Normal lymphocyte transfer reaction in humans and its possible mechanism.

This study illustrates the development of the skin reaction in human recipients to injected allogeneic lymphocytes from two aspects: the capacity of lymphocytes to elicit the reaction, and the ability of the recipient to react. The reaction is expressed by local skin induration and is biphasic. The first phase seems to be a hostgraft reaction; the second may require proliferation of graft cells as well as the reaction of host cells. Circulating fetal lymphocytes collected from a 12-week human embryo caused no reaction in an adult recipient; those from a 15-week embryo usually caused the first phase, with little or no second phase reaction, while those from 22- and 30-week fetuses and from a mature infant caused a normal, biphasic reaction. So, usually, did 22-week splenic lymphocytes, but fetal thymic lymphocytes usually provoked no reaction in adults. In premature infants given adult cells either both phases or the second were reduced; in normal infants the second response may be reduced but after six years of age the reaction is like that seen in adults.


[Antithrombin III deficiency and tendency to thrombosis (author's transl)].

Antithrombin III (AT III) was determined in 290 patients with deep venous thrombosis and/or pulmonary embolism by immunological methods (radial immunodiffusion, Laurell technique) and by biological activity (heparin cofactor activity and anti-Xa activity). Patients with venous thrombosis had a significantly lower AT III concentration, as determined by the immunological methods or biological method (heparin cofactor activity), than normal persons without any history of venous thrombosis. A decreased level of AT III was found in 27 patients. In these patients the immunoreactive antithrombin III was decreased to the same degree as biological activity (heparin cofactor activity or anti-Xa activity). Thirteen out of these 27 patients belonged to 9 families and, hence, congenital AT III deficiency can be assumed in these cases. The aetiology was unknown in the other half. Patients with AT III deficiency are prone to spontaneous and/or recurrent venous thrombosis. A high incidence of pulmonary embolism and particularly, of fatal pulmonary embolism is remarkable. In more than half of the patients the first thrombotic event occurred before the age of 35. The treatment of choice in such patients is with oral anticoagulants of the coumarin group.


[Inhibition of postprandial increase in serum triglycerides by somatostatin in man (author's transl)].

A test meal containing 100 g neutral fat was administered to 10 healthy subjects. Serum concentrations of triglycerides, cholesterol, free fatty acids and gastrin were determined during an infusion of 1000 microng somatostatin/h over 3 hours. In comparison with a control group (infusion of normal saline solution), somatostatin caused almost complete suppression of the triglyceride increase. The free fatty acids showed a slight increase under somatostatin while there was no change in the cholesterol levels. Gastrin release was also completely blocked by somatostatin. The suppression of the serum triglycerides may be explained by the inhibition of digestion and absorption of fat in the small intestine under the influence of somatostatin which suppresses exocrine pancreatic secretion.


[The clinical relevance of scintigraphic adrenal imaging (author's transl)].

Labelled steroid precursors have been found to be valuable in scintigraphic imaging of localized adrenal disease or even in adrenal hyperplasia. Scanning procedures are non-invasive diagnostic methods and, in the case of the adrenals the images reflect anatomical as well as functional changes in the organs, constituting an advantage over angiographic methods. However, careful preparation of the patient, sophisticated technical prerequisites and a case-oriented programme of the procedure favouring either dexamethasone suppression, comparsion with phantom measurements adrenal profiles and/or multichannel analysis are  necessary for the attainment of optimum results on scintigraphy.


[Interactions between oxygen under high pressure and drugs (author's transl)].

A. The clinical applications of oxygen under high pressure (OHP) are limited by oxygen toxicity. Hence, an investigation was carried out in mice on the influence of drugs on the lethal effect of OHP. 1. The lethal effect of OHP is diminished by phenobarbitone, propranolol, clonidine, succinate and tris buffer. 2. The lethal effect of OHP is enhanced by methamphetamine, acetazolamide and guanethidine. 3. The lethal effect of OHP is enhanced by reserpine two hours after administration, but diminished 12 hours after administration. B. The clinical usage of OHP is often necessarily connected with drug therapy. Hence, alteration in drug effects under OHP were investigated in mice and rats. 1. The convulsion threshold of pentetrazol is reduced under OHP by 26%. 2. The duration of the hypnotic effect of hexobarbitone is reduced under OHP by 27%. 3. The analgesic effect of morphine is unchanged by OHP. Practical aspects with regard to the use of drugs during clinical use of OHP are discussed.


[The efficacy of guanidine hydrochloride in the treatment of Werdnig-Hoffmann disease (author's transl)].

The use of guanidine hydrochloride is reported in the treatment of 4 cases of Werdnig-Hoffmann disease. Improvement was achieved in two cases. Amelioration was initially observed in the third patient, but a relapse occurred during temporary discontinuation of therapy and the disease progressed, albeit at a slower rate, after resumption of therapy. The final case was a terminal one in which, however, slight temporary improvement occurred in response to therapy. A maximum dosage of 0.4 g (based on the assumption of an average body weight of 15 kg in these children) was reached by gradual increments. Side effects like shortlasting vomiting were observed only in case 1. The pharmacological action of guanidine hydrochloride is discussed. According to Otsuka and Endon the mechanism of action may be based on an increase in the end-plate potential amplitude. However, an augmented supply of spinal transmitters may also play a role in the mediation to the pharmacological action.


[The advantages of multiple choice tests in undergraduate teaching of pharmacology (author's transl)].

Multiple-choice tests in pharmacology were carried out with students who had no previous experience in this kind of examination. The curriculum in pharmacology was divided into four parts. Each part was followed by a test consisting of 90 questions. A special arrangement was made for those students who voluntarily participated in all four tests during academic year. Pass marks in all four completed tests were considered equivalent to a successful outcome in the one oral examination which is, at present, obligatory. In order to encourage a high level of participation amongst the students, failure in one or more of the tests had no adverse consequences. As a result, a markedly increased attendance at lectures, as well as a positive feed back of information for the faculty, were ascertained and assessment of the efficiency of the teaching methods facilitated. Application of multiple choice tests to the teaching of Pharmacology to undergraduate students proved to be recommendable, both as a test procedure and of advantage in the actual learning process.


[Therapeutic results in sarcoma of the uterus (author's transl)].

60 cases of sarcoma of the uterine body were treated at the Ist Department of Obstetrics and Gynaecology, Vienna University, during the period 1960 to 1971. Treatment consisted of combined surgery and irradiation (37 cases), surgery alone (8 cases) and irradiation only (14 cases). The 5-year survival rate was 53.3%.


[The clinical value of radioimmunological oestradiol assays in the diagnosis of menstrual disorders. Evidence suggesting the presence of an ovarian "inhibin" (author's transl)].

The radioimmunoassay of oestradiol 17 beta (E2) from the blood without chromatography was evaluated in regard to the diagnosis of menstrual cycle disturbances. Two significantly different classes were distinguished, viz. 1. Women with higher E2 values, consisting of three groups: normal controls, cases of oligomenorrhoea, and WHO II (normogonadotropic, clomiphen-positive amenorrhoea). 2. Women with lower E2 values, consisting of two groups: WHO I (hypogonadotropic, clomiphen-negative amenorrhoea) and WHO III (hypergonadotropic amenorrhoea). Within these classes no significant differences were found between the groups. Only values below 43.1 pg/ml can be assigned with 95% certainty to the low-value class and only values above 108.8 pg/ml can be assigned with 95% certainty to the high-value class. The fact that 40% of all E2 values in hypergonadotropic, (i.e. ovarian) amenorrhoea fell within the range of the double standard deviation of the normal group and, likewise, the fact that physiological doses of oestrogen cannot reduce postmenopausal FSH to the level found in women of reproductive age suggest that E2 is not the only FSH-reducing factor, which leads us to postulate the existence of an ovarian "inhibin".


[Case report of a Gartner's duct carcinoma of the vagina (author's transl)].

A case report is presented of a malignant tumour of the vagina arising from the mesonephric duct (Gartner's duct) in a 34-year-old woman. The diagnostic difficulties are illustrated on the basis of the course, clinical findings and cytological and histological reports. In an attempt to classify the histological picture amongst the great diversity of forms of mesonephric tumours it would appear advantageous to distinguish between a mesonephric tubulopapillary "Gartner's duct type" and a metamesonephric "clear-cell type". Management by extended radical operation and subsequent combination chemotherapy, as carried out in this patients, appears promising.


[Nutritional status, food consumption and food supply of studies in Saudi Aribia. I. Anthropometric data].

A field study about the nutritional status was made in school classes with boys 6 to 19 years old in different regions of Saudi-Arabia. It is reported about 341 pupils in regard to weight, height, skinfold-thickness, circumferences and other body-size measurements. In comparison with anthropometric measurements of comparable surveys in other countries, the Saudi-Arabian school boys were found to be smaller and leaner than boys from the USA, Europe, other Arabian countries and well-to-do Indian boys.


Study on the effect of food irradiation on some blood serum enzymes in rats.

The effect of feeding an irradiated diet on the activities of some blood serum enzymes in rats have been studied. This study revealed some significant changes of SGOT due to sex differences. The results obtained failed to show any significant changes in the enzyme activities of SGPT and serum LDH neither in relation to sex nor to the irradiation doses studied.


Protein and amino acid pattern in juvinile diabetes.

A number of 21 diabetic juveniles and 20 controls comprised the material of this study. Serum total proteins and their electrophoretic separated fractions were estimated. Serum free amino acids were also investigated. Results showed that serum proteins were within normal range. An average increase of 49.5% in total free amino acids was reported. In general, the data for all the detected amino acids showed an average increase when compared with normal values. The significance of these findings in relation to the normal values were discussed.


[Liver cirrhosis--classification, etiology, pathogenesis, progress, reversibility].

On the basis of our modern knowledge of structure and function of the liver at first the cause of the liver cirrhosis and the essential possibilities of classification are discussed. A further important problem is the question of progression and regression of the liver cirrhosis. Here special immunomechanisms play a part, the possible influences of which on a progressing of the disease are demonstrated in detail. Of particular importance are, apart from this, the influence of the virus hepatitis and the question, how many liver cirrhoses are of hepatitic genesis. Also, the importance of alcohol and the mechanisms which from an alcoholic liver damage form a cirrhosis are treated. Finally the author deals with the evidence of the diagnostics of biopsy, in which case, apart from the diagnostics, first of all the prognostic judgment of the development of the cirrhotic process is of importance.


[Immunopathological aspects of liver cirrhosis].

After a short historical retrospect and a comment on the nomenclature and on the notion of chronic hepatitis and liver cirrhosis the diagnostic criteria and immunopathological peculiarities of virus-induced HBsAg-positive, non-virus-induced autoimmune, drug-induced and finally cryptogenic chronically progressing liver diseases are discussed. Immunoserology and immunohistology are nowadays to be regarded as the most important enrichments in the diagnostic spectre for the differentiation of chronic inflammatory liver diseases. In order to complete the diagnostic programme and to understand the pathogenesis of cryptogenic chronic hepatitides as soon as possible an establishment of the hepatitis-A- and C-serology is necessary. Apart from a further analysis of the group of the non-B-hepatitides the diagnostic use of other markers of virus hepatitides will be able to adopt a definite attitude to the unclarified question of virus-induced autoimmunopathies in liver diseases. The primary biliary cirrhosis with the morphologic findings of a chronically destructing, non-purulent cholangitis is an immunologically conditioned liver diseases of unknown etiology, which in contrast to the autoimmune chronic active hepatitides and liver cirrhoses is not to be influenced in the course by therapeutic measures.


[Liver cirrhosis and diabetes mellitus].

Statistically there exists an increased coincidence between liver cirrhosis and diabetes mellitus. The higher frequency of cirrhosis in diabetics compared with the normal population is to be explained partly from the higher risk of hepatitis. In addition to this the diabetic suffers from disturbances which further the development of cirrhosis, such as fatty degeneration of the liver, abuse of alcohol, more frequent inflammatory diseases of the bile duct and others. When a diabetes mellitus exists in liver cirrhosis it is to be differed between a diabetes due to absolute or relative insulin deficit and disturbances of carbohydrate clearance which are associated with normal or increased insulin levels. The latter form can be denoted as so-called liver diabetes. Main cause of this carbohydrate intolerance is an insulin resistance, partly by deminution of the metabolically active liver parenchyma, partly by the diminished reactivity of the peripheral tissues. By prophylactic measures and differentiated therapy may be favourably influenced lesions of the liver in diabetes mellitus as well as disturbances of the carbohydrate metabolism.


[Conservative therapy of liver cirrhosis].

After a short survey on the history of the therapy of liver cirrhosis the importance of the prevention of alcoholism is emphasized. A "liver diet" is regarded as unnecessary, prednisolone is recommended for the treatment of the active cirrhosis. After a short description of the principles of the therapy of biliary cirrhoses, of haemochromatosis and of Wilson's hepatocerebral degeneration the use of restriction of salt, saluretics and aldosterone antagonists in the treatment of ascites is discussed in detail. After description of the conservative therapy of the haemorrhage from varices with the compression sound, intraarterial octapressin infusion and combat against consumption coagulopathy finally the prophylaxis of the hepatoportal encephalopathy with reduction of the protein intake and the restriction of the formation of toxic products of protein metabolism in the intestine by application of neomycin or lactulose, respectively, is described.


[Laboratory diagnosis in kidney- and bladder diseases].

The laboratory diagnostic spectre in diseases of the kidneys and the urinary bladder is demonstrated in form of a 3-step-programme. The concentration of suitable investigation methods in complexes allows a rational and economical diagnostics for patient and physician. A standardisation of the diagnostics in out-patient department and clinic essentially contributes to the reduction of excessive work in overcharged laboratories as well as to the shortening of the patient's stay in the hospital.


[Use of the leukocyte migration test in the clinical diagnosis of liver diseases].

A simple performance of the leucocyte migration test is described and its use in the clinical laboratory diagnostics is recommended. The reduction of the methodical expenditure is prerequisite of a broad use and obtaining of experiences in large groups. The possible loss of specifity can be compensated by critical inclusion into the general picture. The test can help in the decision, whether the indication of an immunosuppressive therapy is necessary.


[Function of the left ventricle in the acute phase of myocardial infarct].

In the acute phase of myocardial infarction in 22 patients intraventricular pressure measurements (left and right heart catheters) were performed. In addition to this in 17 cases a qualitative and quantitative angiocardiographical judgment of the function of the left ventricle was done. A group of 9 patients with healthy heart served as control group. The group with infarction showed typical findings deviating from the normal. Stroke volume, cardiac output and stroke work of the left ventricle were significantly decreased. The systolic ejection fraction which was highly significantly reduced in contrast to the normal value proved as a particularly sensitive index. The contractility parameters dp/dt max. and VCE(dp/dt max.) were also highly significantly reduced; aortic mean pressure and heart rate did not show any significant changes. A compensation of the decrease of the heart function depending on contractility is achieved in the acute phase of the myocardial infarction by a significant increase of the wall stiffness, in which case apparently the ventricle practically exclusively by this means strives for an optimum filling pressure in order to maintain a sufficiently large stroke volume. The practically unchanged enddiastolic ventricle volume excluded at least for the uncomplicated infarction in the acute stage an essential participation of Frank-Starling's compensation mechanism.


[Steatosis of the liver cells--subclinical liver damage or more?].

The basis of the results are histological investigations of the preparations of liver biopsy of 134 donors who were evident in the SGPT-screening and of 100 patients with viral hepatitis after normalisation of the clinical and the laboratory-chemical findings. The liver casts were got by means of Menghini's method. In patients with hepatitis we found in 43% and in donors in 44% a small-droplet to medium size droplet fatty change in the liver cells. A large-droplet fatty change in the liver cells occurred in the patients with hepatitis only in 2% of the cases, in the donors, however, in 25%. Factors which favour the fatty change in the liver cells, such as adiposis, alcohol and prednisone therapy, were excluded. Our results increase the suspicion that in one part of the clinically healthy donors who are evident in the SGPT-screening we have to do with persons who are in the healing phase of a viral hepatitis with abortive course. Therefore, these persons should be excluded from blood donation. Donors and patients with the findings of a large-droplet fatty change in the liver cells must be investigated systemically. Blood donors with the findings of a fatty liver may remain in the team of donors.


[Prognostic significance of serum iron level, hemoglobin and rheumatoid factor titre in rheumatoid arthritis].

On the basis of the results of a five-year examination of the course on 120 patients with rheumatoid arthritis the authors adopt a definite attitude to the prognostic significance of hypersiderinaemia, anaemia and height of the titre of the rheumatoid factor. With the help of the chi2-test and the rank correlation after Spearman the statistical relations to stage, activity, clinical and radiological progressing as well as to the number of the affected joints were examined. In seropositive patients we found a correlation of the titre of rheumatoid factor and stage. Furthermore a clear correlation existed to clinical and radiological progressing as well as to the number of the affected joints. Early highly positive titres of the rheumatoid factor as an expression of high immunologic activity suggest an unfavourable prognosis in the majority of cases. Constant anaemia and hyposiderinaemia as symptoms of a high basis activity of the disease also showed close relations to the progressing. From this result indications for the early use of important therapeutic measures. For the prognostic judgement of the course of the disease of rheumatoid arthritis it is necessary to have at disposal further methodically simply determinable parameters for the recognition of the basis activity and the immunologic activity.


[Idiopathic adrenal cortex dystrophy with the clinical picture of Addison's disease].

Clinical and autopsy findings are reported of three cases of Addisons disease due to idiopathic dystrophy of the adrenal cortex as seen in two women, 20 and 37 years of age respectively as well as a boy of 14 years. Idiopathic dystrophy of the adrenal cortex as a cause of Addisons disease has become aware of more and more frequently for some years. Its classification as an auto-aggression disease has been made a subject for discussion. Morphological findings and immunological investigations with three own cases confirm this conception. This disease should be reminded of with regard to the problem of clinically diagnosing it and the fatal prognosis of untreated cases.


[Dependence of lactate on pulse rate, performance and cardiac volume performance quotient in rehabilitated myocardial infarct patients during bicycle ergometry].

All males of the district Cottbus who suffered from an acute myocardial infarction between 1 June 1973 and 30 June 1974 and survived the first rehabilitation phase of a definite myocardial infarction were included in the study. Their arterial lactate level, the oxygen intake, the heart rate and heart size were determined by means of standardized ergometry and radiology. Patients who had performed a rehabilitation training programme showed a higher efficiency and equal values of lactate level and heart rate compared with the patients without training programme. A close correlation also existed between lactate level and heart rate. There was no dependence on the age of the patient or the degree of heart insufficiency. These results allow to conclude that the lactate level can be used for the determination of the training intensity of patients after an acute myocardial infarction.


[Digitalis intoxication: specifity and significance of cardiac and extracardiac symptoms. part I: Patients with digitalis-induced arrhythmias (author's transl)].

In 1164 cases clinical and electrocardiographical findings were correlated with serum digoxin concentrations (SDC). The diagnosis of digitalis intoxication was based on rhythm disturbances which disappeared on withdrawel of the drug. The mean SDC for patients with digitalis-induced arrhythmias was 3.07 ng/ml compared to 1.02 ng/ml for patients with normal Ecg's and 1.01 ng/ml for patients with rhythm disturbances of other origin. Taking 2.0 ng/ml as the lower limit of digitalis intoxication a more than 85% coincidence was found between the diagnosis based on serial Ecg's and on SDC levels. No signs of cardiac toxicity were found in patients with SDC's less than 1.6 ng/ml, some patients, however, showed normal Ecg's despite SDC's up to 4.5 ng/ml. Patients with SDC's greater than 1.9 ng/ml and normal Ecg's were significantly younger than patients with digitalis-induced arrhythmias at comparable SDC's. Although no definite diagnosis of cardiac toxicity could be established in 327 cases, the clinical data of patients with SDC's of 2.0 ng/ml and greater resemble closely those with digitalis-induced arrhythmias while patients with SDC's less than 2.0 ng/ml showed close resemblance to patients with no cardiac evidence of toxicity with regard to: mean age, kidney function, mean digoxin dosage and mean body weight. Patients with elevated SDC's showed a 45% incidence of severely impaired kidney function in contrast to 28% of the patients with  SDC's less than 2.0 ng/ml. Even in patients with normal kidney function the correlation between the orally administered digoxin dosage and SDC levels was poor. The correlation was significantly better when dogoxin was administered intravenously. Therefore knowing the amount of digoxin taken (according to the patient's statement) seems of little benefit in the evaluation of digitalis toxicity. In patients with digitalis-induced arrhythmias mean age and mean body weight were significantly lower, mean creatinine concentration and the incidence of severe cardiac insufficency and of typical ST-T-changes were significantly higher. There was no significant difference in mean potassium concentration and incidence of coronary artery disease compared to nontoxic patients. Compared to patients with cardiac arrhythmias of other origin there were no significant differences in mean age, mean potassium and creatinine concentrations and cardiac insufficiency while the incidence of coronary artery disease was significantly higher among patients with rhythm disturbances of other origin. Every type of rhythm disturbance can be digitalis-induced. Among our patients the incidence of digitalis-induced second-degree atrioventricular block (Wenckebach), ventricular bigeminy, nonparoxysmal nodal tachycardia and PAT with block was significantly higher while patients with rhythm disturbances of other origin showed an equally high incidence of PVB's and prolongation of PQ interval...


[Digitalis intoxication: specifity and significance of cardiac and extracardiac symptoms. part II. Patients with extracardiac symptoms of digitalis intoxications (author's transl)].

In 1148 cases the serum digoxin concentration (SDC) was correlated with the extracardiac signs of digitalis intoxication. There is a considerably overlap of SDC levels of patients with and without extracardiac signs of toxicity even though the mean SDC's of these two groups differ significantly. An increasing percentage of clinical intoxicated patients with increasing SDC levels was found at digoxin concentrations of 2.0 ng/ml and higher. At lower SDC levels patients with and without extracardiac signs of digitalis intoxication did not differ significantly in their mean SDC but in mean age and in mean creatinine concentration indicating that at least part of the symptoms in these patients might be due to a more severe illness. We could show that many of the extracardiac signs of digitalis intoxication are also seen in patients with impaired kidney function at low SDC levels and may lead to a wrong diagnosis. The most common complaint in patients with SDC's of 2.0 ng/ml and more is nausea (39.4%), followed by tiredness (30.4%), dizzyness (23.7%), vomiting (23.1%), headache (16.0%), visual disturbances (13,5%), colour (yellow) seeing (6;7%), diarrhea (4.2%) and severe neuro-psychiatric disturbances (3.8%). In patients with digitalis-induced arrhythmias the sequence of symptoms is the same only with a somewhat higher percentage rate. Only about one half of the patients with digitalis-induced arrhythmias and SDC values up to 2.5 ng/ml showed also extracardiac signs of intoxication. Therefore these signs are not to be taken as early symptoms of digitalis intoxication. Divided into subgroups (patients with/without digitalis-induced arrhythmias, patients with SDC values of more/less than 2.0 ng/ml) the patients with and without extracardiac signs of digitalis toxicity are compared with each other in regard to: mean body height and weight, concentration of digoxin, potassium and creatinine, digoxin dosage and mean age. The greatest differences were found between patients with combined cardiac and extracardiac signs of intoxication and patients with neither cardiac nor extracardiac signs of intoxication: These intoxicated patients are of significantly higher mean age and lower body weight, their mean concentration of digoxin and creatinine and the digoxin dosage administered are significantly greater, but there is no significant difference in potassium concentration. An important group of patients, namely the elderly with impaired kidney function, are especially prone to develop digitalis intoxication. In this group, however, the extracardial symptoms are of little benefit in the diagnosis of digitalis intoxication. In these patients rhythm disturbances and intoxication-like symptoms are frequently caused by other reasons. In most cases the SDC value can clarify the diagnosis without withdrawal of the drug.


[The relation between the electrophysiological parameters of the right atrium and the AV-node conduction (author's transl)].

40 patients were examined with the extrastimulus method at 3 different driving rates (80, 100 and 120/min). It was found that the atrial conduction velocity during the relative refractory period sometimes explains a paradoxical conduction of a premature atrial beat. The AV-node conduction is mainly determined by the correlation between the functional refractory period of the right atrium (FRPRA) and the effective retractory period of the AV-node (ERPAVN). With increasing driving rate the FRPRA shortened while ERPAVN lengthened. This explains why in this study the number of patients in which the ERPAVN could be reached progressively increased from 23 at a driving rate of 80/min to 31 and 33, respectively, at the driving rates of 100 and 120/min.


[Vectorcardiographic examiniations in the syndrome of Wolff-Parkinson-White (author's transl)].

In 37 cases of WPW-syndrome the delta and the 10 msec instantaneous vectors of the QRS and the ST and T vectors were determined by a triaxicardiometer (TMC) analogue computer. The Descartes' coordinates were calculated from the polarcoordinates by the application of circular functions and the 12 conventional leads were numerically and graphically reconstructed from them by coeffificients. In the case of WPW-syndrome the chambers are activated partly by the ventricular pre-excitation, partly by the normally generated and conducted impulse. The delta vector is formed by the pre-excitation, it is oriented toward the right posterior superior, the right posterior inferior and the right anterior superior spatial octants. The early ventricular depolarization is spreading on a myogenic way, when reaching the conduction system, it is partially activated. Related to the ventricular pre-excitation the normally generated and conducted impulses have a delay. This "phasic aberrant conduction" is the cause of a "fusion beat" or functional block. If the pre-excitation, spreading on myogenic way reaches one fascicle, a bifascicular block-like WPW-syndrome is resulted. If the early ventricular excitation penetrates two fascicles, a monofascicular block-like WPW-syndrome is developed. If the early excitation of the three fascicles or of the bundle of His takes place by the activation of the James bundle, delta-wave is not generated, the ventricular depolarization remains normal (LGL-syndrome), but in such a case the normally conducted sinus impulses are also delayed.


[Systolic time intervals and abnormal left ventricular contraction in coronary heart disease (author's transl)].

Systolic time intervals (STI) were determined in relation to haemodynamic and angiographic data in 72 patients (pts.) with chronic cornary heart disease (CHD). Routine right-and left-heart catheterization was performed with a view to coronary surgery and/or left ventricular (LV) aneurysmectomy. LV and pulmonary pressure were measured before LV and coronary angiography. Non-invasive investigation (not simultaneously done with catheterization) included the registration of phono-and apexcardiogram and the carotid pulse. The following time intervals were averaged over a period of 5 beats: electromechanical systole (QA2), left ventricular ejection time (LVET), pre-ejection period (PEP), electro-mechanical interval (EMI), isovolumetric contraction and relaxation period (IVCT and IVRP), and the ratio PEP/LVET. LV angiography showed normal con-raction in 24 pts., localized dyskinesis in 25 pts., aneurysm in 12 and generalized dyskinesis in another 11 pts. (groups 1-4). in pts. with chronic CHD, PEP and IVCT are prortionally prolonged (r=0.816***). QA2 and (even more) LVET are shortened. The correlation of LVET and QA2 with heart rate remains significant (p less than 0.005). Prolongation of PEP and IVCT and shortening of LVET and AQ2 increase with the extent of LV contraction abnormality. The degree of STI abnormality correlates with an increase in pulmonary pressure. Shortening of LVET does not correlate with lengthening of PEP. PEP/LVET ratio increases significantly with LV dyskinesis: being 0.394+/-0.085 in pts. with normal contraction, 0.448+/-0.076 with normal contraction, 0.448+/-0.076 with localized dyskinesis, 0.541+/-0.167 with generalized dyskinesis and 0.565+/-0.093 with LV aneurysm. -IVRP is prolonged (to 0.131+/-0.019 sec) without significant differences between the four groups. Non-invasive findings in chronic CHD roughly classify pts. into groups with definite LV contraction abnormality. However, clear estimation of the actual pressure in the (diastolic) LV and in the pulmonary circulation from non-invasive data is of course not possible.


[Initial serum potassium level in relation to cardiac arrhythmias in acute myocardial infarction (author's transl)].

In 565 patients with acute myocardial infarction admitted to a coronary care unit within 12 hours of the onset of symptoms, serum potassium level was determined on admission. The incidence of dysrhythmias occurring during the first 12 hours was referred to the initial serum potassium level. Hypopotassemia (less than or equal to 3.5 mmol/l) was seen in 9.2% and associated with a significantly higher incidence of ventricular arrhythmias in 33% as compared to 18% in the control group. Especially ventricular fibrillation was significantly more frequent in the hypokalaemic (14%) than in the normokalaemic (3%) patients (P less than 0.01). Hyperpotassemia (less than or equal to 5.1 mmol/l) was found in 6% with a higher incidence of second and third degree AV block and left-bundle branch block. This group was much more prone to severe haemodynamic complications and therefore had a bad prognosis with a high clinic mortality of 53%. There was no relation between supraventricular arrhythmias, sinuatrial bradyarrhythmias and intraventricular block other than left bundle branch block to serum potassium level.


[Comparative studies of thresholds after implantation of pacemaker leads of different size (author's transl)].

Within the first 14 days after implantation, thresholds were measured at three transvenous pacemaker electrodes with different surface areas. It should be verified, 1. to what extent a correlation existed between maximal threshold increase and electrode surface, 2. how electrode impedance and 3. how the amplitudes of the R-wave voltages developed. The results were: At initial implantation, thresholds were all the lower the smaller the electrode-surface area was. On overage, 9-10 days after implantation the highest thresholds were reached. Thereby, in small surface area electrodes the threshold-increase factor was greater than in larger ones. In all cases the current threshold increase exceeded that one for voltage thresholds. 14 days later, thresholds had dropped again compared to the maximum. And this decrease was depending on the electrode-surface area also. The electrode impedance decreased after implantation to rise later on once more to 80-88% of the original value. The magnitude of the detected R-wave was independent on electrode-surface area. Indeed, using small surface electrodes, signal reductions up to 50% could be found. But 14 days later they reached again 80-95% of the initial amplitude. The key finding there is that when applying small surface-area electrodes and presuming suitable initial thresholds it seems to be possible to connect low-output pacemakers (output 5,4 V and impluse duration 0.25 ms or 4 V at 0.5 ms) to those electrodes. By this reduction of the safety margin, a considerable increase in pacemaker lifetime could be achieved.


[Hemodynamic study on a new antihypertensive drug (a pyridopyridazine) in the treatment of hypertensive crisis and resistent hypertension. First findings in man (author's transl)].

Hypertension presents many unsolved therapeutical problems. On this reason further examinations on new antihypertensive agents are needed. BQ 22-708 is a pyridopyridazine with peripheral vasodilating activities, which has been shown in animal experiments marked antihypertensive properties of dihydralazine-type. A hemodynamic study revealed now similar effects in man, as could be demonstrated in 5 patients with resistent hypertension and additional hypertensive crisis in two cases. At these patients BQ 22-708 in doses between 5 and 15 mg reduced the mean arterial pressure by 48 mm Hg, but at the same time increased heart rate. Peripheral resistance was significantly reduced by 30-60%. Cardiac output increased. Stroke volume remained unchanged in patients without heart failure, but in those with cardiac insufficiency increased. There was a slight but non-significant reduction in pulmonary artery pressure and capillary wedge pressure, wheras right atrial pressure remained unchanged. The onset of drug activity was noticed 10-20 minutes after application of a single dose BQ 22-708 and lasted for about 5-6 hours. Therefore BQ 22-708 may prove to be useful in the therapy of resistent hypertension.


[Osteotomy of the pelvis (Chiari) (author's transl)].

Judging by 203 cases the pelvic displacement osteotomie by Chiari has proven to be a very effective method to correct the deficient femoral head cover of the dysplastic acetabulum, in many cases however it is difficult to normalize the roof angle. We examined 51-joints in which the pelvic osteotomie by Chiari had been performed just before and particularily after growth had come to an end, in view of the prophylaxis of arthrosis of this operation. Hereby we observed that development or increase of anthrotic signs on an average of 10 1/2 years was less frequent than could be expected without the osteotomy, the clinical condition remaining approximately the same as before the operation, but nevertheless did not deteriorate.


[Quadriceps femoris muscle during immobilisation and remobilisation (author's transl)].

40 patients of which one leg had been immobilized in a pop cast for 3 and 12 weeks have been investigated with view to the quadriceps muscle. Mechanical and electromyographic investigations revealed the muscular changes under immobilisation and their recovery after removal of the cast. After 12 weeks of immobilisation and 24 weeks of remobilisation the muscle mass is still diminished.


[Reaction of synovial membranes in knee joint with primary extra-articular systemic diseases (author's transl)].

Postmortal histologic examinations of the synovial membrane of both knee joints were conducted in 85 selected cases. The following conditions were given priority: diabetes mellitus, advanced renal insufficiency, liver cirrhosis with ascites, chronic insufficiency of the right heart, vericose syndrome of the lower extremities, tumours compressing organs of the pelvis minor as well as a few rare infectious and tumerous diseases. Comparison of the histomorphologic findings revealed consistancies such as pronounced ultravillous branching of the synovial membrane with villous hyalinosis in diabetes mellitus, increased, coarse villi formation in renal insufficiency and liver cirrhosis, edema of the synovial membrane in chronic insufficiency of the right heart and renal insufficiency as well as a number of nonspecific reactions of the synovial membrane in obstruction of venous drainage. In the context of generalized fibrotic processes such as in Ormond's disease and scleroderma, similar reactions of the synovial membrane are pronounced. Arthralgic complaints and secondary arthroses in those systemic diseases not primarily involving joints can be at least partially clarified by histomorphologic findings.


[Reactive-periodical variations of vegetative parameters following orthopedic operations (author's transl)].

Continuous examinations during 4-6 weeks following various orthopedic operations of circulatory, retinuous improvement of the factors examined. E.g. frequency of resting pulse showed periodic variations with, in parts, regressive tendencies. In individual cases the maxima and minima of these variations showed considerable differences, but had a peak of frequency at 6-7 days. Similar variations of stabilizations of circulation were seen in 7 amputees of the lower limb, at rest and when learning to walk. Such variations with mainly circaseptan periodicity are unspecific accompanying reactions as part of vegetative adaptation, as known elsewhere. Similar investigations on 15 patients, walking after replacement of the hip joint and before the operation, are reported on. During the first 3-5 postoperative weeks circulatory findings were much worse, but 2 years later the values at rest and when walking were much improved, because of better walking economy.


[The influence of the countersink geometry on the cortical screw force (author's transl)].

In vitro examinations on deformation and relaxation were carried out on cortical countersink of different geometry under a compression load of up to 2000 N through a screw head. Conical countersink showed plastic deformations of an average of 1300 N whereas with spherical countersink they did not occur at the same load. After reaching the load of 2000 N and keeping the deformation constant we saw a significantly stronger reduction of force with the conical countersink then with the spherical type. As far as fracture fixation is concerned a smaller postoperative reduction of screw force can be expected if applying a cortical screw with a spherical head in a spherical countersink.


[Legal claim of integration (author's transl)].

For more than 100 years in different sectors the attempt has been made to define rehabilitation and to make it significant in the practice of rehabilitation. If you watch especially the past 70 years in Germany, then the legislature concerning the protection of health, the provident measures, the case of invalidity is so progressive and from year to year becoming more extensive, that there is actually always an area, in which there is a legal way to help the disabled. Nevertheless there are always gaps within a measure of rehabilitation which are necessary to be filled in common efforts. In the Federal Republic of Germany there is a legal clain of rehabilitative measures in a comprehensive way indeed, in which we think of the necessity of a federal rehabilitation law, since certain methods in the arrangement and exhausting of previous legislature for the disabled is often too difficult. In spite of best legal conditions, however, it has to be considered, and the dynamics in the accomplishment not only of the particular functions, but also of the special aims always will be significant for the understanding of a society. Legal claim of integration should therefore never be in doubt.


[Medial-and simultaneous anterior-transfer of the tibial tuberosity (author's transl)].

Because of the triangular cross-section of the tibia medial transfer of the tuberosity according to Hauser and Roux leads to a backward displacement of the insertion of the patellar ligament accompained by rotation. This mechanically unfavourable effect can be made good by a change in technique of removing the tuberosity. It is not removed as a flat disk of bone but as a bone-block of triganular shape in cross-section and fixed on the medial surface of the tibia with a special flat-headed screw. The technique is described in detail.


[On the differential diagnosis of shadows due to calcigerous soft tissue in the extremities (author's transl)].

We report a case of an unusual compact limy shading of the soft part in the lower leg, obviously caused by unphysique material the origin of which even retrospectively could not be clarified. Pathological compact limy shadings of the soft parts of the extremities are possible because of numerous reasons. Hereby the tissue calcination will be defined from the real ossifications and the direct exogene shades. Deficient knowledge of the pathophysiology often makes a preoperative difference very difficult with equivalent reoentgenological statements. The own difficulties in diagnosis of the case in question will be shown.


[Directional selectivity of neurons of the superior colliculi of the lamina quadrigemina in visually deprived rabbits].

The reactivity of neurones in the superior colliculi to the movement of the optic stimulus was studied in monocularly and binocularly deprived rabbits (MD and BD). Deprivation was effected by suturing the eyelids before the eyes opened. The neurones were classified into three groups by the degree of their directional selectivity (absolute, relative and zero). The effect of a prolonged (ten weeks or more) early MD consisted in the absence of collicular units with absolute selectivity. Proceeding from the existence of such units in the MD type rabbits in the third week of their life, it is suggested that prolongation of the MD time leads to their functional reduction. As the recorded characteristics of unit responses do not change in BD rabbits, it is assumed that the MD effect is not linked to limiting the  function of vision and is just a consequence of a prolonged asymmetry of optic stimulation. The deprivation effect at the collicular level in different vertebrates is discussed.


[Effect of motor activity of adolescents on visual evoked cortical potentials].

Light flashes, indifferent to the subject, of 5 msec duration and of 0.27 joule intensity, were presented during school period to two groups of children with different levels of motor activity. The school children whose mobility was by 40 to 45% below the physiological norm exhibited longer latencies of late P3 and O3 components of averaged visual evoked potentials. It is assumed that the longer latencies are due to a lowered level of functional activity of the non-specific brain structures working in conditions of hypokinesia in a more synchronized regime. The introduction of a daily lesson of physical exercises of enhanced motor activity suffices to compensate for disturbances in the brain integrative activity, caused by hypokinesia.


[Evoked potentials in cortical and subcortical structures of the visual system to photic and acoustic stimuli under conditions of early light deprivation].

Rabbits raised during one month in the dark have exhibited a lower amplitude and longer peak latencies of evoked potentials (EP) to photic stimuli in the visual cortex and the lateral geniculate body with a simultaneous increase of amplitude and decrease of EP latencies in these formations to acoustic stimuli. Similar changes have been observed in the EP amplitude as well as unvaried latencies in the superior colliculus. An assumption has been made that under light deprivation monosensory units change after the type of function deficit, while polysensory ones, change after activity increase type. The later sets in as a result of compensatory processes due to enhanced activity from the receptors of other sensory systems (auditory, olfactory, somaestetic, and others).


Social goals, health policy and the dynamics of development as bases for health education.

Among the most powerful social forces in this century is self determination of nations and of people. The relatively recent phenomenon of community participation in health decisions in some countries is but one aspect of the larger societal value. We can assume that self care, mutual care and collaborative involvement between providers and citizens flow from the concept of self determination. Although the pace is uneven and varies greatly among different communities and in different countries, there is a global movement towards health by the people. This is reflected in the decline of professional dominance of the health field as people in communities assume greater responsiblity for tasks previously monopolized by the health professionals. At the macro level, communities are making decisions in the allocation of resources for health and setting health priorities. At the macro level, health education is increasingly concerned in assisting consumers to develop skills in self diagnosis, self help and self care. However, if health is a human right, it must also be appropriated responsibly by those who claim it. Many healthy problems have their roots in community life. Today, major reductions in death and disability cannot be expected from curative services; instead, future progress will have to result from changes in the environment and lifestyle. Environmental changes will require in turn the cooperation of non-health sectors. Traditionally, professionals and others in these sectors have been reluctant to touch health planning and health policy due to medical dominance and a general attitude that health care belongs to the health professions. A primary task in health education is therefore to build stable linkages with other workers and the public in order that health status may be improved by finding areas of common concern and by institutionalizing joint efforts in seeking solutions through multipurpose planning. In-service training and continuing education for professionals and decision-makers are important strategies in this connection. The fostering of community capabilities for health planning and citizen responsibility in health matters is a priority in health education. This represents an investment in health resource development since the basic resources for collaboration in health improvement are people themselves, both professional and lay. Through community participation, all of us become both shapers of societal goals and governmental policies concerning health and health care, and recipients of the fruits of those goals and policies.


[Cortical evoked potentials in children with lesions at different levels of the brain stem].

Analysis was made of EPs in the occipital and central cortical areas of injured rhombencephalic and basal diencephalic parts of the brainstem. Localization of the pathological focus in the rhombencephalon brought about facilitation of the EP as expressed in stability of its forms in different subjects, increased amplitude and distinctness of early components in the occipital projection area. When the basal diencephalic structures are injured the EPs are reduced. The most affected in the occipital area are the early waves, and in the associative area, the late components of response. The results so obtained help to elucidate the role of the brainstem structures in the EP genesis.


[Effect of neurotropic substances on a change in evoked potential amplitude following hypothalamic stimulation].

Records of evoked responses to clicks in the cortex, reticular formation and hippocampus as well as determination of thresholds of hypothalamus stimulation eliciting fear and rage reactions, have shown that after emotional excitation the hypothalamus excitability is enhanced and the thresholds of perception of foreign signals are higher causing a slackening of attention to them. Trifluoperasine and galoperidol in a dose of 0,5 mg/kg, diazepam (0.5 and 1,0 mg/kg), benactizine (0,5 and 1,0 mg/kg), chlordiazepoxid (2.5 and 5 mg/kg), amitriptiline (2,5 and 5,0 mg/kg), imipramine (2,5 and 5,0 mg/kg) normalize the attention after emotional excitation by reducing the excitability of the hypothalamus. Pentobarbital (1,0 and 2,0 mg/kg), chlorpromazine (0,5 and 1,0 mg/kg) as well as trifluorasine and galoperidol in a dose of 1,0 mg/kg, deepen the attention disturbances after emotional excitation due to a blockade of inhibitory effects of the basolateral amygdala and dorsal hippocampus on the hypothalamus.


The real challenge: a self-health system with genuine commitment.

Major concepts and principles of health education have succeeded when they have been applied in the field with genuine commitment as illustrated by the programme at the Rural Health Training Centre in India and demonstrated by health education projects in Indonesia, Nepal, Sri Lanka and Thailand. But community health programmes have either failed or their progress  been retarded by lack of true commitment to these concepts and principles. At the political, administrative and technical levels of administration, commitment can be developed and strengthened by involvement in health education programmes which apply and adapt health education concepts and principles. Commitment spreads vertically and horizontally, and health education faculty in the schools of public health should facilitate this process. Health education with commitment should operate as a self-reliant health care delivery system to meet the primary health needs of people. Its evolution and development into a self-health system which links and involves the individual, family, community, school, work place, institutions and the total environment in an integrated self-care process is a challenge to be faced. Though the individual and his family assume responsibility for their health, each component of the system has an important role in maintaining and promoting it. In addition there are facilitating systems like the drug industry, whose participation will be crucial for effective functioning of the self-health system. Development of self-health systems is the emerging challenge which the health education specialists of the future will have to meet and they have to be trained adequately in new areas of knowledge, relationships, experience and skills. The new role, in addition to traditional skills, requires a high degree of competence in pioneering, innovating, planning, coordinating and evaluating education for self-health care measures. Above all, health education specialists should be continuously engaged in action research activities which reinforce their commitment  to the principles and concepts of health education and promote its spread to all the key levels of the administration.


[Influence of the mesencephalic reticular formation on the synchronization of cortical evoked potentials].

It has been shown in experiments on alert rabbits that evoked potentials (EP) of the visual and motor cortex to a millisecond stimulation of the midbrain reticular formation (RF) have a greater similarity (due to increased amplitude and coherence of the theta-rhythmic components) as compared with preceding background activity and evoked potentials to a photic flash. The EPs of these neocortical areas to a photic flash had a more similar form after preliminary RF stimulation. The similarity of evoked responses to stimulation of RF increased after its repeated presentations. The summate poststimulus histogram in which the responses of individual units (24 neurones) of the visual cortex to a single RF stimulation were summed up, proved to be similar in form to EP recorded on the surface of the visual cortex after a similar RF stimulation.


Health: an essential component of long-term economic and social development.

Isolated growth of the economy in a developing country, without due consideration of social aspects, does not necessarily increase the welfare of all its population. In such cases, there will always be a large group with poor education and negligible health care. Health services in these countries should not try to duplicate those of the technologically developed nations and should be more health-oriented than disease-oriented. This entails wider utilization of auxiliary and paramedical personnel and, above all, community  involvement. At the same time, the teaching of medicine should be based on the needs of the country rather than try to emulate developed countries' programmes, which can only result in dissatisfaction among physicians and/or in emigration. The Inter-American Development Bank considers that health is a component of long-term economic development; it is therefore fostering and participating in the expansion of rural health services with strong emphasis placed on community participation. In this process health education, both of the public and of local and national authorities, is paramount. Of particular importance is the interaction of health officials and the community itself in order to enlist the rural dweller in spontaneous and active participation that will ensure the success of health programmes.


[Evolution of the functional properties of neurons during the process of elaborating a conditioned reflex].

A comparison was made between unit responses of the motor and auditory cortical zones and the parvocellular (auditory) and magnocellular nuclei of the medial geniculate body (MGB) to test presentations of sound and electro-cutaneous stimulation of the limb, both in units recorded before elaboration of conditioned connections and in those recorded in the course of defensive motor conditioning to sound. It has been found that in the course of conditioning, the functional properties of the neurones in the projection structures were changing towards an increase in the number of bimodal cells and a reduction of the number of monomodal cells which respond to a stimulus adequate for the given structure. The number of monomodal cells which in the tests reacted to a non-adequate stimulus became greater. Such changes were not manifested in the magnocellular part of MGB which plays the part of an associative nucleus in the subcortical auditory system.


[Measures and criterion of confidence of nerve cell impulse responses].

A new method for evaluation of phasic spike responses is proposed. It is based on defining the time interval deltat in which spikes occur after the stimuli so often that the probability of finding a similar or more "suspicious" interval when the response is known to be absent (i.e., probability of error) is minimal. The offered response measure combines on the probability basis two different parameters: the time interval deltat and the number of trials containing at least one spike in deltat. The deltat interval may have any duration and location acceptable in the physiological sense, and is not supposed to be chosen a priori. This approach has been proved to be adequate and unambiguous. A technique is also proposed for estimating the error probability without using the characteristics of distribution of interspike intervals, which for this reason can be applied to any neurone. By means of this technique a table for non-parametric estimation of significance of spike responses has been compiled.


[Effect of aminazine on elaboration and extinction of an instrumental alimentary reflex in puppies].

The role of the adrenoreactive structures of the stem reticular formation in the elaboration and extinction of a food-procuring reflex of lever pressing was studied in 40 to 50 days old puppies. A 0.05 mg/kg dose of chlorpromazine proved more effective than a 0.5 mg/kg dose, in reducing both the rate of formation and of extiction of the reflex. The change in the course of elaboration was connected with the appearance of the phenomenon of reinforcement anticipation, which is not inherent in normal puppies of an early age. It is assumed that a 0.05 mg/kg dose diminishes the adrenergic ascending influences which prevail in normal puppies of the given age, while a 0.5 mg/kg dose exerts not only an adreno- but a cholinolytic action as well, without changing the balance between the systems or influencing the behaviour of the puppies.


Interaction between consumers and providers of health services: new roles and their implications.

In the last few years, there has been an active effort in Italy to involve the population in solving health problems at the community level. This movement had its origin in the industrial setting, where workers succeeded in promoting legislation which gives them control over matters affecting their health. This experience lead to the development of a health education methodology based on the following principles: (a) the assessment of health needs must be based on the subjective experience of the people who have acquired knowledge and interest in health problems; (b) the evaluation of health needs by professionals serves to complement and integrate the assessment of needs as experienced by the community; (c) the self-diagnosis of the community -- in particular of homogenous community groups exposed to similar health risks and experiencing the same needs--and the diagnosis of the professionals must undergo cross-validation and be accepted by both parties; (d) on the basis of this mutual agreement, community health programmes should be planned and carried out jointly by the professionals and the people.


[Cortical neuron activity in the presence of sound combined with electrophoretic application of L-glutamate].

Unit activity in the sensorimotor cortex of rats immobilized by d-tubocurarine, was studied at random and paired presentations of sound and microionophoretic application of L-glutamate. 54% of the studied units exhibited specific plastic changes of spike activity in the course of the pairings; the changes were manifested in a significant increase or modification of the initial response to the sound. These activity reorganizations differed from those appearing during pseudoconditioning. Simultaneous records of the activity of two units have revealed that a micropool of units manifesting specific plastic properties is restricted to a sphere with a radius of up to 200 micronm. It has been assumed that one of the conditions of formation of plasticity in the activity of individual units is the regularity and intensity of the response to the unconditioned stimulus.


[Compensatory capabilities of the symmetrical regions of the dominant and subdominant hemispheres of the human brain].

A comparison was made between the EEG characteristics and spectral power of EEG frequencies in symmetrical parts of both cerebral hemispheres in order to elucidate the involvement of these areas in compensatory processes in patients with tumours localized in one of the cerebral hemispheres, before and after the removal of the tumour. Before the operation, the presence of a focus of pathological activity causing inactivation of adjacent cortical cells, is attended with activation of cells in the symmetrical areas of the intact hemisphere. Elimination of the pathological focus results in the fluctuation of interhemispheric asymmetry; for certain time periods inactivation in the sick hemisphere is replaced by activation, while in the intact hemisphere activation changes over to inactivation. The revealed properties are termed by the authors as interhemispheric compensatory conjugation of reactions. They probably reflect the potential possibilities of different areas in the process of compensation.


Health administrators and health education: some mixed feelings.

It is no secret that many health administrators still consider systematic or professional health education as a discipline towards which one has to pay a certain lip service, but which in its most common interpretation (i.e. imparting knowledge) has no formal place in the health services. Yet with the growing dissatisfaction of the public with the quality of health care and the growing costs incurred in the  different parts of the health services, especially the hospital sector, the authorities could certainly use a skilled group of people, trained both in the health and medical fields and in pedagogic techniques, who would serve as a bridge between health services on the one side, and the population, and especially the politicians, on the other. In parts of the world where ignorance, superstition and harmful traditions still prevail, there is no doubt that health educators are of the utmost importance. In the more or highly developed parts of the world, where consumer participation in daily work and decision-making is becoming more and more common and more and more difficult, there is an urgent need for education of the public and politicians, and also of the medical profession in "community health" as different from "individual health". This is by far the most difficult task, and will require special training, both in background knoweledge and in techniques to reach the population. These considerations serve to reinforce the pressing demand of the World Health Organization for the "professionalization of health education activities without regard to the educational background of the agents who carry out the activity" -- an area where the International Union for Health Education has also an important responsibility.


[Effect of defocusing a visual stimulus on a human evoked potential].

A study was made of EP recorded in the visual projection area of the cerebral cortex in children with normal sight and in those with disturbed refraction when presented with blank and checkered patterns, the dimensions of the chess squares equalling 10, 20, 40, 60 and 120 angular minutes. In children with normal sight the patterns were defocussed by eyeglass lenses of --1 to +/- 6 dioptries. The investigation revealed a different EP configuration on the presentation of blank and checkered patterns. There was a similarity between the EP change when a blank pattern was replaced by a checkered one, and when the checkered pattern was made sharper. It is assumed that these EP changes results from enhanced lateral inhibition due to the contrast boundaries of the checkered pattern, The experiments carried out on children with disturbed refraction indicated that the maximal EP amplitude corresponded to the optimal optic correction, which shows that theuse of EP is a promising cue in determing vision acuity.


Environmental health education: a different orientation.

The indiviual behaviour, group habits and corporate activities that are the keys to environmental prevention are markedly different in character from the personal hygiene and illness behaviours of primary care and patient education. Education for personal care is oriented towards the educatee's own future behaviour and related to the internal processes of his or her physiological organism. It is learning that is aimed both at children and adults. In contrast, in environmental prevention, education is oriented to changing present behaviour related to external stressers and feedbacks. In most programmes this learning is aimed at adults. The health education impact on environmental risks differs in three distinct types of environmental programmes i.e.: (1) when control applies cost-effective technological advances (sewer systems, etc.) which usually bring about behaviour change with little educational effort; (2) when the programme aims at correcting infectious or injurious conditions which require adequate motivation on the part of the people; and (3) when the focus is on social stressers and behaviours, on the reduction of chronic diseases and mental disorders, an area where education and community organization have then a major role to play. Do techniques that effectively develop awareness, communicate information, develop individual or group know-how, and thus lead to preventive action differ between patient behaviour education and environmental health education? The answer must be a partial but important "yes". In environmental prevention programmes the motivating appeal has to be more altruistic, more "other" oriented, and the programme has to be group involving. The behaviours to be changed are not one's own alone, but those common among individuals or corporate bodies around one. In fact, health education faces five challenging problems in the area of environmental risk prevention. First, how do we most quickly and effectively communicate our concern about some stresser or behavioural matter to a specific population? Second, how can we keep voluntary community organizations, which we have helped to develop, from faltering or expiring after three or four years of useful endeavour? Third, how do we reach the populations typified by anomic personalities--the withdrawn, disillusioned or apathetic? Fourth, how do we identify key influential people and interest them in becoming involved in our environmental programmes, in participating in the setting of priorities and contributing to their realization? And last but not least, how can we best ensure that health education services will be provided to community organizations long enough in order to obtain confirmation that the population's behaviour changes have become self-continuing habits or customs?


Stimulating community involvement through mass organizations in Cuba: the women's role.

Among the foundations of the Cuban health system is the principle of active participation by the community, an expression of the mass policy introduced as part of the revolutionary process in 1959. At present every action launched by the Ministry of Public Health is carried out with the cooperation of the mass organizations and, depending on its nature, the public health problem to be solved is the responsibility of the Committee for the Defense of the Revolution, the Federation of Cuban Women, the National Association of Small Farmers or the trade unions. The role played by Cuban women over the years is worth mentioning. The Federation of Cuban Women (FMC), which was created in 1960, groups at present about two million women, nearly 75% of the country's female population over 14 years old. FMC members  carry out a number of activities in the field of public health, and help to raise the consciousness of women concerning health and hygiene. A total of 35,000 FMC health representatives have participated in all the actions programmed by the Ministry of Public Health, among them the mother and child care programme, antipolio vaccinations, blood donation campaigns, environmental sanitation and the fight against parasitic diseases. There are at present more than 47,000 FMC health brigades, composed of women who have followed health and sanitation courses. Under the public health system, each health area is comprised of 25-30,000 inhabitants, sub-divided into sectors of 3-5,000 inhabitants each. These sectors are divided into sub-sectors composed of 300 inhabitants, in each of which a FMC health brigade functions, its members being local inhabitants. Acting as the link between the mass organization, the Ministry of Public Health and the community, this brigade carries out a variety of preventive activities for the promotion of health. Monthly health meetings are held, during which educational materials provided by the Ministry are discussed, with subjects ranging from disease prevention in women and children, to pre-and post-natal care, and to sex education. It is this constant link between divulgation, information and education which has made possible the achievement of almost every goal in the field of public health.


Improving out-patient care through participation: the Newark experiment in staff and patient involvement.

Several studies have confirmed that well-organized health services and vital health information are critical in insuring that consumers utilize health services and practice preventive health habits adequately. Inaccessibility actively discourages the consumer while the lack of on-going health education activities limits his ability to practice life-promoting health habits. Recent work of the Health Education Project (HEP) at the College of Medicine and Dentistry of New Jersey in Newark, has demonstrated tangible ways of eliminating some of the barriers that limit consumers in receiving health services in an out-patient setting. Redesigning the health services in ways that reflect consumer and provider needs and involving the staff and consumers in this process has been a dominant aim of the project which has resulted in the elimination of unnecessary laboratory work, improved coordination of human resources, and increased staff and patient morale. Health education activities are now integrated into the clinic routines as a result of structural changes in outpatient procedures. The work of HEP has been focused on multi-racial, inner-city health problems. Nonetheless, its findings in terms of how to deal with organizational aspects of delivering health services and ways to develop comprehensive health education activities should be of use to health providers and consumers in many other settings. The second part of the paper deals with special aspect of the project, namely, the development of low-cost, community oriented videotapes which are used regularly both in the outpatient department and in various community settings as a teaching tool for providing consumers with critical health information. Tailored to specific teaching objectives and interwoven into health education discussion groups, the videotapes use recognizable local settings and residents to stress the relevance and importance of controlling and taking charge of one's health care. Among the outcomes of the use of these videotapes have been increased demands by consumers for physician continuity, information concerning medication and laboratory tests, and, in general, more information  about how to  stay healthy.


Detection and identification of natural water-soluble colouring matters in foods.

The natural colouring matters of foods can be isolated and identified simultaneously with the synthetic dyes by the benzalkonium method. In the course of isolation anthocyanins, carmine, betanin, caramel and riboflavin are separated from synthetic dyes, as well as from one another, with the exception of first two, which are separated from one another by chromatography or distinguished by oxidation.


[Pesticide residues in dried apples (author's transl)].

60 samples of dried apple cubes, flakes and powder imported from april 1975 to may 1975 were analyzed for organochlorine and organophoshorus pesticides. All values lay well below the maximum limits for pesticide residues allowed in the Fed. Rep. of Germany. The level of total DDT in apple powder was significantly higher than in cubes and flakes.


[Patulin in foods of vegetable origin. 2. Several kinds of fruit and vegetables and fruit and vegetable products (author's transl)].

Patulin was found in fruit with spontaneous brown rot (bananas, pineapples, grapes, peaches, apricots) as well as in moldy compots and in sallow-thorn juice. Fruit, vegetables and fruit and vegetable product were artificially infected with Penicillium expansum, P. urticae and Byssochlamys nivea; patulin was subsequently found in peaches, apricots, greengages, bananas, strawberries, honeydew melons, tomatoes, red and green paprika, cucumbers and carrots; in several kinds of compot, in tomato juice and tomato pulp --but not in ketchup. The influence of the temperature on growth and toxin production is different in the various fungal strains; in the temperature range of 5 degrees C to 25 degrees C, however, the possibility of patulin synthesis must nearly always be expected.


[A contribution to the distinction of biogenic vinegar and vinegar made from synthetic acetic acid by determining the specific 14C-radioactivity (author's transl)].

The method of Simon et al. [2] for the separation of the acetic acid from vinegar prior to the determination of the specific 14C-radioactivity has been modified. The precipitation as calcium acetate and the preparation of free acetic acid by addition of diphosphoric acid has been replaced by an extraction procedure with diisopropylether which is faster and cheaper. On the Austrian market glacial acetic acid (Merck, p.A.) having the natural spezific 14C-radioactitivity was found. The natural specific 14C-radioactivity is therfore necessary but not sufficient to prove the biogenic origin of vinegar.


Heavy metal determination in sea water and in marine organisms with the aid of flameless ASS. IV: Description of a routine method for the determination of cadmium in small samples of biological material.

Some important environmental poisons, e.g. the element cadmium, are rather volatile during flameless AAS determination. This causes difficulties the in case of matrices consisting of large amounts of salts and organic materials. Therefore, as an example in the case of cadmium, a detailed method has been developed. The following method is now used for determinations in large series of samples. Its main advantages are: the sample size must not exceed the mg to microng range; the digestion takes place in small polypropylene tubes and in the graphite tube itself; to obtain high accuracy, a special device for the flamless AAS is used. An intercalibration exercise will be described elsewhere.


Identification of the lipid components of honey.

The constituent lipids of Greek Honey have been isolated and studied by an initial simple extraction procedure (comparable to that of counter-current distribution) and consequent chromatographic separation on a silicic acid column. The fractions collected were subjected to: (I) qualitative T.L.C before or after saponification and (II) gas-chromatographic analysis of methyl esters. In addition to the fatty acids mentioned by other investigators, honey has been found to contain a number of neutral lipids, albeit in small amounts, i.e. hydrocarbons, waxes, cholesterol esters, fatty acid esters, fatty acids, fatty alcohols, sterols, dihydroxy and trihydroxy compounds, as well as some esters of polyols. The probable nature of another three unknown constituents is also discussed.


[Determination of aflatoxins in milk and milk products (author's transl)].

During the period from September 1972 till December 1974 260 samples of milk, 41 of milk powder, 54 of yoghurt, 80 of fresh cheese, 65 of camembert, 77 of hard cheese and 134 of processed cheese were investigated for their contents of aflatoxin B1, B2, G1, G2, and M1. In all products containing toxin only aflatoxin M1 could be detected. The average values of aflatoxin M1 concentration during the period of investigation amounted to: 0.07 microng/1 for milk, 0.50 microng/kg for milk powder, 0.20 microng/kg for yoghurt, 0.23 microng/kg for fresh cheese, 0.43 microng/kg for hard cheese, 0.26 microng/kg for processed cheese, and 0.31 microng/kg for camembert. As maximum values the following concentrations were found: milk 0.33 microng/1, milk powder 2.0 microng/kg, yoghurt 0.47 microng/kg, fresh cheese 0.51 microng/kg, camembert 0.73 microng/kg, hard cheese 1.3 microng/kg, and processed cheese 0.55 microng/kg.


[The behavior of polyphosphates during production and storage of long keeping milk products (author's transl)].

Polyphosphates added as stabilizers in the production process if liquid sterilized milk products are completely hydrolyzed to mono- and diphosphates. The diphosphate is further hydrolyzed during storage of the products. The extent of hydrolysis of diphosphate depends upon the processing conditions and may vary from production to production. During spray-drying of milk, the polyphosphates added are only partially hydrolyzed; further degradation of the polyphosphates takes place during storage.


The adsorption of volatile aroma constituents by foods. VIII. Adsorption of volatile carbonyl compounds by amino acids.

The adsorption of some volatile aldehydes and ketones by 22 dry amino-acids was studied. The adsorbed amounts decreased approximately in the order: propanal, biacetyl, hexenal, hexanal, acetone, pentan-3-one, nonan-3-one, undecanal and nonan-5-one, but there were great differences in the adsorption capacity of the amino acids. Lys adsorbed best and often irreversible, arg, his, phe, trp, pro, and val (leu, ile) very good. With cys, thiazolidinecarboxylic acids were formed. In most cases of adsorption exceeding 100 mmol/mol, except for the monoketones, strong discoloration, probably of the maillard type, was observed. Propanal and hexanal were to a great extend converted to aldol addition and condensation products. Tyr and hyp adsorbed less than the corresponding amino-acids without hydroxyl groups. This is attributed to stronger crystal-lattice forces.


[On the heavy-metal-contamination of vension (author's transl)].

A survey is given on the heavy-metal-contamination of venison (total number of samples: 224) with special consideration of geographical and ecological aspects. In the liver of rabbits, and average of 0.55 ppm Hg and 1.10 ppm Pb was found, which was more than ten resp. three times the amount found in the livers of roe, red deer and wild boars. The mean Cd-content of wild-boars'-livers was 0.06 ppm, a value double as high as in rabbits, roes and red deer. The regional or ecological differences were of minor importance. Whereas the Hg- and Pb-values did not show any remarkable dependency on the animals' age, the Cd-values were higher in older animals. The Hg-values of the hair were in the range of 0.1 ppm.


[On the presence and the content of aflatoxin M in commercial cheese samples (author's transl)].

Between May 10 and August 9 1976, a total of 197 commercial cheese samples were tested on their aflatoxin M1 content; 136 samples (69%) were positive. The highest value was at 0.23 mug/kg, the average value of all positive samples was at 0.09 mug/kg. In more than half of the positive samples (54%), only traces of aflatoxin M1 could be detected, 21% contained up to 0.1 mug/kg and 14% more than 0.1 mug/kg. In soft cheese definitely less aflatoxin was found (57% positive samples) than in other cheese varieties (83--85% positive samples). Supplemental feeding of concentrates during spring season and pasture grazing of dairy cows resulted in more respectively less aflatoxin-positive cheese samples. This was especially true in soft cheese. The other cheeses with longer ripening periods showed the same effect, however, less pronounced with a clear lag phase. Inspite of many positive identity reactions on aflatoxin M1, a routine control of cheeses so far cannot be recommended because of the negative results on mass spectrometry.


[On the determination of chlorocholine chloride (CCC) in cereals (author's transl)].

For the determination of CCC residues samples of grains and straw of four varieties of spring wheat and oat were extracted with ethanol. CCC was purified by column chromatography with an ion exchanger and alumina as well as by TLC. After its identification by the Rf and a colour reaction on the thin layer plate a colorimetric method with dipicrylamine was used for the quantitative estimation of CCC. The recovery rate amounts to 98+/-5% for wheat grains and straw and to 80 +/- 5% for oat grains. The detection limit is at 0.1 ppm. The amounts of CCC reach in wheat grains 0.3--0.7 ppm, in wheat straw 1--7 ppm and in oat grains 0.9--3.4 ppm in the dry matter. In oat straw CCC could not be detected with this method.


[Proof of polychlorinated biphenyls in milk (author's transl)].

Today organochloric compounds are found in all kind of food; of those compounds HCB, HCH, Dieldrin, DDT and PCB are ubiquitous. This paper informs about PCB-residues in milk, analysed in our laboratory.


[Endangering of health by ingestion of soft-polyvinylchloride (author's transl)].

Four trials to evaluate the pathogenicity of Soft-Polyvinylchloride were conductet by feeding pigs soft plastic objects. The plastic objects contained ca. 60-75% softening agents. Only in one trial did the plastic object remain in the pigs stomach. The object remained in the stomach 102 days and caused lesions of the mucous membranes. In the stomach the soft plastic became very hard and the projections of the object became pointed, resembling needles. The amount of softening agent in the object had been reduced from 69,8% to 42%. The danger, especially to children, after eatingf such plastics, either consciously or involontary, is therefore demonstrated. Aspects of state food laws concerning this problem are also discussed in the article.


The blood acid-base changes in acute cyanide poisoning in the rat in comparison with those in acute anoxic anoxia: with special reference to the relation with the time to death.

Rats were given orally various doses of NaCN (20,15,10, and 7 mg of CN per kg). When respiration stopped, the chest was opened and heart blood was taken anaerobically, and blood acid-base, lactate, and glucose determinations were made. As a control to chemical anoxia by cyanide, indentical determinations were made in the rat acutely made anoxic by exposure to N2. The time to the cessation of respiration ranged 2,4 to 14 and 2.3 to 9.3 minutes in cyanide and N2 experiments, respectively. The Po2 at the time of the sampling was much higher in cyanide experiments than in N2 experiments. the Pco2 became lower as the time to the cessation of respiration became longer in cyanide group, and it was considered to diffusion of CO2 into extravascular spae method, described by Oya and coworkers was modified. In this way, venous blood from pregnant and nonpregnant women in blood stains can be reliably differentiated up to at least 19 months storage although as a qualitative test only. 1--3 cm2 of cloth stained with blood is needed and even less from placental blood stains.


Throat-skeleton fractures by strangulation.

The frequency of throat-skeleton fractures was investigated in a series of 30 unselected cases of strangulation. Less than half of the victims showed fractures. From the data obtained, it seems to prove that this is a connection between the frequency of fractures and the age of the victims. The radiological investigation shows that this connection is based on the degree of ossification of the throat-skeleton. This ossification starts often already at early age and should be considered as a process of ageing. Notwithstanding the irregular occurrence of throat-skeleton fractures, these injuries are obviously of a vast diagnostic value.


Chromatographic determination of some corticosteroids, with special reference to horse doping.

Some chromatographic procedures, which can be used to detect and determine certain corticosteroids in samples from race horses, are described. These procedures include thin-layer, gas and high pressure liquid chromatography.


A study on fungal radioresistance and sensitivity.

Lower doses of gamma and X-rays (5 and 1 Krad, respectively) stimulated the spore germination and growth of 7 tested fungi. Higher doses (500 and 100 Krad, respectively) revealed that Epicoccum nigrum was the most radioresistant, while Alternaria humicola, Stemphylium verruculosum, Rhizopus nigricans, and Cladosporium herbarum were of moderate resistance. Aspergillus niger and Penicillium oxalicum were the most radiosensitive. Protein and polysaccharide synthesis were inhibited in the mycelium developed from irradiated spores; the inhibition was a function of dose. Study of the different factors (morphological, biological, and biochemical) indicates that variability in fungal resistance to ionizing radiation is, most probably, an inherent character, connected with mycelial water content and the natural production of a chemical substance(s) that acts as a radioprotector(s).


[The effect of biocides on the microflora of soils and their degradation. I. The selection of suitable biocides and ways of selective influences in soil-microorganisms (author's transl)].

The influence of 544 biocides on soil-microflora was investigated by a special plate-test and by a soil-test. Fungi were particularly sensitive to active substances. They were more inhibited by a greater number of substances, by lower concentrations and by a larger time-interval than bacteria. A differentiated sensitivity of fungi becomes apparent. The pseudomonads, a species of Agrobacter (AIA), flavobacteria and some coryneforme bacteria were relatively resistant. Actinomyces responded similar to fungi. The plate-test is suitable as preliminary test for the selection of substances retarding the degradation of straw. These organisms already favoured by treatments with active substance locate in higher quantities in such soils where the biological balance was disturbed in after the injection. Therefore, the effect of the active substance exceeds that of the injection. The displacement-effect by bacteria resistant to active substances and little active against cellulose plays a minor role in opposite to bacteria active against cellulose, because bacteria don't develop any homogeneous protective coat. A priority effect is therefore excluded.


[The effect of biocides on the microflora of soils and their degradation. II. Correlations between a changed population of micro-organisms and the degradation of straw (author's transl)].

Fungi are of precedent importance for the decomposition of straw in comparison with bacteria and actinomycetes. Several genera and species are able to replace one another. For the fungi, by biocides easier reduced than other kinds of organisms, an inhibition of the decomposition of straw by application of fungicides is possible. An unrestricted or promoted flora of bacteria is not able to replace a restricted flora of fungi. The decomposition of straw cannot be stopped completely. Certain types of fungi locate in higher quantities as a result of the elimination of the competition by bacteria and in dependence on the used antibiotic. Then the special intensity of the decomposition of straw depends on the cellulase-activity of the in each case located fungi. In order to stop the decomposition of straw completely it is necessary to inhibit both the physiologically active bacteria (pseudomonads and bacteria) and the fungi for a longer period of time. Combinations of bactericides and fungicides can bring about synergistic decomposition retarding effects. A persistent stimulation of the straw-decomposition by application of active substances was not successful.


Bacterial stalk rot of Maize, its symptoms and host-range.

Stalk rot of maize, caused by Erwinia carotovora f. sp. zeae Sabet (re-designated as Pectobacterium chrysanthemi pathovar. zeae by KELMAN 1974) showed first premature withering and drying up of the uppermost leaves which was soon followed by the lower leaves. The rot either extended from the base upwards (basal rot) or from the top downwards (top rot). In the case of basal rot, the leaves become yellow and the infected tissue becomes brown, soft, and water soaked. Internally, the stalk turns into a soft mass of disintegrated tissue. At this stage the plants usually topple over. A foul odour, accompanied with the presence of dipterous larvae on and in decaying tissues, are the characteristic symptoms of this disease. With the advance of the disease the stalk finally dries up into a conglomeration of dry and shredded or disjointed fibrous tissue. The top rot begins with wilting and drying up ot the tips of middle leaves of the whorl. A decay that continues rapidly spreads downwards throughout the stalk and the affected plants soon droop. The host range studies were suggestive of the fact that the maize pathogen, apart from causing the disease on maize, could produce soft rot in potato, carrot, onion, sugarbeet, sweet potato, papaya, cabbage, and many other plants and could also infect Sorghum vulgare, Pennisetum typhoidium, tobacco, and tomato.


Studies on certain aspects of chemical control of bacterial stalk rot disease of maize.

Sandoz seed dressing 6335 showing high efficacy in checking the growth of the maize stalk rot pathogen Erwinia carotovora f. sp. zeae Sabet in culture. Brestan, Antracol, Difolatan, Aratan, Duter, Ceresan wet, Flit-406, Cuman, Blitox-50, Streptocycline, Agrimycin, Terramycin, Actidione, Aureomycin, Chloromycetin, Penicillin G, and Streptomycin were moderately effective. The rest of the 35 chemicals was negligible in its influence. 15 different chemicals, namely Agrimycin, Streptocycline, Chloromycetin, Sodium penicillin G, Actidione, Terramycin, Aureomycin, Sandoz seed dressing 6335, Antracol, Aratan, Blitox-50, Diflotan-80, Ceresan wet, Cuman and Brestan 60 could also control the disease, but only when the plants were treated in vivo immediately after inoculation. They could not show any effectiveness, however, after 24, 48, and 72 hours of inoculation, showing their failure to control, once the infection has taken place by the pathogen.


[Effect of early feeding with glucose solution on the incidence of hypoglycemia in dysmature and hypotrophic newborn infants].

Dysmature and small-for-date infants we fed with solution glucosi 20% in a first group of the 12th hour of life, in a second group of the 6th hour. The blood-glucose value in the first three days of life we found in the second group significant greater than in the first group. The hypoglycemia-rate in the first group was 9,2% in the second group 0,6%.


[Pregnancy and diabetes].

There is a mutual effect between gravidity and diabetes. Diabetes can have disadvantageous effect over gravidity, but the state of gravidity can contribute to the earlier diagnosis of diabetes. The author had 4850 cases of gravidity of 1686 women, indiscriminately, suffering from diabetes observed and on the basis of his observation he found that the manifestations of diabetes in the state of gravidity are respectively infrequent nowadays but the number of manifestation increases parallel with the fatness of women. The transitional diabetogen effect, the pathologic gravidities and the huge-embryos are, however, able to indicate the early stage of diabetes, that other methods or medical examinations could not still indicate. The birth of huge-embryos is the earliest and most characteristic praediabetic sign and it can appear 30 to 50 years before the development of diabetic trouble of metabolism. The number of pathological gravidities increases parallel with the advance of diabetic manifestation. The author emphasises on basis of his observations the importance of obstetrical and pregnancy-anamnesis in the prevention of diabetic manifestation and in the reduction of foetal losses.


[Isolated thrombotic omphalovasculitis with marginal insertion--a rare umbilical cord complication].

Report about 2 cases of a rare umbilical cord complication, the isolated omphalovasculitis thrombotica with marginal insertion and about their effects at the feto-placentare unity. Reference is given to an eventual embolic cause of praenatal thrombosis. It will be recommended a regular histological examination of the marginal respectively velamentous insertion for clarification of unclearly fetal deaths.


[Umbilical cord complication as the cause for intrauterine death].

The general set of problems is discussed with reference to 3 stillbirths due to complications caused by the umbilical cord. As far as data and information on cases within this clinic are concerned, out of total of 149 dead births per 13369 births, in 12 cases (8,1%) there is definite evidence of the interrelation between complications with the umbilical cord and intra-uterine fetal death. With another 7 cases (4,7%) an interrelation is likely to be there.


[Role of mother's milk in the development of intestinal microflora in newborn infants].

A study was made of the quantitative and qualitative composition of the intestinal microbial flora in neonates the first 4 days after birth, depending on the type of feeding (crude and sterilized maternal milk). As soon as the 1st day after birth there was revealed a greater bacterial contamination of the neonatal intestine fed with sterilized milk in comparison with with the children given crude maternal milk. It is suggested that the existing order of feeding neonates devoid of maternal milk should be revised.


[Immunologic transformation against pertussis in children following a second revaccination with ADPT-vaccine].

Immunological reconstruction was studied in children aged 6 years after the second revaccination with absorbed, pertussis-diphtheria-tetanus vaccine (APDT) in a strictly controlled trial. Antipertussis protective antibodies were determined in the sera in the passive hemagglutination test and the antigen neutralization test, whose results were characterized by the following regularities: the average (1:160--1:640) and the high (1:1280 and over) antibody titres were recorded 1 to 1.5 months after the vaccination in 46.9--48.9% of the persons vaccinated. Determination of the changes of the immunoglobulins A, M, and G at various periods after the second revaccination demonstrated that 1 to 1.5 months after the revaccination (that is at the peak of the antipertussis antibodies formation) 55.7--50.0% of the children displayed an elevation of the IgA and IgM against the background of the IgG reduction in 69.7% of cases.


[Selecting a method of erythrocyte fixation for the passive hemagglutination test according to the nature of the sensitin].

Quantitative methods were applied to the study of the interaction of albumins, fraction I of Plague bacilli, diphtheria toxoid fractions differing by mol wt, flagellin of typhoid bacilli, 19S- and 7S-fractions of normal human, cholera horse, and paratyphoid B donkey sera with erythrocytes, fixed by 10 different methods. Fixation with acetaldehyde proved to be optimal for the binding of all the proteins, including flagellin, but the latter sensitized erythrocytes formalinized after Vainbach better. The significance of the method of erythrocyte fixation and of the nature of sensitin in the process of the erythrocyte loading without any utilization of the conjugating agents was demonstrated.