Mucoceles of the sphenoid sinus: neuro-ophthalmologic manifestations.

Seven examples of mucocele of the sphenoid sinus have been described. The characteristic symptoms and signs have been described, and the diagnostic neuroradiologic features have been demonstrated. The condition is not a benign one, as is demonstrated by total blindness which occurred in one patient (Case 2). A high index of suspicion for this condition with early referral for neuroradiologic diagnosis leads to proper management and treatment which is usually successful.


Variability of expert observers in evaluating the optic disc.

A significant amount of variability exists between observers in designating cup/diac (C/D) ratios. Further, different methods are used for evaluating the size of the cup. On method uses a combination of contour and color, the other specifically measures contour and pallor separately. This study confirms that these methods yeild different numerical results. Interestingly, the "cupping/pallor" observers show no significant difference among one another in C/D determination which may support the notion that cupping observations are more consistent than "standard" C/D ratios. Though both groups feel the cup is larger on stereo compared to monocular viewing, the "cupping/pallor" group demonstrated much greater differences in this regard. However, the evaluation of pallor by the latter group corresponded closely to the C/D ratios of the "standard" group both for nonstereo and stereo. An individual observer is reasonably consistent on repeat evaluation, but at times, inconsistency is quite substantial. These inconsistencies lead to the conclusion that C/D ratios are an inexact method of recording the status of a disc. Except for considerable changes over time, this numerical method is probably not reliable in checking for small disc changes. However, the disc alone can provide clues as to whether it is physiologic or pathologic. Nevertheless, even with expert observers, significant variability exists in interpretation of an optic disc in this regard. Individuals who evaluate the disc cup by cupping and pallor tend to call discs more pathologic than other observers. The clinical implications of this study suggest that certain observers are more accurate than others and certain discs are more easily evaluated than others. Yet, no one method seems foolproof and no specific criteria can as yet distinguish a normal from an abnormal disc. Stereo color transparencies are evaluated more accurately than are nonstereo color prints. Vessel detail and pallor patterns are probably the most useful disc characteristics to observe. In this regard, a C/D ratio does nothing to indicate whether a disc is normal or not. A statement as to the observer's opinion should be made for each disc evaluation in addition to recording the appearance of the disc.


Pseudotendons after extraocular muscle surgery.

Following recession of a rectus muscle, a band of connective tissue designated as a pseudotendon may form between the recessed muscle tendon and the former insertion. The cut edges of the episclera at the former insertion and the sheath of the recessed muscle seem to be the primary sources of this vascularized connective tissue which replaces the avascular episclera which normally underlies the muscles. Repeated operations, excessive inflammatory reaction, injury to the sheath and intermingling of the conjunctiva and deeper wounds are predisposing factors. Pseudotendon formation does not reduce the effectiveness of a recession, because simple excision has little effect on the alignment of the eyes. Sometimes a well-formed pseudotendon can be used as a tendon to achieve additional recession of a previously recessed insertion.


Efficacy of levamisole hydrochloride administered subcutaneously against Oesophagostomum dentatum infection in pigs.

Critical and controlled anthelmintic trials in pigs were carried out with levamisole hydrochloride administered subcutaneously at 7-5 mg per kg against adult, immature and larval infections of Oesophagostomum denatum. Anthelmintic efficiencies of 79-1-96-3, 83-6-99-4 and 64-7-91-6 respectively were recorded.


Acute myopathy in outwintered cattle.

An outbreak of acute myopathy occurred in a group of 23 Hereford cross and Aberdeen Angus cross 18-month-old heifers, running outside with a bull in February. One morning two were found recumbent, five were ataxic and one had fallen into a river and drowned. Subsequently two of the ataxic ones became recumbent. Serum creatine phosphokinase values were found to be directly proportional to the severity of the clinical manifestations. Myoglobinuria was not observed. Serum calcium, magnesium and inorganic phosphate levels were all within the normal ranges. Treatment of affected animals with selenium and/or alpha-tocopherol had no clear effect; from biochemical estimations carried out, the selenium and alpha-tocopherol status of both affected and unaffected animals was considered adequate. Five recovered, two spontaneously without treatment, but the two most severely affected did not improve with therapy and had to be slaughtered 13 and 25 days respectively after the onset of symptoms.


Heifer sterility associated with single-birth freemartinism.

Thirty-four heifers not conceiving to three or more inseminations or natural service were bled and karyotyped by leucocyte culture. Twelve were found to be sex-chromosome chimeras of which five were single-born. Three out of the five singleton sex-chromosome chimeric heifers were slaughtered and at post mortem examination abnormalities of the reproductive tract were observed. Two the the slaughtered animals were Friesian heifers that had shown normal oestrous cycles and had reproductive organs apparently normal on clinical examination; however, one of them with 5 per cent male cells had a nonpatent cervix, while the other with 12 per cent male cells had non-patent uterine horns. Both heifers possessed functional ovaries, the former had an active corpus luteum and the latter had a developing follicle. The third heifer with 45 per cent male cells had a normal vagina, enlarged clitoris, seminal vesicles and gonads resembling fetal testes with both primitive ovarian and testicular structures. The Old Gloucester and Friesian heifers with 2-5 per cent and 12-0 per cent male cells are alive and have normal external genitalia but rudimentary uterine horns with no palpable gonads. Cytogenetic examination has demonstrated for the first time the existence of single-born freemartins resulting from the death of their male co-twins after fetal vascular anastomosis has been established.


Transmissible gastroenteritis in pigs: some observations on laboratory aids to diagnosis.

Thirty seven piglets with transmissible gastroenteritis (TGE) and 41 with other enteric diseases were examined for evidence of villous atrophy and reduced lactase activity. Widespread villous atrophy appeared indicative of TGE whereas normal lactase activity tended to exclude this possibility. However, both tests are far from specific and neither is recommended to practitioners as an aid to clinical diagnosis.


Anoestrous conditions in the mare, their diagnosis and treatment.

The condition of anoestrus in the mare is described and the various causes of this syndrome are discussed. A regimen for examining systematically the clinically anoestrus mare is proposed, and methods of treatment are suggested.


Immature stages of Trichonema spp as a cause of diarrhoea in adult horses in spring.

Several incidents of diarrhoea and loss of weight occurred in adult horses during the spring of 1976. Detailed investigation of one typical case suggested that maturation of inhibited larvae of Trichonema spp was responsible.


Swine vesicular disease: continuing serological surveys of pigs presented for slaughter in the United Kingdom.

Following the first serum survey for swine vesicular disease [SVD] in Great Britain in 1974 (Watson and Hedger 1974), three further surveys have been carried out. In these four surveys an overall total of 9760 sera have been examined, involving pigs from 958 premises in the first three surveys and an unknown number of premises in the fourth survey taken on a national basis. Forty-three farms were visited as sources of origin or possible sources of origin of the pigs from which positive or inconclusive results were obtained. Subsequent to the one clinical case of disease already reported with the results of the first survey, no further clinical cases of SVD have been confirmed, although lesions suggestive of the disease were found in some pigs on four of the premises visited. SVD quarantine restrictions on these four farms were removed subsequent to further serological sampling and when there was no indication that a spreading vesicular condition existed.


Epiglottic entrapment in the horse.

The diagnosis and surgical correction of epiglottic entrapment is described. Four cases are presented each with a different history. They serve to illustrate that the aetiology is complex, being either congenital or acquired. The use of a thorough endoscope examination is stressed in order to successfully diagnose this condition.


Haemorrhagic syndrome of cattle of suspected mycotoxic origin.

An outbreak of disease characterised by haemorrhages, anaemia, leucopenia, thrombocytopenia, skin lesions, degenerative and inflammatory tissue changes and death was investigated in herd of dairy cows. A tentative diagnosis based on circumstantial evidence was of mycotoxicosis arising from the feeding of mouldy barley.


Animal welfare and the law.

A description of farm animal welfare legislation in Great Britain is given followed by a discussion of similar legislation in Europe. Methods of unifying legislation for the protection of animals in Europe and a summary of current activities are outlined.


An antigen for the diagnosis of M. pneumoniae infections by passive hemagglutination.

The authors establish the optimal conditions (protein concentration, temperature) for the coupling of purified mycoplasma antigen to sheep red blood cells, in order to obtain an antigenic complex stable for at least 1 year. This comples allows specific determination by passive hemagglutination--a simple and rapid technique--of anti-mycoplasma antibodies in the sera of men or animals suspected of mycoplasma infections. Under the stated experimental conditions, antibody titers equal to or higher than 1/128 indicate an infection with M. pneumoniae.


Studies on the different properties of adenovirus penton.

The physical, chemical, immunological and biological properties of the soluble penton antigen of adenovirus strains types 1, 5, 7, 8 and 9, belonging to three distinct subgroups of human adenoviruses, were analysed. Mono-, di-, and polymers of the penton were studied by complete and incomplete hemagglutination and a method was developed to separate pentons of subgroup II. Immunological techniques were developed for the rapid detection of penton antigen. Elution characteristics of the pentons of various types were studied by anion exchange chromatography and the amino acid composition and isoelectric point of the purified adenovirus type 1 penton were determined. The virion-associated endonuclease activity and its correlation with the penton of this adenovirus type were demonstrated.


Incidence of hepatitis B surface antigen (HBsAg) in some areas of Romania.

The incidence of HBsAg in several areas of Romania was studied by 253,460 routine determinations performed from 1973 to 1975. HBsAg incidence was of 1.5% in blood donors and reached the highest value in acute viral hepatitis patients undifferentiated according to the clinical form. The values obtained were in agreement with the results of other studies covering more limited zones of the country. Considerable differences in HBsAg incidence depending on geographic area were observed.


Study of chromosomal alterations in bovine leukosis.

The results of a cytogenetic study of the "CT 384" cell line obtained from bovine leukemic lymph nodes are presented. Multiple chromosomal alterations were found in the 265 metaphases examined: numeric anomalies (aneuploidy and polyploidy), morphologic aberrations (dicentric, annular, giant, filamentous chromosomes) and chromosomal lesions (arm breaks).


Hepatitis B antibodies in hospital personnel.

Sera from 544 hospital personnel members with different degrees of exposure to the agent of hepatitis B were tested for HB8Ag and anti-HB8 by counterelectrophoresis, radioimmunoassay and passive hemagglutination. The laboratory staff and persons having direct contact with patients exhibited a significantly higher prevalence of anti-HB8 (16.2%) as compared with the other groups: administrative staff (4.4%), healthy persons (4.6%) and blood donors (7.9%). These data prove the relationship between exposure to HB8Ag and anti-HB8 prevalence, more obvious in the laboratory staff handling human serum and plasma specimens (anti-HB8 incidence--25%).


Agranulocytosis and antithyroid drugs.

Propylthiouracil and methimazole are used widely in the treatment of hyperthyroid disorders. The most important complication of the use of these drugs is depression of the neutrophilic granulocyte count. Granulocytopenia occurs in about 4 percent and agranulocytosis occurs in about 0.3 percent of treated patients. Although this depression of the granulocyte count is reversible after the drug is discontinued, serious infection frequently accompanies agranulocytosis and accounts for almost all deaths related to the drugs. It is important to be aware of the clinical features of granulocytopenic reactions due to antithyroid drugs.


The absolute granulocyte count in ascites fluid. An aid to the diagnosis of spontaneous bacterial peritonitis.

The absolute granulocyte count of peritoneal fluid was determined for 98 consecutive patients with ascites in order to assess its value as an early indication of bacterial infection. The absolute granulocyte count was found to be more sensitive and specific than either the total leukocyte count or differential count alone. When the absolute granulocyte count in ascites fluid is greater than 250 per cu mm, then it is likely that infection is present.


Acute spinal-cord lesions from diving--epidemiological and clinical features.

The aquatic activity that produces the greatest number of spinal-cord lesions is diving. Persons in the general population at greatest risk are males aged 15 to 19 years. Of the cases identified, 45 percent resulted from diving into a river or stream, 27 percent into swimming pools and 28 percent into lakes, reservoirs or the ocean. Distribution by age differed for the major groups of bodies of water. The incidence of spinal-cord injuries was related to season (spring-summer) and day of the week (weekends). The incidence of injuries was highest in those county areas with the least opportunity for exposure to swimming pools or rivers. Of the injured persons, 60 percent were tetraplegic at hospital admission. The most frequent radiologic finding was wedge fracture. This finding, in the absence of objective evidence that most divers struck the bottom of the water reservoir or a hard object, suggests that hyperventroflexion was the mechanism responsible for injury in most of the cases. Physicians and others should be aware of strategy options for preventing or reducing such injuries.


[Effects of experimental hypovolaemic shock on platelets in the pig (author's transl)].

The effects of standardized blood loss on the platelets, as well as on coagulation, fibrinolysis and complement parameters were studied in the pig. A simultaneous fall in arterial and venous platelet counts was demonstrated during the initial phase of blood loss, with a concomitat rise in pulmonary vascular resistance. After exsanguination to the extent of about 40% of the blood volume, the arterial platelet counts increased significantly, whilst the pulmonary vascular resistance, which was negatively correlated with the arterial platelet counts throughout the experiment, fell. Venous platelet counts, on the other hand, remained low during this experimental period and were correlated with cardiac output, but not with pulmonary vascular resistance.


[Formation of sub-units of antihaemophilic globulin (factor VIII) by means of high centrifugal force (author's transl)].

The human coagulation factor VIII with a molecular weight greater than 1 X 10(6) Daltons forms active subunits under conditions of high centrifugal force, namely, 200.000 g at 20 degrees C for 32 minutes, as demonstrated by sedimentation analysis. This result was confirmed by Sepharose 4 B gel filtration analysis of the ultracentrifuged product, which revealed, in additon to mateial with a molecular weight of more than 1 X 10(6) Daltons, three F VIII-active fractions with smaller molecular weight values. These observations indicate that these sub-units so produced are not united in the starting matrial by covalent bonds.


[Experimental investigations on the effect of various doses of streptokinase on blood viscosity (author's transl)].

The decrease in blood viscosity induced by streptokinase (SK) in the present investigation in proportional to the streptokinase concentration up to a concentration of 2000 IE/ml blood. A maximum decrease in viscosity is attained with a dosage of between 200 and 300 IE/ml blood. The decrease in viscosity is already clearly detectable at 10 minutes at all investigated doses and is completed after 20 to 30 minutes. An increase in SK resistance delays the decrease in viscosity. Prevention of the decrease, however, only seems to occur with a very high SK resistance and a very low SK dosage (50 IE/ml blood). The optimum dosage of SK to achieve a maximum decrease in viscosity is 200 IE/ml blood.


[Newborn mass-screening programme for histidinaemia: increased efficiency through selective thin-layer chromatography (author's transl)].

Histidinaemia, detected on urinary screening in cases which had not been discovered by neonatal blood screening induced us to lower the control limit for histidine from 6 to 4 mg/dl. This was possible by the development of a thin-layer chromatographic control method for the Guthrie test. The combination of thin-layer chromatography (TLC) and the Guthrie test (GT) proved to be considerably more efficient than the Guthrie test alone: among 44,510 newborn infants tested in the first six months of 1975 twice as many cases of histidinaemia were found (TLC + GT 6, GT 3) in spite of a gready lowered control rate (TLC + GT 0.4%, GT 2.4%). Of 87,729 newborn infants tested in 1975, 9 cases of histidinaemia were detected (incidence: 1 in 9,748). Only 4 of these infants showed initial blood levels of larger than or equal to 6 mg/dl. 5 children with histidinaemia, 3 with an initial level of 4 mg/dl and one each with 5 and 8 mg/dl, respectively, had to be put on a histidine-restricted diet becuase the blood histidine level was constantly elevated above 8 mg/dl. The further course of histidinaemia does not appear to correlated with the height of the initial blood histidine level.


Survival of patients with duodenal fistulas from necrotizing pancreatitis.

Acute necrotizing pancreatitis associated with occult duodenal necrosis and perforation developed in 3 patients 2 to 4 weeks after initially successful treatment of hemorrhagic pancreatitis. Exploration was required for fever, abdominal mass, or X-ray findings of an intra-abdominal abscess. At operation all pancreatic and retroperitoneal abscesses were drained with sump tubes, and the duodenal fistula was closed. An intraluminal tube, placed via a gastrostomy, was used for decompression of the duodenum. Postoperative management included total parenteral nutrition, antibiotics specific for aerobic and anaerobic flora, and frequent X-rays to locate new intra-abdominal abscesses. One to 4 reoperations were necessary because of continuing pancreatic necrosis and abscess formation in each patient. Necrotizing pancreatitis with unrelenting retroperitoneal sepsis and fistula formation results in serious morbidity, hospital stays of several months, and is now the major cause of death in patients with pancreatitis. Survival of all 3 patients resulted from drainage of evolving retroperitoneal abscesses and improvement in our technique for management of large duodenal fistulas.


Prevention of pulmonary embolism by inferior vena cava filters: results in 62 cases.

The most effective methods of preventing recurrent pulmonary embolism involve interruption of the pathway of emboli through the inferior vena cava. Of the several procedures that interrupt vana caval blood flow, percutaneous implantation of a screen filter is associated with the lowest risk and appears to be as effective as any of the other procedures in preventing recurrent emboli. This article describes the experience with 62 cases of screen filter implantation performed between 1971 and 1975. Pulmonary embolism recurred in 1.6% of the patients, and 10% of the patients developed swelling of the lower extremities that did not exist preoperatively. Inferior vena cava phlebography performed 6 to 24 months postoperatively in 25 patients showed a patent inferior vena cava in 9 patients, partial occlusion of the vana cava in 8 patients, and complete occlusion of the vena cava with extensive collateral veins in 8 patients.


Surgery for gastric ulcer.

Despite the initial healing achieved by medical treatment with carbenoxolone, surgery is frequently needed in the management of gastric ulcer. We have studied 150 patients over the past 10 years in an attempt to define the place of conservative surgery compared with the standard partial gastrectomy of the Billroth I type. Functional results have not been significantly different and the individual surgeon's choice will depend on his philosophy with regard to the risk of cancer in the postoperative stomach, and his technical expertise with the newer kinds of vagotomy. To my mind it is perfectly justifiable to use highly selective vagotomy with excision of the ulcer to treat gastric ulcer alone, especially if the patient is one in whom postgastrectomy symptoms could be disabling. Further follow-up is needed to decide whether it should replace partial gastrectomy as the standard procedure.


Geographical aspects of peptic ulcer surgery.

The geographic distribution of duodenal ulcer and its characteristics in rural areas of high incidence in developing countries are reviewed. The choice of surgical procedures is discussed in light of the bulky diet and nutritional problems of these countries. A vagotomy procedure is advised for  duodenal ulcer and a Billroth I gastrectomy for gastric ulcers of the body of the stomach.


Surgery of hemophiliacs--20 years' experience.

Seventy-seven hemophilic patients of type A or type B were subjected to a total of 108 major surgical procedures mainly in the field of general surgery, orthopedic surgery, or neurosurgery. The principles for the substitution therapy in the different types of procedures and different types of hemophilic diseases are described, as well as the indications for surgery and the surgical technique. The importance of prolonged substitution therapy postoperatively to avoid late hematoma, particularly in patients with severe hemophilia undergoing major surgery, is stressed. With this type of management there has been no increased intraoperative hemorrhage, and very few cases of late hematoma formation. By combining the substitution therapy with immunosuppression, it has been possible to operate also on patients with inhibitors against factor VIII or IX. The rate of complications, particularly the incidence of hepatitis, has been low with the type of substitution given in this series of patients. It is concluded that major surgery can be carried out even in severe hemophilia without significantly increased risk. The handling of the substitution therapy, and the surgical judgment and technique, offers however, special problems, necessitating centralization of elective cases.


Bronchobiliary fistula due to echinococcosis of the liver.

In Greece, which has the second highest incidence of echinococcosis in the world, there has been an overall decrease in the frequency of this disease and its complications during the past 15 years. Between 1920 and 1960, approximately 46 patients per year were operated on for echinococcosis at the Hellenic Red Cross Hospital, and 1.8% of 1037 hepatic hydatid cysts had ruptured into the bronchi. From 1960 to 1975, the number of patients requiring operation decreased to approximately 25 per year, and incidence of rupture into the bronchi declined to 1% of 288 liver cysts. The reduction has resulted from improvements in preventive medicine and surgical care and a decrease in the frequency of infected cysts. Bronchobiliary fistula is a serious complication of hydatid cyst of the liver and it must be treated surgically. A right thoracotomy or thoracoabdominal approach offers the possibility of dealing simultaneously with the hepatic cyst and the pulmonary lesions. The choice of operation depends on the findings and ranges from simple drainage of the hepatic cavity with division of the bronchobiliary communication, to resection of the lung (usually lobectomy) when a chronically infected pulmonary cavity is present. If a hydatid cyst of the liver ruptures simultaneously into the lung and the extra-hepatic biliary tree with resultant obstruction of the common bile duct, unblocking of the common duct by evacuation of cysts and debris through a laparotomy takes priority over any other surgical action. Of 3 patients with bronchobiliary fistulas treated during the past 15 years, 2 were cured by simple drainage through a transabdominal approach.


Metabolic disposition of chlorambucil in rats.

1. The metabolic dispositionof chlorambucil, 4-p-(di-2-chloroethyl)aminophenylbutyric acid, was studied in the rat. 2. After oral administration of [14C]chlorambucil to rats, plasma, liver, and kidney showed the highest concentration of 14C. After intravenous administration, plasma and kidney were heavily labelled. Although plasma contained as much as 10% of the administered dose in the first few hours after administration, the level decreased to 1% by 24 h. Elimination of radioactivity was mainly through the kidney. 3. Ten metabolites were isolated and characterized by mass spectrometry. Most metabolites had undergone oxidation on the butyric acid side-chain to form phenylacetic acid and benzoic acid derivatives. Spontaneous degradation products of [14C]chlorambucil were analysed and compared with the metabolites.


Identification of 3-methyl-2-thiohydantoin, a metabolite of carbimazole, in man.

1. Classical and high-pressure liquid chromatographic separations were devised for the separation and isolation of the metabolite 3-methyl-2-thiohydantoin from the urine of patients receiving carbimazole orally. 2. 3-methyl-2-thiohydantoin was identified by comparing its absorption and mass spectral properties with authentic material. 3. 3-methyl-2-thiohydantoin was also detected in the plasma of patients receiving methimazole intravenously.


[Protein crystals and tubuli bundles in yeast cells. VI. Light-and electron microscopy studies as well as biochemical studies on alcohol dehydrogenase activity of isolated crystals].

Isolated crystals from Saccharomyces carlsbergensis, stabilized by Cd2+ or Zn2+, retain their enzymatic activity as shown by topochemical reactions. During these reactions the crystals disintegrate characteristically. Stages of this disintegration and deposition of reaction products have been demonstrated by light and electron microscopy. Ground plasmatic and mitochondrial alcoholdhydrogenase has been solubilized by means of 0.01 M EDTA from Zn2+ stabilized crystals separated by gel electrophoresis and proved to be active.


[Mode of action of terrazoleon Mucor mucedo].

It is assumed that the fungistatic effect of terrazol in Mucor mucedo is induced by a liberation of phospholipases within within the mitochondria and perhaps at other membranes. In isolated mitochondria a rapid formation of lysolecithin can be demonstrated at low concentrations of terrazol. This would explain the lytic symptoms in mitochondria visible by electron microscopy. Lipid peroxidation could not be demonstrated. The only antidots at present known for the growth inhibiting effect of terrazol and on its ultrastructural effects are impure saccharose, which seems to contain an unknown factor, and procain hydrochloride or to a lesser extent lidocain, which are well-known inhibitors of phospholipases. The pathological thickening of the cell wall induced by terazol seems to be an unspecific side effect reflecting a diminished phosphorylating activity of the mitochondria.


[Physiology of aniline catabolism by achromobacter Ir2].

A bacterium was isolated from soil which utilizes aniline as sole source of carbon and nitrogen. It was identified as Achromobacter sp. The cells grow at concentrations in the range of 0.5 to 1.25 mg aniline/ml with a growth rate of 0.3 h-1. Substrate inhibition was observed at concentrations higher than 1.5 mg/ml, 3.0 mg/ml completely inhibit the growth. The yield coefficient was 0.63. Aniline was degraded with an activity of 200 microng/mg cell dry weight/hour. Aniline was assimilated and completely degraded. The remaining nitrogen was quantitatively detected as ammonia. The enzyme system involved in aniline degradation was induced by aniline but not repressed by succinate and ammonia.


[Physiology and biochemistry of streptomycetes. IX. Hydrolysis of cyclohexyl, carbohydrate-and aryl-esters by a carboxyl-esterase from cultures of Streptomyces hygroscopicus JA 6599].

Carboxylesterase in cell-free extracts of Streptomyces hygroscopicus was characterized with cyclohexylacetate and beta-penta-acetyl-D-glucose as as substrates. After concentrating the enzyme, activity with alpha/beta-methyl-4-O-propionyl-L-mycarosid as substrate was also observed. The influence of enzyme effectors was studied. Esterase activity was also found in the culture filtrate of. S. hygroscopicus.


[The role of preventive chemotherapy in the present tuberculosis epidemiology of GDR (author's transl)].

The risk of "Gesunde Befundträger" (healthy carriers of pulmonary lesions) to develop pulmonary tuberculosis is compared with that of persons with X-ray shadows in the lung. In the group of "Gesunde Befundträger" this risk can be further differentiated, being highest among males with positive tuberculin skin test and more extended X-ray shadows in the lung. Judging from a follow-up of 4 years in the double-blind trial on isoniazid preventive treatment in persons with fibrotic lesions, the risk of developing pulmonary tuberculosis is reduced by 2/3 by giving 300 mg isoniazid daily during 24 weeks. In the present epidemiological stage of tuberculosis in GDR, preventive treatment of persons with highest risk of developing tuberculosis disease is the most promising prophylactic measure. The recommedations to reduce side-effects must be observed.


[Hilar lymph node swelling as a reaction to BCG-hypersensitivity (author's transl)].

Report on an uncommon reaction to BCG-vaccination in a 7 years old child. A general BCG-allergy occurred manifesting by far extended alterations of the skin and by swelling of the hilar lymph nodes. In connection with this case the author recommends to apply only the intracutaneous testing in tuberculin diagnostics. Repeated BCG-vaccination should be done only with the greatest caution.


[Unilateral aplasia and hypoplasia of pulmonary artery in childhood (author's transl)].

In the light of 8 observations, made by the authors, vasoanomalies underlying the syndrome of the unilateral hyperlucent lung are discussed in their correlation to homolateral bronchial lesions. There were 3 cases with unilateral aplasia of the pulmonary artery in which the unilateral hyperlucency was found always on the healthy side. In these cases there was a normal bronchogram on both sides. The vascularization by the bronchial arteries causes characteristic changes both in the X-ray-picture and endoscopy. Hypoplasia of the pulmonary artery occurring simultaneously with hyperlucency of the affected side  of the lung was found in five cases, 4 times in connection with homolateral, severe, diffuse deforming bronchitis and bronchiectases and 1 case with congenital bronchus stenosis. There is the opinion that besides a congenital form of the hypoplasia of the pulmonary artery a (virus?) --pneumonia, acquired in early childhood, can lead to a pulmonary hypoplasia and a bronchopulmonary dysplasia. The diagnosis can be made only after several special examinations performed in a multi-step system. The significance of the lung scintigraphy within the scope of this complex diagnostics is especially emphasized. Indication for surgery should be made very cautiously. Antibiotic long-term therapy and dsipensary care are considered to be essential.


[Metastatic pleural effusions from MAMMA carcinoma (author's transl)].

43,7% of 1262 pleural effusions investigated between 1958 to 1975 proved to be malignant. In females the malignant effusions caused by mamma carcinoma ranged at the first place. The diagnostic and therapeutic possibilities were studied in 60 cases of these effusions. For etiological diagnosis the criteria of clinical findings, chemical parameters and cytology proved to be important. Cytostatic treatment was more effective in cases of mamma carcinoma than in other tumours of the thoracic organs.


[Possible development of pulmonary scar cancers in patients with pulmonary fibrosis due to cytostatica and X-ray therapy (case-study) (author's transl)].

In two patients with chronic pulmonary fibrosis their history and findings of autopsy suggested, that X-ray therapy in a 31-year old male and Cytostatica-drug therapy in a 52 years old female have had an influence to development of a scar cancer. These cases are discussed with informations of the literature.


[Surgical bronchoscopic interventions (author's transl)].

The author reports about he indications, procedures and results of surgical bronchoscopic interventions in 10 patients with bronchial papilloma due to broncholithiasis, primary amyloid tumor, tracheal adenoma, oesophageal carcinoma perforated into the trachea, bronchial chondroma, tracheal haemangioma, bronchoadenitis tuberculosis perforans, broncholithiasis majoris gradus. Patient's history of 4 cases is demonstrated in detail.


[The anteroposterior (a--p) X-ray-picture in lateral radiographic position in patients after thoracic surgery (author's transl)].

A new approach to the X-ray checking after chest operations is described. Instead of sitting upright the patient is lying on his nonoperated side, the operated side of the chest upward. By this way it is easy to differentiate pleural effusions from basal infiltrations of the remaining lung segments. Furthermore it is possible to check the diaphragm and the lateral portions of the lung much easier than with the conventional X-ray pictures taken in sitting position.


[Improvement of the endogenous creatinine clearance by blocking the tubules].

In the endogenic creatinine clearance at present a blocking of the tubuli with phenol red cannot be achieved. The elimination follows in the 20th and 40th minute after the injection of a simple exponential function and thus allows the determination of the half-life period. The phenol red 60/60 value lies in the phase of the backflow of phenol red from the space of distribution.


[Current problems in the pathology of the thyroid gland].

22 chloramphenicol allergics, 10 penicillin allergics and 6 patients with a chromate eczema as well as altogether 34 non-allergic control persons with healthy skin were examined according to the skin chamber method. After addition of the adequate antigen (chloramphenicol, penicillin, ammonium bichromate) into one of the two simultaneously applied skin chambers in sensitized persons an inhibition of the leucocyte migration in the antigen chamber develops. The polymorphonuclear neutrophilic granulocytes mobilised into the inflammation field were regarded as indicator cells. 5 chloramphenicol allergics with eczematous skin abnormalities and all control persons were negative. The investigation method is simply to be performed and therefore it is particularly suitable for clinical routine work.


[Significance of the determination of serum and urinary creatinine for the clinical use, dispensatory care and screening of patients with kidney diseases].

In the early recognition, control of course and therapy of patients with chronic renal diseases the proof of disturbances of the renal functions has a particular value. Here the determination of creatinine in the serum and in the urine increasingly gains significance, since an automatisation stood the test. The creatinine values may be used as orientation values for the clearance method in the dispensary or in the screening as well as in the sense of reference values for other substances normally contained in the urine. In patients with chronic renal diseases a shift of the daily variation of the renal function according to the development of a nycturia is to be observed still before the formation of an isosthenuria. In female test persons the excretion of creatinine is on an average lower than in male ones. This may be based on the differently developed muscle masses. When creatinine is used as reference value for other substances the dependence on age and sex must be taken into consideration in the case that the substance concerned does not reveal the same age- and sex-specific course of behaviour.


[A model of cooperative analytical diagnosis].

The special branch of clinical chemistry and laboratory diagnostics as an independent speciality has specific comprehensive tasks in research, teaching and education as well as in medical care. Here the organisation of scientific work in the branch of public health concerned is of great importance. For the territory of Leipzig a model a cooperation of medical diagnostics was developed in which a central automation laboratory, a district laboratory and 22 corrdination area laboratories whith all institutions have achieve a high level according to the conditions existing at present.


[Proof of drug hypersensitivity using an in vivo leukocyte migration inhibition test].


[Diagnosis of paranephritic abscess].

The paranephritic absecess belongs to the more infrequent clinical pictures. On the basis of a not common fistulography of the lumbar region on the right, in which we succeeded in a complete description of the cavitary system of the kidneys retrospectively the diagnostic approach in the paranephritic abscess is briefly described. Hereby, as a rule, no too extensive investigations are necessary, as far is at all thought of the possibility of a paranephritic abscess. With typical clinical findings alone - pain and exteriorly visible swelling - the diagnosis seems to be nearly ascertained. Radiologically in many cases the general radiograph of the abdomen (references to radio-positive concrements) and the intravenous pyelogramme are enough. When a fistula is present one tries to find the starting point of the process by means of a contrast remedy filling. In the majority of patients an operative treatment follows.


[Differential diagnosis of malabsorption syndrome].

On the basis of two cases the development of a severe postoperative malabsorption syndrome after resection of the stomach with predisposition to a gastroenterostomia ileoterminalis. The fatal course in one of the patients is made the occasion to discuss the causes of the operatively conditioned failures and to demonstrate the symptomatology of a gastrointestinal anastomosis with a lower ileum loop. The duration of the disease can be retarded by insufficient examination technique. In  postoperative distrubances of the passage as soon as possible the radiological control of the condition of the anastomosis including the whole samll intestine should be carried out.


[Therapy of thyroid diseases].

A survey is given on the therapy of hyperthyroidism, hypothyroidism and the bland struma including the thyrogenic crises. Indications and contraindications of the therapeutic measures available are described. During the therapy of hyperthyroidism the suppression test for the control of the course is recommended. Furthermore it is shown that the thyroxine is more favourable for the long-term treatment than triiodine thyronine or the combination preparations offered at present. But the rules described for the treatment of diseases of the thyroid gland must always be adapted to the individual case.


[Studies on stress-conditioned secretion of somatotropin].

72 of 413 adults and 55 of 112 children with intact function of the hypophysis revealed secretions of the growth hormone already in the preparation time for a clinical test. These variations of the HGH basal levels must be regarded as conditioned on test. In the judgment of the function of the anterior lobe of the pituitary gland with the help of the dynamics of the HGH-secretion the changes in the pretest-period should be included in order to avoid false diagnoses. From the secretion of the growth hormone conditioned on stress hitherto no conclusions can be made to the following course of the HGH-secretion.


[Radioimmunological determination of aldosterone in the serum. New method for the localization of aldosteronism].

It is described a radioimmunologic method for the determination of aldosterone in the plasma and the urine. The method possesses a high specifity, so that a chromatographic prepurification can be given up. The achieved sensitivity allows an analysis in 0.2 ml plasma. This radioimmunoassay can be used for the determination of the aldosterone concentration in the blood after side-separated taking from the adrenal veins by means of the catheter technique. With this a localisation diagnostics of the aldosteronoma is possible.


[Effect of ultraviolet and visible light on nucleic acids and proteins].

Three possible photochemical reaction mechanisms have been discussed which might cause changes in biological materials: 1. Photoreactions induced in that constituents of cell substrates absorb UV-light by themselves, i. e. heteroaromatic moieties of nucleic acids and proteins. 2. Photoreactions induced in that constituents not belonging to the natural biological system absorb UV-light, i. e. furocoumarins or cancer producing hydrocarbons. 3. Photoreactions induced in that proper sensitizer molecules absorb UV-light or visible light. The latter type of photoreactions consumes molecular oxygen but does not consume sensitizer molecules (photodynamic action). Examples have been given for the three possibilities concerning photochemistry of nucleic acids and proteins. Damages of biopolymers were discussed with respect to their biological consequences. Photodynamic changes in the blood system might be caused either after addition of sensitizers to blood or by sensitizers which are constituents of blood itself, i. e. porphytines.


[Studies on blood traumatization following heart-valve prosthesis].

In 47 patients blood traumatisation was checked after interventions on cardiac valves. The cases in question were: 34 implantations of valve prostheses, 10 valve reconstructions and 3 re-operations because of paravalvular leakages. The tested valve prostheses according to Starr-Edwards, Björk-Shiley and Beall revealed subclinical haemolyses of various degrees. In aortic position the values for Björk-Shirley prostheses showed advantages as compared to the Starr-Edwards valve. Of all tested valve types the Beall prostheses caused the highest blood traumatisation. Manifest haemolytic anaemia was found only in 3 cases, two of them showing paravalvular leakage. In the cases of double valve replacement performed with combined Starr-Edwards and Beall prostheses the haemolysis was only slightly higher than in cases of mitral valve replacement with Beall valves only. In three cases with paravalvular leakage the parameters of haemolysis increased very much, returning to normal in 2 patients after successful correction. The assessment of the parameters of blood traumatisation is indispensible for the choice and improvement of the different types of valves and essential for the diagnosis of paravalvular leakage as well as for the control after leakage repair.


[Osmolar and mechanic resistance of erythrocytes in chronic liver diseases].

Out of 120 patients with chronic liver diseases (45 liver cirrhosis, 38 chronic hepatitis, 15 fatty degeneration of the liver and 22 stasis liver) the osmotic resistance of the erythrocytes after Hennemann and the mechanic resistance after Schubothe was determined. 24% of the patients had a decreased osmotic resistance of the erythrocytes, even 55% a decreased incubation resistance. 16% of the patients with liver diseases had a decreased mechanic resistance of the erythrocytes. The comparison of the groups of disease and the stages of the diseases resulted in an increased mechanical resistance of the erythrocytes only for the decompensated liver cirrhosis. A positive correlation was the result between the degree of the haemolysis and the spherical index of the erythrocytes.


[Cis-polyenecarboxylic acids and other fat-metabolism parameters in carcinoma of the digestive tract].

In 24 patients with a neoplasm of the gastro-intestinal tract cis-poly-unsaturated fatty acids were determined in the serum together with cholesterol, free and total glycerin as well as with neutral fats. In the cis-polyene acids a statistically ascertained diminution occurs, all the other parameters remain practically unchanged. To what extent very low values of poly-unsaturated fatty acids are to be connected must still be tested. It cannot be judged about a correlation of cancer and values of neutral fats, since the breadth of the normal area of this parameter of fatty metabolism is very large and the number of test persons is relatively small. The content of cholesterol of patients with cancer is prettily constant and deviated only little from the normal.


[Hematuria due to foreign bodies in a woman-patient with the Munchhausen syndrome].

It is reported on a female patient with Münchhausen syndrome who was referred by the family doctor for the clarification of a haematuria. As cause of the haematuria two stones of about 1 cm in diameter each were found which were artificially brought into the bladder.


[Interferon and herpes].

Interferon, a protein produced by cells, is the only non-toxic antiviral inhibiting virus multiplication in the cell. Although the industrial-technical production of the substance is more expensive the exogenic interferon treatment (interferon which is produced in cell cultures is being administered to the organism) is preferred to the endogenous interferon therapy (by application of slightly-toxic substances the organism is stimulated to produce interferon) since with the first therapy the factor toxicity can be neglected. Clinical trials with exogenous interferon treatment of herpes virus infections of men gave encouraging results, they must however be confirmed by double blind studies. Should it come to a clinical application of interferon on a large scale, first of all methods of production must be worked out to make available sufficient exogenous interferon for treatment of patients.


A micro-method for PHA-induced stimulation of human lymphocytes. II. communication: effect of splenectomy on the inhibitory activity of serum in patients with Hodgkin's disease.

Lymphocytes of 19 unselected patients with Hodgkin's disease were stimulated with PHA in vitro using a microculture system. The sera of these donors were simultaneously tested for their ability to support PHA-induced stimulation of normal lymphocytes as compared to sera drawn from healthy volumteers. Wheras DNA synthesis in Hodgkin's disease using normal sera was almost uniformly decreased, transformation of normal lymphocytes was suppressed in 9 of 11 sera from patients with Hodgkin's disease without splenectomy, but only in 1 of 8 sera from patients tested after removal of the spleen. 3 donors could be tested both before and after splenectomy, 2 showed a complete disappearance of inhibiting substances in their sera. These findings are discussed as to the immunological significance of inhibiting factors and splenectomy in Hodgkin's disease.


Deviated lysis: transfer of complement lytic activity to unsensitized cells. IV. Parital isolation of the activity.

Deviated lysis (d.l.) was previously characterized as the lysis of non-sensitized erythrocytes by activated complement (C) in the presence of EDTA (1, 2, 3). The lytic activity was present in serum fractions of a m.w. in the proximity of 220,000. All the C factors C5 through C9 were found in these fractions and they were all needed for lysis. It is proposed that in d.l. small aggregates of the C components C5 through C9 coexist in the reaction mixture without further interaction. Only when appropriate receptors such as present on target cells surfaces are available, the factors react in a sequential order eventually to result in lysis of the target cell.


Age-dependent appearance of A-specific ovarian glycolipids and syngeneic "natural" anti-A hemolysin in mice.

C57BL/10 inbred mice produce a "natural" antibody which in the presence of complement selectively lyses human blood group A erythrocytes, and the sera of females display significantly higher levels than the sera of males. This pronounced anti-A hemolysin production in females follows the appearance of specific endogenous A-determinants which are associated with water-soluble ovarian glycolipids specifically blocking the syngeneic anti-A hemolysin activity. Moreover, this hemolysin activity develops poorly in mice ovariectomized at the age of 20 days. The coincidental production of (auto)antigenic structures in morphologically and functionally normal ovarian tissue and of antibodies against them is thought to be tolerated through the modulation of a thymusdirected control mechanism.


HLA-D typing with homozygous lymphoblastoid cell lines.

Lymphoblastoid cell lines (LCL) was established from peripheral blood lymphocytes (PBL) of 2 HLA-DW 3 homozygous siblings. HLA-D typing was performed with the homozygous LCL and PBL in a group of 51 unrelated individuals selected according to their HLA-A,B locus antigens. All the individuals who were typed positive for DW3 with PBL typing cells could also be typed positive with the LCL typing cells. Both homozygous LCL behave very similarly in the tested population. These experiments showed that the same HLA-D determinants were represented both on LCL and PBL cells and that LCL derived from MLC homozygous donors can be used for HLA-D typing.


[Effect of early food deprivation on elaboration and preservation of a defensive conditioned reflex in rats].

A study was made of the influence of unlimited vs. insufficient feeding with mother's milk of fifteen litters of rats in early postnatal period on the rate of "incomplete" twofold learning (elaboration of a conditioned avoidance reflex) at the age of 30 and 90 days, and the degree of retention of conditioned reflexes in 30-second, 24-hour and two months intervals. The experiments were carried out in Fyodorov's modification of the apparatus with program control. A conditioned reflex of active avoidance of electric current was elaborated in response to a photic signal. It has been established that unlimited feeding of young rats with mother's milk has a positive influence in the early postnatal period on the general development, on the rate of twofold learning and the level of retention of a conditioned reflex, while unsufficient feeding has a negative influence on these characteristics.


[Conditioned trace reactions of hypothalamic neurons following exposure to vibration].

Trace reactions were studied in 112 hypothalamic units in rabbits during motor defensive conditioning to time after vibration action of two intensities. A later formation of conditioned trace reactions was observed as compared to the control. Vibration of lesser intensity improved the course of trace processes and slightly increased the number of neurones responding to the conditioned stimulus (45% as against 43% in the control); after a stronger vibration action, conditioned reactions to time were recorded only in 29% of the hypothalamic cells eith a simultaneous diminution of the trace response. It has been assumed that the observed transformations result from changes of the significance of the reinforcing factor in the formation of a motor defensive conditioned reflex after the action of vibration.


[Simultaneous differentiation of visual stimuli in chickens].

Differentiation of colour stimuli and geometrical figures was studied in chickens by the food-procuring reflex method with simultaneous presentation of the stimuli. The percentage of correct selections of the positive conditioned stimulus was chosen as a measure of the degree of differentiation. Stable differentiation of colour stimuli appeared after 15.44 +/- 0.6 presentations of the conditioned stimuli reaching 97.66 +/- 0.69% of correct responses. Incomplete differentiation of geometrical figures appeared after 39.07 +/- 3.6 presentations, attaining 67.69 +/- 2.64%. Differentiation of geometrical figures became stable after training, its level rising up to 80.37 +/- 3.89%.


[EEG-correlates of direct and reverse conditioned connections in a food-getting reflex formed to electric stimulation of the lateral geniculate body].

In the course of formation of a food-procuring conditioned reflex to low-frequency electrical stimulation of the cat LGB, the corresponding evoked potentials underwent a change: the main negative component of the evoked potential in the visual area of the cerebral cortex increased; a distinct evoked potential not recorded before conditioning appeared in the sensorimotor area. The changes are regarded as EEG-correlates of formation of a forward conditioned connection. In tests with an isolated presentation of the reinforcing stimulus, a 6--8 c/s rhythm was recorded in the visual cortical area, similar to that of conditioned stimulation of LGB and considered as an EEG-correlate of a backward conditioned connection.


[Effect of sectioning cortico-hippocampal connections on the impulse activity of dorsal hippocampal neurons].

Characteristics of spontaneous and evoked neuronal activity in the fields CA1 and CA3 of the dorsal hippocampus were studied on alert rabbits aged from 30 to 40 days, intact and with an undercutting of the entorhinal cortex (EC) on the 15th to 20th day. The nature of neuronal reactivity depends on the pattern of spontaneous spike activity (three types of cells). Elimination of the afferent input from the EC leads to a sharp drop in the field CA3 of the spontaneous activity of II type neurones with spike complexes achieving inhibitory reactions and, accordingly, to the absence of these reactions. The frequency of background activity of I and III type neurones, which give activating responses, increases. At the same time their reactivity and duration of feactions to indifferent acoustic stimuli increase, especially in the field CA3. The number of phasic and forming responses diminishes. The data obtained attest that the elimination of the cortical input disturbs the capacity of hippocampal neurones to form adequate reactions to indifferent stimuli, which may be due to reduced lability in the system of the orienting reflex owing to a deficit of inhibitory mechanisms.


[Interrelationships between the background impulse activity of cortical neurons and the EEG].

Spike activity of cortical units and EEG on the surface of the cortex near the microelectrode were recorded simultaneously in alert non-immobilized rabbits. The technique of synchronous summation used in the data processing has revealed a statistically significant interrelation between background spike activity of the cortical units and the surface biopotentials. A predominant tendency was revealed toward generation of a spike during the maximal surface-positive deviation of slow biopotentials. The average level of cross-correlation between the spike and slow processes in the background has a magnitude of the order of +/- 10(-2), while individual cross correlation coefficients attain the magnitude of 10-1.


[The relevance of spontaneous ruptures of the aorta in forensic medicine (author's transl)].

Report on 42 cases of "spontaneous rupture of the aorta" (0.4% of the examined autopsies in the case of 9817 court-ordered post mortem examinations, or 1.4% of the deaths by "natural causes"). The ratio of sexes male to female was 2:1. The cause of changes in blood vessels were arteriosclerosis (53.6%) and medionecrosis (31.7%). In 57.1% of cases, ruptures were in the ascending part, in 11.9% in the arch, in 7.1% in the thoracic descending part and in 21.4% in the abdominal descending part. With the exception of 3 cases with  incomplete rupture and death due to circulation failure, the commonest causes of death were pericardial tamponade or hemorrhage into the thoracic or abdominal cavity. In 6 cases (1 X arteriosclerosis, 5 X medionecrosis) the question had to be examined as to whether external influences were only an initiating factor or whether they constituted a legally relevant cause for the rupture and subsequent death. In 4 cases such a relationship was ruled out after examination of the circumstances and autopsy findings. In 2 cases (cases 3 and 4) the role of an external influence could not be ruled out for the moment. The penal and insurance problems are discussed in depth on the basis of the literature.


[On the suitability of spectrophotometric analyses for the estimation of blood stain age (author's transl)].

The spectrophotometric methods of Kind et al. and Kleihauer et al. were checked by more than 900 experiments on 85 blood stains on different material (cotton, nyltest and paper) from native and citrate blood, aged at room temperature up to 5 years. As a result, the variation of values within one age-group exceeded the differences between the values of samples of different age. Therefore, both methods are thought to be unsuitable for the estimation of blood stain age in practical forensic medicine, although the general trend described by the above authors could be confirmed.


[The gaschromatographic mass spectrometric detection of amphetaminile (author's transl)].

Detection of Amphetaminile by GC/MS is presented. In diethyl ether solution the main peak is that of 2-benzylidenamio-1-phenylpropane, which has a retention time of 23,2 minutes under the condition delineated. Under these conditions HCN is eliminated from the Amphetaminile.


[Calculation of retention indices with the pocket calculator HP 65 (author's transl)].

An universal measuring system for retention datas in Gas Chromatography using retention indices (RI) by Kovats is well established. The meaning of RI is explained and a simple calculation by programmable pocket calculator is proposed.


[Demonstration of air inclusions in human hair by light and UV microscopy (author's transl)].

Cranial hairs of 47 randomly selected probands were examined for the presence of air inclusions by conventional light microscopy and by short-wave ultraviolet-light microscopy. The air inclusions seen in UV light stand out as brightly luminous regions against the surrounding hair substance. Two sorts of air inclusions were observed-strips-like or cleft-like regions running parallel to the longitudinal axis localized inthe cortex of the hair and air containing pores on the hair surface. The presence and amount of the air inclusions is independent of the hair colour.


[Additional post-mortem examination techniques to detect patho-morphological findings of nose and throat in cases of sudden infant death syndrome (SIDS) (author's transl)].

To detect histopathological findings in nose and throat. These methods are especially advisable in cases of sudden infant death syndrome, as it could be proved, that in 25 of 30 in this manner examined cases there were inflammatory processes of different extent up to necrotic rhinitis. The morphological findings as well as the accompanying information of anamnesis and the bacteriological findings are discussed. We consider, it advisable, to make use of  the described additional investigational methods.


[The liver and the so-called absorption deficit. Results of animal experiments (author's transl)].

Experiments with ethanol were performed in two dogs with indwelling catheters in the portal vein, in the hepatic vein and the aorta. 2.5, 2.0 and 1.5 g ethanol per kg bodyweight in 10% aqueous solution were administered via stomach tube. A loss of ethanol during the first pass through the liver could be measured both in experiments after 24 hours fasting and after feeding. However, these findings do not completely explain the problem of the socalled "Resorptionsdefizit" of ethanol. It is concluded that the absorption of ethanol from the gastrointestinal tract is mainly influenced by factors related to foodintake.


[Determination of morphine in the vitreous and cerebrospinal fluid by radioimmunoassay (author's transl)].

In 12 cases of fatal poisoning with morphine or heroin a radioimmunological determination of morphine was carried out in vitreous humor, cerebrospinal fluid and urine. The concentrations varied between 30 and 350 ng of morphine-equivalents/ml in the cerebrospinal fluid and between 45 and 280 ng/ml in the vitreous humor (urine concentrations: 120-100.000 ng/ml). The counts per minute differed significantly for samples with and without prior ingestion of morphine, when vitreous and cerebrospinal fluids were tested by the morphine (3H) radioimmunoassay. Thereby it was clearly demonstrated, that radioimmunoassay is a valuable screening procedure for the rapid identification of morphine in corpses, even when urine is not available.


[Concerning the casuistics by aspiration of waste oil sediments (author's transl)].

When cleaning an underground waste oil dump, an 18 year old worker suffered loss of consciousness by inhaling vapours of trichloroethylene and then suffocated by aspiration of waste oil sediments. Histological examination of the lungs proved the copious presence of partly granulous darkish-brown and of rather light coloured crystalloid foreign substances up to the multiple size of erythrocytes. "Chemical examination of blood, brain and urine showed the presence of trichloroethylene and its metabolites, respectively. The trichloroethylene concentration has been determined in the brain."


[Problems and possibilities of documentation in the field of analytic psychotherapy].

The article is concerned with the problems of documentation in the field of psychotherapy and psychoanalysis. A report is given about the different ways of documentation which have been used in the Institut for Psychogenic Diseases, Berlin. It is described which facts are important to be recorded, what kind of informations about the patients can be collected without to much bias of the facts, and which kind of theoretical systems will create difficulties if they are used for data collection.


[Urological symptoms in aneurysms of the abdominal aorta and its branches].

The clinical symptomatology of the sclerotic aneurysms of the abdominal aorta and its large branches is described, especially are described symptoms which are erroneously referred to the urinary tract. In our own clinical material of 47 patients with an aneurysm of the abdominal aorta 11 patients (23%) were primarily transferred to the urological treatment. The typical clinical picture, especially characteristic radiological changes are characterised in detail. It is referred to the early diagnosis and thus to the improvement of the prognosis of the aneurysms of the aorta.


[Study on the behavior of a female patient during psycho analysis].

1. This paper studies the meaning of an "acting" and its effect in the development of the analytical process. 2. Two phases can be discerned in this analysis: one before the "acting" and the other after it. The first one, with little development of insight. The second, of frank progress. 3. The study of countertransferencial reactions of the therapist became a valuable of the understanding of the motives of the patient's acting. 4. The therapist, unconciously, hindered the patient's freedom of expression and her specific fantasies, dealing only with the material inside the limits imposed by him. 5. The "acting" seen as a protest of the patients against the imposed limitation, contributed for the development of the analysis.


[Preoperative embolization of the renal artery in kidney neoplasms].

In 15 patients with extensive malignant renal tumours before operation the artery of the kidney concerned was closed by foam substance particles (ivalon) after percutaneous selective catheterisation. The occurring ischaemic pain was controllable by medicaments and eased off after hours. In most cases the nephrectomy followed on the same day, but it can be performed also on the following day. The operation was principally performed from the transverse flank cut in practically bloodless kidney. Compared with the major interventions (transthoraco-abdominal or transabdominal) of the tumour nephrectomy the procedure described in this paper as a more careful one which at the same time meets the principles of modern surgery of cancer and which can also suggested to patients suffering from a severe disease.


[Rapid healing of a chronic drainage fistula after nephrectomy using the paragalalith technic (tissue adhesive)].

The paragalalith technique satisfied the expectations as method of treatment for the obliteration of a fistula also in an incomplete 12 cm long nephrectomy fistula in a 61-year-old patient. More than 13 months this drainage fistula resisted to every other conservative measure. During 2 weeks we achieved a gradual obliteration of the fistula by a filling of the fistula with the subtrate developed by us performed five times. This method for the obliteration of the fistula we applied successfully in closing more than 30 different fistulae in the abdominal and anogluteal region.


[Importance of external reality on the psychoanalytic situation. Contribution to the problem of psychoanalytical setting].

This paper deals with the influence of the "external" arrangement of the psychoanalytic setting on transference/counter-transference. It is based upon a comparison between the classical psychoanalytic situation and that of the analytically orientated treatment in the hospital. Its theme is that the theory behind the psychoanalytic technique contains no concept for handling a variable external reality. Continuing Leo Stones study of the psychoanalytic situation, in this paper the "immanent suggestion" of the structure of the external arrangement is more closely investigated and defined as a primary and general valence of transference. A particular emphasis of this study lies in the discussion of that specific level of information exchange between analyst and patient which is dependent on setting and which is stimulated by the "positional structure" of the external arrangement. Positional structure is defined and described in detail. Further the following questions are discussed: to which forms of communication does the psychoanalytic setting per se give most support; which forms of transference and counter--transference follow "logically" from the external arrangement and are consciously or unconsciously allowed by analyst and patient in the selection of the classical psychoanalytic setting? The paper reaches the conclusion that the setting of the psychoanalytic situation reproduces primarily pre-oedipal conflicts and early experiences of separation in the mother-child-relationship. In contrast, the face-to-face situation reproduces primarily pre-oedipal conflicts and early experiences of bring into focus a priori oedipal conflicts. Both analyst and patient are subject to the influence of the setting on the unconscious. This study suggests further investigations of those transference and counter-transference valences which are dependent on setting and to take into consideration their technical implications.


[Urethral carcinoma in the female].

It is reported on a case of the rare carcinoma of the female urethra. In the 68-year-old patient the tumour was removed by electrocaustic excision, a suprapubic incision into the bladder was made and local radiotherapy was performed.


[Aspects of patient selection in psychosomatic ambulatory care].

A study of selective social factors was conducted among a sample of 350 out-patients of the Psychosomatic Clinic Heidelberg. The findings indicate that the age of a patient, his education and the type of his contacting the psychosomatic ambulance are relevant to a further therapeutical treatment by the clinic. A higher education, an age under 30 and a contact with the ambulance on one's own initiative were found as factors of positive influence for a further therapy. A subsequent study showed an obvious correlation between these aspects of selection and the therapeutical situation, in particular the frequency of a psychotherapeutical treatment, of all patients after 6 months.


[Results of the Anderson-Hynes kidney/calix plasty in 102 ureteral efferent stenoses].

In 102 patients with ectasia of the renal calyx from degree I to III a pyelograft after Anderson-Hynes was performed. The leading clinical symptoms were, arranged according to frequency: flank pain, recurrent infections of the urinary tract, macrohaematurias, diffuse abdominal pain, palpable flank tumours. In general the diagnosis was made on the basis of the infusion urogramme; a retrograde pyelography was indicated only in cases of missing or insufficient excretion of the contrast remedy. According to the results of the operation apart from the Anderson-Hynes-graft in a lower pole vessel compressing the ureteral passage a ventral deposition of the anastomosis or resection of the lower pole vessel with or without simultaneous resection of the pole was performed. The results of the Anderson-Hynes pyelograft correlated with the degree of the preoperative ectasia of the renal calyx; with increasing degree of severity the good results decreased from 90% to 38%, whereas the bad results increased from 3% to 46%. Judging the success of the operation, a good correspondence between the clinical and radiological parameters was revealed in the degrees I and II. In degree III the numbers of cases were too slight, to secure a diverging tendency of these criteria.


[Comparative psychological studies on disease management and attitude to life in patients with hemophilia with special reference to their motor disabilities].

The motor skills of 39 haemofiliacs are examined under the question to what extent they are permanently disabled and how this disability is subjectively experienced. Besides the question is followed how far the restriction of the motorial functions in relation to other psychological stress within this illness reduces and neurotizises their attitude to life. The results are discussed unter depth-psychological points of view and with regard to the Psychology of Neurosis.


The importance of human odour in non-verbal communication.

Approximately one-third of the human subjects could identify their own odour and that of their partner among 10 subjects. Nearly 50% consistently identified their own odour, or that of their partner, incorrectly. One-third of the subjects were capable of distinguishing between male and femal odour. Asked to attach the attributes 'pleasant', 'indifferent' or 'unpleasant' to several odour, the subjects judged femal odours more often pleasant and less often unpleasant than male odours. Women judged their own odours more often pleasant and less than unpleasant, men on the contrary their own odours more often unpleasant and less often pleasant. Both sexes judged the odour of their partner more often pleasant than unpleasant.


[Anaesthesiologic problems in old age (author's transl)].

Elective surgical procedures in old age can be planned and the patient be prepared for surgery. In contrast to this emergency procedures have a much higher risk. Beyond the 7th decade the mortality rate has a steep increase and in the 9th decade comes to more than 50%. In cases of ileus and peritonitis with preoperative shock the mortality is about 90%. The operation time ist of decisive importance, it should be as short as possible. Having an experience anaesthesiologist at disposal, the used anaesthesiologic method is of less interest.


[Risk and postoperative complications in abdominal surgery in elderly patients (author;s transl)].

1005 case histories of patients, older than 70 years, were studied retrospectively: 496 abdominal interventions (lethality - 29%), 509 extraabdominal interventions (lethality - 14%). In each patient 75 preoperative data are compared to 50 data of the intraoperative and postoperative period. There is a correlation between preoperative findings and postoperative complications and lethality. The main factors of risk are: Hb less than 10 g%, Creatinine greater than 1,5 mg%. The analysis implies the necessity of intensive preoperative therapy as well as the immediate correction of even slight post-operative deviations of the "norm".


[On biliary surgery in old age: indications, risk groups, results (author's transl)].

Report on 179 operations on the biliary tract of patients over 70 years old. The significance of a preparation specific to the case, general anaesthesia and a quick technique of operation avoiding additional stress is emphasized. Special attention is devoted to postoperative treatment. The main complications in old age patients are still caused by postoperative azotemia due to the hepatorenal syndrome. The concentration of geriatric surgery at decentralized service units is suggested.


[Surgical intensive care].

Patients for intensive care in surgery can be divided into 3 groups: 1. Patients in poor preoperative conditions which should be corrected before surgery is performed; 2. Patients with extensive operations and expected or unexpected postoperative complications; 3. Patients with extensive traumas. --In the postwar period medicine developed at a tremendous speed. Modern intensive treatment of those patients with managed by a new group of doctors who had based their primary training in Surgery and continued their professional career in Anaesthesiology. In the last two decades, however, pathophysiologic thinking found its way and a new type of surgeon emerged. Special fields such as cardiovascular-endocrinological-gastroenterological surgery etc, appeared. Nowadays preoperative as well as postoperative treatment is considered to be an important factor in surgery and applied by all specialists. --Anaesthiologists however still play a major role in intensive medicine for surgical patients. But due to the fact that surgical training only plays a little or no part in their professional training, their role is hardly more than that of an important and necessary consultant. A new type of a doctor for surgical intensive medicine may perhaps develop somewhere in the future, but at present successful intensive care in surgical patients can only be achieved by perfect cooperation.


[Pathology and clinical treatment of the carcinoma of the urachus (author's transl)].

A case of a carcinoma of the urachus is described with particular reference to special pathological anatomy and clinical treatment. Due to the rareness of this kind of tumour and its unspecific symptoms its diagnosis is difficult. The therapy corresponds to the general rules of carcinoma surgery.


[Surgical treatment of obesity by jejuno-ileal bypass (author's transl)].

50 patients were operated on; 42 women and 8 men at the age of 17 to 57. The weight of the patients was 100 to 184 kg. and the overweight amounted in most cases to 70 to 188%. Long lasting conservative treatment proved to be inefficient. The endocrynological basis of the obesity was excluded. 6 patients were operated upon according to the Salmon-method and 44 according to the Payne-De Wind-method. 3 patients died. 47 patients recovered without complications. For two years after the operation the loss of weight was 28 to 50% compared with the initial weight. Diarrhoe stopped six months after the operation. During this time a decrease in the concentration of potassium and calcium in the blood serum was observed. Judging from the positive changes the decrease of the cholesterol concentration in the blood was observed as well as the general improvement of the patients health. All patients are in good health and have taken up their jobs again.


[Influence of jejunoileostomy on the lipid fractions in morbidly obese patients (author's transl)].

In 35 morbidly obese patients, operated by Payne-De Wind's jejunoileostomy, the serum concentration of the lipid fractions was examined before and after operation. Before the operation an increase of total cholesterol and beta-lipoproteins was noted in 1/3 of the patients. Six months after the jejunoileostomy a considerable decrease of total cholesterol, beta-lipoproteins, total lipids and free fatty acids has been observed.


[Liverfunction and serum concentration of electrolytes in patients operated for morbid obesity (author's transl)].

50 patients with morbid obesity underwent a Jejuno-Ileostomy. The liver function was tested before operation and postoperatively up to 24 months. Simultaneously the concentration of potassium, natrium, calcium, magnesium and chloride was examined. The concentration of bilirubin did not show any important changes. Thymol turbidity was within the limit. 3 months after the operation an increase of the activity of SGPT and SGOT was noted, as well as the increase of BSP retention. 6 months after the operation a decrease of concentration of potassium and calcium in serum was observed. 3 patients developed tetany. 12 months after the operation no changes in the concentrations of ions in the blood serum have been noted and the tests of the liver showed an improved function compared with the pre-operative period.


[Radiation exposure to personnel during fluoroscopy in operating rooms (author's transl)].

The radiation doses to various sites of the body received by physicians and nurses during fluoroscopic work in the operating room have been measured by using LF/teflon dosimeters. The results are presented separately for skeleton and bile operation as well as implantations of cardiac pacemakers. The doses to hands, head, dorsum and gonads decrease in the given sequence. As to the radiation protection, the use of lead-rubber aprons is considered to be adequate.


[Nuclear alterations on organ cultures of human malignant melanomas (author's transl)].

Report on ultrastructurally striking nuclear anomalies in organ cultures obtained from amelanotic and pigmented human melanomas. These nuclear anomalies are more impressive than the nuclear invaginations present in tumours cells of several other malignant growths. Numerous nuclear fragments varying in size and held together by nuclear membrane bands may occur. The karyoplasm of these nuclei reveals nothing unusual no degenerative changes can be found.


[The diagnosis of hepatic metastases (author's transl)].

The report deals with 404 patients suffering from hepatic metastases. Average age is 62,2 years. The primary tumour was situated in the stomach in 43,8%, followed by extrahepatic bile ducts or the gallbladder, rectum, pancreas and colon. Hepatomegaly is the most frequent symptom. 72,2% of all patients had a positive liver-scan, 78% a pathological bromsulfalein test.


[Machine output of standardized operation reports. Rationatlization by means of small computers (author's transl)].

Report on measures of rationalization in daily surgery by using the small computer C8205 for printing of standardized operation reports. Description of the questionnaire, explanation of the machine programme and the organisational process in making the operation reports.


[Interlocking nailing; indication an technique (author's transl)].

This procedure is efficient, inexpensive and technically easy to perform. It can be used for fractures and pseudoarthroses of the femur and tibia.


[X-ray diagnosis of fractures of the facial part of the skull in a small country hospital (author's transl)].

Tomography is of special value for diagnosing fractures of the facial part of the skull. These tomograms permit exact decisions to be made about the existence and size of traumatic alterations.


[Solitary plasmocytoma (author's transl)].

The problem of solitary plasmacytoma is demonstrated in a rare case. The diagnosis was delayed for different causes. The course was followed up over 6 years. The difficulties of diagnosis and further treatment are discussed.


[Ambulant surgical treatment of Dupuytren's contracture (author's transl)].

Since 1973 we have increasingly performed Dupuytren's contracture as an outpatient procedure. The results are the same as after hopital care. No prolongation of the out of work time.


[Two unusual bone tumours of the hand (author's transl)].

Two unusual cases of bone tumours of the fingers are described: an isolated metastasis of the bronchial carcinoma and an ossifying osteofibroma. Brief review of the literature, clinical picture and histological findings.


[Secondary peritonitis in urological diseases (author's transl)].

Report on 11 cases of diffuse peritonitis following diseases of the efferent urinary tract. This relatively rare form of peritonitis originates either in a disease of the kidney or the bladder with about the same percentage. The invasion of germs took place either by way of perforation or in a lymphogenous way. 9 patients died.


[Interpretation and misinterpretation of sperm findings as fertility criterion].

In any case of sterility the andrological examination is absolutely necessary; firstly because 50 per cent of the examined men don't show normospermic ejaculate and secondly because nearly 14 per cent of the examined men are infertil. Fertility of man is normal in hypospermia (20 to 40 mill. spermatozoa per ml); it is decreased in oligospermia (less than 20 mill per ml), but real possible. Even kryptospermia (less than one million spermatozoa per ml) can not be identified absolutely with infertility. Hypokinesis and increase of pathomorphic spermatozoa apparently prevent the opportunity of conceptions. It is doubtful that fructose of spermaplasma is a certain criterion of fertility. Extra-matrimonial conceptions probably often occur, for that reason any statement about fertility of man is inaccurately.


[First results and experiences with artificial donor insemination (ADI) in the treatment of sterile and infertile couples].

Statement of the importance, indications, contraindications and conditions of the artifical donor insemination (ADI) as a possibility of therapy in sterile and infertile married couples. Report about 34 wifes, in which hitherto in 12 cases the ADI led to a desired pregnancy. One of the pregnancies resulted in abortion, in 7 cases after a normal pregnancy and a normal delivery 7 normal developing infants were born and in 4 wifes present exists regular pregnancy in the 15 th to 30 th week. From these are 3 pregnancies, which obtained with helps of frozen semen (cryo-sperm). The successes  are hitherto exclusive in the first cycles of the treatment. The biggest number of conceptions (8) have been reached, if the ADI have been led one day before rise in morning temperature. After strict consideration of all conditions and conscientious selection of the donors, ADI belongs a stable place in the therapy of sterility and infertility


[Cytological accuracy of intraepithelial atypical findings on the uterine cervix].

At the municipal hospital for women in Darmstadt 223 prestages and commencing phases of the cervix-carcinoma were determined histologically from 1/1/1972 to 31/3/1976. In almost half of all low-grade dysplasias we were at first surprised due to our prospective cytologic statement. Examining all preparations, we found cytomorphologic criteria indicating dysplastic alterations. These are cytologic cell complexes with a distinct anisonucleosis without tumordiathesis. By this knowledge the registration quota of slightly dysplastic alterations could be raised to abt. 65%. The failure quota regarding the prospective cytologic statement "pre-invasion" amounts to abt. a quarter of all preformations. The results will be discussed in the connection with cytologic alterations and the histomorphologic building of intraepithelial atypias.


[Therapeutic procedure in prospective cytodiagnosis].

If the prospective cytology speaks for an intraepithelial atypia, it is possible, due to an extended gynecologic indication, (descensus uterus myomatosus, etc.) to make a primary hysterectomy, avoiding a conisation. As well the complication of the conisation and the eventually following hysterectomy, as as second hospitalisation will thus be avoided. Only twice in 101 cases the cytologic prospective statement of pre-invasion could not be confirmed. These were cases of microinvasion in the sense of a "reticular infiltration". We made no further error "upwards". This proceeding for the diagnosis and therapy of early alterations at the portio uteri can only be carried out in clinics with gynecologically-clinically experienced cytologists. The clearing by conisation of cytologically not definite findings continues to remain the leading principle.


[Experiences with cesium contact therapy in uterine cancer].

Till the end of 1969 contact therapy (CT) of the cervix and corpus carcinomas was performed with radium at the gynecological clinic of the Medical Academy Dresden. After taking out the radium of the gynecological CT we continued the therapy with cesium. Iitally, there were no experiences with respect to isodoses, periods of storage and efficiency on the tumor. On direct measurement of the provided cesium containers an essential higher dose rate than that of radium was found. This dose rate was twice the rate of radium at a distance of 3 cm. Thereupon the periods of storage were shortened half the time at constant carrier activities. A measurement of the radiation exposure of the bladder and the rectum was performed on priciple. In evaluating the patients radiated with cesium from 1970 to 1972 we discuss the results of the patients treated with radium from 1968 to 1970 by way of comparison. The 5-year healing quotients attained did not show any significant differences.


[Therapy and healing results in corpus cancer (1954-1968)].

It is reported on the results of the therapy and healing of 603 female patients, who suffered from carcinoma corporis uteri and were treated in the period from 1954 to 1968. Operation with following irradiation was and is still the method of choice. In primary radiotherapy it is prefered applying endo-cavernous contact therapy in combination with percutaneous irradiation. The absolute healing rate was 60.4 per cent. But if the cases are evaluated, it will become evident that the total healing rate can only give evidence to a certain extent. Thus, stagerelated and relative healing should be considered much more important.


[Malignant hemangiopericytoma in the uterus].

Case report of a 80 years old woman having undergone hysterectomy for myoma of the uterus. Histopathological examination revealed a malignant hemangiopericytoma in the uterus. Pathology, including electron microscopy, and clinical behaviour of these vascular tumor, normally situated outside of the uterus, are discussed with reference to the literature.


[A specific radioimmunologi determination of plasma estradiol without chromatography during the cycle and in pregnancy and determination of the free non-protein-bound fraction using dialysis].

The plasma concentrations of estradiol were measured by radioimmunoassay without chromatography. The antibody against estradiol was produced in rabbits immunized with 17beta-estra-diol-6-(0-carboxymethyloxime): bovine-serum-albumin. The lower limit of quantitation is 2.6 pg estradiol. A coefficient of variation of 5.9% was ascertained. The recovery of this method is 93% in the range of 89.8 to 95.2%. The concentrations of estradiol during the menstrual cycle are from 30 pg/ml to 300 pg/ml. Estradiol levels during the anovulatory cycle were found below 70 pg/ml. Similar values (2.0 to 2.5%) of percent of unbound estradiol in normal and anovulatory cycle were calculated. The concentrations of estradiol increase in pregnancy on an average of 16 ng/ml. The percentage of free estradiol decreases (up to the 24 weeks of pregnancy) from 2.3% to 1.2%.


[Magnesium level in the serum and erythrocytes during pregnancy, delivery and puerperium].

Complexometric determinations of serum magnesium levels, moreover partly of Mg concentrations in whole blood, and withal determinations of hematocrit in 489 healthy pregnancies, parturients, puerperants (1 to 10 days post partum), and nonpregnant women were performed. By aid of these values we were able to calculate Mg concentrations in 100 ml erythrocytes (Mg E 100). The apparent decrease of serum Mg during pregnancy may be founded according to the changes of the plasma volume. However, actually the total (absolute) ammount of serum Mg is increased in pregnancy. We suppose some influences on serum Mg due to stimulation of the thyroid gland in pregnancy and further those of Mg being released from the muscular cells of uterus those been destroyed after delivery. The increased erythrocyte Mg during pregnancy and post partum confirm the view that there are no corresponding relations between Mg concentrations of serum and those of erythrocytes. The possible causes of the increase of erythrocyte Mg in pregnancy are discussed in detail.


[Subcellular distribution of adenosine-, adenosine-5-monophosphate- and cytidine-5-monophosphate desaminase activity in the humna placenta and amnion tissue].

With the method of pH-Stat the adenosinedeaminase-, adenosine-5'-monophosphate deaminase-, cytidine-5'-monophosphate deaminase activities are determined in the nucleus-, mitochondrial-, microsomalfractions and in the cytoplasmatic fractions of the human termplacental and amniotic tissues. The desaminase activities were higher in the amniotic fractions. The possible importance of the adenosinedesaminase and adenosine-5'-monophosphate desaminase for the fetal-placental blood circulation is discussed.


[Barbiturate determination in maternal as well as fetal serum during anesthesia of diabetic and non-diabetic pregnancies].

The rapid decrease of the hexobarbituralnatrium level is observed in the course of narcosis carried out on occasions of Caesarean section, when examining the development of the barbiturate blood level in the maternal, and umbilical blood taken at delivery, whilst in diabetic patients a delay and dragging tendency is observed in the decomposition rate of the hexobarbituralnatrium. The difference manifesting itself in the barbiturate elimination among diabetic and non-diabetic pregnancies, draws attention to the conscientious selection of drugs and doses employed in the course of narcosis during Caesarean section.


[Pregnancy and delivery in a case of osteogenesis imperfecta].

After a short description about the symptoms of Osteogenesis imperfecta a case of pregnancy and delivery in Osteogenesis imperfecta tarda is reported.


[Delivery in adolescents].

The course of delivery to patients aged 16 and under during 1957 to 1961 and 1967 to 1971 is reported. The frequency of deliveries has not changed. Vaginal delivery occurred in 140 of 142 patients. The delivery of the young girls was characterized by an uncomplicated course. The incidence of breech, cesarean section and assisted deliveries was low. Neonatal complications and the perinatal mortality rate are attributed to prematurity and malformation. Prematurity might be reduced by an intensive care of pregnancy.


[Structure and ultrastructure of the endometrium with the depot contraceptive Depositon].

Endometrium was investigated histologically in 55 fertile women and by electron-microscope in 6 women under the influence of Deposiston (Jenapharm), a sequential contraceptive containing a long acting oestrogen--ethinyloestradiolsulfonate. The drug was administered orally in 1 mg doses on the 5., 12. and 19. day of each cycle. To achieve proper withdrawal bleeding a single oral dose of 10 mg norethisteronacetate was given on the 26. day of the cycle. Whereas Sequenz- Ovosiston (Jenapharm), a "classical" sequential preparation causes only insignificant variations from the physiological endometrium of fertile women, Deposiston developes irregularly proliferated patterns in more than 50% of the patients, due to differences of the elimination rate of ethinyloestradiolsulfonate. The degree of proliferation covers a wide range from a slightly proliferated endometrium to changes similar to hyperplasia of the endometrium with cystically enlarged glands. The secretory transformation takes place 2 or 3 days following the progestogen application. In 2 of the cases a secretory pattern could be found several days before the intake of the progestogen. This indicates break-through-ovulations.


[Results of high dosage progesterone therapy in carcinoma corporis uteri].

The authors report their results on the treatment of progressive endometrial carcinomas of cases not suitable for conventional therapy by means of long term progestogen application in high doses. It is demonstrated the effectiveness of this method of treatment if the progestogen is given in necessary doses without stopping the application. An additional short term treatment in low doses in all cases of operated endometrial carcinomas is assesed not to be useful.


[Early mortality in geriatric-gynecologic surgery].

The death rate of 6662 major gynaecological operations on women of 60 years or more in 17 West-Berlin Gynaecological Departments (1960--1969) was 7,7% (512 cases). Of these, 89 women (16,8%) died either during operation or within 3 days after the operation. In all cases there was an adequate indications for surgical intervention. With few exceptions the procedures of the operations could not be criticized. Only a very small part of the intra- and postoperative mortality could be attributed to the anesthesia. In some cases medication was insulfficient (e.g. lack of preoperative treatment with digitalis or postoperative replacement with substitutes or blood). This may partly be explained by the fact that during the period under investigation in many cases the anesthesia had to be done by the gynaecologists. Publications on early postoperative mortailty supply better information on the quality of medical care given to the gynaecological patients, than surveys of so called "Anaesthetic dealths".


[Is uterine excision indicated in uterine prolapse?].

The authors investigated pathohistological changes of uterus of 591 women over forty years that have been operated in the 1966-1974 period using the Mayo-Ward technic. In one third of all cases there were found pathological changes either on the endometrium (9,2%) or they were cases of myoma uteri (21,8%). Only once it was a case of cancer in situ and another time microinvasive cervical cancer. The authors have come to the conclusion that vaginal hysterectomy with plastic correction of the pelvic floor is the method of choice.


[Prophylactic gynecologic examinations in a stationary region].

We prophylactically examined female patients on the occasion of clinical treatment by other medical branches. Our gynaecological examinations were performed corresponding to a recommendation of the common decision of the SUP Central Committee, the GDR government and the TUF Central Board of Sept. 25th, 1973. From April 1th, 1974 to April 1th., 1975 2960 patients from 26 other clinics were screened. The  frequency of histologically confirmed diseases of tumors due to registration (56 cases = 18,9(0/00) was higher than supposed compared with similiar screening programs. Under the cases were 5 carcinomas in situ, 3 microcarcinomas and 3 cervical carcinomas of stage Ib and higher. The share of discovery was 1,7 (0/00) for carcinomas in situ and 2 (0/00) for invasive cervical carcinomas. 28,6(0/00) of all women had a benign disease due to treatment or control. These examinations support, screening programs of a whole territory. The requisite expense is less than for similar programs on the outside of clinics.


[Determination of heat stable alkaline phosphatase].

In this work the method for determination of serum heat-stable alkaline phosphatase (HSAP)--valuable as a placenta function test in pregnancy--is discussed. There are different informations about the optimal conditions for inactivating the nonplacental heat labile isoenzyms, and therefore the opinions on the clinical efficiency of HSAP vary in different studies. Sera of nonpregnant and pregnant females were heated at 40 degrees to 65 degrees C for 5 to 60 minutes. It is demonstrated, that in opposite to suggested opinions in several reports a temperature of 56 degrees C for 30 minutes is notsufficient to inactivate all nonplacental alkaline phosphatase isoenzymes. At 60 degrees C for 20 minutes and at 65 degrees C for 5 minutes in sera of pregnant and nonpregnant female controls we could find concordant results, so that these two conditions of inactivation are regarded as the best. We prefer a temperature of 60 degrees C and inactivate for 20 minutes, since these conditions are to reproduce more easy and allow a beter precision of the results, than 65 degrees C for 5 minutes.


[Cold preservation of human sperm].

The authors report the development and investigation of a new technique for freezing and storage of human spermatozoa. Utilizing isolated container of different kind the average rate of freezing was between 1,3 grd/min and 14 grd/min in the sphere from 5 degrees C to--10 degrees C and between 2,9 grd/min to 55 grd/min in the sphere from--10 degrees C to--60 degrees C. The technical expense was low. Semen specime were provided by 33 andrological patients. A total of 53 samples of human semen were frozen and stored for periods of time up to 25 days. The authors used the cryoprotective medium from Behrman and Sawada. The best results were obtained in the mode of freezing at 2,8 grd/min respectively 12 grd/min in ejaculates of original motility about 80%. The recovery of motility and fertilizability of spermatozoa was 50% of original motility, in cases of oligospermia only 34%. The results of this new technique of freezing and storage of human spermatozoa are similar to other new reports in literature.