[Effect of autotransplantation on various functions of the small intestine in swine]. The effects of anoxia on orthotopic small bowel autotransplantation were studied in 22 pigs respectively on the operative day (before and after transplantation) and post-operatively (on the 1st, 3d, 5th, 7th and 15th day). Absorption of D-xylose (as evaluated by xylosemia curve) and several brush border enzyme activities were compared with histological and histoenzymological data. After transplantation D-xylose test, enzymatic assays and to a lesser degree histoenzymology showed some impairment until the 15th day. By contract mucosal morphology as evaluated by optical microscopy was normalized as soon as the 3d post-operative day. From these data it may be assumed that in allotransplantations, optical microscopic abnormalities seen after the fourth post-operative day are no longer due to anoxia but may be related to early rejection. Other functional tests could be of some value only after the 15th day.


[The "Preflow technic", a new method of pharmacoradiography of the mesenteric area]. In 16 dog experiments we were able to demonstrate that the conventional selective angiography of the superior mesenteric artery (sma) is performed in a status of underperfusion. By the injection of 50% glucose in a well defined time interval preceding the application of the contrast medium an increase of blood flow can be achieved, which allows the contrast medium to pass through the mesenteric circulation as a bolus. This shows a significantly better opacity of parenchyma and of the venous phase. This technique is easily applicable, carries no side effects on the general circulation and can be recommended for clinical use.


[Injuries, --causes and mechanics of motor vehicle side impacts]. In 228 vehicle-accidents the incidence of side-impact was 25%, being second to frontal impact. 20% of passengers involved sustained severe trauma (AISm 3 - 5). Characteristic of side-impact is a higher trauma rate of upper body with relative sparing of the cervical spine. Pelvic and abdominal injuries are rare but usually severe. The high risk for head and thorax is shown by the "absolute-trauma-index" (incidence x severity of trauma). Severity of trauma rises with vehicle-deformation and is more severe on the side of the impact.


[Morphology and x-ray picture of the rat lung in experimental lung contusion]. Partial contusion of the lung was performed on 131 albino rats. X-ray and histological findings are comparable with lung contusion in man. Three phases are remarkable. X-ray studies of the thorax do not show impressive changes in spite of histological findings of the lung. This means: X-ray picture of the posttraumatic lung is less eventful than the impressive anatomical histological findings.


[The growth hormone in craniocerebral injury]. Following head injuries with various degrees of cerebral trauma increased STH-concentrations of plasma can be measured. Blood glucose values are elevated reflecting a diabetic metabolism lead to a suppressive effect of increased STH-blood levels. In general it can be stated, that a stress situation is followed by an increase of STH-secretion despite of elevated blood glucose concentrations. The reasons may be: 1. increased liberation of catecholamines, 2. an intracellular glucose deficit due to disturbed glucose utilisation, 3. alteration of regional blood flow after trauma.


[New results on the genesis of traumatic Achilles tendon rupture]. As a result of the development of a new fixing mechanism, which permitted the test of peak value of tensile strength in Achilles tendons, the following facts were demonstrated: 1. The average value of static maximum of tensile strength is about 7, 5 kp/mm2, of the dynamic maximum is about 10, 1 kp/mm2. 2. The charge maximum decreases with progressive age. 3. The tensile strength depends on the minimal cross-section plane of the tendon. 4. The minimal cross section plane decreases with progressive age. 5. With the test of dynamic tensile strength it is possible to malinger a Achilles tendon rupture.


[Experimental studies on the biomechanics of syndesmosis]. The amplitude of movement of the distal fibula was measured with the tibio-fibular syndesmosis intact, severed and transfixed after anatomical and insufficient reduction. Transfixation by means of a location screw inserted above the syndesmosis horizontally and at an angle of 30 degrees in the frontal plane proved to be optimal since the quality of movement is not altered while its amplitude is only minimally reduced. Malalignment with shortening leads to rotation outward.


[Electromyographic changes in temporary tourniquet ischemia in man]. After inflating a tourniquet with 600 mm Hg around the thigh a total blockade of the n. peronaeus occurs. This blockade is due to ischemia and spreads from proximal to distal. It is an ischemic blockade as the delay of nerve conduction was measured distal of the tourniquet and therefore cannot be due to the pressure under the cuff.


[Incorporation of autologous spongiosa into compact substance of bones in relation to the vitality of transplanted cells]. Different types of autogenous cancellous grafts were inserted into both femora of 20 sheep subsequent to special preparation or lethal radiation. The results were indicative of the primary role of the amount of grafted cancellous substance rather than the vitality of the transplanted cells. As compared to the outstanding effectiveness of the muscle-periosteum-flap with its revascularizing ability the significance of the compact receptor bed is minimal. These facts enhance the importance of early formation of vessels and the quantity of the osseous fraction of the substance grafted.


[Quantitative determination of tissue tolerance to corrosion products in organ culture]. The tissue tolerance for metal was investigated using an organ culture of embryonic rat femora. We found reproducible results using a standardized experimental method. A good correlation between the applied concentrations and resulting growth inhibition occurred and dose-response curves were established. The experimental model is applicable for testing tissue  tolerance for the soluble products.


Haemostasis and healing following median sternotomy. Experiments in goats showed that the application of bone wax to the divided sternum retarded healing. An autologous red cell compound was an efficient haemostatic and lacked the obstructive effect of wax. A human autologous red cell compound has been applied to the sterna of 15 patients following median sternotomy with good effect.


[Titanium, steel and their combination in bone surgery]. The combined application of Titanium plates with stainless steel screws appeared interesting, making a more elastic plate available without the risk of screw fractures. 3 different combinations of Titanium und stainless steel implants were tested in the animal and on humans. A morphometric evaluation of the soft tissue (animal) gave similar good results for stainless steel implants as for the combination of Titanium and steel, while pure Titanium gave the best result. Atomic absorption tests (human) showed that in case of the Titanium/steel mixture only the stainless steel screws did corrode. Delayed fracture healing or mechanical instability always gave risk to more metal deposits in the soft tissue than primary bone healing. If the advantages of Titanium seem important and if the rigidity of stainless steel screws may not be missed, the combination of the two metals appears possible and without danger.


[Use and limitations of acute normovolemic hemodilution]. Acute normovolemic hemodilution was performed in 46 pts. before major surgical procedures 1800 ml of pt's blood were withdrawn and hct. lowered to 24.8% mean. The hct. after retransfusion averaged 31.8% while homologous blood could widely be avoided. 78% of pts tolerated a.n.h. well or sufficiently. During a.n.h. circulatory parameters remained constant while CO rose from 4.4 to 6.1 1/min. Shortly after a.n.h., in 13 cases slight, in 10 cases, however, severe side reactions occurred: rise in BP, HR and PAP, peripheral vasoconstriction with decrease of peripheral blood flow, unproportional increase of CO and ST-depression in ECG. As a reason of this centralisation reaction a sympathetic reaction and hypoxia are discussed.


[Total blood exchange with circulatory arrest in deep hypothermia]. Total body wash out (hct less than 1%) with circulatory arrest of 30 to 60 minutes in deep hypothermia (esoph.temp. at 14 degrees C) was performed in 17 mongrel dogs by exchange against modified Ringer's Lactat-Solution. During rewarming the pump fluid was partly replaced by homologous packed red cells for readjustment of the hematocrit. After perfusion with a colloidfree perfusate all animals died under signs of massive interstitial edema. 8 out of 13 animals were long term survivors after exchange perfusion with colloid containing perfusate (dextran 60, 25 g/1). It has been demonstrated that a sanguineous circulatory arrest in deep hypothermia can be tolerated for 30 to 60 minutes if the formation of interstitial edema is prevented by use of an oncotically active perfusate.


[Immunologic studies in patients with clinical human albumin incompatibility]. 17 cases of clinical incompatibility reactions due to human serum albumin were examined. The reactions consisted of tachycardia, fever, exanthema and hypotension. Regarding the onset of time, "early" and "late" reactions were distinguished. Pollution of the administered albumin batches as etiologic factor was excluded. The results of immunodiffusion, antigen elimination and skin tests suggest a pathogenetic influence of immunological reactions. The application of further purified albumin solutions might reduce the frequency of incompatibility reactions.


[Determination of the size and concentration of microemboli in ACD-blood following varying storage periods of preserved blood]. A method for the determination of the frequency-distribution of emboli in banked blood has been described. A significant shift towards larger emboli in banked blood can only be demonstrated within the first 10 days of storage. The possibility of a disturbance of microcirculation of the lung may only be of a higher degree after massive blood transfusions as the concentration of emboli in banked blood is relatively low.


[Value of physiological coagulation parameters in perioperative consumption coagulopathy using low heparin doses]. In the course of extensive operations there are disturbances of the turnover-rate because of the activation of the clotting-system. These may equally be demonstrated by simple reproducible and quick global tests as by methods which are expensive and reserved only to special laboratories. By consequent low dosis-heparin-medication hypercoagulability-conditions and reactive hemorrhage complications are prevented and the hemostasis situation is significantly improved. No disturbance of the hemostasis by antithrombin-3-effect of the heparin-application in this dosage can be proved. The results of the examination including quality control and interpretation can be obtained in 30 minutes.


[Prevention of thrombosis using acetylsalicylic acid following vascular prosthesis and endarterectomy]. In 20 dogs one common iliac artery was intimectomized, an equal segment of the other was replaced by a knitted dacron prosthesis. Ten animals were given Acetylsalicylic Acid 30 mg/kg BW/d. Four weeks later these arterial segments were examined grossly and histologically for the presence of thrombotic depositis. In the treated animals these segments always remained patent. Three of the untreated animals showed a complete thrombotic occlusion of the prosthesis. The amount of thrombotic deposits on intimectomized and prosthetics segments was clearly reduced in the treated animals.


[Experimental demonstration of hemogenous growth of various collateral nets in chronic iliac av-fistulas]. A 2 cm long iliac av-fistula is established in 13 dogs. Flow and pressure measurements are performed in the distal fistula artery and the adjacent arteries before and immediately (stage I) as well as 3 months (stage II) and 6 to 12 months (stage III) post shunt. The development of extensive collaterals adjacent to the chronic iliac av-fistula is demonstrated angiographically and by post-mortem vascular casts. After occlusion of the proximal fistula artery a retrograde flow is directed towards the fistula even in the acute stage. This "free" retrograde flow increases from 70 ml/min to 1230 ml/min in stage II and 1755 ml/min in stage III. Collaterals of the tail artery contribute approximately 44%, of the contralateral iliac artery 20% and side branches of the abdominal aorta most of the remaining 36% of the retrograde arterial fistula flow. Successive occlusion of the tail artery and the contralateral iliac artery in stages II and III results in a nearly identical per cent decrease in "free" retrograde flow and in pressure. Even in the pre-fistula stage clamping of the iliac artery induces the same relative pressure-drop in the distal iliac artery. These findings indicate, that the three main collateral networks adjacent to the iliac artery all expand proportionally to their prefistula status in the 6 - 12 months following construction of the iliac av-fistula.


[Effect of arginine on insulin liberation during intra-abdominal operations]. During abdominal surgery the basal and glucose stimulated insulin secretion rate is reduced. An arginine-infusion of 0,5 g/kg over 30 minutes is able to stimulate the basal as well as the glucose stimulated insulin secretion under stress condition. A synergism between the effect of arginine and blood glucose concentration concerning the influence on insulin secretion can be proven. The results are important for the postoperative (posttraumatic) infusion therapy.


Colonic dialysis.

Colonic dialysis. It has been demonstrated using sheep that the colon is permeable to urea. Of nine sheep subjected to bilateral nephrectomy, six had an increased life span when dialysed via an isolated loop of colon compared to the other three used as controls. Further experiments were carried out on urea-loaded sheep and in sheep made chronically uraemic by an immunological technique which confirmed that urea could be dialysed across the colon at lower blood urea levels as well.


[Blood-pressure behavior in rats following the diversion of renal-vein blood into the portal vein]. Experimental studies on 22 hypertonic rats which had previously one kidney removed show that the deviation of the renal vein blood into the portal vein through a cavorportal or splenoportal anastomosis does not result in a lowering of the experimentally induced renovascular hypertension. These anastomoses did not alter the blood pressure in 3 normotonic rats. The prophylactic use of these anastomoses could not prevent the development of experimental renal hypertension in 2 of 3 test animals.


[Selective parathormone determination for localizing parathyroid tumors]. A method for localization of parathyroid tumors by selective venous blood sampling and measurement of parathyroid hormone is reported. The blood samples are taken after catheterization of the femoral vein from the veins of the neck and the thyroid gland. Parathyroid hormone levels are measured by radioimmunoassay. By this method localisation of 13 parathyroid adenomas in 15 patients was achieved. Parathyroid venous sampling seems to be more effective than any other localisation method used.


[Early recognition of relapse hazards following thyroidectomy using TSH serum level]. The determination of the serum level of TSH, the essential factor in goitrogenesis, was the best indicator in order to recognize imminent recurrence of goitre in strumectomized patients. The functional reserve of the hypothalamic-pituitary system proved to be important: Elevation of basic TSH level and increase of TSH after stimulation with TRH was significantly higher in patients with recurrent goitre. We, therefore, recommend this test for the postoperative surveillance of patients after strumectomy.


[Evaluation of reliable pituitary suppression therapy through varying thyroid hormone dosage following total thyroidectomy due to a differentiated thyroid carcinoma]. The reliability of pituitary suppression by administration of 1-thyroxin (t4) or a combination of thyroxin and triiodothyronin (t3) of variable dosage following radical surgery for thyroid cancer in 13 patients was investigated by means of TRH-test and measurement of serum hormone levels. In contrary to generally applied higher doses the results were able to demonstrate that 0.2 to 0.3 mg 1-thyroxin is a sufficient dosage for a complete suppression of TSH-stimulation. In the presence of obviously more side effects the treatment with a combination of t4 and t3 is not of any advantage.


[Effects of acupuncture and conventional anesthesia on hemodynamic changes and blood gas values in cardiac surgery]. The influence of Acupuncture-O2-N2O-Analgesie (group I) and of Neurolept-Analgesia (group II) on the changes of blood flow and blood gases during cardiac operations in extracorporal circulation (EKZ) was investigated in two groups of 55 patients. During EKZ constant arterial pressure between 60 - 70 mm Hg in both groups was maintained, and the amount of blood flow during the EKZ in group II was higher than in group I. A clinically significant difference of pH, PO2 and pCO2 of both groups could not be shown. At the end of the EKZ there was a rise in the level of blood-glucose, lactate and pyruvate in both groups.


[Primary hyperparathyroidism (1st degree HPT): plasma vitamin D and urinary cyclic AMP during the postoperative phase]. In 30 controls and 30 patients with primary hyperparathyroidism 25-OH-vitamin D in serum and urinary cyclic AMP were determined by competitive protein binding assays. Removal of hyperplastic or adenomatous parathyroid glands resulted in hypocalcemia with 1. low urinary cyclic AMP in surgical hypoparathyreoidism 2. high urinary cyclic AMP in skeletal calcium deficiency, 3. high urinary cyclic AMP in 25-OH-vitamin D deficiency. In calcium or vitamin D deficiency, therapy with calcium or calcium and vitamin D corrected hypocalcemia and urinary cyclic AMP.


The adrenergic response to cardiopulmonary bypass. 12 out of 13 patients who underwent cardiac surgery requiring extracorporeal circulation survived the operation. Arterial and venous catecholamines were measured throughout the operation. Larges rises in catecholamine levels were not seen although significant changes did occur in arteriovenous differences and also between samples at certain points in the operation. These facts do not agree with Lillehei's findings (3) and may reflect improvements in surgical technique, anaesthesia and the reduced time on bypass. However the lack of an overall measurable adrenergic response in terms of plasma catecholamine levels does agree with similar findings after open heart surgery (4) and during other surgical procedures (5).


[Enzyme levels and morphological picture of normal and cirrhotic rat livers following portal vein ligation and subcutaneous transposition of the spleen]. The effect of portal vein ligation after subcutaneous transposition of the spleen is investigated on enzyme-activities. and morphological pattern of the normal and cirrhotic rat-liver. The increase of glycolytic enzyme-activities and the decrease of enzyme-activities of oxidative metabolic pathways can be explained by adaptation on throttled blood supply of the liver. Significant decrease of arginase-activity (urea-cycle) can not be explained by reduced protein content of food (pair-fed-animals). Diminished substrate (ammonia)-level (NH3/t/hepatocytes) may be an explanation. Histological pattern of normal and cirrhotic rat liver is nearly unchanged after portal vein ligation.


[Effect of a decrease in viscosity on myocardial blood flow and function in myocardial infarct]. In 5 dogs the effect of a decrease in blood viscosity on myocardial blood flow (radioactive microspheres) and left ventricular function (Sarnoff curves) following ligation of the left anterior descending coronary artery was tested. Moderate anaemia produced a significant increase in coronary blood flow to the total left ventricle (+ 100%) and to the ischemic area (+ 400%). Depressed left ventricular function after coronary ligation alone was restored when blood viscosity was lowered only slightly. Severe anaemia further increased coronary blood flow but left ventricular function worsened.


[Ventricular function following reinforcement of the mitral ostium]. After implantation of a metal ring into the mitral position the ventricular function seems to be slightly impaired in the early postoperative phase. 6 months after operation, however, ventricular function is unchanged which excludes a significant hemodynamic influence of mitral valve stiffening.


Early clinical experiences with a heart assist device. A method of left heart (left atrium-aorta) support after open heart surgery is described. Thoracic reentry is not required when support is terminated. The system has been employed in 10 patients, 4 of whom are long-term survivors.


[Effect of temperature on heart preservation over 24 hours]. By heart preservation about 24 hours in hypothermia series A at 40 degrees C was compared to series B at 10 degrees C. The preservation was only possible at 10 degrees C. These hearts normally regained a good myocardial performance by allogenic perfusion.


[Chemotherapy of cancer: the present status (author's transl)]. Especially in the treatment of solid tumors, chemotherapy with single agents has so far not been very successful. The principles and results of polychemotherapy are therefore discussed. The experimental and clinical data available suggest that there is no correlation between the number of substances combined and the therapeutic effects. The results of "blind" polychemotherapy are compared with the author's and coworkers own experimental and clinical results with partial synchronization of the tumor cells. If possible the tumor-cell kinetics are determined by a double-labeling method devised by Hilscher and Maurer. In both the experimental field (literature and our group's own examinations) and in clinical experience (still limited), partial synchronization has proved clearly superior to "blind" polychemotherapy.


[Oncobiograms and cancer chemotherapy: Hope or reality? (author's transl)]. On the basis of animal experiments it is shown that the results of tumor chemotherapy can be predicted with the aid of in-vitro test systems. In investigations carried out on human tumors, the correlations obtained between in-vitro test results and response to therapy are promising. However, definitive proof of a correlation can only be provided by planned, statistically supported clinical studies. Two types of information can already be obtained from the in-vitro tests: data concerning the rate of proliferation of the tumor, on which the activity of cytostatic agents depends, and data on certain types of resistance to cytostatics.


[Cell cycle and carcinochemotherapy: reality or hope? (author's transl)]. Different cytostatics interrupt the biochemical dynamics of tumor cells at different stages of the generation cycle, according to their mode of action. As a result of an additive or potentiated increase in efficiency, the therapeutic effect of each substrance can be improved by the use of suitable combinations in treating the treatment of carcinoma of the breast, carcinoma of the ovary, seminoma and other progressively swelling tumors. The difficulty in defining and interpreting quantitative parameters of concerous growths prevents the wider use of cytostatics.


[Arteriosclerosis: morbid anatomy (author's transl)]. Pathology is a variant of physiology with obstacles. No arterial wall is absolutely impermeable. The basic form of arteriosclerosis results from a disturbance of the lifelong flow of humors ab intima in adventitiam et ex centro in peripheriam (author's "Perfusion theory"). Special forms develop from this basic form. Analysis of postmortem material with special reference to the so-called risk factors allowed us to establish connections between some of these factors and arteriosclerosis, while some other connections, e.g. with smoking, were called in question. It is pointed out that prospective treatment of arteriosclerosis will begin only when the cluster of risk factors can be broken down.


[Epidemiology and clinical aspects of atherosclerosis (author's transl)]. Prospective epidemiologic studies have uniformly demonstrated that a high plasma cholesterol level is indicative of an increased risk of myocardial infarction. Beside elevated serum cholesterol, diabetes, smoking, hypertension, obesity, and stress have been correlated with an elevated incidence of atherosclerosis. At the Medical Department in Heidelberg it was demonstrated that four weeks after myocardial infarction (MI) only 59 percent of 753 men and 53 percent of 348 women were still alive, and that smoking cigarettes leads to early MI. Nonsmokers had their first MI at 63 years, cigarette smokers at the age of 53. These results stress the importance of early detection of the above-mentioned risk factors.


[Cerebrovascular insufficiency (author's transl)]. Cerebrovascular insufficiency arises from multiple causes, including cardiovascular insufficiency and local obstacles to the blood flow in the "four brain vessels". These obstacles are caused by primary thrombosis, by embolism, or by stenosing or ectatic arteriosclerosis. As there are anastomoses in the extra- and intracranial vessels, a collateral circulation can arise when hemodynamic conditions (blood pressure etc.) are adequate; this is also necessary for the preservation of these collaterals in later stages. Since particular hemodynamic conditions (terminal and watershed zones) have particular roles, different patterns of infarction can arise. Local obstacles to the blood flow can be subjected to vascular surgery as a preventive measure or even for vital conditions. The details of cerebral blood flow and brain viability have not become completely clear from the results of modern experimentation. The setting up of research institutes to concentrate on arteriosclerosis and ischemia in collaboration with clinical centers devoted to coronary and cerebral infarction seems to be very necessary.


[Arteriosclerosis: efficiency of angiography (author's transl)]. Stenosis, occlusion, and aneurysmatic dilation are the principle angiographic signs in arteriosclerosis. Aorto-arteriography, either by direct puncture or indirectly via a catheter, permits visualization of all vascular sites of surgical interest, determination of the location and extent of the lesion, and evaluation of the function of the collateral system as well as the inflow and outflow. This stresses the extreme importance of angiography in preoperative planning and postoperative documentation of successful therapy.


[Arteriosclerosis: a challenge for the surgeon. Prevention and postoperative care (author's transl)]. A review of the possibilities for primary and secondary prevention of arteriosclerosis is followed by a critical analysis of long-term therapy with anticoagulants and platelet aggregation inhibitors with regard to the prevention of occlusive vascular disease (with a review of the pertinent retrospective and prospective studies).


[Vascular surgery and patient stress tolerance with reference to anesthesia (author's transl)]. This paper lists the factors that affect the stress tolerance of patients undergoing surgery. Hypertonicity is observed in 64 percent of these patients, and signs of depleted coronany supply in 82.5 percent. The stress tolerance can be tested before surgery by means of gas analyses and determination of the minute volume and the pulmonary arterial pressure. During surgery, circulatory crises occur due to occlusion and release of large arterial branches. The anesthetic technique must be selected with due consideration of the increased risk. After surgery the oxygen consumption is increased, which lays heavier demands on the myocardial performance.


[Results of reconstructive vascular surgery (author's transl)]. This report is based on experiences with reconstructive vascular surgery for obliterative and aneurysmal vascular diseases in 5245 patients of the Surgical University Hospitals in Cologne and Munich during the last 15 years. An analysis of early and late results is given to illustrate the presnet standard of operative possibilities, but also their limitations in vascular diseases. This approach is used to give both vascular and general surgeons practical hints on procedure.


[Carcinoma of the pancreas: pathologic anatomy (author's transl)]. Carcinoma of the pancreas is seen in 1.2 percent of autopsies. Often it is not possible to determine definitely: whether it is a carcinoma of the head of the pancreas, of the papilla, or of the distal part of the common bile duct (periampullary carcinoma). 90 percent of these carcinomas arise in the small ducts. They cannot be recognized by ERCP until spreading into the main duct has occurred. Differential diagnosis is concerned mainly with differentiating between chronic pancreatitis and carcinoma of the pancreas. Chronic pancreatitis and carcinoma of pancreas are not mutually exclusive; on the contrary they are closely related in diagnosis and pathogenesis. There can be no carcinoma of the pancreas without pancreatitis. For an accurate diagnosis which is vital, a diagnostic laparotomy should be performed at an early stage.


[Carcinoma of the pancreas: conventional roentgenologic procedures (author's transl)]. Hypotonic duodenography has opened up new dimensions in the diagnosis of space-occupying lesions of the head of the pancreas. The procedure with out intubation has become routine over the last few years. Differentiation between severe alterations caused by chronic relapsing pancreatitis and those caused by a carcinoma of the pancreas is only seldom possible, whereas inflammatory swellings and tumors of Vater's Papilla are easily recognized. Endoscopy is necessary for confirmation of the diagnosis. When jaundice is already present, transhepatic cholangiography can yield more information; in the pre-icteric phase intravenous cholangiography can also be useful. More complicated diagnostic procedures should not be applied until all conventional roentgenologic methods have been exhausted.


[Carcinoma of the pancreas: angiographic diagnosis (author's transl)]. Morphologic changes seen in angiographs and ductographs (endoscopic retrograde pancreaticographs) in the presence of carcinoma of the pancreas are described. The average diagnostic accuracy of angiography is currently 75 to 95 percent, while that of endoscopic retrograde pancreaticography is 90 to 95 percent. The combination of both methods increases the accuracy. The main problem with pancreatic carcinoma now is not early diagnosis, while is now possible, but early examination of the patient.


[Nuclear medical diagnostic--pancreatic carcinoma (author's transl)]. Of the procedures available for diagnosis of pancreatic carcinoma, particular significance can be attributed to scintigraphy. The method is based upon the accumulation of a labeled amino acid in the glandular tissue. The scanning technique delineates functionable tissue. The diagnosis of carcinoma of the pancreas cannot be deduced from the scintigraphic picture alone, however, because functional deficiency of a different origin could result in the same picture. In these cases, carefully planned exploratory surgery  is indicated. The limited expense in terms of time and personnel and the modest stress to the patient make pancreatic scintigraphy a method that can reasonably-together with internal procedures-be applied right at the beginning of the process of diagnosis.


[Semimalignant bone tumors (author's transl)]. Semimalignant bone tumors are characterized by local destructive and invasive growth and the tendency to recur. Haematogenous metastases are exceptional or a late manifestaion. Typical examples of semimalignancy are giant-cell tumors, large chondromas of the pelvis, and recurrent chondromas in any location. The treatments of choice are resection or amputaion.


[The central bone tumor registry for the Federal Republic of Germany (author's transl)]. Among malignant tumors, bone tumors present a particularly acute problem. Bone tumors frequently occur in childhood; their etiology is completely obscure; early detection is still hardly possible, and the chances of success therefore leave much to be desired. A registry for bone tumors is being built up in the German Cancer Research Center in Heidelberg, which is to collect epidemiological data on all malignant and semimalignant primary bone tumors occurring in the Federal Republic. The lecturer gives an introduction to the registry and requests the cooperation of German surgeons in reporting pertinent cases.


[Surgical procedures in cleft-palate patients, with reference to phonetic function: primary and secondary methods (author's transl)]. Surgeons undertaking the closure of cleft lip and cleft palate must develop a therapeutic technique that will give the best possible phonetic results and cause the minimum disturbance to normal growth of the maxillae in each case. Clinical observations reveal that different operative procedures achieve normal phonetic function in 60-80 percent of cases. The author has observed the best results when patients have been operated on for cleft lips at 4-6 months of age and for cleft palate at 2-3 years. If nasal speech persists after a cleft-palate operation, a secondary pharyngoplasty can be undertaken in the preschool period, with favorable results in about 70 percent of cases.


[Restoration of grip by means of repair of the injured peripheral nerve and/or muscle-tendon transfer (author's transl)]. Muscle or tendon transfers are indicated after lesions of peripheral nerves if regeneration does not occur or remains incomplete after nerve repair or if the paralyzed muscles themselves are damaged. In long-standing cases the authors try nerve repair to attain adequate sensitivity, and perform the tendon transfer independently. The different techniques are discussed; transfer of the brachialis muscle to replace deficient flexor muscles is described and nerve-into-muscle implantation is mentioned.


[Reconstruction and Replacement of the grip function in the maimed hand (author's transl)]. The minimum requirement for a functional hand is the presence of one or more fingers to which a sensitive, mobile thumb separated from them by a deep cleft can be opposed. Of the reconstructive techniques available for the hand, those for the thumb are the most numerous, and they are usually applied at a secondary operation. Reconstruction can only be performed at primary surgery if the state of the hand and the resources available in terms of surgical facilities and personnel are ideal, which is of the bony structure as possible, to be used as a base for reconstruction later.


[Priniciples of reconstructive surgery of the rheumatic hand (author's transl)]. Rheumatic diseases such as rheumatoid arthritis, psoriatic arthropathy, and ankylosing spondylitis very often cause deformities of the hand. Especially during the early stages of these diseases, synovectomy of joints and tendons is indicated; destructive and degenerative lesions can be limited in this way. If they are already present, in most cases only reconstructive operations such as arthrodesis, resection, interposition arthroplasty, articial joint replacement, tendon transfer etc. can improve the impaired function.


[Practical tasks in cancer research (author's transl)]. Particularly urgent tasks for practical cancer research are pointed out: (1) recognition of the multidisciplinary character of oncology, (2) placement of the cancer patient more than before in the focus of research, (3) the use of modern methods of genetics to specify the definition of a "disposition", (4) the intensification of investigations into the field of chemical carcinogenesis, since prevention of cancer diseases seems most likely in this sector, and (5) elaboration of practical experimental models for the study of chemotherapeutic possibilities


[Gynecological remarks on the problem of the artificial vagina (author's transl)]. Accurate differentiation of the pathologic state must precede surgical construction of an artificial vagina. Moreover, it is necessary to know whether a uterus is present and whether the psychosexual development of the patient is female. Differential diagnosis is concerned with various forms of intersexuality, especially aplasia and atresia of the vagina. Relevant cases are reported. The author prefers the McIndoe operation, because of its low risk. If the patient has a uterus (i.e. women with AGS with complete masculinization or women with atresia of the vagina) more effective operations should be done, as intercourse and conception are possible after surgery in these women.


[Surgery of hypospadias (author's transl)]. The formation of an opening on the lower side of the masculine urethra is a developmental malformation. It is never combined with incontinence of the bladder. Difficulties with micturition and erection are due to a usually stenotically misdirected external orifice of the urethra, with a shortened urethra and nonelastic chorda, a remnant of the undeveloped corpus spongiosum urethra. For surgical correction (construction of a sufficiently long urethra and adequate skin extensibility) several operations are necessary, which are discussed. The most frequent complications are fistulas and problems in the wound-healing process (in approximately 30 percent of cases).


[An assessment of the functional results of various forms of surgery for epispadias and exstrophy (author's transl)]. Urinary continence can be achieved by total reconstruction in perhaps 20 percent of patients born with exstrophy of the bladder. Uretero-rectal anastomosis offers a reasonalbe alternative but carries a high morbidity. Cutaneous diversion is the safest form of long-term management, but this involves the life-long penalty of a stoma and the need for appliances. Conservative reconstructive surgery is advocated in the first instance, but repeated surgical procedures may be necessary for a successful result.


[Gracilis-muscle transplant for the treatment of fecal incontinence (author's transl)]. Between 1962 and 1974, 40 children were treated by transplantation of the gracilis muscle. Clinical and electromyographic follow-up studies were performed on 37 children. Results were good in 12 cases, satisfactory in 11 cases, and poor in 14. Children with myelomeningocele showed the poorest results. Four girls with ano-vestibular fistula were treated by a modified method of operation. Because of the special anatomic situation, the gracilis muscle was positioned around the dorsal rectum in a semicircle only and then fixed to the os pubis under high tension. Results were good in 3 cases and satisfactory in 1 case.


[Soft-tissue damage caused by fracture (author's transl)]. Bone fractures are combined with damage to the soft tissue, which consists in swelling, contusion and open injury. Depending on the degree of the traumatic deformation on the bones, there are large avasculated zones, and hypoxia and acidosis are found in the whole of the injured region. This is followed by a catabolic situation that continues-according to the degree of the injury-for at least 72 hrs. The treatment regime is affected by this as it determines the point at which surgery can be undertaken, the treatment of open wounds, access to the fracture, the method of stabilization, and the follow-up treatment.


[Local traumatic injury of the soft tissue and internal fixation (author's transl)]. The influence of local traumatic injury of the soft tissue on the decision as to whether surgical therapy is indicated and on the method of internal fixation selected for a fresh, closed fracture is discussed. General descriptions of injuries to the soft tissue are followed by a critical discussion of the possibilities of closed and open methods of internal fixation with some examples.


[Bone fracture and vascular lesion (author's transl)]. Combined lesions of bone and blood vessels require a high degree of diagnostic skill and of therapeutic care (routine clinical examination of the vascular status and if necessary angiography). From a therapeutic point of view, all major vascular lesions proximal to the knee or elbow should have vascular continuity restored (artery and vein). Primary internal fixation of shortened long bones is an important technical principle which, in most cases, will allow direct vascular suture in a stable operating field.


[Internal fixation with soft-tissue lesions: fracture with nerve damage (author's transl)]. Typical nerve damage after fractures due to the topographical proximity of the nerves to the bones, are shown and therapeutic principles are discussed. Primary traumatic lesions are differentiated from so-called "creeping paralysis". The methods of choice are neurolyses, nerve suture or transplantation, each at the appropriate time. Evaluation of 83 of the 128 Patients undergoing microsurgical operations on the nerves in recent years is presented after re-exmination by independent neurologists. One-third showed definite signs of regeneration, more than one-third had good functional results, and poor results were recarded for 25 percent of the patients.


[Disturbances of venous flow (author's transl)]. 1. Local rupture of the veins by fracture. Compression and local spiral thrombi. 2. Failure of the venous pump at the ankle joint due to immobilization. 3. Failure of the pump in the calf muscles, leading to propagation of thrombi in the venae gastrocnemiae and in the veins of the soleus muscle, frequently with varicosity. 4. In 22 percent of left-sided fractures a venous spur is found in the left V. iliaca com.; increased likelihood of thrombosis in left leg in case of stasis due to immobilization.


[Intramedullary fixation of fragments in soft-tissue injuries (author's transl)]. In cases of open fractures, careful reconstruction of the soft tissue and stable internal fixation are generally regarded as the best means of preventing infection. With this in mind, some of the author's own cases of open fractures of the upper and lower leg-stabilized either with conventional intramedullary nails or with interlocking nails-are demonstrated. The infection rate in the especially vulnerable open fracture of the tibia was 7.89 percent.


[Compression osteosynthesis with soft-tissue damage (author's transl)]. The advisability of open reduction with internal fixation by means of compression plates, screws, or tension band is dependant upon the localization and type of fracture, the kind and extent of soft-tissue damage, and also the time factor. Fractures in the vicinity of joints and intra-articular fracture dislocations are practically absolute indications. Its application is less frequent when the metaphysis is involved, except in the case of the forearm. Caution is suggested in the presence of chronic soft-tissue damage subsequent to peripheral circulatory disorders.


[Fixateurs externes for fractures combined with damage to the soft tissue (author's transl)]. The indications for external fixation with fixateurs externes are discussed and some important technical and biomechanical aspects are reviewed. The three-dimensional fixateur externe is recommended on the basis of clinical experimental research. Stability can be obtained with this even when bone defects and short metaphyseal fragments are present. The results observed after the treatment of aseptic and infected pseudarthroses of the tibia are shown in tabular form.


[Osteosynthesis in the presence of soft-tissue lesions: delayed internal fixation and indications for conservative treatment (author's transl)]. When there are concomitant soft-tissue lesions with closed fractures, delayed osteosynthesis is indicated to prevent infection. Nonetheless, primary osteosynthesis is rarely necessary. In the case of open fractures, internal fixation should only be performed when bone and the materials used for fixation can be covered with tissues that are well supplied with blood. In case of doubt the surgeon can rely on the fact that most fractures can be effectively treated by conservative methods, and it is wise in such cases to forego the advantages of osteosynthesis and avoid the risks involved.


[Internal fixation in the presence of soft-tissue damage in childhood (author's transl)]. Internal fixation is considered for the treatment of 10 percent at most of all fractures that occur in childhood. Only minimal fixation should be applied, to avoid the induction of an epiphyseal lesion in addition to the original fracture. Internal fixation allowing stability during weight-bearing or exercise immediately is not necessary in a child. Concomitant soft-tissue damage hardly affects internal fixation in childhood, except in the case of unstable reduction when there is extensive soft-tissue damage.


[Medical guidance of the cancer patient (author's transl)]. Cancer is a diseased state, but it is not incurable. Indications and methods of therapy have been standardized almost internationally. Early diagnosis leads to better rates of cure. Cancer presents as an individually characterized multiplicity of symptoms of the disease. Individualization is the real art of medicine. Truthful information, adjusted to the individual patient in each case, should be given at the right time. There should be no rush to make early statements of prognosis, especially statements of hopeless despair. No physician has the right to prolong the supravital and subhuman stage of dying. Absolute dominance of the physical time factor over the specifically human qualities and the patient's own individuality is not justified. The legal situation with regard to the gray area of passive euthanasia should be more clearly defined.


[Surgical textiles-material, methods, effects (author's transl)]. Wound textiles suitable for placing immediately over a wound and materials for securing them in position are discussed. Wound texiles have a curative function (blotting-paper effect, antigravitation effect). Conditions for their use are three-dimensional capillary drainage, plane compression, and nonstick and cooling properties. Cellulose fibers absorb moisture in all three dimensions, while synthetic fibers transport moisture around their strands in a two-dimensional course. The nonstick properties are achieved by means of overtwisted threads in the warp (tunnel effect) in woven fabrics, and in nonwoven fabrics (when moisture is produced) by combination with overstretched cellulose, producing corrugations, or (for drying) by the uneven incorporation of overtwisted fibers into the fabric, which produces a ventilating effect. The nonstick properties always become obvious when the dressings are moistened.


[Replantation of amputated extremities (author's transl)]. After some short remarks about the organization of microsurgery in Australia, the microsurgical technique of retransplantation of dissected extremities and the conservation methods are described in detail. In 175 out of 208 cases, retransplantation of extremities was successful, i.e. certain functions were reestablished. Results were better in children than in adults. The most important factors in successful treatment are the conservation methods, skilled technique, and postoperative care, which may last up to 1 year. One retransplantaion center with 4 experienced surgeons per 5,000,000 population seems to be mandatory.


[Rescue service: initial measures on the spot and in hospital (author's transl)]. Improvement of any rescue service is inextricably bound up with the provision of optimal conditions with regard to first aid at the site of the accident, transport and immediate care in hospital. Only properly trained and experienced doctors are able to take appropriate life-saving action on the spot. Therefore ane should aim at getting the doctor to the site of the accident by helicopter or by ambulance as fast as possible. After immediate life-saving action has been taken, the various injuries should also be provisionally attended to as well as possible. The entire scope of these problems was discussed at the refresher course.


[Vagotomy (author's transl)].

[Vagotomy (author's transl)]. The course reviews the present status in the field of Vagotomy with reference to pathophysiology, gastrin release, anatomy, neural changes in the antrum, acid secretion, GI hormones, gastric motility, pepsin concentration, mucus production, O2 tension in the gastric mucosa, changes in the numbers of parietal cells, glucose tolerance, indications, diagnosis, necessity for drainage, acute complications, exclusion of malignancy in gastric ulcer; technique, intraoperative tests, results with TV, SV with antrectomy, recurrences, SPV and pyroplasty (controlled study), training. Nonresecting surgery of GDU is possible if vagotomy (SPV) and drainage (pyloroplasty) are correctly combined.


[Possibilities and limitations of the surgical treatment of cancer (author's transl)]. Human cancer is a worldwide problem. In most cases of cancer of an organ the best method of treatment is complete excision. Therefore the late results are dependent on the stage of the tumor at the time of operation. The most efficient weapon against cancer is early diagnosis. Progress in the development of diagnostic techniques sounds optimistic. The clinical results are still disappointing in relation to the cure rates. The first symptoms that lead the patient to consult the doctor are often already late symptoms. Progress can only be expected in the area of prophylactic screening for cancer.


[Legal problems in the treatment of cancer (author's transl)]. According to the principles developed by the legislature, the treatment of cancer requires particularly careful diagnosis. The principle of free choise of methods is accepted in the treatment of cancer; in many cases, however, surgery plus irradiation must be regarded as the method generally accepted as the most effective, of which the doctor regularly has to avail himself. Revelation of the diagnosis involves particular problems. If telling the patient of the diagnosis likely to have a deleterious effect on the results of treatment, the type and extent of information given to the patient must be left to the discretion of the doctor.


[Evaluation of therapeutic success in cancer (author's transl)]. The development of generally valid rules for the treatment of cancer obviously requires the comparison of different forms of treatment and their results. The basis for these comparisons is a reliably reproducible and sufficiently detailed internationally applicable classification scheme for the characterization of tumors affecting different organs and their extent on the basis of objective findings. The TNM system proposed by UICC is the only one answering all these demands. It ought to become universally accepted and be the only system used.


[Anastomoses of the urinary tract for treatment of duplicated ureters (author's transl)]. Anastomoses between the kidney pelves or the ureters are excellent operative procedures to correct duplications of the urinary tract in distinct cases. Heminephrectomy may be avoided, when only one of the ureters is affected and the parenchyma of both portions of the kidney is intact. Indications are megalureter, recurrent refluxes, ureteroceles and ectopic ureteral orifice. The operative technic used in 13 cases is described. Advantages and disadvantages are discussed.


[The penetrating duodenal ulcer. Operative technique and postoperative complications (author's transl)]. The results of 133 gastric resections for penetrating duodenal ulcer are reported. Because of the postoperative complications (acute hemorrhagic pancreatitis, duodenal stump insufficiency, icterus and intraluminal postoperative bleeding) in future only the atypical closure of the duodenal stump according to the method of Nissen-Bsteh should be carried out. A bleeding ulcer should be operated within 48 hrs. If the bleeding needs more than 2500 ml blood substitute, this means a indication for a immediate operation.


[Problems of the one- or two-stage operations of carcinoma on the left part of the colon (author's transl)]. 260 radically operations of carcinoma of the colon were carried out from 1963-1972; 163 of these operations have been done on the left part of the colon. The results of the one- and two-stage procedures were compared with the related literature. 46.5 per cent of the resected lymphnodes were affected by carcinoma. An expanded resection was done in 24 cases complicated with tumour perforation in adjacent organs. Among 147 one-stage left-side resections 20 insufficiencies of the anastomoses (13.5 per cent) were observed. To protect the anastomoses in 8 cases a coecal fistula and in 4 cases a fistula of the transverse colon were performed. There was no insufficiency of the anastomose. In 4 cases of two-stage precedures insufficiencies of the anastomose were found at the extraperitoneal replaced anus. The mortality was found to be 11.6 per cent. Peritonitis occurred in 18 cases: after 6 right sited and 12 left sited resections.


[Differentialdiagnosis and surgical treatment of the familial intestinal polyposis (author's transl)]. Between 1959 and 1974 we observed 18 patients with familial intestinal polyposis. 4 patients were from one family. Two brothers refused the operation and died 7 respectively 8 years after diagnosis had been made. The typical symptoms, the diagnostic procedure and the therapy are demonstrated. We prefer the proctocolectomy (eventually with the "Kock-Ileostoma"), because we observed a lot of recidivs after ileorectostomy. The prognosis of the familial intestinal polyposis is good, if the operation is performed early (also in cases of carcinomatosis). Only those patients died, who rejected the operation or were operated too late.


[Juvenile bone cysts and giant cell tumors (author's transl)]. The attempt is made to demonstrate clinical, radiographical, morphological differences between juvenile bone cyst and giant cell tumor as shown in the patients of the Surgical Department of the University of Dusseldorf and literature. It is possible to derive inferences in differential diagnosis from the age of the patient, clinical course and statistically most frequent locations. Radiographically the bone cyst distinguishes itself by its central localisation in the metaphysis, where as the giant cell tumor has an excentric position in the epiphysis with a tendency of extending into the metaphysis. Giant cells occur in both diseases. While the bone cyst is an tumor-like lesion, the giant cell tumor is a real neoplasia. The therapeutical procedure varies according to different prognostical significance of the two diseases. Therefore, it is necessary to draw an exact line of demarcation between the comparetively harmless juvenile bone cyst and the semimalign giant cell tumor.


[Clinical indications for pacemaker exchange and functional studies of the explanted aggregates (author's transl)]. For the purpose of examining the clinical exchange indication 96 removed Demand-pacemakers (type Medtronic 5842, 5843, 5942, 5943) had been sujected to a functional test by the manufacturers. After a service-life from 31-45 months 71% (i.e. 42 out of 59 units) and, in the group with a service-life from 31-35 months, 66% (i.e. 33 out of 51 units) of pacemaker units removed at that time were still working regularly. The mean energy loss exceeded 70% with a simultaneous mean drop of the output voltage down to 2.5 Volts. After the 25th month of the implantation date the number of battery failure increased spasmodically. Under the suspicion diagnosis of "battery exhaustion" a prophylactic "selective" exchange operation of the pace-maker units implied does not appear justifiable to us but in cases with stable AV-Block III. Providing reliable supervision of patients with sufficient self-rhythm, the exchange may be delayed up to about the 40th month after the implantation.


Epidermoids involving the temporal bone: clinical, radiological and pathological aspects. Epidermoids or congenital cholesteatomas arise from aberrant epithelial remnants and are, therefore, considerd blastomatous malformations. Their predilective sites are the intracranial cavity, the diploe of the skull and the spinal canal. In the base of the skull the temporal bone is the most frequent site. Epidermoids account for about 0.2-1.5 percent of all intracranial tumors. The majority originate in the cerebello-pontine angle where they account for 6-7 percent of all tumors. Their age incidence reveals a great scatter from birth to 80 years. The majority are recognized during the third and fourth decades with the onset of clinical symptoms occurring much earlier. They affect males more frequently than females. Their delicate capsule with a whitish mother-of-pearl sheen lends them a typical appearance. Epidermoids are generally slow growing lesions which may remain asymptomatic for years. The irritative effect of their content, however, can produce symptoms of dysfunction and intense inflammation. Malignant changes occur infrequently. Diploic epidermoids are easily recognized, whereas, intradural epidermoids are more difficult to identify. Epidermoids may arise in the vicinity, on the outer aspect or within the temporal bone. Epidermoids originating in any of these locations have certain characteristic features which may arouse suspicion of their presence. Examples of an epidermoid with origin in the typical locations within the temporal bone and cerebello-pontine angle are discussed to portray their individual characteristics.


[Histologic patterns of liver damage in chronic poisoning from tri-ortho-cresyl phosphate (author's transl)]. Six subjects, affected with TOCP polyneuritis, were submitted to liver biopsy by means of Menghini's technique. By means of both optic and electron microscopy, histologic and ultrastructural findings of liver damage were evaluated, whose genesis is believed to be due to the toxic effect of TOCP. The hepatocytes showed changes, mainly represented by cloud-vacuolar swelling of the cytoplasm, with abnormalities of nuclear membrane and lipofuscin pigment accumulation. The above mentioned patterns were found in all the examined needle biopsies, which possibly account for their toxic nature.


[Functional conditions of the respiratory system and work site pollution. II. Prevalence of respiratory function changes in workers employed in bichromate and chromic acid production (author's transl)]. The authors report the prevalence of respiratory function changes in two groups of workers employed in bichromate and chromic acid production. In the first group (82 subjects) examined at the Institute of Occupational Medicine, the following tests were performed: filling out of a questionnaire for cronic bronchitis; chest x-ray; spirometry; pulmonary diffusing capacity (DLco) measurement; blood gas analysis on arteriolized capillary; He and CO2 rapid expiratory curves determination. No environmental pollution data were available. In the second group (180 subjects) examined at the working site, the following tests were performed: filling out of a questionnaire -or chronic bronchitis; spirometric determination. Environmental pollution data were available. A causal connection is hypothesized by the authors between either roentgenologic or respiratory functional changes and chromium exposure, and an increased proportion between lung function changes and exposure length is stressed.


Chromosome changes induced by ionizing radiations. Case reports (author's transl). The authors, after a short review of the literature, report four cases of acute accidental irradiation from Co60 exposure, however of slight degree. A cytogenetic study showed chromosome changes of unstable type only, which were also found in the case with 1,5 rem absorption.


Uptake and metabolism of alpha-monopalmitin by rat lung in vitro. CO2 production from and uptake of alpha-glyceryl mono (palmitate-1-14C) were studied in an in vitro system using minced rat lung. Monoglyceride radioactivity was readily incorporated into lung tissue lipids. In a time course of 5-120 min, ca. 2.9-21.9% of the initial medium 14C-radioactivity was recovered in tissue lipids, including free fatty acid and monoglyceride, per one g of tissue. From 93 to 72% of the initial radioactivity remained in the medium during the same incubation periods. The ratio of tissue neutral lipid to phospholipid radioactivity decreased from 2:1 at 5 min to ca. 1:2.1 at 120 min. Most of the phospholipid-14C was in phosphatidyl choline, and this accounted for 80% of phospholipid-14C. Analysis of the tissue lipid radioactivity pattern revealed that during early periods of incubation (5-15 min) there was a rapid accumulation of 14C in monoglycerides and free fatty acids, which decreased with increasing incubation time concomitant with increase in radioactivity of tissue phospholipids and triglycerides. During the same time course, 6.5-85.3% of medium-14C was in free fatty acid, indicating the presence of an active alpha-monopalmitin-hydrolyzing system. After 2 hr of incubation, only 1.8% of the initial medium-14C had been oxidized to CO2. Under the same experimental conditions, 14C-alpha-monopalmitin and palmitate-1-14C were almost equally utilized and the patterns of lipid incorporated from both substrates were similar. It is suggested that rat lungs can utilize alpha-monopalmitin in a similar manner as palmitate after the former is hydrolyzed.


Effect of ethanol on utilization of plasma free fatty acids for liver triacylglycerol synthesis and its relation to hepatic triacylglycerol accumulation in rats. The effect of 3 different single doses of ethanol on the liver triacylglycerol concentration and on the metabolism of intravenously injected 14C-oleic acid in fasted rats was studied. All 3 doses (2, 3.75, and 6 g ethanol/kg body wt) caused a rapid increase in the liver triacylglycerol concentration during the first 5-6 hr after the ethanol was given. Until the plasma ethanol concentration had fallen to low values, the high liver triacylglycerol levels were raised and were independent of the ethanol dose given. The incorporation of radioactivity from intravenously injected 14C-oleic acid into liver triacylglycerols was increased over control values to the same extent in all rats given ethanol as long as the plasma ethanol concentration was above a low level. High rates of ethanol oxidation and increased utilization of plasma free fatty acids for liver triacylglycerol synthesis were closely correlated with the development and maintenance of the ethanol induced liver triacylglycerol accumulation.


Tumor extracellular triglycerides in mice during growth of Ehrlich ascites carcinoma. Our earlier work with Swiss-Webster mice has shown that most of the lipid in Ehrlich ascites tumor extracellular fluid is in the form of free fatty acids. This finding is in direct contradiction to earlier and subsequent reports from another laboratory that has found free fatty acids to be a very minor component and triglycerides to be the major lipid of Ehrlich ascites tumor extracellular fluid. In light of these contradictory reports, we have carried out a study patterned after that of other workers, but using our Swiss-Webster mice. As predicted from our earlier study, we have found very little triglyceride in Ehrlich ascites tumor extracellular fluid. Although we could demonstrate a significant, transient hypertriglyceridemia during tumor growth, maximum plasma triglyceride concentrations were an order of magnitude lower than those reported by other workers. In addition, and again in contrast to other reports, we found that plasma triglyceride and tumor extracellular fluid triglyceride levels in tumorous mice fell significantly with fasting. Thus, interesting differences in triglyceride metabolism between mouse and/or tumor strains seem to exist. Our present findings suggest, but do not prove, that triglycerides in the tumor extracellular fluid probably are not a major source of the rapidly turning over, tumor extracellular fluid free fatty acid in our mice.


Quantitative, multicomponent analysis of fatty acids from cholesteryl esters by chemical ionization reconstructed mass chromatography. Reconstructed mass chromatography using methane as a carrier and reagent gas for chemical ionization gas chromatography-mass spectrometry of the derived methyl esters allows rapid, quantitative microdeterminations of complete cholesteryl ester fatty acid profiles. The sensitivity of this method is consistent with completely specific, multicomponent assay at the picomole level. Introduction of two homologues as internal standards, one into the intact biological specimen and the other after derivatization, provides a measure of the net efficiency of the processes of extraction and derivatization. This procedure may be extended readily to the determination of fatty acid profiles in most biological fluids.


Lecithin:cholesterol acyltransferase activity in hypercholesterolemic subjects and in hypercholesterolemic subjects treated with clofibrate. The lecithin:cholesterol acyl transfer reaction in the plasma of hypercholesterolemic subjects and of hypercholesterolemic subjects treated with clofibrate was studied. An increased enzyme activity was found in the first group of patients, while lecithin:cholesterol acyl transfer activity tended to normalize in the second group. This increased enzyme activity might be a defense mechanism against the accumulation of cholesterol in the arterial wall.


24-Methylenedammarenol: a new triterpene alcohol from shea butter. A new triterpene alcohol was isolated from shea butter and its structure was shown to be 24-methylenedammarenol (24-methylene-5alpha-dammar-20[21]-en-3beta-o1). Dammaradienol (5alpha-dammara-20[21],24-dien-3beta-o1) also was isolated from shea butter.


Intestinal lipid absorption: evidence for an intrinsic defect of chylomicron secretion by normal rat distal intestine. Intracellular triglyceride accumulation and delayed chylomicron secretion were demonstrated in distal but not in proximal rat intestine following prolonged steady state fat absorption. After 1 and 4 hr of intraduodenal triolein infusion, the mucosal triglyceride content in distal intestinal segments was greatly increased compared with proximal segments. Electron microscopy at each time interval disclosed greater quantities of lipid droplets within the distal cells and these were much larger than the intracellular droplets in the proximal cells, some attaining an enormous size (9000 mum). When proximal and distal cells were compared at intervals after cessation of a 4 hr triolein infusion, the differences in intracellular lipid accumulation were also evident because, even after 6 hr the distal cells were still filled with large droplets, whereas the proximal cells were almost devoid of fat. These results indicate a basic cellular difference between proximal and distal intestine in the processing of fat and, in contrast to current concepts, suggest that defective chylomicron secretion is not necessarily associated with limited B-apoprotein availability.


Free fatty acid and glucose metabolism during increased energy expenditure and after training. The amount of fat available as substrate to provide the energy needed for submaximal exercise is almost unlimited; therefore, it stands to reason that the organism will adapt so that it uses fat as the major energy substrate during very prolonged exercise. Nevertheless, the quantitatively smaller body stores of carbohydrate, which contain only one to two percent as many calories as the fat stores, play a very important role during exercise, since depletion of either muscle or liver glycogen will force an individual to terminate strenuous muscular work. In normal dogs during long-lasting exercise, at energy expenditures ranging from the resting state of 0.73 kcal/m2 min to a work load of 4.66 kcal/m2 min, the FFA mobilization, and participation of FFA oxidation in total energy expenditure increases. During prolonged exercise in trained dogs, 50-90% of the energy may derive from plasma FFA, while plasma glucose contributes not more than 10% to the energy expenditure. However, there is an inverse relationship between the amount of glycogen stored inside the muscle, its rate of depletion, and muscular endurance during prolonged strenuous work. Oxidation of FFA spares muscle glycogen and in this way increases work endurance.


The body composition of a college football team. The body composition and anthropometric measurements of 65 college football players were studied. Body composition was determined by underwater weighing with an accurate assessment of residual volume. The anthropometric measurements included height, weight, seven skinfolds, waist circumference and wrist diameter. A step-wise multiple regression analysis of the data indicated that body density and body fat could be predicted from anthropometric measurements. A multiple correlation of .96 was found between body density and three independent variables (waist circumference, triceps skinfold and height). The derived regression equations' standard errors of the estimate were 0.0041 body density units and 1.64 percent fat respectively. The team data were divided into five categories by position. When subjected to analysis of variance, significant differences at the .01 level of confidence suggested that at least two separate groups, backs and linemen, be used in future body composition studies of football teams. The estimated optimal playing weights of each player were determined by densitometry, and each player and the coach estimated that their optimal weights through personal experience. It was found that the players and the coach estimated the players optimal mean weight by 9 and 6 pounds heavier, respectively, than the densitometric analysis indicated as optimal.


Effects of fatigue on stabilometer performance and learning of males and females. The effect of severe physical fatigue on the learning and performance of males and females was compared. The task used in the study was a stabilometer balance task, and fatigue was induced by walking on a treadmill. Thirty male and 30 female subjects were randomly assigned to 2 experimental and 2 control groups. Each subject was pretested, received 20 trials, and was post-tested the following day. The experimental groups were fatigued to a heart rate between 175 and 180 bpm for 5 minutes prior to the first trial and for one minute following every second trial. The control groups were not fatigued. Both time on balance (TOB) and total error (TE) scores were recorded for each trial. The TOB data indicated that fatigue was detrimental to both performance and learning of this dynamic balance task. In addition, the TOB learning data revealed that learning is detrimentally affected by fatigue. Conclusions were that severe fatigue is detrimental to both performance and learning of stabilometer balance and that fatigue has similar effects on balance performance and learning of males and females.


Prediction of segmental parameters using the Hanavan human body model. The Hanavan mathematical model of the human body was updated utilizing Clauser et al.'s multi-step weight distribution regression equations. The influence of these equations upon the predicted segment weights, specific gravities and principal moments of inertia of 30 adult male athletes was compared to that of Barter's regression equations employed in the original model. Both methods resulted in descrepancies between actual body weight and the predicted sum of the segment weights with Barter's equations consistently underestimating total body weight by an average of 2.03% and Clauser et al.'s overestimating it by 4.59%. Proportional distribution of the discrepancies produced corrected segment weights which were used in the Hanavan model. Clauser et al.'s equations predicted heavier trunks and thighs, and lighter heads, upper arms, forearms and hands with these differences being reflected in the specific gravities and principal moments of intertia. While it was not possible to establish the definite superiority of Clauser et al.'s equations in the prediction of body segment parameters, it is suggested from inferential evidence that they be used in subsequent biomechanical investigations of adult male athletes which involve the Hanavan model. It is also recommended that continued efforts be made to refine the Hanavan human body model.


Decline of physiologic training effects during the competitive season in members of the U.S. Nordic ski team. Various physiologic parameters were examined during submaximal and maximal treadmill exercise in nine members of the U.S. Nordic Ski Team prior to and following three months of on-snow ski training. In addition, four of this group were re-tested at the conclusion of the competitive skiing season. Results indicate a perceptible increase in training effect during the fall and early winter before starting on the European race circuit with subsequent decline in this effect as measured in the spring. It is suggested that this latter phenomenon occurs at least in part due to lack of adequate training time during the period of long-distance travel and racing.


Effect of caffeine upon maximal muscular endurance of females. The effect of various dosages of caffeine upon maximal endurance capacity in females was studied. The effect of caffeine upon resting heart rate (RHR), submaximal heart rate (SHR), maximal heart rate (MHR), and ratings of perceived exertion (RPE) was also studied. Prior to undertaking a standarized progressive workload to exhaustion on an electric bicycle ergometer, each subject consumed either a placebo, small (4 mg/kg), medium (7 mg/kg) or large (10 mg/kg) dose of caffeine. A double-blind procedure was followed. Mean times to exhaustion for the placebo, small, medium and large dosages of caffeine were, respectively, 299.5, 312.1, 299.8, and 303.2 seconds. MHR were respectively, 183.4, 185.0, 185.4, and 184.4. Maximal RPE were 16.6, 17.0, 16.3, and 17.1. The analysis of variance revealed no significant differences between the drug trials for the above three variables; in addition, no significant differences were noted for the RHR, SHR, and submaximal RPE. Within the limitations of this study, the following conclusion appears warranted: A small, moderate, or large dose of caffeine exerted no significant effect upon maximal endurance time, RHR, SHR, MHR, or RPE at either submaximal or maximal workloads.


National Operating Committee on Standards for Athletic Equipment football helmet certification program. Wayne State University, Department of Neurosurgery, was contracted in 1971 by NOCSAE to develop voluntary standards for football helmets. Preliminary tests of representative football helmets on cadavers and the Z-90 metal head form showed that a more realistic head model was necessary before it was possible to understand helmet performance. A synthetic model was developed which approached human cadaver performance and at the same time was more rugged and repeatable than a cadaver head. A test method was devised and a human tolerance limit of 1500 Severity Index based on resultant CG head accelerations was adopted as the performance standard. All new football helmets available for use in high school and college football have now been certified by the NOCSAE standard and the wearing of such helmets is mandatory for college players in 1978 and high schools in 1980. By means of design or material changes, certified helmets on the NOCSAE tests are performing at a Severity Index of 1/2 those posted by prestandard models, on the average. Experience with the equipment at a helmet reconditiong plant shows that 25% of precertified helmets being received are rejected and 84% of the remainder are testing on the front location (most critical) above a Severity Index of 1450, and should be replaced as soon as possible with certified helmets.


Serum uric acid, body fatness, and heart rate response to exercise. Serum uric acid was determined in 2298 males and 2237 females, age 10-64. Body fatness (sum of four skinfolds) and heart rate response to a modified Harvard Step Test were also measured in these subjects. Age and sex specific correlation coefficients between SUA and heart rate response to the standard exercise were low (about 0.15 on the average) but more than half were statistically significant. SUA was more closely related to body fatness than to heart rate response to exercise. Removing the effects of body fatness from the SUA - heart rate response correlations decreased these correlations so that only about one per cent of the variation in SUA among people is associated with one's physical fitness as reflected in heart rate response to exercise.


[Determination of the number of cells with multiple nucleoli in histological sections (author's transl)]. A method has been described for correction of a bias, when cells with more than one nucleolus are counted by counting their nucleoli. The true numbers of cells and nucleoli per cell can be estimated by a system of linear equations, with coefficients depending on the thickness of the histological specimen, the average nuclear diameter and the probabilities of nuclear slices, which one gets by cutting a cell nucleus with a certain number of nucleoli. The presuppositions for this method have been discussed with respect to different practical situations. Uncorrected and corrected numbers of motoneurons in the nucl. n. oculomotorii of Tupaia belangeri have been compared.


Structure of enamel surface as demonstrated by absorbed electrons. The current induced by absorbed electrons in electron microprobe analysis was utilized to illustrate the surface structure of dental enamel. The electron images depicted a typical arcade or key-hole pattern on the surface of human incisors, while the surface of rat incisors was characterized by polygonal structures. Differences in electron density of the two specimen materials were observed, probably due to differences in their chemical composition. Absorbed electron images appear to be a valuable supplement to light microscopy, especially in the study of curved surfaces.


[Respiratory activity of Acholeplasma laidlawii cells and its role in the active transport of carbohydrates]. The respiratory activity of the Acholeplasma laidlawii cells was studied in order to elucidate a possible mechanism of coupling of transport with energy. The respiration of the cells is stimulated by ethanol, glucose, NADH, lactate, and pyruvate. The substrates of the Krebs cycle have no effect on the respiration. The respiratory activity, stimulated by ethanol and glucose, is inhibited by the inhibitors of the respiratory chain, SH reagents, and the inhibitors of glycolysis. The results of experiments with inhibitors suggest that the respiratory chain in the A. laidlawii cells is reduced and terminated by flavoprotein. This is confirmed by the results of spectroscopic analysis of cytochromes. Respiration coupled with phosphorylation did not play any important role in the active transport of carbohydrates. Probably, the energy, necessary for the transport of carbohydrates, is supplied by the substrate phosphorylation. This explains the activation of respiration by glucose, which is so sensitive to arsenate. The respiration of the A. laidlawii cells is not stimulated by some carbohydrates (fructose, 3-O-methyl-D-glucose).


[Hydrogenase activity of the methylotroph, Pseudomonas methylica]. The cells of Pseudomonas methylica, strain 2, cultivated in a medium containing methanol, displayed the activity of hydrogenase in the exchange reaction (D2--H2O) and in the absorption of H2 in the presence of methylviologen, azocarmine, methylene blue, and ferricyanide. The rate of H2 utilization was highest in the presence of methylviologen. Cell extracts absorb H2 in the presence of methylviologen, NAD, and NADP, but much faster in the presence of flavin mononucleotide. The bulk of the hydrogenase remains, during centrifugation of the initial cell extract (3,000 g), in the soluble fraction (144,000 g). The absorption of oxygen by the cell suspensions and the incorporation of 14C of formiate into the cells are stimulated by H2. The cells, however, cannot grow in the autotrophic conditions at the account of molecular hydrogen and CO2.


[Effect of ammonium on certain oxidoreductases of wine yeasts]. The effect of ammonium ions on the activity of alcohol:NAD-, L-malate:NAD-, L-glutamate:NADP-oxidoreductases was studied in wine yeast during fermentation of wine wort containing 18% of sugar, and also after the biomass cultivated in the conditions of nitrogen deficiency had been transferred to media with various amounts of nitrogen and carbohydrates. Ammonium stimulated the activity of all these enzymes during fermentation and their activity in the biomass transferred to a medium with a low content of nutrient component; its effect was less pronounced on a complete medium.


[Extracellular polysaccharides in yeasts of the genus Sporobolomyces Kluyver et van Niel]. Nineteen yeast strains belonging to the genus Sporobolomyces were tested for the ability to produce extracellular polysaccharides during submerged cultivation in a defined growth medium. These polysaccharides, accumulated by the yeast Sporobolomyces in the cultural broth, are a heterogeneous group of polymers.


[Fractional makeup of the lipids of some yeast species]. The fractional composition of lipids was studied in 32 yeast strains belonging to the genera of Rhodotorula Harrison, Lipomyces Lodder et Kreger van Rij and Cryptococcus Kutz. The effect of C/N ratio in the growth medium on the content of various lipid fractions was studied. Lipids of the most studied cultures were found to contain di- and triglycerides, waxes, free fatty acids, sterines, their esters, and phospholipids. The fraction of monoglycerides was also detected in Rhodotorula and three species of Cryptococcus, but not in Lipomyces and Cr. laurentii. If C/N ratio equals 10, the predominant lipid component in Lipomyces is triglycerides, and in Rhodoturula and Cryptococcus phospholipids. The fraction of triglycerides prevailed in all cultures at C/N ratio of 100. The content of phospholipids decreased with an increase of C/N ratio in the medium from 10 to 100.


[Synthesis and breakdown of poly-beta-hydroxybutyric acid in Rhizobium lupini]. The effect of various substrates on synthesis and decomposition of poly-beta-hydroxybutyric acid (PHBA) was studied in cell suspensions of the effective strain of Rhizobium lupini and in suspensions of the bacteroids of this strain which were isolated from lupine nodules at different growth stages of the plants. Glucose and beta-hydroxybutyrate were found to be the best substrates for synthesis of PHBA in all variants. The content of PHBA in the presence of these substrates increased in suspensions by 2.0 to 2.5 times during ten hours of incubation. In the presence of succinate, PHBA was actively synthesized only by the bacteroids isolated during the stage of active nitrogen fixation (flowering of the plants). In the absence of exogenous substrates, PHBA was decomposed, especially if ammonium ions were present in suspensions. No synthesis of PHBA was registered in the presence of ammonium and glucose, and the rate of PHBA decomposition was high in this case during the stage of active nitrogen fixation.


[Activity of methane-oxidizing bacteria in the adsorbed state]. Adsorption of pure cultures of methane oxidizing bacteria, Methylosinus trichosporium 20 and Methylococcus ucrainicus 21, on glass and coal was studied; the former strain was sorbed on both sorbents, the latter strain was sorbed on coal but not on glass. The rate of methane oxidation by the cells of adsorbed microorganisms was higher than in the case of free cells, and increased with a decrease in dimensions of the sorbent particles.


[Thermophilic and thermotolerant bacteria that assimilate methane]. Microorganisms assimilating methane at temperatures above 40 degrees C were isolated from various natural sources: ooze, mud, waste water of coal pits. The bacteria are obligate methylotrophs and are represented by two groups: (a) thermotolerant, growing at 37 to 45 degrees C; and (b) thermophilic, growing at 50 to 62 degrees C. The selective factor used to isolate various physiological forms of methylotrophs is corresponding temperatures of growth which allow to isolate from the same substrate meso-, thermotolerant, and thermophilic forms. Morphological and physiological properties of the strains are described. The thermotolerant cultures of methylotrophs are similar to Methylobacter vinelandii, though differ from it by some characteristics. The thermophilic microorganisms should be classed as a separate species Methylococcus thermophilus.


[Change in the content and biosynthesis of RNA in the process of development of a Saccharomyces carlsbergensis culture]. The concentration of RNA in the cells of Saccharamyces carlsbergensis was found to vary from 3.51 to 7.54% with aging. A high content of RNA, a high rate of the incorporation of 14C-uridine into RNA and the acid-soluble fraction are typical of the cells in the logarithmic phase of growth. The total RNA can be separated into three zones on Sephadex G-100. No changes in the chromatographic profile were detected with aging.


[Macromolecular subunits on the surfaces of the cell wall of Thiocapsa roseopersicina]. A layer of fungiform macromolecular subunits was found on the surface of the cell wall of Thiocapsa roseopersicina, a purple sulphur bacterium, strain BBS. The cap of a particle has a diameter of 40 to 60 A; the stalk is 80 to 100 A long and 20 to 30 A thick. Under the conditions of nitrogen fixation and a low content of vitamin B12 (0.1 mcg/litre) in the cultural broth, a second layer of similar particles is formed over the first layer.


[Ultrastructure of the mycelium and spores of Actinomadura fastidiosa sp. nov]. A new species of the Actinomadura genus, A. fastidiosa sp. nov., is described. The ultrastructure of the vegetative mycelium and spores of this organism was studied. The vegetative cells have a multilayered cell wall, often consisting of five layers with different thickness and electron density. The spores are similar to the vegetative cells by their inner structure but have a thicker wall.


[Primary distribution of n-alkane through the structures of yeast cells]. When n-alkane enters the cells as a result of molecular sorption and diffusion, it is distributed within all membrane structures of the cell (microsomes, mitochondria, membranes, vacuoles, cytoplasmic membranes, and cell walls). Sorption of n-alkane by all these structures in vivo comes at equilibrium after incubation of the cells with n-alkane during 3-4 min. Accumulation of the hydrocarbon in the morphological fractions of the cell depends on its concentration in the incubation medium. Isotherms of the sorption are convex curves. Sorption power, maximum sorption capacity, affinity and strength of the bonds with the hydrocarbon differ among the membrane structures of the cell. The maximum capacity of sorption of n-alkane by the structures does not correlate with the content of lipids and phospholipids in the structures. Sorption of n-alkanes is presumed to depend on the structural organization of lipids in the morphological fractions.


[Fungal origin of PBV-group viruses isolated from Penicillium brevi-compactum]. Treatment of extracts from the disintegrated mycelium of Penicillium brevi-compactum with antisera against viruses PBV-1 and PBV-3 grown on bacteria results in a considerable decrease in the infectiveness of micellar preparations toward E. coli C. This is a specific reaction since treatment with a heterologic antiserum against phage T2 has no effect on the infectiveness of the micellar extracts. The kinetics of reassociation of DNA from PBV-3 and DNA from Penicillium brevi-compactum has shown that the value of Cot at half-reassociation of these DNAs is 13.3 times higher than the value of Cot at half-reassociation of DNA from PBV-3 and heterologic DNA from chicken embryos. As was found by calculations, DNA isolated from the fungal mycelium contains virus sequences at an amount of 3.7 virus genomes per cell. These data confirm the micellar origin of the viruses PBV-1 and PBV-3. The virus PBV-3 is supposed to be present in the cells in the form of prophage.


[Correlation of the DNA nucleotide makeup with the physiological and cytological characteristics of spore-forming anaerobic bacteria]. The nucleotide composition of DNA from 12 studied species of anaerobic bacteria belongs to AT type, with G+C varying from 28.4 to 36.8 mole%. In the anaerobic group of Clostridium bifermentans, a correlation has been established between the nucleotide composition of DNA, the type of appendages on spores, and some physiologo-biochemical characteristics. The nucleotide composition of DNA in the spores of four anaerobic species is shifted toward GC type as compared to DNA in the vegetative cells. Data on the content of GC pairs in DNA of the spores may sometimes be of a higher taxonomic value than the corresponding evidence on DNA of the vegetative cells.


[Effect of ultraviolet rays on the activity of clover nodule bacteria]. The effect of UV on the survival, morphological variability, and effectiveness was studied with nodule bacteria of clover, strain 374a. The survival of the strain directly depended on the dose of UV rays, being 43.3% at 130 erg/mm2 and 0.000022% at 22,900 erg/mm2. UV irradiation yielded two morphological types of colonies; they differed by the production of slime which was less at higher doses of UV (15,970 to 22,900 erg/mm2). Variants with either positive or negative effectiveness were obtained by the action of UV. The positive variants increased the crop of clover by 21-60%, as compared with the parent strain 347a, while the negative variants decreased it by 18.3-35%.


[Role of phenol-decomposing microorganisms in the process of phenol destruction in the Black Sea]. The number and species of phenol decomposing microorganisms, as well as the activity of their biochemical oxidation of phenol, were studied in waters of the shelf zone of the Black Sea, from the Danube estuary to Batumi. The number of these microorganisms and their phenol decomposing activity were higher in waters near harbours than in regions outside the anthropogenic activity. These parameters were highest in contaminated waters of the river origin. Most of these phenol decomposing microorganisms belong to the genera Pseudomonas and Bacterium, with the predominance of the species of Bacterium album and Pseudomonas desmolyticum (subspecis Pseudomonas rathionis).


[Manganese-oxidizing microorganisms inhabiting the phylloplane]. Manganese oxidizing microorganisms belonging to the genus Metallogenium were found in the phylloplane of various trees and grass plants. This is the first evidence that epiphytes participate in the transformation of mineral elements, and that microorganisms belonging to the genus Metallogenium can be found not only in fresh water and soil.


[Enzymatic determination of the autotrophic fixation of carbon dioxide in aerobic and anaerobic ecosystems]. An enzymatic method is suggested for determining the role of chemoautotrophs in bacterial populations of a high density. The method involves an assay of the activity of ribulose-1,5-diphosphate carboxylase, the key enzyme in autotrophic assimilation of carbon dioxide. The chemoautotrophic activity of microorganisms is rather high in ecosystems based on decomposition of organic matter in both aerobic and anaerobic conditions.


[Increased flavinogenesis in 1 of the strains of Candida tropicalis]. Candida tropicalis IBFM 303 is capable of the active production and liberation of flavins during the oxidation of solid paraffins with the carbon chain consisting of 20 carbon atoms and more. Unlike other known strains, this strain does not accumulate considerable amounts of the vitamin neither on media containing liquid n-paraffins not on media with glucose, even under the conditions of iron deficiency.


Are antibiotics necessary in acute cholecystitis? The value of antibiotics in 302 cases of acute cholecystitis was examined. Antibiotics are valueless in decreasing the incidence of local septic complications, such as empyema or pericholecystic abscess formation. Antibiotics are valuable in decreasing the number of wound infections and the incidence of septicaemia in patients who are at risk. Patients at risk are aged over 60 years or have a debilitating disease which lowers host resistance to infection or already have a septic complications, such as a pericholecystic abscess. Patients who are aged under 60 years and who have uncomplicated acute cholecystitis do not require antibiotics.


A volunteer crisis service. Pattern of utilization and referral. One characteristic of contemporary Australian society is the increase in the number of self-help and volunteer groups operating at the social-medical interface. An analysis of the utilization and referral pattern of a volunteer crisis team shows that for a large number of people, it becomes the point of access to other helping agencies, 9% of which are medical and 7% legal.


Ototoxicity of chloramphenicol ear drops with propylene glycol as solvent. The ototoxicity of chloramphenicol ear drops was studied  in guinea-pigs. The ear drops consisted of chloramphenicol sodium succinate in propylene glycol; hence the ototoxicity of each chemical was also studied. The diluted chemicals were instilled in the middle ear cavity; thus clinical conditions were simulated, and the cochlear microphonic responses from the electrode on the round window of the cochlea were monitored as an indication of the hair cell function. Our experiment revealed that propylene glycol at the concentration of 10% or more caused irreversible deafness. Chloramphenicol sodium succinate in a concentration of 5% or more in Ringer's solution also caused irreversible deafness. It is recommended that propylene glycol should not be used in the ear drops as a solvent of the drug. Chloramphenicol at higher concentrations is not recommended for use in the middle ear cavity.


Acute renal failure with myoglobinuria after tiger snake bite. This report concerns a cause of snake bite by a tiger snake (Notechis scutatus) in which the predominant pathological feature was acute massive rhabdomyolysis with myoglobinuria, hypocalcaemia and acute renal failure.


Fulminant tropical splenomegaly syndrome. Eight patients with the tropical splenomegaly syndrome who presented with an acute febrile illness and severe anaemia due to haemolysis are described. None was pregnant. All were treated with anti-malarial drugs, four received steroids, and another two steroids and other cytotoxic drugs. Two patients died from causes which were, in part, attributed to this complication of the tropical splenomegaly syndrome. This mode of presentation is seldom documented in this condition. The management and differential diagnosis are discussed.


Towards demythologizing epilepsy. An appraisal of public attitudes. A questionnaire was administered to a representative sample of Sydney adults to assess the public's general impression of epileptics as people and their performance and reliability in a variety of social situations. It would appear that a number of attitudes are prevalent which may impede the social rehabilitation of these patients.


Australian pacemakers: a follow-up survey. The Royal Prince Alfred Hospital experience with Australian-made pacemakers shows that the Telectronics P7 fixed-rate pacemaker has a 90% survival rate at two years. Such a figure compares favourably with those of its predecessor and other makes of pacemaker. Survival of the P6 ventricular synchronized units is slightly less than that of the P7.


Serum doxycycline levels after intravenous administration in haemodialysis patients. Serum doxycycline levels were measured after intravenous administration of doxycycline to three patients receiving regular haemodialysis therapy. Drug levels were predictable, fell within the therapeutic range, and remained so throughout dialysis. Doxycycline did not accumulate and may be used safely in these patients. A dosage regimen is recommended for maintenance dialysis patients.


Activated ppsb in the treatment of a patient with haemophilia and antibodies to factor VIII. A patient with haemophilia and antibodies to factor VIII was treated with activated prothrombin concentrate (PPSB). Clinical manifestations of haemophilia subsided after treatment with PPSB, and the prolonged partial thromboplastin time shortened temporarily. There were no untoward side effects of the treatment.


Control of haemorrhage from hepatic vein and vena cava after blunt trauma. A case of uncontrollable haemorrhage after blunt liver trauma is described in which a technique was used to expose rapidly and ligate the right hepatic vein, and suture the vena cava at the expense of the right lobe of the liver. It is believed that this method may be appropriate and life saving when techniques of vascular isolation of the liver appear too cumbersome in the emergency situation.


The isolation and identification of haemoglobin Lephore Boston (Washington) in an Australian family. Haemoglobin Lepore is a haemoglobin variant associated with a thalassaemia-like disorder. It has been only rarely detected in Anglo-Saxons and its occurrrence in an Australian family of British and stock is reported for the first time. The appearances of the blood film resemble those seen in various hypochromic anaemias, inclusing thalassaemia traits, and on this account it is of clinical importance to recognize it in order to avoid unnecessary investigation and treatment. The chemical structure of nine examples of haemoglobin Lepore has been confirmed by peptide mapping and amino acid analysis, and the genetic mechanisms postulated for the production of haemoglobin Lepore are discussed.


Limitations of the Nash Logoscope or diagnostic slide rule. The diagnostic efficacy of a commercially available diagnostic slide-rule (the Logoscope) was evaluated on 50 cases detailed in the leterature. In only 13 cases (26%) was the Logoscope of any practical assistance in diagnosis and even then it did not always indicate the entire final clinical diagnosis. Some major deficiencies of the Logoscope system are outlined.