound combined with electrophoretic application of acetylcholine]. Reactivity to sound and electrophoretic application of acetylcholine-chloride (ACH) was studied in 170 sensorimotor units of non-anaesthetized rats. Reactivity to sound was found in 60 per cent of the cells, and to ACH, in 83 per cent. Plasticity of the reaction to sound ("conditioned stimulus") was studied in 44 units, when it was presented jointly with ACH ("unconditioned stimulus"). After pairing, the reaction to sound changed in 14 units out of 36 (40%). In the control procedures of pseudoconditioning, reactivity to sound changed in four units out of 15 (27%). Pseudoconditioning and stimuli pairing was successively carried out in seven units: four units manifested plasticity of their reactivity, two of them changed the response to sound both during pseudoconditioning and subsequent pairing of stimuli. It is assumed that the plastic properties of the examined neurones are determined by the integrative activity of the cell micropool with a radius of 70 to 150 mu.


[Alcohol consumption among pregnant women and outcome of pregnancy (author's transl)]. A prospective survey of more than 9,000 pregnant women showed that those who consumed more than 0.4 l of wine or equivalent in other alcoholic beverages per day during pregnancy had a higher risk of unfavourable outcome. The risk of stillbirth was higher, particularly that due to abruptio placentae. The average birthweight was lower and the risk of giving birth to a small-for-date infant was higher. Furthermore the men placental weight was lower. Women with moderate or high alcohol consumption also differed from those with low alcohol consumption in some classical risk factors for the outcome of pregnancy, but the increased risk with consumption of alcohol remained significant when these other factors were taken into account. The increased risk among women with moderate or high alcohol consumption appeared to be limited to beer drinkers, although the mean quantity of alcohol consumed by beer drinkers was smaller than that consumed by wine drinkers.


[Epidemiological study of youth suicide: comparison between primary suicidals and repeaters]. A survey of 537 subjects, under 20 years old and hospitalized after attempted suicide, showed that 30% had attempted suicide at least once before. There were statistically significant differences between repeaters and non-repeaters in psychopathological characteristics (psychiatric diagnosis and previous school behavior problems), socio-demographic characteristics (family size, alcoholism in the family) and in family relationships. Verification and development of these findings would lead to the construction of a scale of risk of repeating attempted suicide.


[Alveolar CO as an index of ambiant CO in schoolchildren (author's transl)]. As it is impossible to use alveolar CO as an useful index of the exposure to ambiant CO in smokers, young children between 8 and 11 were used in this study, who had no contact with smoking. In a sample of 306 schoolchildren living in rural or urban areas, it was shown: a) that the technique which is usually employed in adults to get a sample of alvelolar air was applicable to young children, b) that alveolar CO concentrations did reflect very closely in these children ambiant CO concentrations, c) that smoking habits of parents have to be taken into account before assessing the relationship between alveolar CO concentrations and exposure.


[Feasibility survey on the reliability of questionning on past eating habits in a group of men (author's transl)]. Among men 50-57 years old surveyed in 1969 and again in 1974 on their food intake, both questionaires of 37 who stated in 1974 that they had changed their eating habits in the preceding 5 years were selected for analysis. The mean reported caloric intake had dropped very significantly, but about 500 calories. When these persons were questioned in 1974 on their 1969 food consumption, the results compared to the 1969 questionary were identical for almost all food catergories and for total calories. Thus, a food consumption survey retrospective over a 5 years span appears no less reliable than a survey on present eating habits.


[Air pollution in the vicinity of streets]. Air samples were collected in plastic bags simultaneously at various measuring points in the close range of streets. When examining the various bag materials, Teflon bags showed the smallest deviations in direct analyses and in analyses of up to two hours after the drawing of samples. The following methods were used for the analysis of the air samples collected in the bags: coulometry for CO and SO2, chemiluminescence for NO/NO2, chromotrophic acid for CH2O and flame ionization for hydrocarbons. The various components were measured close to a highway and near streets in residential and business areas. The simultaneously drawn samples showed a marked dependence on traffic frequency, type of built-up area along the streets as well as meteorological conditions. An opinion survey among adjacent residents on annoyance caused by air pollution and noise resulted in distinct differences between the sections with different traffic intensity.


[U.I.C.C. information office on controlled therapeutic trials in cancer: an example of an information service in on-going research (author's transl)]. Since 1967, the U.I.C.C. Information Office has been collecting and reviewing, from a methodological point of view, data on controlled therapeutic trials in cancer in progress all over the world. The aim is to transmit the information to researchers who are interested, to encourage co-operation, to study methodological problems to study the distribution of trials by countries, sites, etc..., and lastly to determine the part of controlled therapeutic trials in progress in cancer therapy. At present, such services in on-going research have a tendancy to develop in other fields of scientific research.


[Sampling problems in a survey of blood lead levels in city children]. A study on lead pollution was carried out on a sample of ca. 300 city children. This paper presents the errors producing bias in the sample. It is emphasized that, in Switzerland, the difference between the Swiss and the migrant population (the latter being mainly Italian and Spanish) must be taken into account.


[Air pollution due to cigarette smoke: physiological and irritating effects]. We assessed the effects on the judgement of air quality, eye blinking rate,and lung functions of air pollution due to cigarette smoke. At the same time, subjective irritations were recorded. The measured effects were brought into relationship with the concentration of some pollutants in the air.


[Disturbances caused by noise in offices]. Noise measurements were carried out in 57 offices. At the same time 228 employees were asked about their opinion on the noise situation. Relations between objective and subjective criteria, noise values and complaints about disturbance caused by different types of noise were analyzed. Noise parameters comprising noise peaks are more adequate to assess disturbing noise than parameters based on a mean noise level. Statements on extent and frequency of disturbance in general and of communication depend on noise. Statements on disturbances of concentration and on impairment of performance do not depend on noise. Outdoor noise and "subjectively worst noise" are measurable in dB values; indoor noise, however, is independent from the measured values.


[Noise in an intensive care unit].

[Noise in an intensive care unit]. An Intensive Care Unit is noisy. These Noises are made by the Machines and the Staff. Nose must be limited and also the patient isolated.


[Sources and importance of indoor air pollution]. Indoor air quality affects a person's performance and well-being. This justifies the study of indoor air pollution for the development of comfortable and safe environments. A simultaneous indoor/outdoor sampling programme was carried out at three sites in Zurich. Parameters included CO, NO, NO2, and HCHO.


[Application of industrial hygiene principles as exemplified in a chromium plating plant]. Recognition, evaluation and control of hazards were carried out in a typical case where chromium was the major pollutant. It was also emphasized that industrial hygiene is necessary in the prevention of occupational diseases.


[Mercury levels found in fishermen of Lake Geneva]. This paper presents an evaluation of the mercury levels found in a population eating principally fish coming from the Lake of Geneva. A good correlation exists between the blood mercury level and the amount of fish ingested weekly. Interpretation of the results shows that the threshold of fish comsumption should be about 1.4 kg per week and per person.


[The effect of nicotine on body weight and feeding behavior of rats]. Daily nicotine injections for 6 weeks produced a transient anorexia with a concomitant reduction of the body weight. Upon nicotine withdrawal, the rats developed a compensatory hyperphagia and gained nearly control weight.


[Risks incurred by dental technicians working on metallic prostheses]. A short description of working conditions is given. Out of 25 radiographs, 5 show possible pneumoconiosis due to hard metal and one is abnormal. The hazards due to the presence of beryllium in numerous alloys is emphasized as well as the necessity of technical and medical supervision in dental laboratories.


[The importance of bacterial exposure in sanitation employees when collecting refuse]. During their Work, Dustmen are exposed to important and various microbiological Aerosols, which, according to the Granulometry, could have an Influence on the Start and the Progress of chronic Bronchitis.


[Current developments in violent crime]. In the years 1960-1973 we see a great stability of all crimes of violence in Switzerland, while in the USA in the same years their increase was constant; in England and France, robberies with violence increased in the years 1960-1970.


[A method of visual representation for the distribution of variables in the Geneva area]. Using a 10,000 square meter partition of the Geneva area, a computer mapping was developped for the geographical distribution of variables such as population density or pollutants emissions. An example is given in which the method is applied to epidemiological date (age and respiratory performance of a population sample).


[Averaged electroretinograms (ERG) of rats exposed to 2 organomercury compounds]. Averaged ERGs of rats treated with phenylmercury borate and methylmercury chloride were recorded. Amplitude differences were seen only with the latter treatment. A high Hg tot. level was found in eyes of animals treated with methylmercury.