A mathematical model of microbial growth including an intermediate. I. Growth in batch cultures.

A mathematical model of microbial growth is presented and examined which, in contrast to the well-known MONOD model, includes transitions from one cell "bottle-neck" to another. This is achieved by introducing an intermediate product in the model. Three variants of the model for different regulatory functions of the intermediate are considered. The results permit to describe a set of experimentally observable microbial growth curves. According to the model, the shape of the growth curves, the kinetics of substrate consumption and changes of intermediate concentration depend on culture prehistory and the nature of the intermediate regulatory function.


Transient bacteremia due to suction abortion: implications for SBE antibiotic prophylaxis.

The incidence and character of the bacteremia associated with elective suction abortion was investigated in volunteer subjects aged 19 to 35 years who were to undergo first trimester abortion by suction curettage. One hundred and forty-four blood cultures were obtained from thirteen pregnant and four non-pregnant (control) subjects matched for age. Transient bacteremia occurred during or soon after suction abortion in 11 of 13 (84.7%) study subjects. Four of these patients were bacteremic after bimanual pelvic examination, just prior to initiation of the abortion procedure. Seven others developed bacteremia temporally related to cervical dilatation and suction abortion. The bacteremia was intermittent in some, persistent in others, existed as long as one hour after the procedure, and was transient in all patients. Microorganisms isolated from the blood were all normal genital tract flora and were predominantly anaerobes, although alpha hemolytic streptococci were also recovered. Mixed bacteremia occurred in six patients. In contrast, blood cultures from four non-pregnant women were sterile. This study indicates that the systemic circulation-uterine cavity barrier is significantly disrupted during abortion by suction curettage permitting endogenous genital tract microorganisms to gain access into the bloodstream. These observations also suggest that there may be some risk of developing endocarditis during suction abortion in patients with cardiac deformities, and lend some support to the current practice of giving antibiotic prophylaxis to abortion patients with cardiac lesions which predispose them to endocarditis.


[Physiology and biochemistry of streptomycetes. XIII. Biosynthesis of paromomycin by Streptomyces albus var. metamycinus nov. var. supplied with 14C-glucose, 14C-glucosamine, 14C-2-desoxystreptamine and 14C-ribose].

Distribution of radioactivity in paromomycin ascertained after application of 14C-D-glucose, 14C-D-glucosamine, 14C-2-deoxystreptamine, respectively, 14C-D-ribose is taken as basis for a biosynthesis scheme: While ribose bound in the antibiotic originates from glucose by oxidation and following decarboxylation, glucosamine is formed via fructose-6-phosphate. Paromose I arises from glucosamine, but not the cyclohexan derivative 2-deoxystreptamine, whose biosynthesis pathway is directly branching off glucose.


Interplay of factors leading to adverse drug reactions in the liver, a personal viewpoint.

Adverse drug reactions in liver involve formation of a reactive metabolic intermediary of the drug, binding of the intermediary to macromolecules in the cell, notably proteins in the plasma membrane, immunological response to these altered proteins and attack against hepatocytes bearing these altered proteins by immune mechanisms. At each step in this complex process many factors act to enhance or depress drug metabolism, metabolite disposition, macromolecular binding, neoantigen formation, and the cell mediated and humoral immune attack. The extent and direction of each step may be dose dependent but the complexity of the overall mechanism is so immense that predictability of hepatic drug reactions is unlikely in most instances.


The hepatic vasculature and its response to hepatic injury: a working hypothesis.

The hepatic circulation is unique in that high volumes of low pressure blood flow are supplied through a dual venous and arterial circulation. This vascular supply is modulated both by the gastrointestinal vascular bed and an intrahepatic microcirculation. This complex vascular system is influenced by pathologic processes within the liver. Alterations in the hepatic circulation reflect hepatic metabolic adaptation and injury. It seems reasonable to assume that in some circumstances hepatic circulatory alterations are inappropriate, exaggerated or inadequate and contribute to the initiation or perpetuation of hepatic injury. This paper attempts to focus on evidence derived from studies of the normal and abnormal hepatic circulation that provide insights into hepatic circulatory responses and their role in the initiation and perpetuation of hepatic injury. A possible relationship of these vascular changes to pathologic processes within the liver is proposed. Ultimately, precise measurement and understanding of hepatic vasculature changes may allow appropriate intervention to offset injury or stimulate maximum effective repair.


Curriculum change needed at Yale.

The United States Congress has recently passed an important bill entitled, The Health Professionals Assistance Act of 1976. It seeks to right physician maldistribution in the country and curtail the over specialization of medical practitioners. Quotas have been set in terms of the number of medical school graduates who must enter primary care training programs over the next few years. Failure to comply risks loss of the federal capitation grant of twenty-one hundred dollars per student or about one million dollars a year in Yale's case.The causes of physician maldistribution are discussed. Partial blame is ascribed to the medical schools themselves and recommendations are made for curriculum changes which if adopted may achieve better physician distribution without further government inroads into medical school affairs.


[Occurrence and behavior of fibrin fibrinogen degradation products in concentrates of factor VIII, cryoprecipitate and dextran precipitate during long-term preservation].

In deep-frozen and lyophilized cryoprecipitates and dextran precipitates it was analyzed by the TRCHII and the SCT, whether these factor VIII concentrates contain fibrinogen fission products effecting as inhibitors of the coagulation of blood and how they act during storage for 200 days. Simultaneously the parameters total protein, fibrinogen, fibrin monomers, plasminogen and factor VIII activity were always determined. In all preparations being tested fibrinogen fission products could be detected. Lyophilized cryoprecipitates showed the highest average values with 7.97 microgram/ml (TRCHII) resp. 18.31 microgram/ml (SCT). They were followed by deep-frozen cryoprecipitates with 6.93 microgram/ml (TRCHII) resp. 7.54 microgram/ml (SCT). Deep-frozen dextran precipitates free of heparin contained the fewest fission products (TRCHII: 0.36 microgram/ml; SCT: 3.13 microgram/ml). At the beginning of the storage only few fission products were found in all groups of preparates. A predominantly clear rise with forming a peak after about 115 to 145 days and a drop following happened with extended storage period. This course of storage of the quantities of fission products shows that the fibrinogen fission products arise during storage.


[Diagnostic and differential diagnostic value of cytological findings in toxoplasmic lymphadenitis].

The cytologic investigation of needle biopsy material from lymphomas of unclear genesis may give valuable diagnostic references in patients with lymphadenitis toxoplasmotica. Findings of 19 patients are explained. Suspicious for a toxoplasmogenic genesis are colouredness of the cell picture with large basophilic roundnuclear cells, conspicious macrophagocytosis in reticulum cells and small-focal proliferation of the epitheloid cell. In own material these 3 criteria only 5 times appeared together. Two simultaneously existing, suspicious for Piringer's lymphadenitis findings, were shown in 11 patients. Most frequently was found the coloured picture of the round-nuclear cells (16/19). A conspicuous RHS-phagocytosis was to be observed in 12 smears. In careful clinical and serological controls only in 4 out of 19 patients a histological investigation was necessary. In the cytological findings also other lymphomatous processes must differential-diagnostically be taken into consideration.


[Mycological studies of patients with hemoblastoses].

40 patients with haemoblastosis were examined clinically and by cultures for presence of yeast mycosis. Moreover, we analyzed specific antibodies with the help of cell agglutination, the passive haemagglutination and the precipitation using Candida antigen. 29 test persons were found having a yeast mycosis, 3 patients without clinical symptoms in pharynx showed presence of yeasts by culture, 8 test persons were clinically and mycologically negative. In cell agglutination we recorded titres of less than 1:20 to 1:5 160 and in haemagglutination titres of less than 1:20 to 1:5 160 and in haemagglutination such of less than 1:20 to 1:320. 5 patients showed positive precipitation reaction with antigen extracted of membranes of Candida albicans cells. We observed different titre motions with these patients: during illness the titre either rised or decreased clearly, or the patients were in a condition of humoral anergy against the Candida albicans antigen. It is hinted at the necessity to watch over susceptible patients mycologically.


[Dependence of lactate and heart rate in ergometer-, running- and swimming stress and its use for the preparation of individual conditioning programs for patients with myocardial infarct in rehabilitation phase III].

The dependence of the heart rate of 25 patients between 6th and 12th month after myocardial infarction on the lactate deflection during bicycle ergometry was compared with values being measured in physical conditioning in gymnasium and in indoor swimming-bath. There were found congruent statements in all three types of stress. The immediate comparison of patients undergoing rehabilitation who realized a gymnasium and swimming program simultaneously, showed no differences in lactate deflection and heart rate, too. So heart rates of equal level signal the production of equal metabolic training irritations in the three types of stress being tested. Moreover it was to be ascertained that the optimum intensity of the physical conditioning of patients with myocardial infarction is reached with a lactate deflection of 2,5 to 4,0 muMol/1, appropriate to a heart rate of 104 to 120 beats every minute resp. an efficiency of 70% of the submaximum aerobic capacity.


[Use of RR-interval distribution within the scope of ambulatory functional diagnosis in the angina pectoris syndrome].

The distribution of the interval of the heart beat of 93 test persons of the 4 groups normal group, group with labile essential hypertension, group with apparantly vegetatively conditioned heart pain and group with angina pectoris syndrome in coronary sclerosis may be described with the help of log normal distributions. In the vegetative group a dependence of the distribution parameters was proved. The results of a linear discriminance analysis for the vegetative group and the group with coronary sclerosis as well as the unequivocal age dependence of sigma at first do not allow a differentiation significant for practice according to the results got up to now. The different age structure might be regarded as cause in the two groups, so that further investigations are necessary.


[High-dosage glucocorticoid therapy in acute heart infarct and in cardiogenic shock].

40 patients with cardiogenic shock in consequence of contractility insufficiency of the heart were treated with high doses of prednisolon for short time. In 10 cases a good result of the treatment was to be seen so that the lethality quota was smaller than that of a reference group of the same age. The pharmacodynamic effect is seen in an improvement of the micro-circulation by a peripheric vasodilatation. 10 patients with acute myocardial infarction got a therapy with glucocorticoid combined with a treatment with anti-coagulants during the first both weeks. In this connection modern experimental examinations of animals are discussed which showed that glucocorticoides improve the anoxy tolerance of the heart muscle cell.


[Disorders of carbohydrate metabolism in severe fibrou-inflammatory pancreatic changes].

22 patients with bioptically found severe fibrou inflammatory changes of the pancreas underwent an after examination in order to exclude endocrine disturbances of the pancreas. The biopsy of the pancreas was carried out during an operation of the bile-duct. A restriction of the glucose tolerance was to be proved the more frequently the more distinct were the histological changes of the pancreas and the older were the patients. Post-operative increases of the fasting blood sugar appeared above all transitorily and rarely led to a manifestation of diabetes. It is recommended to exclude an endocrine functional disturbance of the pancreas not only when a typical symptomatology of pancreatitis is present, but also when there are possibly clinically not expected bioptical findings of a severe fibrous inflammatory change of the pancreas.


[Electromyographic findings in disorders of calcium and potassium metabolism].

The electromyographic findings in disturbances of the calcium and potassium metabolism are discussed. Particularly in the tetanic syndrome the authors deal with the difficulty of the interpretation of the findings. Finally a casuistic report on relapsing paralyses of the muscles in hypopotassiaemia is given.


[Fiber-optic endoscopy demonstration, incidence and clinical significance of intestinal lymphangiectasis].

The intestinal lymphangiectasia can be proved enteroscopically, laparoscopically as well as histologically after preceding aimed or unaimed biopsy. In 2,250 fibre-endoscopic examinations of the upper gastrointestinal tract we found 54 times endoscopically and 48 times also histologically a lymphangiectasia. Of these 54 patients 9 had an advanced carcinoma of the stomach. The evoking causes of the lymphangiectasia are discussed. When an intestinal lymphagniectasia is diagnosed it should always be sought for an evoking cause and last not least should be thought of a primary or secondary neoformation in the region of the epigastrium.


[Leiomyoblastoma of the stomach].

The leiomyoblastoma of the gastrointestinal tract is a tumour which arises from the smooth musculature. With regard to its malignancy it is between leiomyoma on the one hand and leiomyosarcoma on the other. In 12% of the patients the leiomyoblastoma shows a malignant course. Males somewhat more frequently fall ill with leiomyoblastoma than females (ratio 1.3:1). The average age of the patients is 56.6 years. The most impressive clinical symptom is the gastrointestinal haemorrhage. In an own case problems of therapy are discussed. The mere enucleation of the tumour is not enough for cure. The resection of the stomach, at least of the involved part of the stomach, seems to be necessary.


[The Saint syndrome].

At the instance of a 78-year-old female patient the possible causes of the simultaneous appearance of gallstones, hiatal hernia and diverticulum of the colon are discussed. The syndrome might be the sequel of a weakness of the connective tissue. But it would be also thinkable that it is an accidental combination of diseases, the number of which increases at growing age.


[The technic of microvascular anastomoses: the rat as a model].

During the last few years microvascular surgery has assumed an increasingly important role in the modern plastic surgery. For persons still learning without much experience a step by step training program for learning end-to-end anastomosis in very small vessels is recommended. The technique of microvascular suture is described using the Arteria and Vena femoralis of the rat.


[Behavior of various serum enzymes following ligation of the superior mesenteric artery in the rat (preliminary report)].

In rats, shortly after ligation of superior mesenteric artery serum enzyme activities are found significantly altered. Those changes concern aspartate aminotransferase (GOT), alanine aminotransferase (GPT), lipase, alpha amylase, and isocitrate dehydrogenase as well as glutamate dehydrogenase. The causes are discussed. The authors emphasize that the assessment of serum enzymes possibly gives some help in diagnosing acute intestinal ischemias in early stages.


Investigations on tensile strength of intestinal anastomosis in pharmacologically induced blood clotting disturbances.

The authors present the results of investigations on tensile strength of intestinal anastomosis in pharmacologically induced blood clotting disturbances in the postoperative period (1-16 days). Experiments were carried out on 50 male rabbits in two groups- a treated group and another for control only. Animals in the experimental group were treated with Sincumar 24 hours before and in the postoperative period. The dosis of Sincumar was calculated to reduce the prothrombin index below 40 percent. The tensile strength of intestinal anastomosis was tested the 2nd, 3rd, 5th and 15th day after operation and in the same time histological examinations of anastomosis specimen were performed. In conclusion the authors found that the reduction of the prothrombin index below 40 percent does not influence the process of healing of anastomosis of the small intestine, prevents the formation of adhesions and inflammatory peritoneal reaction following operation.


[Therapy of acute experimental pancreatitis with the antifibrinolytic drug PAMBA (author's transl)].

In acute experimental pancreatitis in the rat neither intravenous nor intramuscular therapy with the antifibrinolytic drug PAMBA (p-aminomethylbenzoic-acid) had any influence on the lethality, enzyme content in either serum, ascites and pancreas or on the amount of destruction of the organ.


A controlled trial of glucagon in acute experimental pancreatitis in rats.

Acute pancreatitis was induced in 245 rats by retrograde instillation of Na-taurocholate into the pancreatic duct. Mortality rate in animals treated 6-hourly with glucagon (1 mg/kg) after induction of pancreatitis was 50% as compared to 30% deaths in the controls treated with 0,9% NaCl (chi2-test: p less than 0,05). Mortality rate in animals treated 6-hourly with the same dose of glucagon before induction of pancreatitis was 36,5% as compared to 28% deaths in the corresponding controls (chi2-test: p greater than 0,05). Glucagon in lower doses (0,1-0,5 mg/kg every 6 hours) did not alter mortality rates as compared to animals treated with 0,9% NaCl. 2. A nonletal form of pancreatitis was induced in 26 rats by ligation of the pancreatic duct. Injection of glucagon (1 mg/kg) seemed to suppress amylase activities in blood for a short period of appr. 1 hour. However, 7 and 9 hours after induction of pancreatitis, amylase activities were significantly higher in animals treated one or two times with glucagon as compared to untreated controls. It is concluded that glucagon in the high dose of 1-4 mg/kg/24 hours does not only not influence the course of acute experimental pancreatitis in rats but can even deteriorate it.


[Problems with therapy of familial intestinal polyposis (author's transl)].

This study describes a family with gastrointestinal adenomatous polyposis. One member had symptoms of Peutz-Jeghers disease with histologically typical polyps besides those of the adenomatous type. In cases of clinical gastrointestinal polyposis the exact histologic diagnosis of an endoscopic sample is mandatory. The benign e.g. non adenomatous, finding compels one to auxiously care for those patients and to prophylactically examine all members of the patients family, while adenomatosis implies prophylactic surgery. The indications are discussed.


[Pancreatic pseudocyst of head: compressing of vena cava inferior with lethal embolism of pulmonary artery (author's transl)].

As rare complication of post-pancreatitic pseudocyst in a 43-year-old patient, an obstruction of large vessels, situated retroperitoneally, is described. The partial thrombosis lead to a recurrent embolism of pulmonary artery with terminal right cardiac failure.


[External version from breech to vertex presentation (author's transl)].

An analysis of 51 attempts at version was made of which 27 were successful (53%). In 3 cases an emergency cesarean section had to be performed following the attempt at version. In 2 of these cases there was partial premature detachment of the placenta. Attempts at version were begun in the 36th week of pregnancy. Up to the 38th week there was a 67% success rate, while from the 39th week onward it was only 41%. In cases of parity it can be shown clearly that the success rate increases with parity. When the pregnancy is the mother's first, 58% of attempts fail, while in fourth pregnancies this figure is only 25%. Attempts at version are most successful when the placenta is attached to the posterior uterine wall. The size and weight of the fetus do not affect success. The average weight of the placenta in the success group is significantly higher (by about 60 g) than in the failure group. There were no significant differences between the two groups as regards the dimensions of the mother's pelvis. In about 30% of cases there was a fetomaternal transfusion. The frequency of erythrocyte transfer is dependent on the force of manipulation used in the attempt at version and on the position of the placenta. The frequency of section is significantly lower (14%) in the success group than in the failure group (43%). Diagnoses of the newborn's condition (pH value and Apgar score) did not reveal any decisive differences between the two groups. In view of the high rate of complications and failures external version from breech to vertex presentation cannot be recommended.


[Results with a new method for objectivation of rheobase measurements in normal pregnancy and risk of miscarriage or premature birth (author's transl)].

The rheobase (fundamental current strength), which can be used in obstetrics as a parameter of neuromuscular excitability, alters at the onset of labor, as Jung et al. first reported in 1969. It can be determined objectively to a considerable degree using the single-channel myograph manufactured by the Thönnies company, and an improved measuring method. Results of preliminary investigations can be confirmed which indicate that the rheobase in patients with premature labor and bleeding is lower than in women whose pregnancy is normal. Thus, where there is a risk of miscarriage or premature birth, neuromuscular excitability is increased. The fact that rheobase values in some patients who had undergone cerclage for cervical insufficiency are depressed indicates that the insufficiency is partly due to premature labor. It remains open to question whether etiology of the depressed rheobase is an indicator of increased neuromuscular excitability where there is a risk of miscarriage or premature birth.


[The possibility of heart-muscle damage through fenoterol (elektrocardiographic and blood-chemistry studies with particular reference to the heart-muscle-specific isoenzym creatinkinase MB.) (author's transl)].

Fifty patients with premature uterine contractions were treated with the uterine relaxant Fenoterol in combination with the calcium antagonist Verapamil. In order to exclude the possibility of myocardial damage, the heart-muscle-specific isoenzym Creatinkinase MB was routinely evaluated, in addition to ECG-checks. In none of the cases could a significant enzyme activity be shown, even in long-term therapy with high doses of Fenoterol.


[Uteroplacental blood flow in normal pregnancy before and after short-term treatment with (isoxsuprine) beta-sympathicomimetica (author's transl)].

The uteroplacental blood flow was measured in 26 normal pregnant women between the 36-43 weeks of pregnancy before and after a short-term treatment of isoxsuprine. The patients had no complications of pregnancy and no uterine contractions during this time. We used our intravenous Xe-133 method for measuring the intervillous and myometrial perfusion (20). During the blood flow measurements we also measured maternal arterial blood pressure and heart rate. To evaluate the short-term treatment effect of isoxsurpine we applied an intravenous injection or infusion. The placental flow was (124 +/- 32) before and (117 +/- 39) ml/min/100 ml after isoxsuprine application. The corresponding values for myometrial flow were (7,8 +/- 3,5) and (6,2 +/- 3,0) ml/min/100 g. The pathological changes of the uterplacental blood flow with vena caval syndrom will referred in text. There was a statistically significant increase in maternal heart rate and a decrease in blood pressure.


[Clinical investigations relating to a causal connection between abruptio placentae and subsequent birth of an underweight child (author's transl)].

The question was studied as to whether there is a causal connection between abruptio and birth of an underweight child in the subsequent pregnancy. While the phenomena involved are still largely unexplained, though clearly manifold, which can lead to the birth of "low birth weight children", it is shown that abruptio cannot be regarded as a prime risk factor. A comparison with the international literature shows that the specific features of the patient group investigated must always be taken into account when answering this question.


[Serum folic acid, vitamin b12 and iron values during pregnancy (author's transl)].

Of 125 pregnant women, of whom 81 were treated and 44 not treated, 14 (12,5%) were found to be suffering from anemia, with a hemoglobin count to be diminished. In 31 cases iron deficiency was established and in 8 women vitamin B12 in serum was reduced. Iron and vitamin deficiencies were found more frequently in the non-treated group than in the treated group.


[Photometric micro-determination of bilirubin in capillary plasma of newborns (author's transl)].

The determination of bilirubin in capillary plasma of 52 newborns was carried out with the diazo method according to Jendrassik and Grof and with two bilirubin spectrophotometers (BB-meter model 468 and Bilimeter). The results obtained by these instruments are correlated with those obtained by the diazo method. As far as the influence of hemolysis on the direct photometric analysis with the Bilimeter is concerned, up to 300 mg hemoglobin/100 ml can be compensated in the range of 20 mg bilirubin/100 ml, and up to 600 mg hemoglobin in the range of 15 mg bilirubin/100 ml. Increasing hemoglobin concentrations cause an elevation of the bilirubin data. However, in the range of 10 mg bilirubin/100 ml, hemoglobin concentrations greater than 300 mg/100 ml cause a decrease of the bilirubin data. The precision in the series is less than 3%. A linear relationship was found in the range of 2.5-20 mg bilirubin/100 ml.


Transport of the newborn.

Analysis of facilities used in the transfer of neonates with respiratory distress syndrome (RDS) to the Newborn Intensive Care Unit (N.I.C.U.) of the Free University Amsterdam during the period 1969-1976 revealed many deficiencies. Most of the sick newborn infants were accompanied by inadequately trained personnel. In a number of cases they were in incubators which could hardly guarantee the neutral thermal temperature for the infant concerned. In the most cases there were no facilities either for resuscitation or for ventilatory assistance during transport. It was found that infants born in the referring hospitals more often required artificial ventilation than infants born in the University Hospital. Since the former were--on an average--more severely ill than the latter, the duration of ventilatory assistance was usually longer and their survival rate was lower. Retrospectively, in many instances referred infants were on admission already in such a condition that artificial ventilation should have been started long before. General aspects of newborn transport, viz. way of transport, incubator with facilities for emergency care i.e. artificial ventilation and intravascular therapy, accompanying personnel, stabilization of the infant, role of education and evaluation of the transport are discussed.


[Syndrome of the ingrown nails?].

Among the 20 patients with ingrowing toenails operated on in the Department of Dermatoloy in Cologne in 1976, we noticed a combination of the following signs: ingrowing big toenail, latent diabetes, tall stature, pseudo-acromegaly, hyperhidrosis and a preponderance of the male sex and of the age group 12-16 years. Our findings indicate that all patients with ingrowing toenails should be examined for latent diabetes, and that ingrowing toenails are mainly to be found in young male patients with a particular type of constitution.


[Bee-venom allergy].

The allergy to bee venom is dangerous and life threatening. Skin tests and immunotherapy should be done with bee venom extracts. The RAST proves to be helpful if blood taking is done within a short period after stinging. In the meantime immunotherapy should be given lifelong and total and specific IgE antibodies controlled. In addition we believe that the determination of IgG-blocking antibodies is important.


[Histopathology of erythema nodosum].

The histopathology of erythema nodosum is discussed with reference to the literature and of 19 cases of our clinic. There is a significant vascular involvement especially of the subcutaneous tissue. The veins and arteries are equally affected. The histological picture consists not only of an acute inflammatory process in the subcutaneous tissue, but also of inflammatory cells which area see to a lesser extent in the dermis. In many cases the typical small granulomatous foci of MIESCHER which are considered to be pathognomonic for erythema nodosum do not develop. In the cases which we examined we were not always able to tell from the histological picture how long the erythema nodosum had been present. Multinucleated giant cells which are often found in the septal connective tissue are seen even in relatively acute cases.


Differentiation between various effects of cytotoxic fractions of lymphocyte culture medium.

This paper describes the partial characterization of supernatants derived from mitogen stimulated lymphocytes by ammonium sulfate precipitation, ultrafiltration on Hollow-Fiber beakers and gelchromatography. Fractions from these purification procedures were tested on FL-target cells and the following target cell alterations were measured: RNA- and protein synthesis, 3H-TdR incorporation, cell number and lysis of target cells. Target cell alterations of control fractions from supernatants of non-stimulated lymphocytes, from culture medium and from FCS were compared to the effects of fractions from activated lymphocytes. 3H-TdR incorporation was not only inhibited by the fractions of activated lymphocyte cultures but also by fractions of various controls. Inhibition of 3H-TdR incorporation disappeared when control fractions were serially diluted. Only fractions of supernatant from activated lymphocytes could lyse target cells. It were the same fractions which still inhibited 3H-TdR incorporation of target cells after serial dilution and which showed stimulating effects on RNA synthesis. MW of fractions which were differentiated from control fractions with respect to target cell lysis were: 90,000, 45,000 and lower than 20,000 d.


Studies on the chemical composition and biological properties of transfer factor.

Dialyzable transfer factor (dTF) was fractionated on Sephadex G-10 and G-25 fine columns, and biological activity was found in 3 fractions. One of these, designated VIa, and having a tendency to adsorb to the Sephadex G-10 gel, was shown to have a therapeutic effect on certain immunological diseases. Analysis of this fraction on thin-layer and gas chromatography and with infrared and mass spectroscopy indicated that about half of this fraction was composed of uracil; additional unidentified heterocyclic and aromatic substances were present in this fraction. Adjacent fraction V contained tyrosine and a small polyribonucleotide, and fraction VII hypoxanthine and additional unidentified components. Our results suggest that the therapeutic activity of dTF is not mediated through an immunologically specific informational molecule, but is rather based on non-specific stimulation of the expression of the immune response.


[Secretory antibodies in saliva against group G streptococci (author's transl)].

Saliva of 310 persons were examined for their ability to agglutinate 33 streptococcal strains of the groups A-T. It was found that the saliva of persons with blood group O agglutinated significantly more often streptococci of strain G9 than the saliva of persons with blood group A (33.3%, and 18.75% resp., p less than 0.01). A statistical significant difference between persons of blood group B and O, or A and B did not exist. The agglutination reactions were caused probably by unspecific immunoglobulins because this strain G9 binds unspecifically human IgG. It is known, that some streptococcal strains of the groups A, B, C, D, and G contain receptors for the Fc-fragment of IgG and/or IgA. The results demonstrate that persons of the blood group O secrete more often immunoglobulin than those with blood group A.


Studies on lymphocytotoxicity in acute and chronic liver disease.

The cytotoxicity of lymphocytes from patients with chronic active hepatitis, chronic persistent hepatitis, acute hepatitis B and rheumatoid arthritis as well as from normal controls was studied in a microcytotoxicity assay according to COHEN et al. using 125I-iododeoxyuridine labeled embryonal liver cells and Chang cells as target cells. Unfractionated lymphocytes of the peripheral blood from patients with chronic active hepatitis and rheumatoid arthritis showed a high frequency of cytotoxic activity. The lymphocytotoxicity in chronic active hepatitis was significantly increased in comparison to normal controls at the EC/TC of 10:1 and 100:1. Specificity of the cytotoxic reaction to target cells could not be demonstrated. Addition of autologous serum to the cytotoxic assay blocked the lymphocytotoxicity in patients with chronic active hepatitis. A weak potentiating effect on lymphocytotoxicity was observed in patients with hepatitis B after addition of autologous serum. It is discussed that this reaction is due to the presence of HB-antigen in the serum since addition of HB-antigen from other sources increased also the lymphocytotoxicity in hepatitis B patients. This effect was observed neither in HB-antigen positive nor in HB-antigen negative patients with chronic active hepatitis or chronic persistent hepatisis.


Electron microscopic detection of the cryptantigen AhumHP (Friedenreich antigen) on human erythrocytes by means of gold-labelled agglutinin from Helix pomatia.

Using the gold-labelled agglutinin anti-AHP from Helix pomatia (edible snail) the ultrastructural site and distribution of the cryptantigen (Friedenreich antigen) AhumHP was revealed on neuraminidase treated human O and B erythrocytes. On A1 and A2 cells the antigen was demonstrated simultaneously with the blood group antigen A by labelling the cells with anti-AHP-ferritin followed by removing the neuraminic acid and labelling with anti-AHP-gold. The cryptantigen is focally distributed on the cell surface.


[Relationship between haptoglobin types and group G streptococci (author's transl)].

A relationship was found between the haptoglobin types of human sera and the agglutinability of some strains of group G streptococci. Sera with the haptoglobin types Hp 2-2 and Hp 2-1 agglutinate these streptococci to high titers, from 1:200 up to more than 1:6400. On the other hand, the sera with haptoglobin type Hp 1-1 agglutinate not more than up to titers of 1:16 (mostly lower). Out of 102 strains of group G streptococci only 3 showed this characteristic phenomenon. This study was undertaken in order to elucidate whether the Hp 2-2 and Hp 2-1 proteins have antibody activity. Incubation of Hp 2-2 or Hp 2-1 sera with antihaptoglobin antisera or with anti-Hp 2-antiserum did not change the agglutinating activity but the haptoglobin was eliminated from the sera. Absorption of Hp 2-2 and Hp 2-1 sera with these group G streptococci lowered the titers significantly but the haptoglobins are detectable as in the non-absorbed sera. Sera with haptoglobin 1-1 contain an inhibitor. Mixing of Hp 2-2 and Hp 2-1 sera with high agglutinating titers with Hp 1-1 sera (low titers) was followed by a significant decrease of the titer.


[Riskfactors and coronary morphology in 218 patients with myocardial infarction under 40 years of age (author's transl)].

With 218 postinfarction patients under 40 years of age who all underwent coronary angiography, the question in priority is: Can myocardial infarction in young age be characterized by special constellation of risk factors and by specific coronary morphology? Compared with results from literature the risk factors hypertension and diabetes seem to be of less importance than in older patients, smoking on the other hand seems to be more significant: 90.5% of postinfarction patients under 40 years of age were smoking regularly. Coronary angiography proved  a pre-domination of 1-vessel disease: 72% showed 1-vessel, 17.9% 2-vessel and 10.1% 3-vessel disease. These findings and those from literature show that the majority of patients with myocardial infarction in young age have the following characteristics: In connection with the risk factor smoking the sclerotic coronary vessel process is developing rapidly, very often at a single spot. Since no longterm gradual occlusion process occurs, no prolonged period of angina pectoris precedes the infarction. There is no time for the development of an adequate collateral circulation; it follows that the infarction is a large one. After the acute infarction there is no angina pectoris.


[Contractile and relaxation reserve of the left ventricle. I. Normal left ventricle (author's transl)].

The validation of parameters of left ventricular contractility at rest is pure. Therefore, the contractile function of the left ventricle was measured during exercise. The reserve in contractility and relaxation was obtained in a group of 13 patients with normal left ventricle (ergometer). The maximal rate of left ventricular pressure rise (max dP/dt) increased from 1721 +-378 to 4954 +- 1246 mmHg/s and the peak measured velocity of contractile elements (dP/dt/P) from 38 +- 9 to 76 +- 11 s-1 at a mean load of 112 +- 43 (+-SD) watts. The parameter of the isovolumic relaxation phase, the maximal rate of left ventricular pressure fall (min dP/dt) increased from 1862 +- 343 to 3128 +- 445 mmHg/s. Left ventricular enddiastolic pressure was unchanged. All patients reached at least 3200 mmHg/s (max dP/dt) 60 s-1 (dP/dt/P) and 2400 mmHg/s (min dP/dt). The difference between rest- and exercise values was at least 1800 mmHg/s (max dP/dt), 22 s-1 (dP/dt/P) and 1000 mmHg/s (min dP/dt).


[Contractile and relaxation reserve of the left ventricle. II. Patients with rheumatic valvular disease (author's transl)].

The function of the left ventricle is important for the success of surgery. To differentiate between normal and abnormal ventricular function, the contractile and relaxation reserve was measured. In 19 patients, 10 with mitral and 9 with aortic valve disease, max dP/dt and min dP/dt were measured at rest and during exercise (ergometer). Max dP/dt increased in 7 patients above 3200 mm Hg/s and dP/dt/P above 60 s-1 (normal contractile reserve). Only 3 of these patients reached a normal increment of relaxation velocity (min dP/dt above 2400 mm Hg/s). In 12 patients the contractile and relaxation reserve was decreased. All patients with mitral stenosis had abnormal relaxation reserve despite normal contractile function in 4 cases. Left ventricular enddiastolic pressure did not correlate well with myocardial dysfunction. Isovolumic contractility during exercise was decreased in patients with aortic valve disease. Enddiastolic pressure increased from 18 +- 8 to 22 +- 14 mm Hg during exercise.


[Dihydralazin versus prazosin. The hemodynamic effect of the modul substances (author's transl)].

The hemodynamic effects of dihydralazine and prazosin (0.1 and 1.0 mg/kg i.v.) on the circulatory system and left ventricular dynamics and contractility has been performed in 10 purebred beagle dogs (15.5 +- 1.4 kg) under pentobarbital sodium (35-40 mg/kg i.p.) anaesthesia by means of thermodilution and catheter technics. The changes of cardiovascular values were: 1. Either dihydralazine and prazosin decreased mean arterial blood pressure in the dose of 0.1 mg/kg i.v. Following application of 1.0 mg/kg intravenously, the arterial pressure abruptly decreased after prazosin. 2. Both pharmaca caused tachycardia. Being slowly introduced but continued by dihydralazine, the increase of pulse rate after prazosin was only initial. 3. The cardiac dynamics were differently influenced by dihydralazine and prazosin. In the estimated dose range prazosin led to an increase of cardiac output directly after application while dihydralazine induced a gradual enhancing of cardiac output. 4. The stroke volume was decreased by prazosin and slightly increased by dihydralazine. 5. While distinctly decreasing initially after prazosin, peripheral total resistance was slowly reduced by dihydralazine. 6. The contractility of the left ventricle, estimated as dp/dtmax and VCE, showed a distinct increase of the myocardial inotropy after both compounds. The maximal effect after prazosin, however, was to be seen immediately post applicationem. Dihydralazine led to a deferred enhancing of the measured contractility parameter.


[Clinical value of multiple praecordial chest leads for evaluating the course of acute anterior myocardial infarction (author's transl)].

Percordial ST-segment mapping using an improved 48-lead system was evaluated 2-to-3-hourly in 322 single measurements on 24 patients with acute anterior myocardial infarction. Changes in the sum of ST-elevation (capital sigma ST) or in the number of leads with ST-elevation (NST) could be distinguished in two different phases: an initial rapid increase and decrease in capital sigmaST and NST was followed after 6 to 12 hours, by a more plateau-like course, which exhibited, especially in uncomplicated cases, only slight further changes. During the initial phase, marked differences in the maximal rate of decrease were observed for capital sigma ST and NST. In this phase, interpretation of therapeutical interventions using changes of capital sigma ST or NST as reference is therefore very critical. However, during the second plateau-like phase, extension of myocardial necroses is significantly associated with a new steep increase in capital sigma ST. Thus precordial mapping is suitable for rapid and sensitive detection of infarct extension in patients with anterior myocardial infarction. The development of pericarditis or bundle-branch block, which principally can disturb the evaluation of capital sigma ST and NST, occurred only sporadically in a few patients and therefore caused no major problems.


[Percutaneous implantation of permanent pacemakers (author's transl)].

2 methods for the implantation of permanent pacemakers with percutaneous puncture of the subclavian vein are described. The first one was used in 44 patients with the aid of an introducing catheter-set Desilets-Hoffman consisting of guide-wire, inner Teflon dummy catheter and outer thin-walled sheath; through this a shoulder-less electrode catheter no. 8 could be inserted for permanent pacing. The other technique was applied to 20 patients and used thinner special electrodes no. 6F, which could be introduced directly through a plastic cannula inserted with a puncture-needle. The advantages are: diminished risk of infections, local anesthesia instead of general anesthesia, applicability by the cardiologist in the catheterization-laboratory or under a simple fluoroscopy-unit, short stay of patients in the hospital without transfers to other departments, few personnel (1 scrubbed doctor, 1 non-scrubbed nurse), recognition of venous anomalies (singular left superior caval vein) without useless incisions for the patient. Complications such as pneumothorax, puncture of the subclavian artery, and dislocations of the electrodes have also been encountered.


[The so-called pacemaker twiddler's syndrome in pervenously implanted pacing systems (author's transl)].

Eight own cases of the so-called pacemaker twiddler's syndrome in pervenously implanted pacemaker-electrode-systems are reported. A scheme to classify that syndrome is proposed mentioning the grade of distinction and mechanism. Furthermore preconditions, therapy, and steps that will have been taken to prevent a pacemaker twiddler's syndrome are discussed.


Interactions in vitro between sporozoites of Eimeria tenella and host peritoneal exudate cells: electron microscopal observations.

The interactions of sporozoites of Eimeria tenella with peritoneal cells from normal and from immunized chickens were examined in vitro. Although the uptake of sporozoites by cells from immunized birds was greater than by cells from susceptible birds, no differences were apparent in their appearance in electron micrographs. Entry into both macrophages and heterophils (comparable to mammalian neutrophils) was by phagocytosis. The findings are discussed.


[Degeneration of the tongue of Boops [(Boops boops L., 1758) (Teleost, Sparidae)] parasitized by Meinertia oestroides (Risso, 1826) (Isopoda, Flabellifera, Cymothoidae) (author's transl)].

Host fishes (Boops boops) parasitized by the cymothoid isopod Meinertia oestroides show an atrophied tonuge: its length and its initial weight can decrease of about 50%. These morphological variations are connected with deep histological alterations, such as: A more or less important vanishing of epidermis. A disorganization of the connective tissue, by numerous invading blood cells. A total vanishing of cargilage and a partial vanishing of bone, resulting from the lysis of their own fundamental substance.


The role of Chaetogaster limnaei in the dynamics of trematode transmission in natural populations of freshwater snails.

Chaetogaster limnaei, an oligochaete was always found infesting Bulinus (Phy.) globosus, B.(B.) forskalii and Lymnaea natalensis in Bo, Sierra Leone, living below the shell or embedded in the mucus of the foot. The worms had no preference for snails with trematode infection. The population was highest in the dry season when fewer snails were infected by trematodes. This is suggested to be a result of the protection the worms give to snails against invading miracidia.


Free amino acid composition of Opisthorchis pedicellata (Trematoda) from the gall-bladder of a fresh water fish, Rita rita (Ham.)

The paper chromatograms reveal the presence of 12 free amino acids, viz. leucine, isoleucine, valine, proline, tyrosine, phenyl-alanine, alanine, glycine, glutamic acid, serine, aspartic acid and lysine, in Opisthorchis pedicellata.


Babesia bovis (argentina): observations of coagulation parameters, fibrinogen catabolism and fibrinolysis in intact and splenectomized cattle.

The results of this paper indicate that cattle infected with B. bovis (argentina) have a markedly altered and activated coagulation system. A degree of thrombin activation occurs due partly to release of thromboplastin-like substances from lysed erythrocytes but due primarily to activation of kallikrein by babesial proteases. This produces a hyperfibrinogenaemia, particularly in intact cattle, with soluble fibrin complexes constituting up to one-third of the total fibrinogen concentration. High molecular weight non-coagulable fibrinogen-like proteins are detected terminally but more so in splenectomized cattle. Plasminogen concentration decreases in splenectomized but not intact cattle while low molecular weight fibrinogen degradation products are not easily detected. It is suggested that a hypercoagulable intermediate state with little or no fibrin deposition occurs rather than terminal disseminated intravascular coagulation.


[Scoliosis and spondylolisthesis (author's transl)].

The coincidence of a scoliosis with a lumbosacral spondylolysis or spondylolisthesis has remained largely ignored in the German language literature. After a survey of the foreign literature the pathogenesis of various combination forms is discussed. Primarily with the aid of oblique X-rays of lumbar scoliosis a scheme of classification involving 7 categories is worked out. The two main categories comprise unstable spondylolisthetic scolioses with increasing abnormal posture and scoliotic spondylolistheses. In these cases a lumbar scoliosis probably induces an asymmetric spondylolysis. The scheme provides the basis for discussion of conservative and surgical treatment. Taking of a standing X-ray is indispensable as a preliminary measure with every lumbar scoliosis. Oblique X-rays of the lumbosacral section appear to be equally necessary at least once. Unilateral laminar sclerosis can be a valuable sign of contralateral one-sided spondylolyses, as can scoliotic E-forms of the spinal column as well. Spondylolisthetic "scolioses" should be fused in the lumbosacral section at an early stage to prevent secondary structural curvatures. Scoliotic spondylolyses-spondylolistheses at this level should on the other hand, only be fused in serious cases accompanied by pain and progression, supplementing dorsolumbar fusion of scoliosis. In any case, the lowest lumbar vertebra must only be fused in an almost straight position. The correction should also be carried out in the case of difficult spondylolisthetic scolioses prior to the lumbosacral dorsolateral fusion using the v. Lackum transsection cast if certain, above all neurologic, findings permit.


[The improvement of pulmonary function after scoliosis treatment via Harrington's method (author's transl)].

53 spine fusions using Harrington's method were performed in adolescents (average age 14 years) between 1966 and 1972. Follow-up examination at early intervals showed that the values for pulmonary function, particularly the vital capacity, are lower one year after operation but then definitely increase in the following years. The percentual increase is not statistically significant. The evaluation must take into account, however, that the normal values for pulmonary function in these patients increase markedly because they become 4--5 cm taller on operation. Spine fusions using Harrington's method not only prevent deterioration of pulmonary function but also lead to its improvement. Further evaluations should be carried out to discover to what degree scoliotic patients are trainable without increasing the danger of pulmonary vascular obstruction.


[Notes on the indication of corrective osteotomy in Perthes' disease (author's transl)].

The results of surgical (corrective osteotomy) and conservative therapy (Thomas splint treatment) are compared in 88 patients suffering from Perthes' disease. It is attempted to show whether the age of the patients, the stage of disease, centric or excentric head of femur, Cattherall's stage or any risk factors influence the results. Statistics show that only young children profit from surgical treatment whereas it offers no advantage to children over six years of age. Among the young children only those with excentric head of femur, show significantly better results as opposed to conservative splint treatment. Surgery is otherwise only indicated when it is seen as an alternative to prolonged splint treatment.


[Slipped capital femoral epiphyses in ten members of one family: probably autosomal dominant transmission with variable penetrance (author's transl)].

Ten members of a family suffered from slipped capital femoral epiphyses (ECF), and two further descendants had coxarthrosis possibly following subclinical course of an ECF. This pedigree is suggestive for a dominant inheritance with variable penetrance. Besides a few families with more than two affected members, almost 95% of the cases in the literature occur sporadically, many of these probably representing phenocopies. In view of the recurrence risk (at least 5% in sporadic cases), genetic counseling of the parents of any patient is recommended. Since early onset of treatment improves the prognosis considerably, parents of an affected child should be informed to pay special attention to early symptoms in their younger children. Moreover, preventive radiological examinations may be indicated in families at a higher risk. For imminent ECF, bilateral epiphyseal spiking is the treatment of choice.


[Should osteotomy after Imhäuser be performed immediately or only following setting and healing of epiphysiolysis of the head of the femur? (author's transl)].

In slipping of the femoral epiphysis, operative treatment is necessary when slipping exceeds an amount of 30--40 degrees. Therapeutically, the three dimensional intertrochanteric osteotomy, as performed by Imhäuser since 1950, has shown good results. According to a follow-up study of 130 cases, it seems to be advantageous first to carry out a fixation of the epiphysis. An intertrochanteric osteotomy should be carried out as a second step (usually after 6 to 12 months), as in the meantime an increase in range of motion can be obtained.


[Epiphysiolysis of the inferior portion of the tibia and fibula (author's transl)].

Based on an analysis of the authors own patients and observations presented by Suessenbach and Weber, a new, enlarged classification of injuries of the epiphyseal cartilage of the ankle joint was presented which makes it possible to compare the anatomic and functional results of therapy. According to our analysis, the age of the patient seems to be significnat for the success of treatment.


[Injuries to the locomotor apparatus of young people in competitive alpine sports (author's transl)].

139 school children were examined for pre-existent support and locomotor system disorders brought about by athletic damage and injury results. A great deal of the positive clinical findings consisted of juvenile kyphosis in 44% of all cases and posttraumatic damage was found in one third. Nextly insertionstendinopathy with apophysis disorders and aseptic necrosis were also noticed. Particular physiological and biomechanical perculiarities of the support and locomotor system tissues will be specially and generally demonstrated. The mutual effect of age and stress factors are indicated. An orthopaedical qualified examination and follow-up examinations are for legal, preventive and therapeutic reasons indispensable.


[Long-term results of operation for congenital muscular torticollis (author's transl)].

Tenotomie of the sternocleidomastoid muscle seems to be an operation without complications. This impression is confirmed by the majority of reports, most of which however deal with early follow-up results. The basis of this paper is a follow-up of 100 patients, 37 years postoperatively and a review of the literature. There were several avoidable inter- and postoperative complications. Unadequate treatment was one reason for poor results. Good alternative to the cast postoperatively were offered by physiotherapy or the Schanz cotton wool bandage. The use of a cast was followed in a few cases by reversible plexus damage and decubitus ulcers of the head. On the whole the longterm results after torticollis operations were good. Scars and slight recurrence did not disturb the patients seriously. There was no correlation between age at operation and asymmetry of the face.


[Personality tests done by the "Freiburg Personality Inventory" on patients after leg amputation (author's transl)].

47 patients after leg amputation were investigated by the "Freiburg Personality Inventory" (FPI). Results showed that the personality structure of these patients corresponds to that of the normal population.


[Operative treatment of hallux valgus with varus of the first metatarsal (author's transl)].

In cases of hallux valgus tendon transfer combined with wedge osteotomy of metatarsus I yields good results. Considering the experience of 36 operated feet in 25 patients the operation can be recommended especially for young patients. An exact technique helps to avoid complications such as hallux varus and delayed ossification of the osteotomy.


[Basic biomechanics of "stress-correction" by osteotomies in the region of the knee joint (author's transl)].

A recent suggestion by Izadpanah and Keönch-Fraknóy (1977) for the correction of the stressing of the knee-joint, is an epiarticular transpositary osteotomy with either a medial or lateral displacement of the condyle block, thus causing neither valgisation nor varisation. With the aid of compression tests on specimens and a photoelastic test, the authors try to prove the effect of this osteotomy. The tests give a false positive result. The submitted investigation deals with basics of correction osteotomies at the knee-joint. It shows that the effect of Izadpanah and Keönch-Fraknóy osteotomy is essentially slighter that the authors think and that furthermore, Maquet's subarticular rotation osteotomy is so far the best method available for centralisation of the force resultant in the joint.


[Pressure distribution under the human footsole: qualitative and quantitative results (author's transl)].

Results obtained with an already described device (Beierlein 1977) are presented. 16 subjects (4 with "normal feet", 4 with pes valgus and flat-foot, 4 with splay foot and 4 with combined flat- and splay foot) were taken for the following investigations of pressure distribution under the human footsole: Standing subjects: 1. Standing on two feet, barefoot with fixed upright posture; 2. dynamic unrolling of the bare-footed human footsole with constant walking speed. Examples of coloured isobares of the pressure distribution of a "normal foot" and splay-flatfoot are presented. Further the results of a hollow foot are described. The measured pressures vary between 4.9 and 78.5 N/cm2 (= 0.5 and 8 kp/cm2). Examples of interpretations are given to stimulate orthopedic surgeons to use the created measuring technique for definition and diagnosis of foot deformities.


[Biomechanical considerations on stress and strain of the anchorage of femoral prostheses stems (author's transl)].

The nature of load and stress on implanted femoral prostheses is shown by simplified models. Bending stress is responsible for loosening and fracture of prosthesis stems. Implantation in valgus position diminishes the possibility of failure. Investigations on materials and the strength of form could clear up different influences and shall lead to allbountiful criterions and test-methods.


[Biomechanical tests of various operative techniques for recurrent inferior radioulnar dislocation (author's transl)].

Among the great number of operative techniques for stabilization of the distal end of the ulna by grafts in recurrent inferior radioulnar dislocation 6 different methods were tested biomechanically and compared among each other. Those techniques which permit successful treatment of the dislocation are pointed out.


[Programmed correction osteotomy by technical means with arched cut (author's transl)].

The programmed correction osteotomy is a possibility to correct defective positions of long bones with a determinable exactness by a technical appliance of operation. The appliance, resting on the bone, is leading the saw during the section. The cut surface is arcuate. By this technique it is possible to correct in a raised degree of exactness defective positions of bones in three dimensions with only two sections and without radiological checks or measurements. The programmed correction osteotomy and her stage of development up to now are described.


[Medical opinion in hyperextension injuries of the cervical spine (author's transl)].

Hyperextension injuries of the cervical spine often cause controversies in medical opinions. 113 cases of medical opinions about hyperextension injuries of the cervical spine are analysed. Most of the patients only had non severe distorsions. In many cases it was difficult to get opinion because of missing objective symptoms and degenerative signs.


[Synovial hemangioma of the knee-joint (author's transl)].

In monoarticular diseases of the knee-joint of children, especially in case of a blood-stained joint effusion, a synovial hemangioma has to be considered. The histological examination of an ample biopsy specimen can prove the diagnosis. A radical synovectomy carried out as early as possible results in healing of the lesion without recurrence.


[Desmoplastic fibroma of the sacrum (author's transl)].

A case of desmoplastic fibroma at a site not published before, the sacrum. Description of technique of operation. Discussion of special features, recurrences and differential diagnosis.


[Gas-chromatographic-mass-spectral analysis of aroma-compounds of bread (author's transl)].

Analysis of aroma compounds of whithe bread by means of a combined gas-chromatographic-mass-spectral method was carried out. 29 organic compounds were identified, 20 of which were reported for the first time in bread aroma. These for the first time reported compounds are: 1, 1-diethoxyisopentane, 2-phenylethylformiate, n-butylformate, 2-isooctenal, 2-octenone-4, sec. nonanol, nonanol-1, 2-nonanone-4, 2-decenone-4, 2-decenone-5, 1-dodecenone-3, 2-dodecenone-4, 2-dodecenone-5, dodecanol, octylacetate, ethylbenzoate, nitrobenzene, pentadecanone-2, heptadecanone-2, tridecadience.


[Investigations on the molecular weight distribution of wheat glutenin subunits (author's transl)].

Comparative investigations on the molecular weight distribution of the reduced glutenins from untreated and petroleum ether resp. chloroform-methanol defatted wheat flour by means of SDS-PAGE have shown that the molecular weight distribution and the intensity ratios of the electrophoretic bands are strongly influenced by the removal of lipids. It could be shown that defatting of flour causes a decrease in the yield of high molecular components in the course of AUC-extraction. The examination of a glutenin prepared by extraction under reducing conditions (0, 2 percent NaHSO3 in 60 percent propanol-2) has revealed that there is evidence for the participation of gliadin-like subunits in the glutenin structure.


[A quantitative micromethod for the caffeine determination (author's transl)].

A combined procedure with thin-layer-chromatography and densitometry is described for the quantitative estimation of caffeine in biological material. This method is applicable in the nanogram range. Test samples of less than 100 microliter may be used. The samples (capillary-blood) are extracted with the same volume of chloroform. Caffeine is separated from interfering compounds by thinlayer-chromatography. Commercial silica-60-plates with chloroform/acetone (9+1; v/v) as solvent are used. The running time is about 30 min. The quantitative densitometric determinations are performed in the remission mode at 273 nm. In the range from 10 to 60 ng/spot the calibration curve is linear. Accurate quantitative data will be obtained even at concentrations of 1 mg/l caffeine. The detection limit is at about 0.1 mg/l.


[Contributions to mechanical dishwashing. III. Dynamics of removal of protein residue from glass surfaces (author's transl)].

Using tracer technique the removal of protein soil--dried casein resp. skin milk--from glass plates by mechanical dishwashing was investigated. Prerinsing for 2 min with cold tap water removes 91.25 percent of the quantity of casein originally present. When this prerinse is followed by 20 min main wash, the residual casein can be removed if at least 30g of detergent has been added to 131 water. Optimum inter-relation-ships of quantity of detergent added with time and temperature of the washing and rinse cycles are given. Dry protein residues from skim milk are more easily removed than casein residues, probably because the salts and lactose dried together with the proteins facilitate the cleaning.


Influence of post mortem changes on experimental safety belt injuries.

Belt protected car occupants involved on head-on collisions do not seem to suffer as severe injuries as unembalmed cadavers subjected to comparable simulated head-on collisions. Therefore it has been questioned if cadavers constitute adequate test specimens for study of thoracic tolerances. This investigation compares injuries in safety belt wearing living and dead pigs which have been subjected to simulated head-on collisions on an acceleration tract. Tests were performed on all 20 pigs (10 living and 10 dead). The arterial side of the circulatory system of the dead pigs was infused. The force in the safety belts, the intraaortic pressure, the impact velocity and the deceleration of the sled were recorded. The tests were high speed filmed. Post mortem examination of the pigs revealed differences in injury severity. Dead pigs more easily suffered rib fractures. Deformation of the rib cage due to stripping of the periosteum and laceration of surrounding tissue occurred mainly in the dead pigs. Laceration of intrathoracic blood vessels was seen in dead pigs while isolated heart lesions were seen only in living animals. The main cause of these differences in tolerance level seems to be post mortem changes of the mechanical properties of the different tissues. The results are valid for pigs but indicate that great care has to be exercised when results obtained from cadaver experiments are evaluated concerning thoracic tolerance.


[Improved skull identification using the superprojection technique with the help of a video-tape system (author's transl)].

The photographic identification of a skull through the well-known superprojection technique can be modified and decisively improved by the use of a video-tape system. The identification method based on electronic photo composition is methodically simple to use. It offers the examiner the possibility to recognize the relationship between bone and soft part proportions, and the structure of the bone surface and the details of the soft part shape, as a concrete, tangible characteristic of identity to a substantially greater extent. The large number of controllable characteristics inherent in the ihgh degree of individuality of the skull offers not just an either/or "The skull fits"/ "It does not fit" into a photograph, but achieves proof of disproof of identity.


[Skull identification by means of superprojection using the electronic photo-composition technique, modified to the animated picture-difference procedure (author's transl)].

Skull identification by electronic photo-composition can, with the help of a video-animation compositor, be further developed beyond the pure superprojection technique into an animated picture difference image. The employment of this combined technique to be recommended on account of the improved possibilities of control to be realized in the congruity of the superprojection composite picture.


Immunochemical studies on blood group A substance from human hair.

Blood group A-active substance was extracted from urea-treated human hair uith methanol-ethyl ether 1:1, v/v) or chloroform-methanol (1:1, v/v). The serological activity of blood group A substance in the hair was destroyed by A-decomposing enzyme from Clostridium tertium with concomitant development of blood group H activity. It is concluded therefore that the extract from the hair of group A contained blood group A-active glycolipid with N-acetylgalactosamine as the non-reducing sugar.


[Derivatisation methods in gas chromatographic analysis. application in the toxicological field (author's transl)].

Derivatisation methods are described, which can be used in gas chromatography of drugs in the forensic toxicological usage. Especially acetylation, silylation and methylation can be performed quite simply and fast. Several procedures for these reactions are compliled from the literature.


On the possibilities of the application of scanning electron microscopy in the forensic medicine.

The aim of the paper is to provide pertinent, information about scanning electron microscopy (SEM), with a detailed survey on the great possibilities of SEM which is becoming increasingly important in research and practical work of forensic medicine. The electronoptical characteristics of the method are discussed and the basic preparation methods to be selected are described. The areas of forensic medicine where these methods have already been used, as well as the results obtained, are briefly surveyed. The present state of affairs as well as personal experiences with hairs, bones, muscle and skin are described in detail. The experience with the critical point drying method is described. This method according to the reviewers, is very useful for work with hairs, bones, nails and sometimes with skin although the preparation may result in secondary destructions of the tissues of high water content to such an extent that the evaluation will be interfered with or becomes impossible. Further possibilities of these perspectivic methods are under research. The discussion of the physiological data is preceded by a historical description of the SEM and TEM systems and the basic principles of its function, which should facilitate reading of the text.


[A computer-tomographical examination of cranial bullet wounds (author's transl)].

The report covers the computer-tomographical examination of six patients with acute cranial bullet injuries and fifteen patients suffering from the sequels of such injuries. The diagnostic and prognostic significance of this method of examination in the case of acute injuries is described. The extent of cerebral defects in the case of sequels can be documented during this process by means of x-ray. The computer-tomography therefore offers an objective basis for the assessment of this type of sequela.


[A possibility for identification of the knife's edge in stab wounds (author's transl)].

It is known from forensic-medical practice that the wound track of stab wounds reflects the form and dimensions of the knife's edge, when there are no supplementary cuts. If the wound channel passes through compact organs (liver, kidney, spleen, etc) it can be exposed for direct observation by removing one of its sides which allows observation of the approximate form and dimensions of the knife's edge. It enables eliminatione of those weapons which do not fit. A case of homicide is described with 9 stab wounds, one of which penetrating the liver, where the above described method was successfully used. A case of an adult man's murder is described with 9 puncture wounds, one of which penetrating the liver, where the above described method was successfully used. A case of an adult man's murder is described with 9 puncture wounds, one of which penetrating the liver, where the above described method has been successfully applied.


[Significance of prostatic biopsy in the diagnosis of chronic prostatitis].

It is reported on the importance of the prostate biopsy for the limitation of the prostate neurosis and the real chronic prostatitis. In own patients the tentative diagnosis "chronic prostatitis" could be proved histologically in only 8 out of 30 cases. We think the biopsy necessary in cases of chronic recurrent prostatitis, because the therapy depends extremely on the exact diagnosis and the complicating quota is relatively small in the prostate biopsy.


[Chronic prostatitis and Bechterew's disease].

A group of patients between 35 and 65 years old with chronic prostatitis were examined for the presence of Becherew's disease. In this connection the New York and Roman criterions for morbus Bechterew were applied. There were found one ankyosing spondylarthritis, one ankylosis of the sacroiliac joint, and 11 times a tentative sacroileitis were stated. Altogether the proved and tentative findings were only 3.68 per cent of all examinations. In our countries the morbus Bechterew is found in 0,21 per cent of the normal population. So the protion of the Bechterew's disease in patients with chronic prostatitis is indeed a little higher than average, but not so frequent as often pretended in recent times. After a second series 58 patients being treated because of Bechterew's disease of different stages and different terms were examined for the possibility of a simultaneously elapsing chronic prostatitis. A chronic prostatitis was found in 38 per cent of these patients which correspondents to the incidence published in literature for the medium-age manhood. Nobody of the test persons had complaints on the part of the urologenital tract.


[Retroperitoneal liposarcoma--contribution to differential diagnostic problems of primary retroperitoneal tumors].

The primary retroperitoneal tumours-a rare, but histologically very extensive group of above all malignant tumours-only late appear with their symptoms. Though with the help of the modern radiological investigation methods the proof of a tumour is frequently successful, so in special cases a coordination to organs may make great difficulties also when the total diagnostic spectre is used. These problems shall be shown by the demonstration of a case report.


Vibrations and predatory behaviour of Plectrocnemia larvae (Trichoptera).

This work analyses the effects of vibrations transmitted across the net on the predatory behaviour of the Plectrocnemia conspersa larvae (Trichoptera). The variations in the frequency has a more marked effect than variations in amplitude especially on the stage 2 (orientation and displacement towards the lure) and on the stage 3 (capture of the lure with mandibles).


Sexual behavior in the cockroach genera Periplaneta and Blatta. IV. Interspecific interactions.

As part of a study of sexual behavior in 6 species of closely related and often sympatric cockroaches, interspecific interactions among the various species were examined. To some degree males of nearly all species court females of a second species. Females almost always rejected these courtship attempts. Experimental evidence indicates that the volatile female sex pheromone of each species is attractive to males of most of the other species. Rejection of heterospecific males appears to be due to species specific male pheromones. These pheromones also appear to mediate the formation of homospecific clusters of courting males in time or space.


Terrain preferences in the play behavior of Siberian ibex kids (Capra ibex sibirica).

Play behavior was studied in a captive group of Siberian ibex at the Chicago Zoological Park. The hypothesis that physical training effects were at least partially responsible for the evolution of play in this species was tested by noting the amounts of play which occurred on flat and on sloped surfaces. The kids showed a clear preference for play on sloped terrain, even though this choice resulted in considerably greater risks. The danger involved in highly active locomotor play performed on steeply sloped areas is presumably outweighed by the physical training benefit for an adult life spent moving in precipitious areas.


[Experimental studies on the significance of mouth markings in zebra finch nestlings].

Wild-coloured Zebra Finch nestlings with fully developed mouth markings were compared with white mutants, which lack the markings, with respect to the ability of these markings to release the feeding response of both wild-coloured and white parents. In more than 80 nestlings, the wild-coloured ones proved to have a higher survival rate, to grow faster, to be given more food, and to have piority to the first feedings in the day. Within the colour groups greater relative age was as advantageous as mouth markings were between groups.


[Studies concerning the biology of rhizobia. 1. Communication: serological investigations (author's transl)].

According to earlier studies the strains of the rhizobia could be put into three biochemical groups (A, B, C) independently of the nodules of which kind of plants having been isolated from. The aim of our experiments has been the determination of the antigenic structure of these rhizobia strains. Regarding the agglutination tests only 24 strains from the 47 ones were agglutinated by A sera, one B strain from the 3 B ones, and 2 C strains from the C ones gave positive reaction with B and C sera, respectively.


Cyanide reduction by nitrogenase in intact cells of Rhodopseudomonas gelatinose Molisch.

Intact cells of Rhodopseudomonas gelatinosa, grown in N-free medium, reduce cyanide to methane and ammonia at a rate 5--8 times lower than acetylene. Cyanide reduction in whole cells is distinctly more sensitive to cyanide inhibition compared with enzyme preparations. These results are discussed in view of the exploitation of nitrogen-fixing photobacteria in the anaerobic detoxification of cyanide-containing wastewaters.


[Biodegradation of the mycelium of Pyrenochaeta lycopersici Schneider et Gerlach in the soil. Ultrastructural study].

Under natural conditions, Pyrenochaeta lycopersici forms a sterile mycelium. Some strains form chlamydospores, while others form micro-sclerotia. The fungus survives by hyphae cells which are present in soil either free-living or momentarily protected by the tissue of the infected root. In a model experiment, the behaviour of the free mycelium was tested in a soil which had been supplied with asparagine and manure, respectively. A known quantity of living mycelium was added to the prepared soils. Samples were taken after 1, 3, 6, and 10 months. They were examined on loss of weight of the mycelium, inoculum potential, and ultra-structure of the hyphae before and during degradation by transmission electron microscopy.


[Analysis of soil respiration-curves (author's transl)].

Soil respiration curves, measured under constant conditions, change after an initial phase to a relative steady course. Now there is an adjustment of an ecological equilibrium in the activity of soil microbes. This state of equilibrium is characterized by a linear course of the log CO2 = f(log t)-curves and is named "Grundatmung" (basic respiration). If this equilibrium ist disturbed by application of primary organic substances or the availability of slowly decomposable organic matter, then microbial growth-phases appear dominating as first-order reactions in the form of increased CO2-delivery. However, in the further course this process changes over again to the state of "Grundatmung".--This linearity of the log CO2 = f(log t)-curves is explained by the existence of a whole series of superimposed first-order reactions, synthetisizing secondary biomasses in the substrate.--This linearity permits a temporary extrapolation of the CO2-release of soils and is important for the quantification of the soil habitat (zoning) mineralisation.


[A contribution to the study of respiration in soil and in the rhizosphere of winter wheat (author's transl)].

In a complete respiration test, involving also other analyses, soil respiration (CO2 evolved) was measured in a fertilization experiment in the rhizosphere of the plants in untreated soil. The highest and most effective CO2 production was obtained by the variants "rhizosphere, fertilized with nitrogen". The decreasing order of the influence on CO2 production is as follows: rhizosphere, nitrogen fertilization, organogenetic state of the plant. With glucose addition, nitrogen fertilization predominated over the effect of the rhizosphere.


[Contribution to the problem of microbially induced urea transformation in soil. I. On the ability of urea utilization by soil micro-organisms (author's transl)].

The present publication is the first of a series on the enzymatic urea tranformation in soil. With about 2,000 pure cultures of micro-organisms it was possible to prove the very good urea utilization by the soil micro-organisms (bacteria, actinomycetes, and fungi). Above all the fungi showed an excellent utilization of urea, while bacteria and actinomycetes were somewhat poorer. Contrary to this is the urease activity of these organisms, and that is the reason why fungi in soil may be regarded as short-time accumulators for urea nitrogen and must not be suppressed by inhibitors.


[Influence of N-serve on mineral nitrogen forms and microorganisms of the soil (author's transl)].

In a model experiment with soil, 2 stages of nitrogen (without additional N and with 200 kg N/ha in the form of ammonia) and 3 N-Serve stages (without inhibitor and with 0.25 per cent and 1 per cent of inhibitor, relative to 200 kg of N/ha) were followed up over a period of 3 and 6 weeks, respectively, with respect to the dynamics of the nitrification process, the saprophytic soil microorganisms, and the autotrophic nitrifiers. In a second experiment, the ammonia form of nitrogen was substituted by the nitrate and nitrite form, respectively. No serious influence on the heterotrophic soil micro-organisms could be detected in any experimental variant; N-Serve was slightly stimulating, the autotrophic nitrifiers were noticeably depressed by N-Serve. The nitrification process could clearly be proved after 3 weeks already; by N-Serve it was remarkably delayed. Nitrite that had been added to the soil was scarcely transformed into nitrate, whereas it was somewhat more ammonified. The high loss of nitrogen in the nitrite variant cannot be caused by denitrification alone. When nitrate was used, the nitrification was not delayed.


[Ascertaining the effect of KMg fertilization on the organic matter cycle in pine stands with special reference to the cellulose test (author's transl)].

The biological nutrient cycle was activated by applying KMg in relatively young and older pine stands growing in the plain of the GDR on former agricultural sandy soils with substrats from the Younger Pleistocene. Application of KMg stimulated tree growth and had a persistent effect on the microbiological processes of organic matter conversion in the AO horizon and in the humous mineral soil. The cellulose test proved to be suitable for assessing the formation and conversion processes of soil organic matter caused by fertilization as to their effect on soil fertility.


[A long-term experiment on the complex influence of cultivating, fertilizing, and crop rotation measures on humic substances in soil and development of yield (author's transl)].

In a 10-year field experiment, the influence of fertilizing, cultivating, and crop rotation measures on the C-content of the soil, humus quality of the organic soil substance, and the yield was investigated. With cultivation of fodder plants only, the C-content of the soil can be improved by increased mineral and increased organo-mineral fertilization at any depth of cultivation. When in the same location there was a turn between cereals and green crops, a decrease of C-rate can only be prevented by increased organo-mineral fertilization. Continuous cultivation of root crops resulted in a decrease of the C-content. Deeper tillage of the soil generally decreased C-content. Within the years, a variability of the pure humin substances could be detected, depending on the rotation of crops and C-content. The composition of the fulvic acids is differentiated in dependence on the factors "time" and "cultivation". The effect of fertilization variants on the yield was different. Fertilization in that location with manure only, compared with mineral fertilization, caused in most cases depression in yield. Decrease on yield by deeper ploughing had the least influence with root crops.


[Effect of plant residues on the parasitic activity of soil-borne pathogens and the saprophytic microflora of the soil. II. Influence of a second crop cultivation one the incidence of Rhizoctonia solani (author's transl].

In a more years-lasting field trial the influence of a second crop cultivation of rye and rape in winter time on the incidence of Rhizoctonia solani Kühn on potato or mustard as indicator plants was studied. The second crops were ploughed in during spring time. On part of the trial was artificially infested by this causal agent. Three crop rotations with different proportions of host plants (potato) were compared. The results obtained demonstrate the following: 1. On the part of experimental area arficially infested the incidence rate was higher for 3 till 4 years than on the control plots, but later it became equally to the control one, which also was very high (approximately 50). 2. In the last very dry year (1969) the disease developed only a little. 3. The second crop cultivation decreased the incidence of R. solani in 7 (rye) or 8 (rape) of 10 cases, but mostly the rate of decreasing was low. 4. A high weed density induced by a diminished mechanical cultivation increased the incidence of R. solani at the end of the experiment (1969), specially in the rotation with 80% host plants. 5. The number of soil bacteria, the respiration rate, and partly also the activity of dehydrogenase and the soil acidity were increased by green manuring of the second crop, however, the number of the actinomycetes, and the cellulolytic activity didn't be influenced remarkably. 6. The second crop cultivation ist nounced as a measure stimulating the soil fertiligy and discussed in connection with the microbial processes taking place in soil.


[Investigations about cause of specific replant disease of fruit trees. VI. Proof of actinomycetes in feeder roots of apple seedlings in soils with different digrees of soil sickness (author's transl)].

Microscopic analysis of longitudinal sections of feeder roots of apple seedlings from soil with experimentally prepared different degrees of soil sickness led to the following results: 1. A colonization of root-barks by actinomycetes could be pointed out in injured and in macroscopic not visible injured feeder roots of apple seedlings from sick soil. 2. The frequency of the colonization of root-pieces of the two highest root classes was in the sick soil at 47.3% and in the two soils with a less degree of soil sickness at 32.4%. In the non-sick soil the root were at a frequency of 0.3% nearly free from actinomycetes. 3. Feeder roots colonizated by actinomycetes showed injuries in the cell-bandage. Increasing injuries of the roots were obtained with increasing intensity of colonization by actinomycetes. In heavy injured feeder roots the proof of actinomycetes was difficult or no more possible. As the share of heavy injured roots was increasing with increasing degree of soil sickness can be supposed that the real frequency of root colonization by actinomycetes is substantially higher than it was observed in roots seeming to be healthy macroscopically. 4. The results obtained support our hypothesis that soil sickness of apple trees is caused by actinomycetes. The injuries of the roots appearing as a consequence of the colonization may explain both, the soil sickness in the case of replanting and the development of soil sickness in growing apple plantations. 5. Since until now there is no proof that actinomycetes cause injuries in roots of fruit-trees further examinations have to be aspired to confirm our results.


[Out-patient or in-patient treatment after trauma? (author's transl)].

The best therapeutic results after trauma are obtained by an optimal and possibly definitive primary treatment. In this case the in-patient and out-patient-treatment have to be a unity. The advantage of a mobile consultation service between highly specialized departments (neurosurgery, thoraxsurgery, blood vessel surgery) is referred to.


[Diagnostic peritoneal lavage in blunt abdominal trauma (author's transl)].

Induced by other authors we included the lavage of the peritoneum in diagnosing the blunt abdominal trauma. From a total of 140 lavages 78 had to be treated operatively, in the negative results there were 3 wrong positive values and 1 wrong negative value. The results obtained are discussed.


[X-ray diagnosis for chronic osteomyelitis (author's transl)].

The basic programme of X-ray diagnosis consists of pictures in the a-p and lateral position in comparison with the healthy side. Tomography and toposcintigraphy give further information and can be completed by fistulography. Complementary information is possible by the use of ultrasonography.


[Operative treatment of chondromalacia patellae (author's transl)].

Operative treatment of chondromalacia patella should be indicated especially in adolescents with great care. It can be clearly identified by a narrowing of the cartilage on the X-ray (tangential picture of the femoropatellar joint) and the presence of osteophytes on the margin of the joint. The following methods of operative treatment are recommended: Proximal decompressive operation by splitting the lateral retinaculum in light cases and the elevation of the tuberositas tibiae for severe chondromalacia and femoropatellar arthrosis. Follow-up examinations and the results are presented.


[Organ preservation in contusion of the kidneys (author's transl)].

The majority of our cases (n = 107) were contusions of the kidneys, they were treated conservatively. If a rupture is to be expected the diagnostic measures should include infusion-urogram and selective arteriography. If a rupture has been proved, the early operation should follow immediately in order to preserve the organ. Treating ruptures of the kidneys conservatively should be an exception.


[Cranioplasty; new ways (author's transl)].

Report on cranioplasty by prefabricated plastic implants, reinforced by stainless steel meshes resp. plates or by glass fibre meshes. In frontal cranioplasties the missing orbital roof was reconstructed by the same technique. To avoid infections the nasal sinuses were sealed by a pedicled mucosal flap resp. a free transplanted flap taken from the periosteum of the tibia. All 39 patients operated on this way during the last 6 years are free of complaints and clinical symptoms.


[Rupture of the achilles tendon and eversion fracture of the inner malleolus - a typically combined injury in alpin skiing (author's transl)].

5.3% of all ruptures of the Achilles tendon occurring during alpin skiing are accompanied by an eversion fracture of the inner malleolus. The frequency of this type of combined trauma has not changed in the last fifteen years. A typical eversion trauma resulting in the inner malleolus being torn off, but not involving a rotation motion, occurs in the second phase of an acute angle foreward fall, in which in the first phase, the Achilles tendon has already been ruptured. Simply catching an edge, for the most part of the outer ski edge, does not lead to an eversion fracture as has formerly been supposed.


[Sequela of pelvic fractures (author's transl)].

Different kinds of pelvic fractures with the presumingly most frequent and serious complication of a socket fracture with luxation and the resulting danger of a hip-condyle necrosis are described concisely. Certain problems of therapy resulting from this are partially dealt with. Expert opinions of the accident sequences and the degree of body damage, which has to be assessed, are pointed out. As a progression must be faced in case of a posttraumatic coxarthrosis a re-examination over a longer period (10 years and more) is recommended.


[To day's biliary surgery (author's transl)].

Cholelithiasis is on the increase and operative indications are of a wider range including even preventive procedures. Surgery for silent stones, intra-operative cholangiography, indications for papillosphincterotomy and anastomoses, as well new procedures for nonoperative removal of residual stones are discussed. Transhepatic drainage for some reiterative stenoses of high anastomoses is recommended.


[Early operation in biliary surgery? (author's transl)].

In the last 15 years from 1961 to 1975 the number of operations caused by cholelithiasis increased three- and fourfold. This phenomenon is more due to the increase of the morbidity than to the extending of indication for operation. Reduction of letality from 2,4% to 0,7% and limitation of the acute complications can be considered as important results during this time. The pathological findings reveal a small improvement only. A correlation between the duration of the disease and the increase of serious pathological findings at the time of operation could not be found. During this period neither a shortening of the history of illness nor a reduction of the patients age at operation could be observed.


[Crohn's disease of the large intestine: some problems concerning the surgical therapy (author's transl)].

Experiences with 37 patients operated on Crohn's disease are dealt with. Radical operations are preferred. Limited resections and exstirpations predominate. Colectomy is performed only in case of extensive affection of the large intestine. No type of operation is reliable with regard to recurrence. The prognosis of operations for recurrence is poorer than that of primary operations.


[Total gastrectomy in cancer of the stomach (author's transl)].

143 cases of total gastrectomy in cancer of the stomach from 1961 to 1976 are reported. A satisfactory function is observed in long living patients having a substitute stomach formation ("Ringplastik") as well as in those having been operated according to the method of Graham. The rare occurrence of reflux oesophagitis is attributed to a special technique for anastomosis.


[Hormone levels in the serum of pregnant woman].

The levels of HCG, prolactin, progesterone, 17-beta estradiol and oxytocinase were simultaneously tested in one serum sample in women during the normal course of pregnancy and in those with late toxaemia of pregnancy or threatened premature labour. The significance of the deviations from the mean values measured in both groups of risk pregnancies was estimated in comparison with the values found in physiological pregnancies. On the basis of the comparison of all parameters followed, it has been found out that the deviations in the hormonal levels as measured in both groups of risk pregnancies were as a rule similar.


[Therapeutic induction of abortion in the 1st and 2nd trimesters with intramuscular 15-methyl-prostaglandin F2 alpha].

The effectiveness of intramuscular 15-methyl-prostaglandin F2alpha (15-methyl-PGF2alpha) application for therapeutic abortion was studied in 16 women during the first and second trimester (12 to 17 weeks) of pregnancy. 250 microgram 15-methyl-PGF2alpha were administered initial and at intervals of 2 hours. Of the 16 subjects, 2 aborted completely, 13 aborted incompletely and 1 failed to abort. The mean abortion time for the 15 successful abortions was 11,25 hours and the mean 15-methyl-PGF2alpha dosage 1,35 mgs. Vomiting and diarrhea were the most prevalent side effects occurring in 12 of 16 patients. No serious complications occurred. In 9 women between 7 to 13 weeks of pregnancy a single intramuscular injection of 250 microgram 15-methyl-PGF2alpha was administered 11 to 13 hours prior to vacuum aspiration. All subjects had a gradual softening and dilatation of the cervix (5 to 8 mm). In 7 of 9 patients occurring gastro-intestinal side effects. Acute ascension was observed in 2 women after vacuum aspiration. All subjects had a gradual softning and dilatation of the cervix (5 to 8 mm). In 7 of 9 patients occurring gastro-intestinal side effects. Acute ascension was observed in 2 women after vacuum aspiration. Intramuscular administration of 15-methyl-PGF2alpha appears to be an effective abortifacient. Gastro-intestinal side effects can be reduced by antiemetic and antidiarrheal agents or lowering the initial dose of 15-methyl-PGF2alpha.


[Blood coagulation studies of therapeutic abortion induced by 15-methyl-prostaglandin F2 alpha].

10 women with unwanted pregnancies in the first and second trimester were terminated by use of intramuscular injections of 15-Methyl-PGF2alpha. Studies of bleeding and recalcification time, platelet count, levels of heat-fibrin, prothrombin, partial thromboplastin time, platelet adhesiveness and heparinocytes were performed before treatment. 30 minutes, 4 and 8 hours after beginning of 15-Methyl-PGF2alpha-administration, 2 hours after the expulsion of the product of conception and 24 hours after first investigation. Prothrombin decreased during treatment with 15-Methyl-PGF2alpha and did not obtain the starting value 24 hours after first investigation. Platelet count showed an equal attitude. The time of recalcification increased continuous. Heparinocytes continuous decreased up to 2 hours after expulsion of the product of conception. 24 hours after first investigation a significant ascent was noticed. The results of the studies on coagulation did not indicate a strong injury of coagulation system. They suggest the positive estimation of termination of pregnancy in the first and second trimester with 15-Methyl-PGF2alpha.


[Influence of long-term beta adrenergic therapy on the HPL blood level and the total excretion of estrogens].

Pregnant women with imminent miscarriage were treated with Partusisten and/or Dilatol for tocolysis beginning in the 29. week of pregnancy. During treatment the mean urinary excretion of total oestrogens (n = 35; p less than 0,01 in 36th week of pregnancy and later) and the mean plasma level of HPL increased (n = 8; p less than 0,01 in 33., 34. and 35. week of pregnancy). These changes have to be concidered in judging the fetoplacental unit or the function of placenta.


[Cardiovascular effect of fenoterol (Partusisten)].

8 normotensive late pregnant women in the early latent phase of premature labor were examined before, during and after the intravenous pump infusion of fenoterol (Partusisten) with the method of quantitative sphygmometry, the bloodless graphic registration of the arterial blood pressure and the direct electronic timing of pulse wave velocity. Dose levels of fenoterol were 3 microgram/min and 6 microgram/min. During the administration of fenoterol systolic blood pressure increases insignificantly, but mean and diastolic pressure decrease distinctly with broadening of amplitude. Stroke volume, cardiac output, work and power of the heart increase significantly. The fall of the total peripheral resistance is much more pronounciated than the decrease of blood pressure. Therefore the hemodynamic mode of action of fenoterol is a favourable one in regard to the perfusion of peripheral tissues. The effects on the cardiovascular system in a dose level usual for tocolysis are smaller than those of nylidrin.