Hemoptysis: diagnosis and management.

Hemoptysis is one of the most important symptoms of cardiopulmonary disease-first, because bleeding even in small amounts may indicate the presence of such serious diseases as bronchogenic carcinoma or active tuberculosis, and second, because untreated massive hemorrhage is associated with a high mortality rate. The cause of hemoptysis may be suggested by the history, physical examination or chest x-ray findings, but often diagnostic procedures such as bronchoscopy, bronchography and pulmonary angiography are needed for definitive diagnosis. The importance of early localization of the bleeding site and surgical intervention in patients with massive hemoptysis is stressed.


Training physicians for primary care: trends and hazards.

Programs to train physicians more effectively for careers in primary care are being organized within academic departments in internal medicine and pediatrics, while the number of training programs in family practice continues to grow rapidly. However, the field of primary care training is expanding without a common vocabulary and with inadequate communication between the specialties involved. If decisions concerning health care policy are to be made rationally, the development of multiple distinct models for primary health care delivery must be encouraged and these models must then be evaluated. The distinction between family practice and family medicine must be made clear if the latter discipline is to realize its potential application to all specialties. The relative exclusion of family practice from universities and the absence of experienced practitioners in university primary care programs are conditions that threaten the future of both types of programs and deserve thoughtful attention from medical educators.


A university/community hospital family practice residency program.

A residency program associated with a major university has many obvious advantages. On the other hand, a residency program located in an area of health manpower shortage is a major advantage to that community. This paper describes the development of a university affiliated family practice residency in the Mojave Desert of Southern California. It reports that it is possible to form a successful alliance between a medical center and a rural community, bringing increased primary care to the community, upgrading the quality of medicine practiced in the community and augmenting the staff of the local hospital without sacrificing training for the family practice residents. Furthermore, the residency program can become financially self-sufficient.


If unprofessional conduct is charged by the California Board of Medical Quality Assurance.

The right of a physician to practice his or her chosen profession must be balanced against the right of the public to be protected from unprofessional conduct by physicians. By providing notice and a hearing before imposing discipline, if any, on a physician for unprofessional conduct, the California Board of Medical Quality Assurance meets the basic requirements of procedural due process. However, although the constitutional rights of the physician may be protected in this way, the administrative disciplinary process itself is likely to be an arduous experience. A basic understanding of the nature and legal effect of such disciplinary proceedings may assist a physician in defending against the charges.


[Scope and limitations of cranial computerized tomography (author's transl)].

Cranial computerized tomography (CT) has revolutionized the scope of diagnostic procedures in intracranial diseases. The method is based on the quantitative registration of x-ray absorption and enables many different pathological features within the skull to be directly visualized for the first time on the tomogram. Cerebral haemorrhage and encephalomalacia can be immediatley differentiated on the basis of the totally different appearance on CT. In the case of tumours, the additional administration of the contrast medium intravenously provides enhancement of the diagnostic evidence. Atrophic processes can be diagnosed by means of CT without recourse to additional neuroradiological methods and this facilitation is of particular value in neuropaediatrics. Orbital processes can be easily spotted due to the high definiation matrix of image. The limitations of CT are based on physical conditions.


[A metal-ceramic composite endoprosthesis for total hip replacement (author's transl)].

A total hip endoprosthesis of our own conception is described. The implantation is done partially without bone cement. The socket and the head are made of alumina whereas the femoral component is of metal. Bone cement is used only for implantation of the shaft. 17 patients on whom operations were performed more than 6 months previously were followed up. The preliminary results are satisfactory. In particular, there were no signs of loosening of the socket. Therefore, this prosthesis is considered to be one step towards a total hip endoprothesis for implantation without bone cement.


[Stab wounds of the brain. A case report (author's transl)].

The case history is presented of a 10-year-old boy who stabbed himself accidentally during play with a knife which penetrated deep into the temporal lobe of the brain via the orbit. The child was fully conscious on admission to hospital without any obvious neurological signs. The knife was removed surgically and the immediate postoperative findings of ptosis, chemosis and slight restriction of movement of the left eye regressed rapidly.


[Stress ulcer-an experimental study (author's transl)].

This experimental study demonstrates by means of electromagnetic flow measurements that hypovolaemic shock results in a significant decrease in gastric flow. 14 mongrel dogs were subjected to haemorrhagic shock for 3 or 4 hours. Significant histological changes are seen in the gastric mucosa as a result of the haemodynamic changes, especially when the duration of shock was 4 hours. All stages of stress ulcer from the superficial erosion to deep ulcers were documented. The possibility that the mast cell plays a pathogenetic role as mediator in the origination of a stress ulcer is considered.


[The effect of dopamine on the renal function in dogs with chronic ligation of the common bile duct (author's transl)].

The influence of dopamine on glomerular filtration rate (GFR), renal plasma flow (ERPF) and urinary sodium excretion was investigated in dogs before and after a chronic bile duct ligation for a period of 16 days. 1. Dopamine (4 microgram/kg/min.) leads to an increase of GFR, ERPF and urinary sodium excretion. 2. There was no change of GFR and ERPF after bile duct ligation. Urinary sodium excretion was decreased. The decrease was, however, not significant (0.05 less than p less than 0.1). 3. After bile duct ligation dopamine induced increase of GFR and ERPF was of the same order as observed in the preoperative period. Compared with the preoperative values for sodium excretion the dopamine effect was lower (p less than 0.05). The present investigation shows that dopamine is worth trying in cases of obstructive jaundice accompanied by acute renal failure.


[Immunological findings in serum and synovial fluid in patients with rheumatoid arthritis (author's transl)].

Sera and synovial fluid were investigated in 45 patients with rheumatoid Arthritis and 50 patients with osteoarthritis in inflammatory exacerbation (control group). The following tests were performed: IgG, IgM, IgA determinations, complement components C3, C3, C4, C3-proactivator, ceruloplasmin, electrophoresis, LDH and total acid phosphatase. 1. Serum levels of the ceruloplasmin, alpha 1, alpha 2 and gamma fractions of electrophoresis are significantly higher in patients with rheumatoid arthritis than in patients with osteoarthritis. 2. Synovial fluid: a) There is a significantly higher concentration of IgG, IgM, IgA, C3-proactivator and total acid phosphatase in the synovial fluid of patients with rheumatoid arthritis. b) C4 is significantly lower in patients with rheumatoid arthritis. c) Both groups were also compared with the help of a point system. Every patient received a plus point when the following criteria were seen:  IgM greater than 150 mg/100 ml, C3 greater than 50 mg/100 ml, ceruloplasmin greater than 35 mg/100 ml, alpha 1 greater than 0.21 g%, alpha 2 greater than 0.44 g%, beta greater than 0.60 g% and gamma fraction on electrophoresis greater than 0.90 g%. Another point was added if the criteria ceruloplasmin greater than 22 mg/100 ml and C4 less than 17 mg/100 ml were simultaneously seen. With the help of this points system 48 out of the 50 osteoarthritis patients (96%) received zero points, one received 1 point and one 2 points, as opposed to the patients with rheumatoid arthritis where 35 out of 45 (78%) received one or more points. d) The differentation is not improved through additional testing of the rheumatic factors.


[Rheology and hyaluronic acid in inflammatory joint effusions (author's transl)].

The Weissenberg rheogoniometer was used to measure viscosity, normal force and the number of molecular entanglements, calculated from a shear modulus obtained by prestationary experiments, in inflammatory and non-inflammatory synovial fluid effusions. The rheological properties show greater pathological change in the inflammatory synovial fluid samples than in the non-inflammatory. Variation in the hyaluronic acid concentration is only partly responsible for the pathological rheology. Initial experiments with a normalization method for the viscosity flow curves suggest the possibility of determining changes in polymerization or structure of the hyaluronic acid by rheological measurements.


[Metabolism of the sulphated glycosamino-glycans of skin, cartilage and bone of rats with adjuvant arthritis (author's transl)].

The time course of the quantitative changes in connective tissue of non-inflamed dorsal skin and of inflamed hind limbs was investigated by means of radioactively-labelled sulphate. Whereas the rate of incorporation of 35SO4 into the skin is reduced, its turnover in the inflamed tissue is greatly accelerated. This increase is observed both in the soft (cartilage) and hard (bone) connective tissue on both hind legs. The citric acid content of affected bone is lower than in healthy animals.


[Functional reaction of a fibroblast surface protein (author's transl)].

Cold-insoluble globulin (CIG) of plasma represents the soluble form of a fibroblast surface protein. As shown by affinity chromatography it is selectively adsorbed from plasma on immobilized collagen of various types. The following sequence of binding strength between CIG and collagen was evaluated by means of fractionated elution: collagen type III native less than type I native less than type I denatured. The affinity to native collagen is important for the capability of CIG to mediate the attachement of fibroplasts on collagen fibrils. In addition, CIG is a substrate of activated coagulation factor XIII which plays an important, but as yet unclarified role in wound healing.


[Morphology of articular cartilage in fab2-induced arthritis of the knee-joint in the rabbit (author's transl)].

An arthritis closely resembling rheumatoid arthritis in man can be produced by the intra-articular injection of Fab2 into the knee joint of rabbits. This experimental model was used for the examination of ultrastructural alterations in articular cartilage. The lesion starts at the surface and advances gradually to the deeper zones of the cartilage. Morphologically, the lesion is characterized by progressive necrobiosis of the chondrocytes, as well as by a continually increasing thickening of the collagen fibres. It is suggested that the initial damage to the cartilage is not brought about by the pannus tissue, but is caused by a direct reaction to the pathologically-altered synovial fluid in response to inflammation.


[Plasma amino acids in ankylosing spondylitis (author's transl)].

The plasma amino acids of male patients with ankylosing spondylitis (ASp) and male controls were analysed and the concentrations statistically evaluated. The total concentration of all 28 amino acids in ASp-patients did not differ from the controls, but there were some distinct differences in the levels of individual amino acids, e. g. arginine and isoleucine which showed raised concentration (29% and 27%). A higher concentration was also detectable with rare amino acids, e. g. alpha-amino-adipinic acid (23%) and 1-methyl-histidine (32%). Correlation between the amino acid concentration and age was detected only in the case of citrulline. Some amino acids showed a significant correlation to one another which was sometimes evident in both groups and other times was noted in the control- or ASp-group only. If such correlations were found to be disease-dependent this finding could be helpful in the diagnosis of certain diseases.


[Biological bases of aging].

The author discusses ageing with special regard to evolution processes. Accelaration and retardation of certain ontogenetic phases or the whole ontogenesis have developed during phylogenesis and have been fixed genetically as a special reaction norm. The limitation of life span in highly differentiated organisms after reproduction is perfected has to be considered as one of the preconditions of evolution. Considering the phylogenesis, those hypotheses which interpret ageing as a continuous accumulation of cell damage, are no longer admissable. The different theories of the genetic control for ontogenesis are discussed on the basis of international literature.


[Anuria--a geriatric emergency situation].

The missing output of urine is an emergency case which is problematic with regard to old patients. This situation is caused by disturbances of renal function (anuria) or by acute ureteric obstruction or by complete ischuria. The possibilities of differential diagnosis and etiology have been illustrated. Anuria and acute ureteric obstruction need a treatment by urological or nephrological specialists, but each doctor must be able in cases of complete ischuria to empty the bladder by catheterization or by suprapubic puncture.


[Relationship between age and inflammatory reaction following mitral commissurotomy].

Out of 347 patients who underwent mitral commissurotomy 204 (59 per cent) developed post-operative pleural effusions which were not evident any more at 83 patients (24 per cent) in the second to third week after the operation. 79 patients (23 per cent) had, during this period, still light angular and/or interlobular effusions, 42 patients (16 per cent) showed pneumonical processes during the early phase after the operation. 122 patients (35 per cent) presented in the course of the clinical rehabilitation pleurisical and/or pericardial rubbing, 62 patients (18 per cent) heavy leukocytosis and 25 patients (10 per cent) chest pains and arthralgias. Upon subdividing the patients into five groups of age, there will be obvious that these phenomena were much more frequent with older patinets. With growing age, also rose the portion of those patients who were treated for months by prednisolon for persistent inflammatory reaction tendency.


[Correlation between visual acuity and ophthalmoscopic findings in presenile and senile macular degeneration].

The exisiting studies in macular degeneration reveal discrepancies between the ophthalmoscopic signs and the degree in reduction in vision. In this study the results of 156 ophthalmoscopic investigations are presented in order to clarify this correlation between the clinical findings and the loss of vision. The patients are divided into four groups, slight macular degenerations, representing group I, being at one of the scala, and very severe forms, representing group IV, being at the other end. Especially in the group I and II with slight macular degenerations very marked discrepancies were observed between the sligns having been obtained through the ophthalmoscope and the vision. In those cases the visual function was more impaired than to the expected from the ophthalmoscopic signs.


[Molecular biology of aging. 8. Aging of intermitotic cells--relationship to protein synthesis in the mucosa of the small intestine].

1. The incorporation of 14C-leucine in a cell free system of intestine mucosa is diminished in aging. 2. The absence of 2-mercaptoethanol in the system of incorporation increases the age differences. 3. By  combination of a system from intestine with liver preparation we observed a participation of both the microsomes and the postmicrosomal supernatant. 4. The activity of Ribonuclease is not changes in the aging process. Our results demonstrated the alterations of the intermitotic cells in aging.


[Smoking in the childhood--results of the school study Berlin-Karow 1976 (author's transl)].

The smoking habits and the lung function of 369 boys and 340 girls aged 6-16 were examined in a school. The boys are beginning to smoke at the age of 9, the girls at the age of 13. 62 per cent of the children aged 16 are smoking (20 per cent of the girls and 30 per cent of the boys are smoking regularely more than 1 cigarette/day). 58 per cent of the children have a smoker in their family. Only 10 per cent of the parents have knowledge about the smoking of their child aged 12, and 59 per cent of the parents of their child aged 16. The lung function tests (ventilation, distribution, bodyplethysmography, single-breath-test, blood gases) of the healthy teen-agers dont show differences between smokers and non-smokers.


[Modifying smoking habits at school--experiences in a town of the GDR (author's transl)].

The number of juvenile smokers in the age-group of 12-16 years is increasing. Sequels of nicotine abuse--as bronchial carcinoma, chronic bronchitis and cardiovascular diseases-are more frequent in persons who begin smoking in the younger age-group. It is our obligation to influence youth in such a way that young people do not begin to smoke at all, or as less as possible. For that reason in 1974 the Chest Clinic of Schwedt began with taking intensive influence to school children for stopping smoking or not beginning smoking. Smoking habits in the youth cannot be changed only by engagement and the possibilities of the physicians. One antismoking campaign confined in time will not result in lasting success. A deep change in the smoking habits of the youth can be achieved only by a continuous, systematic and substantial cooperation between the medical staff, the educational system and the parents. We are reporting about our approach and the experiences collected in this aimed work.


[State of health self-rating scale differences in smoking and non-smoking patients with lung diseases (author's transl)].

1000 patients of a chest hospital, among them 447 non-smokers and 553 smokers were interviewed with a self-rating questionnaire about their physical and psychical state of health, without knowing, that their answers might be evaluated under the view of smoking and non-smoking behaviour. Both groups could be well distinguished in relation to some topics. Non-smokers reported physical complaints more frequently and intensively and feeled more psychic impairments than smokers. The possible influence of the predominantly medical orientated health education upon this unexpected result is discussed. It is proposed to lay more attention upon the social conditions side by side with the medico-scientific informations, till now still insufficiently influencing the smoking behaviour of the population. Only some facts of the original material are reported. Therefore, this is only a report in a preliminary phase.


[Smoking habits and their influence on the development of chronic broncho-pulmonary diseases--results of epidemiologic research on bronchitis in the German Democratic Republic].

Systematic studies were performed in 1971 and 1973 to investigate the epidemiology of chronic bronchitis. The scheme comprised random groups of a sum total of 22176 men and 10829 women aged between 35 and 64 from 25 places all over the territory of the GDR. The examination program comprised an interview with a questionnaire, measurement of FVC, FEV1.0, PO2 and RV/TK, examination of bronchial hyperreactivity. Representative statements emerged as to prevalence of smokers and ex-smokers. The mean prevalence of male smokers was 63 p. c., of femal smokers 24 p. c. The prevalence of chronic bronchitis is higher in smokers than in nonsmokers especially in the polluted area. Significant relationship was found between increasing tobacco consumption and prevalence of chronic bronchitis. Intensive smoking is associated with an increase in obstruction and in bronchial hyperreactivity. The study provides the evidence of the additive effects of smoking, air pollution and dust exposure at work.


[Smoking cessation therapy in the outpatient departments for pulmonary diseases and tuberculosis (PALT) (author's transl)].

Based on experience gained so far in the field of health education and because of the tasks facing them at the moment, PALT is considered to be particularly suitable for establishing Advisory and Information Centres for Smokers. Report will be given on the numbers of participants and the successes achieved as regards the consulting hours for smokers carried through since 1971 and the 5-days-plans. It is stated, that it is impossible to strive to effectively control the smoking habit neither by way of the consulting hours for smokers nor by means of the 5-days-plans. Both methods may, however, be successful in influencing individual persons to give up smoking.


[Lung cancer and smoking (author's transl)].

In all countries from which reliable statistics are available, there has been a striking increase in lung cancer mortality in recent decades. At present lung tumours are the most frequent organ cancer in men. Epidemiological, clinical and laboratory studies have clearly shown that the inhalation of cigarette smoke is a major risk factor in lung cancer.


[Ways for solving the tobacco problem in the german democratic republic (GDR) and in other socialistic countries (author's transl)].

The socialistic society has integrated interests for prevention of health consequences of smoking. Tobacco production is a matter of the state and is not dictated by individual interests of profit. Smoking control in the GDR is focussed on three points: 1. to discourage children and young people from smoking; 2. to protect non-smokers on their place of work and public places; 3. to encourage smokers to give up their habit. Smoking control measures should not intimidate, but encourage smokers for collaboration. A short review about smoking control measures in the USSR, Poland, Bulgaria and Hungary is presented. In the USSR and GDR the activities against smoking derive from the National Health Service. In Poland, Bulgaria and Hungary this task is fulfilled by interdisciplinary societies with voluntary operating members. Governmental decrees to confine smoking already exist in the USSR, Poland and Bulgaria. At present, authorities of the GDR advance a detailed program of measures against smoking.


[Health care activities for outpatients with non-tuberculous lung diseases by the departments for pulmonary diseases and tuberculosis (author's transl)].

Development of capacities and activities of the outpatient departments for pulmonary diseases and tuberculosis (PALT) is represented by the annual reports. At present, patients with non-tuberculous lung diseases are prevailing. Most of them are sent by physicians working in basic public-health-service. Special diagnostic and therapy should be done in close co-operation with the family physicians, the industrial physicians and the hospital physicians; above all this specialized medical care has to contain activities, which are concentrated in these departments, because it is suitable for the patients.


[Radiation exposure to personnel in bronchology (author's transl)].

Radiation doses to hands, gonads, head and dorsum received by staff carrying out bronchological X-ray examinations have been measured using LiF/teflon dosimeters. Because of the relatively high dorsal doses, it is important for the medical personnel to face the patient exclusively with the radiation protected foreside.


[Procedure of the bronchial provocation tests (author's transl)].

A procedure of bronchial inhalation challenge with acetylcholine accepted by the working group "Aerosols in Medicine" of the GDR on its session in autumn 1976 in Leipzig is reported. The decisions on substance, dose, kinds of application and interpretation are discussed and confirmed.


[Physical therapy and exercise therapy in the clinical rehabilitation after lung operations (author's transl)].

Physical training enhances adaptibility in all organs, by this way the morbidity will be reduced. It is of value as well in prophylaxis as in clinical rehabilitation in combination with medical therapy. Indications, contra-indications and the effect of an adequate training in chronic pulmonary diseases and conditions after lung operations are discussed; examples are given. Volume and intensity of training are assessed and administered from the results of cardiopulmonary function testing including ergometry with measurements of pulmonary arterial pressure.


[Functional and social long-term results after lung surgery (author's transl)].

Longterm results regarding lung functions after operations for bronchial cancer or tuberculosis are good in those cases where had been no complications after surgery or recurrences of the disease. Nevertheless fewer patients than expected return to their work despite the good functional results.


[Results of pertracheal punction (author's transl)].

36 pertracheal biopsies with following cytological control have been performed. The results - 21 cases with a confirmed diagnosis give raise to the conclusion, that this method is a suitable supplement of the possible bioptic investigations during the bronchoscopy.


[Symptoms and signs in diseases caused by mycoplasma pneumoniae in infants and small children (author's transl)].

In 12 children aged 8 month to 5 years (in the average 2,3 years), respiratory illness caused by Mycoplasma pneumoniae, could be secured with microbiological methods (growth inhibition, cultivation). The most common clinical, roentgenological and laboratory signs are discussed. A disease from Mycoplasma pneumoniae should be assumed, when a child will begin to cough often with staccato attacks without apnoea at night and has temperature short time after adimission to a group. The findings by auscultation are small but the X-ray-picture is showing marked alterations. A precise diagnosis can be achieved only with microbiological examinations (serology or cultivation). When there are no symptoms and signs described above, the diseases caused by Mycoplasma pneumoniae can be detected only if Mycoplasma serology has become a routine laboratory task in institutions for paediatric bronchopneumology.


[Comparative study between the surface-active substances präwozell NBX (Nekal BX) and Ditalan WO hc for homogenization and decontamination of specimens for the cultivation of mycobacteria (author's transl)].

In cooperation of eight laboratories the new surface-active substance Ditalan WO hc was compared with Präwozell NBX (Nekal BX) used for homogenization and decontamination of the specimens for culture investigations of mycobacteria in routine. Under routine conditions Ditalan showed a slight, but statistically not significant advantage. Out of 1672 specimens pretreated with both detergents 482 cultures were positive in all, 429 (89,0%) after homogenization with Ditalan and 413 (85,7%) after pretreatment with Präwozell. The rate of contamination of the cultures was low in both cases (about 0,5%). Ditalan had a better mucolytic effect than Präwozell. In quantitative investigations the number of positive cultures was equal with both methods, but the number of colonies was somewhat higher and the time of growth was a little shorter after using Ditalan. In the third part the influence of both detergent-reagent-solutions on mycobacteria of different species was compared to that of physiological sodium chloride solution. The rate of growth was decreased by both the detergents in nearly the same degree. But the damaging effect is caused less by the detergent itself than by the sodium hydroxide contained in the solution used for pretreatment of the specimens.


[The management of bronchial hemoptysis - case study (author's transl)].

Two case reports exemplify, that in patients with massive hemoptysis occuring in the bronchial system and owing to known or unknown causes, the emergency surgery must not to be delayed. In the case of minor relapsing hemoptysis, especially in old-age patients or borderline operability, the minimum surgical procedure is indicated after diagnosing and finding the localization of the hemorrhage.


Serum mineral changes under the effect of carbon disulfide intoxication.

Under the effect of carbon-disulfide intoxication on serum levels of zinc, iron, calcium, magnesium, potassium, and sodium of albino rats, five groups of rats were injected with daily doses of carbon disulfide over a period of 50 days. The extent of regression of the developed biochemical derangement was also studied. A significant decrease was observed in the levels of serum zinc, iron, calcium, and magnesium, while a slight elevation in the level of serum potassium. No definite correlation could be found between the level of serum sodium in control and carbon-disulfide intoxicated rats. By stoppage of dosage at 20 days, most of these derangements started to be normal.


Vitamins content of fruits and vegetables in common use in Egypt.

The vitamin content, namely vitamin C, carotene, riboflavin and nicotinic acid, of some popular vegetables and fruits was determined. It was found that the green parts of the plants were the most rich in these four vitamins. Trigonella foenum-graecum (Helba) was the richest of all vegetables and fruits in vitamin C (207 mg%). Scandicium stellatum (Shabat contains the highest value for carotene (57.3 mg%). Solanum tuberosum (Batatis) was the richest in riboflavin (0.3 mg%) and Pisum sativum (Busselah) in niacin (1.8 mg%).


[Nutritional condition, food consumption and nutritional intake in students in Saudi Arabia. II. Food consumption and nutritional intake].

In field surveys in 13 schools in different regions of Saudi-Arabia, energy expenditure, food consumption, and nutrient intake were studied. Cereal products, especially bread, have the greatest significance in nutrition. Many students do not eat other foodstuffs regularly. A certain dependency of food consumption from the region was found in regard to the schools. The frequency of foodstuffs was generally low, but lowest in remote villages. In some age groups, the sufficient energy intake leaves much to be desired, 70 % do not reach recommended dietary allowances of animal protein and 100 % in fat. Intake of carbohydrates was too high, while intake of linoleic acid, minerals and vitamins is too low of nearly all test persons. To secure regularly a sufficient intake of essential nutrients, a school lunch program for the Saudi-Arabian boys is to be recommended.


[Chemotherapeutic strategy and chemotherapeutic regimes].

The problems arisen from plasmid mediated drug-resistance can only be solved by a chemotherapeutic drug policy with due regard to the different ecological processes. The antibiotic policy has the following purpose: 1. Estimation and prognosis of the use of chemotherapeutics in the therapy and prophylaxis of man and animals, the animal production, other paratherapeutic fields of application (feed-stuff industry, cosmetics etc.); 2. methods for the limitation of the spreading of infectious drug resistance; 3. production and import of chemotherapeutic drugs (inclusively antibiotics); 4. development of new drugs especially for their different application in medicine, veterinarian medicine and other fields. The drug policy is based upon the surveillance of infectious drug resistance and drug monitoring (effectiveness, economy, and side effects of the drugs).


[Antibacterial combination therapy].

Reasons for the use of antibacterial combinations are synergistic effects and delayed development of bacterial resistance. On the basis of numerous experiments in vitro the opinion is supported that a clinically useful synergism depends on the addition of an aminoglycoside, the second compound being either one of the penicillins or cephalosporins, or a polymyxin, or a bacteriostatic agent like tetracycline, macrolide, and lincomycine. The decrease of MBC and MIC values varies according to the species and strains of bacteria and in dependence on the components of antibiotic combinations. Combination therapy with antibacterial synergism is indicated in life-threatening infections and in order to suppress bacterial persistences. Combinations with antagonistic effects should be avoided. The use of multiple antibiotics for broader spectrum only is not supported.


[Classes of antibiotics and their mechanisms of action].

The antibiotics used in the chemotherapy of microbial infections are considered with respect to their antimicrobial spectra and their mechanisms of action, respectively. The sites of action of the different groups of antibiotics interfering with the same cellular processes are discussed. According to their primary actions on sensible cells the antimicrobial antibiotics are divided into four groups: 1. Inhibitors of the biosynthesis of the bacterial cell wall 2. Inhibitors of the bacterial protein synthesis 3. Inhibitors of the nucleic acid metabolism 4. Membrane-active antibiotics.


[Generalized mycoses and their therapy].

After valuation of the increasing significance of the medical mycology as an interdisciplinary branch of science which concerns all clinicians the causes for the permanent increase of the endomycoses by yeasts and moulds are demonstrated. As secondary mycoses they need predisposing factors for manifestation which are to be taken into consideration more than up to now done in so-called risk patients. The pathomechanism is demonstrated with the help of the frequency of the lesion of organic systems in candidoses as well as in mould mycoses. Finally, the modern therapeutic possibilities are discussed.


[Therapy of bacterial meningitis].

The therapy of the bacterial purulent meningitis supports itself - at least in the causative organisms appearing most frequently - meningococci, pneumococci - on the application of a sufficiently high and sufficiently long penicillin therapy. In other causative organisms - pseudomonas, E. coli - the therapy demands the aimed use of other antibiotics (gentamycin, carbenicillin, polymyxin). The pneumococcal meningitis with pronounced reference to age shows the highest letality. The urgent admission to hospital must be demanded also when there is the slightest suspicion on the existence of a meningitis. Antibiotic therapy before admission may prevent the demonstration of causative organisms and thus inhibits the aimed therapy.


[Therapy of staphylococcal endocarditis].

It is reported on the therapy with antibiotics of 5 patients with staphylococcal endocarditis with linkomycin--streptomycin. 2 patients were cured, 2 patients died after disappearing of fever and clinically unequivocally controlled septicaemia of typical complications of ulcerous endocarditis. One patient continued fevering to the exitus letalis when negative blood cultures were present, whereby at post-mortem examination an encephalomalacia with fresh haemorrhage was found to be the cause.


[Therapeutic results using combined antibiotic therapy in chronic carriers].

From 1969 to January 1976 82 chronic carriers underwent a sanitation treatment. This treatment consists in an antibiotic combination treatment with ampicillin and canamycin during 24 to 18 days, in which case possibly simultaneously the cholecystectomy is striven for. In chronic carriers of S. typhi in 37 cases the combined antibiotic-operative treatment led to the permanent success. In chronic carriers of S. paratyphi B 21 of 22 cases were present. In patients with condition after cholecystectomy in every case one failure was present. In purely conservative approach the coefficient of success was 50 and 78%.


[Management of Salmonella typhi and paratyphi carriers using Sulprim].

The sanation of carriers of Salmonella germs by means of bactericidal chemotherapy in combination with cholecystectomy is not to be expected in many patients with older age or when concomitant diseases are present. Therefore was tested, whether an exclusive therapy with trimethoprim-sulphamethoxazol (sulprim) is an effective method for the sanation of carriers of the salmonella germs with renunciation of cholecystectomy. Since 1973 up to now 20 carriers of germs have been treated for 12 weeks with daily 2 X 2 tablets of sulprim. Of these patients 84-year-old female patient died of massive pulmonary.


[Results of stationary management of patients with hypertension with reference to previous ambulatory care].

The case histories of 100 patients who were hospitalised in the Department of Internal Medicine of St. George's Hospital in the period from January 1975 to March 1976 are analysed mainly to study their treatment as outpatients (information of the patient, previous diagnoses and treatment, and diagnosis at the time of hospitalisation) and the results of their in-hospital treatment. Most of the patients were admitted to hospital at an advanced stage, usually when out-patient treatment had failed to produce results, but in 80% of the cases the result of in-hospital treatment was satisfactory or good. Besides improvement in drug combination and treatment of cardiac insufficiency, the most frequent complication, observation of general therapeutic principles under conditions of in-hospital treatment was found to be of special importance. Over and above this, we regard close cooperation of hospital and out-patient clinic as essential in the optimisation of the treatment of hypertension.


[Endoscopic demonstration of heterotopic gastric mucosa in the duodenum].

On the basis of 8 observations in 3,140 duodenoscopies is referred to the endoscopic picture of heterotopies of the gastric mucous membrane. The heterotopic mucous membrane of the stomach was found in polypoid rice-grain-sized to pea-sized lesions of the duodenum. The histological examination four times resulted in a mucous membrane of the stomach of corpus type, three times of antrum type and once only in foveolar epithelium. As to other findings endoscopically were twice observed erosions of the gastric mucous membrane or of the mucous membrane of the bulb, respectively, once an antrum polypus, in no case ulcers. Once an achlorhydria was present. A hyperchlorhydria was to be proved in no case. The clinical significance of the heterotopia of the gastric mucous membrane in the duodenum as well as the cause of its existence are discussed.


[The density--viscosity--temperature relationship of infusion solutions].

Viscosity and density of the infusion solution have an influence on the dropping rapidity when the conventional infusion technique is used and on the elevation volume when infusion pumps are used. They depend on temperature and thus may vary the infusion volume. For selected infusion solutions this behaviour was analysed and described. The changing of these parameters depending on temperature is insignificant and might not be relevant clinically.


[Internal medicine and dactyloscopic examinations of mothers with malformed children].

A retrospective study concerning anamnestic data as well as an internal and dactyloscopic examination were caried out on 75 woman who were delivered from a deformed child. Apart from the well-known causes of a deformity the chronic arterial hypertension is emphasized as teratogenetic factor. The dactyloscopic examination did not result in an accumulation of stigmata which refer to a genetic condition of the deformities. Differences concerning the distribution of patterns on the finger-tips need further investigations; at present they are not yet to be explained.


[A comparison of cardiovascular effects of dobutamine and dopamine (author's transl)].

The influences of dobutamine and dopamine 5-40 microgram/kg-min intravenously on hemodynamics and myocardial oxygen consumption were investigated in closed chest dogs (n=9). Heart rate (HR), cardiac index (CI), stroke volume (SVI), mean aortic pressure (MAP), pulmonary artery pressure (PAP), central venous pressure (CVP), left ventricular enddiastolic pressure (LVEDP), myocardial blood flow (MBF) and maximum dp/dt (dp/dtmax) were measured. Total peripheral resistance (TPR), coronary vascular resistance (CVR), myocardial oxygen consumption (MVO2), efficiency of heart work (EME), the ventricular volumes (EDV, ESV) and the ejection fraction (EF) were calculated. When dopamine was infused, the cardiac output rose mainly by an increase of heart rate. During dobutamine an increase of stroke volume and ejection fraction was involved in the improvement of cardiac output. Heart rate and mean aortic pressure increased to a greater extent by dopamine. Dobutamine and dopamine increase myocardial blood flow and oxygen consumption. The comparatively slight effects of dobutamine on afterload and heart rate resulted in smaller increases in myocardial oxygen consumption. The efficiency of external heart work was increased by dobutamine at the doses of 5 microgram and 10 microgram/kg-min. In the higher dose range external myocardial efficiency decreased under dopamine and dobutamine. Load data and heart rate indicate that a greater inotropic effect of dobutamine compared with equal doses of dopamine is involved in the increase of dp/dtmax. The results are discussed in relation to a clinical use of dobutamine and dopamine.


[Regional myocardial motility as evaluated by analysis of "gated blood pool" data (author's transl)].

Cyclic precordial variations of radiation after i.v. administration of 15 mCi 99mTc-HSA correspond to cyclic volume changes of ventricular volumes of the heart. The "gated blood pool procedure" yields reliable data. Extensive analysis of these data results in subsequent information concerning left ventricular myocardial behaviour: 1. extent of the regional myocardial contraction 2. homogeneity of the contraction 3. regional contraction velocity 4. regional relaxation velocity. Four parametric scans present the distribution of each one of those parameters within the heart. Gated blood pool data have been compared with angiographic data. Reliability of those parameters obtained by extensive analysis of the gated blood pool data could be proven.


[Interventricular septal motion in hypertrophic cardiomyopathy. Additonal knowledge from real-time b-scan echocardiography (author's transl)].

M-scan echocardiography had suggested that interventricular septal motion in patients with Hypertrophic Cardiomyopathy is immobile. In this study special attention was paid to this septal motion during Real-time B-scan (RTBS) investigations of 15 patients with proven Hypertrophic Cardiomyopathy. RTBS recordings have shown that the basal part of the interventricular septum (IVS), which bulges into the left ventricular outflow tract (LVOT), exhibits a forceful contraction towards the cardiac apex, while the more apical portion moves normally towards the left ventricular posterior wall. The direction of the basal septal motion is more or less at right angles to the single ultrasonic beam in M-scanning. The amplitude of this motion, therefore, can only be appreciated with M-mode according to that component of motion which moves parallel to the ultrasonic beam. According to the angle of incidence of the ultrasound waves, septal motion may be recorded as mobile or apparently immobile, and the transition zone from apical to posterior septal motion can be appreciated in a semiquantitative manner by using a Continuous Sweep Technique. From these observations and considerations it has emerged that the left ventricular internal diameter and the rate of change of this dimension in the region of the "immobile" basal septum does not allow conclusions to be drawn about the overall haemodynamic situation of the left ventricle in patients with Hypertrophic Cardiomyopathy. Furthermore, this study is another demonstration of the importance of the combined application of M-and RTBS echocardiography for optimal non-invasive clinical cardiac diagnosis.


[Relation between the degree of coronary artery sclerosis  and collateral vessel formation (author's transl)].

A numerical index was developed for reproducible and comparative judgement of the degree of coronary sclerosis. This graded index method takes into account the amount of stenosis as well as its distance from the ostium. 152 selective coronary angiograms were evaluated by this method. There was a close correlation between the degree of sclerosis and collaterals; the index of 63 patients with collaterals was 3.5 times that of patients without collaterals. Anastomoses and collaterals showed typical localisations depending on the antomical position of stenoses. For the evaluation of the clinical importance of collaterals, a classification into one, two and three vessel disease is not adequate; the reduction in perfusion cannot be reliably estimated and should be judged by a more detailed index method.


[Oesophagosternal and oesophagoapical leads for registration of surface his-bundle potentials (author's transl)].

Theoretically there should be two possibilities of recording His-Bundle potentials from the body surface. Extensive amplifying and signal averaging can improve the signal to noise ratio of the His-Bundle potential. Random noise can be filtered and the periodic signal of the His bundle can be selected. On the other hand improvement of the noninvasive leading conditions could be achieved by positioning of the recording electrodes close to the structure to be investigated and by direction of the surface leading according to the anatomical axis of the bundle of His. For this purpose these new oesophagosternal and oesophagoapical leadings have been developed. The different oesophageal electrode is placed nar the upper cava-right atrial border close to the heart. The indifferent electrode is situated at the xiphisternum or at the apex of the heart. The direction of this lead is close to the direction of the anatomical axis of the His-Bundle. By this means a positive wave within the PR-segment can be registered, which we have called the "HP-wave". In a total of 17 patients these bipolar oesophageal leads were employed, in 12 cases simultaneously with the intracardiac HBE as a reference method. At rest the peak of the HP wave correlated to the maximal amplitude of the intracardiac His spike in more than 90% of patients. 4 patients were investigated by atrial pacing, in 3 cases this correlation could be found, too. Apparently the true His bundle signal can be obtained from the body surface by this new leading system. For improvement of the surface His bundle recordings, we reflect the combination of our noninvasive oseophageal lead with a modified signal averaging system with lesser amplication of the original signal.


[Hemodynamic interaction of propranolol and digitalis in patients with arterial hypertension (author's transl)].

Central hemodynamics at rest and during supine ergometer exercise have been studied in 12 hypertensive subjects and three healthy persons before and 20 min after 5 mg of intravenous propranolol. Cardiac output (CO) decreased by 19% at rest (p less than 0.001) and by 15% during exercise (p less than 0.001). Pulmonary capillary wedge pressure (PCP) during exercise rose after beta-blockade by 56% to 28 mm Hg (p less than 0.001); a similar increase could be observed in pulmonary artery pressure (PAP) and right atrial mean pressure (RAM). Brachial artery mean pressure at rest did not change significantly; during exercise this value was 6% below the pretreatment level (p less than 0.001). In order to evaluate the influence of digitalis on beta-blocker induced hemodynamic changes, measurements were repeated 30 min after administration of 0.6 mg beta-Methyldigoxin intravenously. After addition of digitalis, average PCP during exercise was significantly lower than after beta-blockade alone (22.8 mm Hg, p less than 0.001). Likewise, PAP and RAM after digitalis were lower than after propranolol alone. CO did not change following digitalis administration. These findings indicate that digitalis partially counteracts the elevation of filling pressures induced by beta-blocking agents but leaves CO unchanged.


[Repetitive syncopale loss of consciousness by properly functioning pacemaker. Ophthalmodynamographic, ophthalmodynamometric, and cerebral-scinitigraphic investigations (author's transl)].

In spite of an intact pacemaker function, 3.8% of 444 patients with an implanted cardiac pacemaker taking part in a regular follow-up program had repetitive syncopes. The investigation thereafter, whether or not these attacks were symptoms of occlusive vascular disease of the carotid arteries, included a thorough physical and angiological examination, ophthalmodynamometry (ODM), ophthalmodynamography (ODG), and radionuclide angiography. The results were compared to those of a group of 46 cardiac pacemaker patients without syncopes after the implantation of the pacemaker: 29% of the patients with syncopes and 15% of the patients without syncopes showed ODM-, ODG-, and radionuclide angiography results compatible with carotid artery insufficiency; statistically, however, the group differences were insignificant. The reasons are discussed why ODM, ODG, and radionuclide angiography appear to be ineffective for the diagnosis of carotid artery occlusion in patients with an implanted cardiac pacemaker.


[Persistent truncus arteriosus communis (type I) and interruption of the aortic arch (type B) (author's transl)].

Description of the history, the clinical findings, and the autoptic results in a 5-days-old newborn child with a truncus arteriosus (Type I) and an interrupted aortic arch (Type B). Perfusion of the distal aortic arch by a wide open Ductus arteriosus. Additional anomalies: Atrial septal defect with partial anomalous pulmonary venous drainage of the right lung into the right atrium. Persistant left superior vena cava which leads to the left atrium.  Hypoplasia and dysplasia of the left kidney. A tear caused by friction in the left sensorium with intra-and subdural bleeding. Discussion of the clinical, electrocardiographic, radiologic, angiocardiographic and pathologic-anatomical peculiarities of the persistent Truncus arteriosus and of the interrupted aortic arch connected with both defects.


[Postoperative cardiopulmonary function studies in children and adolescents with pulmonary valvular stenosis (author's transl)].

Cardiopulmonary function studies at rest and during submaximal and maximal exercise were performed in 20 children and adolescents who had undergone valvotomy of a pulmonary valvular stenosis. Maximal oxygen uptake of the patients was 90%, stroke volume 95% of expected values. There was a strong correlation between stroke volume and maximal oxygen uptake. Mean right ventricular systolic pressure at rest was 39 mm Hg and increased to 60 mm Hg at a submaximal load corresponding to 1 1/2 Watt/kg body weight. There was no correlation between right ventricular systolic pressure on the one hand and maximal oxygen uptake, stroke volume and pulmonry valve resistance, on the other hand. It is concluded, that the importance of maximal oxygen uptake as the equivalent of cardiovascular performance capacity and of stroke volume alone as a main parameter of cardiac function may not be overestimated regarding their value in the assessment of the surgical result. A reoperation must be considered when a distinctly elevated right ventricular pressure at rest shows an additional overproportional increase at exercise in the presence of a decreasing stroke volume. This was the case in 3 of our 20 patients.


Changes of the CO-diffusing components of the lung in patients with coronary artery disease (author's transl).

In 32 patients with angiographically proved CAD the diffusion parameters of the lung (intracapillary pulmonary blood volume, Vc, and diffusion capacity of the alveolo-capillary membrane, Dm, respectively the reciprocal value membrane resistance) were measured. As reference the pre-a-LVDP was used, as it represents more adequately than the LVEDP the pressure acting on the alveolo-capillary membrane. There was a significant positive correlation between the Vc and the pre-a-LVDP as well as a highly significant positive correlation between the diffusion resistance of the alveolo-capillary membrane and the pre-a-LVDP. This corresponds to a pulmonary congestion with an increase of Vc and an interstitial edema with an increase of the diffusion resistance of the alveolo-capillary membrane. The Dco may be unchanged in spite of a marked increase of LVDP, since the decrease of the membrane component is accompanied by an increase of the blood component of diffusion. Only the differentiation of the CO-transfer in its components Vc and Dm gives an information about changes of the hemodynamics in CAD.


[Transcutaneous PO2-measurement during heart catheterization in childhood (author's transl)].

Transcutaneous oxygen blood tension (tcpO2), heart rate, respiratory amplitude, respiratory rate, and relative local perfusion have been monitored continuously during heart catheterization in 37 children with congenital heart disease. The tcpO2 method allows an adequate measurement of the severity and duration of hypoxemia following arrhythmias or injection of contrast medium. The extent of hyperoxia following diagnostic procedures can also be controlled by this method.


[Multiple chest leads to evaluate the course of acute myocardial infarction (author's transl)].

At present, precordial mapping is the only reliable method to define the course of myocardial ischemia in patients with acute myocardial infarction. To improve registration technique and evaluation an elastic synthetic plate with 48 electrodes and a computer program for calculation of the different ecg-changes have been developed. Registration and evaluation require an average period of 15 minutes (+/-3 minutes) thus allowing repeated application within time intervals.


[Can predictability of coronary angiographic findings be improved by additional measurement of pulmonary wedge pressure during exercise? (author's transl)].

The correlation between the three ischemia indicators angina pectoris (AP), ST-segment depression (ST) and excessive pulmonary wedge pressure rise (PCP) during exercise, and the coronary angiographic findings, were analysed in 293 patients without previous transmural myocardial infarction. This patient material consisted of 253 men and 40 women between the age of 20 and 65 years, the mean age being 48. The exercise tests were performed on a bicycle ergometer in supine position and in relatively steady state conditions. Pulmonary wedge pressure was measured by means of a Swan-Ganz floating catheter. The essential findings were: 1. If all three ischemia indicators were positive, the incidence of a positive angiographic finding i.e. a greater than or equal to 50% stenoses in at least one main coronary artery was 96.3%. 2. If only the two classic ischemia indicators were evaluated and positive, the incidence of a positive angiographic finding was only 86.1% (24). This difference is mainly due to false positive results of AP and ST in women. 3. If all three ischemia indicators were negative, the incidence of a negative angiographic finding was 89.2%. 4. If only the two classic ischemia indicators were evaluated and negative the incidence of a negative angiographic finding was as high (87,6% [24]). This lack of difference is due to the fact that patients with a previous intramural infarcion can be free not only of AP and ST but also of PCP during exercise. 5. The combination of AP and PCP, or ST and PCP, is equally reliable in predicting coronary morphology as the classic combination of AP and ST. It follows that PCP measurement is recommended, if one of the classic ischemia indicators cannot be properly evaluated.


[Systolic and diastolic left ventricular function in hypertrophic obstructive cardiomyopathy].

Systolic and diastolic left ventricular and myocardial performance were analysed in ten patients with hypertrophic obstructive cardiomyopathy (HOCM) from biplane cineangiograms and simultaneous pressure recordings. In spite of significant geometrical abnormalities, pump function of the left ventricle on the average was normal. Only in two cases ejection fraction and isovolumic phase indices, respectively, were moderately reduced. On the contrary nine of ten patients had a considerable reduction of left ventricular distensibility, partly due to a decreased myocardial compliance. The symptoms of patients with HOCM cannot be explained by an impaired systolic pump function, they are primarily caused by a disturbed ventricular und myocardial function during diastole.


[Physical training of patients after mitral valve replacement (author's transl)].

Physical training increases blood flow across the valve and heart rate in patients with mitral valve replacement. The influence of these parameters were studied in 26 pts. (16 SW-disc valves, 10 LK-valves). The investigations were made at rest, during exercise with 1 Watt/kg BW, and during ventricular pacing at 120, 150, and 180 beats/min. The following parameters were recorded: pressures in the right and left heart, pressure gradients (deltaP), cardiac output (CO, CI), pulmonary artery oxygen saturation (SO2PA), blood flow (F), flow velocity (Q), and the fraction of deltaP/SV. All valves were mechanically reliable. Mean opening of the disc in the LK-valves was 62 degrees. There was no myocardial dysfunction. Pressures in the right heart were elevated during all procedures. deltaP at rest was 7.5 mmHg, 20.9 mmHg during exercise, and 12.3 mmHg during pacing. deltaP increased with increasing flow velocity and heart rate. deltaP/SV rose disproportionately with exercise and pacing. Since deltaP increases with flow volume, flow velocity, and heart rate physical activity after mitral valve replacement should be avoided. Alternative therapeutic concepts are discussed.


[Angiographic studies in fluoroscopically detected coronary calcification (author's transl)].

We performed coronary angiography in eighty subjects with radiographically diagnosed coronary calcification. Radiographically proven coronary calcification is highly specific for coronary heart disease. Within certain limitations it helps in locating stenoses and is present more frequently in multiple vessel disease. It sometimes detects coronary artery disease missed by other non-invasive methods.


[Present aspects of bacterial endocarditis in infants and children. Observation during the years 1969-1976 (author's transl)].

21 infants and children with proven bacterial endocarditis were observed at the Unviersity Children Hospital of Düsseldorf from January 1969 to December 1976. There was high incidence of cases in the infant group and again among the 6 to 8 years old children. Some important aspects of the disease were characteristic for the infant group (N=5): No congenital cardiac abnormality was present, but a surgical cerebro-atrial connection in two cases of hydrocephalus and a prolonged artifical respiration in a third patient could have been predisposing factors. Staphylococci were the pathologic organisms in three infants. The course of the disease consistently resembled that of septicemia and the outcome was always lethal. The diagnosis of bacterial endocarditis was disclosed only by the post mortem examination. The mitral and the tricuspid valves were affected twice respectively, the pulmonary cusps only once. In the children group (N=16) fifteen patients had a congenital malformation of the heart confirmed by previous catheterization. 8 were cyanotic and 5 of them had a tetralogy of Fallot with previous aorto-pulmonary shunting procedure (Waterston). Unlike the spectrum of micro-organisms presently found in adults, the streptococcus viridans prevailed as before, it was isolated in 11 of the 13 blood cultures which yielded positive results. The disease displayed a subacute course and mortality remained with 3 deaths relatively low. In 3 other cases a valve lesion subsisted, in two instances severe enough to necessitate surgery (aortic valve prosthesis, mitral annular narrowing). No relapse was observed during the mean follow up period of 2;8 years.


[Investigation by borrowing-lending-phenomenon under conditions of intraarterial induced vasodilatation (author's transl)].

In fourty patients with peripheric atherosclerosis obliterans blood flow was measured by means of venous occlusion plethysmography during an intraarterial and an intravenous infusion of ATP. The intraarterial application showed a significantly higher increase of blood flow than the intravenous in the sick extremities. The "borrowing-lending-phenomenon" happened more seldom than after an intravenous load. This withdrawal of blood occurred most frequently in patients with proximal occlusions, when the infusion reached casually the arteria femoralis profunda only. The "borrowing-lending-phenomenon" can be measured by the poststenotic pressure and by the volume of blood flow in time. Then the patients complain about a begining or an increasing of an ischemic pain at rest.


Effect of anoxic incubation on the oxygen uptake of Isoparorchis hypselobagri (Digenea: Trematoda).

Anoxic incubation for varying periods of Isoparorchis hypselobagri from the swim bladder of the catfish Wallago attu, led to an accumulation of oxygen debt on the part of the parasite. With increasing length of anoxic incubation, there is a corresponding increase in post-anaerobic oxygen uptake, and the longer the period of incubation is, the greater is the time taken to return to a normal rate of oxygen uptake.


[The ketone bodies in the hemolymph of Biomphalaria glabrata under starvation and infection with Schistosoma mansoni (author's transl)].

The metabolism of the snail Biomphalaria glabrata stressed by five days' starvation as well as by infection with Schistosoma mansoni was examined with regard to the metabolism of ketone bodies. Previous studies in the metabolism of this host--parasite relationship always resulted in changes in the same direction with starvation as well as with infection. Contrary to that the concentration of acetoacetate and beta-hydroxybutyrate measured in the hemolymph decreased significantly with starvation but increased significantly with infection. The following problems concerning the ketone body metabolism are discussed: on the one hand the differences between infected and starved snails, and on the other hand the differences between the snails and the mammals as well as in the invertebrates so far investigated.


The cytochemical localization of lysosomal hydrolases in the digestive cells of littorinids and changes induced by larval trematode infection.

The cyctochemical localizations of a number of lysosomal hydrolases have been examined in Littorina littorea, Littorina saxatilis and Littorina neritoides. Reactivity for these enzymes is associated with granular and vacuolar components in the digestive cells, which are presumed to be lysosomes. Seasonal changes in staining intensity in L. littorea appear to be related to the summer growth and winter maturation phases. Invasion of the digestive gland of L. littorea by larval trematodes induces distributional changes in lysosomal hydrolases, which may be related to autophagic and autolytic activities. The distribution of these enzymes in the larval teguments and caecal cells is also described.


[On the occurrence of Ixodes canisuga Johnston, 1848, in Germany, a contribution to the Ixodes-fauna (author's transl)].

As a contribution to the Ixodes-fauna of Germany the occurrence I. canisuga is described from a hunting dog near Aschaffenburg and from kennel dogs in Herford. With regard to the morphology of the areae porosae an aberrant specimen of this tick species is illustrated by scanning electron microscopy.


Development in cell cultures of Eimeria vermiformis Ernst, Chobotar and Hammond, 1971.

Development of Eimeria vermiformis from sporozoite to mature first-generation schizonts in cultured bovine kidney cells, Madin-Darby bovine kidney cells, and primary cultures of whole mouse embryos is described. Intracellular sporozoites were seen at 5 min, and for as long as 120 h after inoculation. Sporozoites were observed penetrating cells, with uninucleate trophozoites and immature schizonts with 2--6 nuclei first appearing 24 h after inoculation. Schizonts with 6 or more nuclei, as well as mature schizonts containing first-generation merozoites, were first seen between 36 and 48 h after inoculation of all 3 cell types used. The first indication of merozoite formation was determined by the appearance of small protuberances of cytoplasm at the periphery of schizonts. Merozoites began development at the periphery of schizonts and were later observed radiating from a central body of cytoplasm, 14--20 merozoites being formed. Some mature schizonts retained a small spherical residual body after merozoite formation was completed. After the rupture of schizonts, intracellular merozoites, which contained anterior and posterior refractile granules, were seen at 48, 72 and 96 h postinoculation. Merozoites were not seen entering or leaving cells. No further development was observed.


Survival of Aegyptianella pullorum, Anaplasma marginale and various parasitic protozoa following prolonged storage in liquid nitrogen.

Various protozoa species were examined using in vivo and in vitro methods to determine their ability to survive prolonged periods of storage in liquid nitrogen. The following protozoan species were successfully recovered after they had been cryopreserved for a period over 10 years: Trypanosoma lewisi, T. cruzi, T. congolense, T. brucei, T. rhodesiense, T. gambiense, T. evansi, T. equinum, T. equiperdum, Leishmania donovani, Plasmodium berghei, P. praecox (relictum), Babesia rodhaini and B. canis. The longest survival period that has been successfully tested so far is between 5 and 7 years for Eimeria species, for monoxenically (A--C) and axenically grown E. histolytica cultures between 2 and 7 years and trichomonades, including Crithidia sp., between 6 and 8 years. Aegyptianella pullorum was successfully recovered after 6.97 years and Anaplasma marginale after 1.92 years. The freezing techniques are briefly described.


Acute Babesia bigemina infection: changes in fibrinogen catabolism.

Plasma from cattle infected with Babesia bigemina contained soluble fibrin in monomer and high molecular weight complex forms. Fibrin(ogen) degradation products were not constantly detected and there appeared to be little or no evidence to suggest fibrinolysis or fibrin deposition. It is suggested that classical disseminated intravascular coagulation does not occur during B. bigemina infection.


Acute Babesia bigemina infection: changes in coagulation and kallikrein parameters.

Plasma from splenectomized calves infected with B. bigemina were assayed for disturbances in the coagulation system. Changes were observed in the WBCT, PTT, PT, TT and RT as well as in fibrinogen, calcium and thrombocyte levels. These changes were most marked during days 6--7 when parasite numbers were greatest. Massive intramuscular haemolysis coincided with these changes. The plasma kallikrein level fell progressively from days 6--11 and the level of activated kallikrein rose slightly. Parasite doubling time was calculated at 8.13 h. The similarities and differences between this disease and B. argentina infections of cattle are discussed.


Growth of Leishmania amastigotes in macrophages from normal and immune mice.

An in vitro system of prolonged culture of Leishmania tropica amastigotes in mouse macrophages is presented. The division rate of parasites was monitored by microscopic observations and by 3H-thymidine incorporation. The dynamics of macrophage infection and parasite division are influenced by the initial rate of promastigotes per cells in culture. Parasites multiply, gradually infect and finally destroy all available macrophages from normal mice releasing large numbers of viable amastigotes. Macrophages from immune donors were inferior in their ability to support parasite multiplication and did not survive long periods in culture.


Scanning electron microscopy (SEM) of some Setaria species (Filarioidea, Nematoda).

Some Setaria spp., such as S. digitata, S. marshalli, S. marshalli pandei, S. equina and S. labiatopapillosa were studied by scanning electron microscopy at the critical points in the anterior and posterior parts of the adult worms. The amphids, Deirids, find transverse striations of the cuticle and phasmidial pare, as well as the transverse bands (lugae), postdeirid and ventral papillae (only of the male) were visualized clearly at this examination. They contribute towards the identification of Setaria spp., in addition to the characteristics which are demonstrated by common light microscopy.


The action of metabolic inhibitors on microgametogenesis in Plasmodium yoelii nigeriensis.

Mature gametocytes of Plasmodium yoelii nigeriensis were incubated in vitro with a variety of antibiotics whose activities were directed against DNA, RNA, protein and microtubule assembly. Following incubation for periods between 5 and 90 min, exflagellation was induced and the degree of inhibition produced by each drug was assayed microscopically. The results obtained show that de novo synthesis of axonemes and proteins is essential to the events of microgametogenesis. The inhibitory effect of actinomycin-D suggests that de novo RNA synthesis is also required. However, the inactivity of 8-azaguanine, a drug also effective against m-RNA metabolism, casts some doubt on the requirement for m-RNA synthesis. DNA synthesis is not required during the three successive mitotic division of the parasite genome during microgametogenesis. The mature microgametocyte therefore contains the 8c DNA required for microgamete production.


Promotion of leishmanial infections in non-permissive host macrophages by conditioned medium.

Leishmania enriettii grows well in guinea pig macrophages in culture but fails to do so in mouse macrophages. Dialyzed and concentrated conditioned medium from L. enriettii cultures promoted the infection in the mouse macrophages at 37 degrees C and at 32 degrees C. Similarly processed medium on which L. tropica had been cultured did not cause the same effect. Immune precipitation of the conditioned medium by anti-Leishmania serum cancelled out the effect. Infections of guinea pig macrophages by L. tropica were also enhanced by the homologous medium, but we were unable to quantitate the effect.


Skin penetration of infective hookworm larvae. III. Comparative studies on the path of migration of the hookworms Ancylostoma braziliense, Ancylostoma ceylanicum, and Ancylostoma caninum.

The lateral skin areas of nine hookworm-free puppies were exposed to infective larvae of Ancylostoma braziliense, Ancylostoma ceylanicum and Ancylostoma caninum. Serial sections, stained with Harris' haematoxylin and eosin, showed that many similarities exist in the migration patterns of the hookworm species used. However, striking differences were observed between Ancylostoma braziliense on the one hand and Ancylostoma ceylanicum and Ancylostoma caninum on the other hand with regard to the speed with which the penetration occurred. Larvae of Ancylostoma braziliense may travel directly from the epidermis into the dermis--apart from migration via hair follicle systems--a path of migration we did not observe in infections with the other species used. Larvae of Ancylostoma braziliense seem to pass the skin more rapidly than those of Ancylostoma ceylanicum and Ancylostoma caninum. Many larvae of Ancylostoma ceylanicum managed to penetrate the skin 2--6 h after the onset of the exposure.


The cystacanth of Moniliformis moniliformis (Bremser, 1811) and its relationship with the haemocytes of the intermediate host (Periplaneta americana).

The nature of the capsule of the cystacanth of Moniliformis moniliformis was studied. Fat body, tracheal system, Malpighian tubules and haemocytes of the host are intimately associated with the cystacanth. The capsule of the cystacanth is cellular. The cells encapsulating the middle and late acanthellae are granular haemocytes of the host, whereas those encapsulating the cystacanth are agranular. Degranulation of haemocytes after encapsulation of the cystacanth recalls the common method for encapsulation of parasites of insect haemocytes, but a difference between the two kinds of encapsulation is that the capsule around the cystacanth does not bring about melanization nor destroys the parasite. It is suggested that the surface of the parasite may have inhibitors against enzyme systems causing melanization. Host haemocytes are also found in the capsular fluid. The infiltration of haemocytes into the capsule may be in response to the release of metabolites by the parasites. It is also suggested that the haemocytes may detoxify the parasitic metabolities. Rarely, capsules containing two parasites were observed. In one of the cases, one of the two cystacanths already possessed its own capsule. This finding, together with the cellular nature of the capsule, suggests that the capsule is of host origin.


Calcification in an ageing Ligula intestinalis (L) plerocercoid from a bream (Abramis brama L.).

Light and transmission electron microscopy of the strobila of a large old Ligula intestinalis plerocercoid has revealed microcrystals with a morphology similar to that of microapatite crystals from vertebrates. Analysis of the microcrystals with EMMA-4 showed them to contain calcium and phosphorus. The tissue in the immediate vicinity of the microcrystals shows signs of necrosis while further away it is histologically normal.


Near-death experiences: dilemma for the clinician.

The rapid development of resuscitation technology points to an increasing number of near-death survivors. Many such survivors relate extraordinary experiences that profoundly color their extended lives. The author classifies a large group of these experiences and formulates the physician's appropriate response to them.


[The detector, the command neuron and plastic convergence].

The paper deals with the structure of detectors, the function of commanding neurones and the problem of relationship between detectors and commanding neurons. An example of hierarchial organization of detectors is provided by the colour analyser in which a layer of receptors, a layer of opponent neurones and a layer of colour-selective detectors are singled out. The colour detector is selectively sensitive to a certain combination of excitations at the input. If the detector is selectively activated by a certain combination of excitations at the input, the selective activation of the commanding neurone through a pool of motoneurones brings about a reaction at the output, specific in its organization. The reflexogenic zone of the reaction is determined by the detectors which converge on the commanding neurone controlling the given reaction. The plasticity of the reaction results from a plastic convergence of the detectors on the commanding neurone which controls the reaction. This comprises selective switching off the detectors from the commanding neurone (habituation) and connecting the detectors to the commanding neurone (facilitation).


[Behavioral and neuronal effects of visual deprivation in cats].

Recent data obtained in the Nencki Institute are reviewed. In the cats deprived of pattern vision from birth several deficits were observed: (I) A simultaneous object discrimination learning for food reward was strongly impaired. However, retention of discrimination was only slightly impaired by bisual cortex ablation. (II) Ocular following reflex was impaired. (III) In the living cages stereotyped behavior appeared. (IV) Direction selectivity of superior colliculus units was impaired. (V) Percentage distribution of insoluble proteins in the electrophoretic pattern from visual and somatic sensory cortex was affected.


[Dynamics of conditioned reflex reorganization in the human visual system].

The dymamics of absolute and relative changes in the brightness thresholds of letters recognition was studied in 21 subjects, under conditions of dark adaptation and molecular observation, before and after pairing of one of the letters with electrocutaneous stimulation of the index finger during one session. Isolated electrocutaneous stimulation was applied on the 10th or 35th day after the session. It has been found that after pairings the relative threshold of recognition of the letter previously paired with electrical stimuli (i.e. the threshold in relation to recognition thresholds for the other letters) becomes for three to three and a half hours significantly lower than the initial one. Then there sharply sets in a phase of threshold elevation. Both in the case of double and multiple tests, this phase persists for not less than 35 days. Following an isolated electrical stimulation, a momentary significant lowering of the threshold sets in only for the letter which was paired with it in the first sessions.


[Dynamics of elaboration of conditioned reflex switching over of dissimilar instrumental conditioned reflexes].

Conditioned switching over of heterogeneous instrumental reactions was elaborated in four dogs. The action of a fan served as a switch from alimentary to a defensive situation. In the alimentary situation, the animal, in response to a conditioned stimulus, pressed the pedal with its right foreleg and, in a defensive situation, in response to the same signal, lifted the left paw attached to the lever. In some dogs the switching over was elaborated quite rapidly and easily, while in others it was achieved only on some days of the experiment. In the course of elaboration of the switching over, the animals responded to the trigger signal with bieffector reactions. The basic features of the dynamics of switching over elaboration revealed for classic conditioned reflexes also proved valid for instrumental conditioned reflexes.


[Role of the head of the caudate nucleus in sensomotor control of different forms of behavior].

In chronic experiments on dogs with models of alimentary and defensive behaviour and with EEG recording in the cortical acoustic area and in the caudat nucleus head (CNH) evidence was obtained of the possible role of the latter in the processes of attention. Special test (CNH stimulation of different strength and frequency) helped to reveal the role of the striatum in this function. Proceeding from facts obtained and from published data, it has been assumed that the involvement of CNH in the process of activation of attention is effected by its inhibitory influences both on the motor systems and on the non-specific afferent input. The electrographic correlate of the CNH inhibitory function consists in the slow-wave high-amplitude component of the caudatogram within the range of two to six osc/sec which is always present in the background and which considerably increases in amplitude in situations requiring activation of attention.


[Activity of cat motor cortex neurons during performance and conditioned reflex inhibition of the reaction of placing the forepaw on a support].

In chronic experiments on six cats a study was made of the unit activity of the contralateral forepaw motor area when achieving the reaction of placing the forepaw on a pedal. Of the 118 units, 32 exhibited tactile receptive fields on the contralateral paw. In the course of achieving the reaction, the activity of 97 pyramidal and non-pyramidal units was studied. The activity of 69 units correlated with some phase or other of the placing reaction. Connected with the movement was the activity of 93% of the investigated pyramidal cells and 65% of the non-identified units. 59.5% of the units changed their activity before activation in EMG, and the rest changed it during or after EMG activation. Two groups of units were singled out when conditioned inhibition was introduced, one with a changing and the other with a non-changing reaction during conditioned inhibition of the placing reactions.


[Neuronal activity of the head of the caudate nucleus during formation of positive and inhibitory motor alimentary conditioned reflexes in cats].

Cellular activity of the caudate nucleus head was studied on 15 cats during motor alimentary conditioning, extinction and elaboration of differentiation response. Analysis of the dynamics of the appearance and stabilization of neuronal conditioned responses attests that the caudate nuclei are a part of the morpho-functional structure of the given conditioned reflex. A functional heterogeneity within the nuclels head has been shown on the basis of responses of the cells during conditioned and unconditioned behaviour. It has been assumed that cellular populations of the ventral segment of the caudate nucleus head are predominantly involved in providing for a normal course of the processes of extinction and detection of significant signals in this form of conditioned alimentary behaviour in cats.


[Relationship between different types of memory in animals after a long stay in a changed gaseous environment].

Male rats were kept for ten days in helium-oxygen mixtures (PO2=0.2, 0.4 and 0.6 kgf/cm2) at atmospheric and higher (30 kgf/cm2) pressure, as well as in nitrogen-oxygen mixtures (PO2 = 0.2 and 0.6 kgf/cm2) under pressure (5 kgf/cm2). After the animals left the chamber their conditioned activity was investigated by the active avoidance method. The stay in a normoxitic helium-oxygen mixture under atmospheric or higher pressure did not affect conditioning, but after exposition in a normoxitic nitrogen-oxygen mixture under pressure, the rats exhibited a retarded elaboration of the conditioned reflex. A rise in partial oxygen pressure in the mixtures affected unfavourably the process of conditioning.


[Proteins of rat brain synaptic structures during conditioned reflex activity].

A comparative study was made of the structural-functional groups of proteins of synaptic structures in the cerebral cortex of albino rats during elaboration of a simple food-procuring reflex in one session. The results of estimation of quantitative and qualitative protein changes by the methods of isotope analysis and discelectrophoresis on polyacrylamide gel point to dissimilar changes in membrane and synapto-plasmatic proteins during learning. The process of temporary connections formation is accompanied by structural-chemical reorganizations of the synaptic membranes which evidently involve conformative transitions of external and integral proteins. There is a drastic rise in the rate of metabolism in the group of watersoluble proteins during learning, along with a possibility of "local" changes of synthesis in the fraction of low-molecular proteins.


[EEG slow components during human mental activity].

A study was made on 13 subjects in a state of rest and mental stress, of interconnection between the level of distant biopotential synchronization of separate cortical zones (which is a criterion of the rate of brain activation) and the spectral power of EEG frequencies. There is a statistically significant positive correlation between the first parameter and the energy of low frequency activity band (delta-theta). At the same time similar dependences for the alpha- and beta-rhythms are negative and topographically less spread. The coherence function likewise increases during mental stress for the low-frequency band alone. The data obtained point to the special role of low-frequency rhythms in the transmission of excitation over the cortex and support the significance of the alpha-rhythm in providing for the mechanisms involved in the control of homeostasis.


[Effect of coagulation of different regions of the hippocampus on elaboration and preservation of conditioned reflexes].

A study was made in rats of the influence of coagulating the anterior and posterior dorsal, medial and ventral hippocampus on the formation and preservation of electro-defensive and food-procuring conditioned reflexes. Statistical processing of the experimental data by the Student t-criterion showed that coagulation of these hippocampal areas does not influence the formation or preservation of the food-procuring reflex. Coagulation of the anterior dorsal and ventral hippocampus does not affect electro-defensive conditioned reflexes. Coagulation of the posterior dorsal and medial hippocampus delays the elaboration of electro-defensive reflexes and to a lesser extent influences their preservation.


[Changes in sleep with different types of reaction to emotional stress].

Polygraphic study of night sleep, carried out on 21 students the night after an examination and one night after vacations, revealed two types of reactions to an emotional stress. It has been shown that in the case of a rapid normalization of vegetative and electromyographic manifestations following the end of an emotional stress impact, the structure of night sleep remains unchanged. When manifestations of the emotional stress persist after the elimination of the stress situation, the amount of the rapid sleep in the following night increases. It is suggested that the differences noted are related to different types of anxiety stress.


[Responses of neurons of the associative parietal cortex during acute extinction restoration of a conditioned reflex].

The dynamics of spike neuronal activity in the parietal associative cortex was studied in the course of acute extinction and restoration of a conditioned reflex. Certain similarities have been found in neuronal firing during the reorganization of behavioral acts (transient processes in neuronal activity, general types of neuronal responses, etc.) The data obtained suggest the involvement of neurones of the parietal associative cortex in the processes related to the reorganization of behavioral acts, and the existence of common mechanisms of search for an optimal regime of neuronal assemblies functioning in different types of conditioned activity.


[Restoration of the process of elaborating a conditioned reflex to light in rabbits following early visual deprivation].

Rabbits with a long period of visual deprivation (up to eight weeks since birth), unlike those with four-week deprivation, require a longer time period (over 30 days) to normalize elaboration of conditioned reflexes and to manifest their electrographic correlates (evoked potentials). The results obtained testify to the ability of recovering CNS functions disturbed by deprivation. It has been suggested that natural early training of the synaptic structures of specific neurones in the visual cortex play a decisive role in this phenomenon.


[Relationship between recognition asymmetry and the interval between the stimuli of a dichoptic complex].

Recognition of optic stimuli (contour drawings, words and word combinations) was studied in conditions of binocular, monocular and dichoptic presentation. The interval between stimuli of the dichoptic complex (ISI) was: 0, 10, 20, 50, 100, 200, 400, 600, and 1000 ms. In all the cases "the effect of the right eye" was revealed. The mean values of the asymmetry index (A) are: high probabilistic monocular dichoptic presentation--45%. With a longer ISI, the percentage of correct recognitions of the second stimulus presented to the left eye, increases, while the A parameter decreases. This dependence is less pronounced in the recognition of the first terms of the stimuli pair. Dependence between the recognition level of the first and second stimuli, presented to the right eye and the ISI, is monotonous. The following A values for the three kinds of stimuli have been obtained: drawings--37%, word combinations--38% and words 59%. The results are discussed in the aspects of functional asymmetry, psychologic refractoriness and attention.


[Characteristics of the stability of functional interhemispheric asymmetry in the cat visual cortex].

A study of EP topography in the cat visual cortex has shown that initial functional interhemispheric asymmetry may be reduced and replaced by symmetry through long and frequent binocular stimulation. Section of the callosal body produced an inversion of one hemisphere dominance. In the callosotomized animals binocular stimulation enhanced the asymmetry. It is more stable in the cat visual cortex than in rats.


Low birth weight: some considerations in a Zambian population.

A retrospective analysis of 2401 consecutive births revealed a lowbirth weight rate of 11.4 percent of all births and 14.2 percent all live borns. Sixty-five percent of late fetal and first week neonatal deaths were low birthweight babies. The cause of low birthweight labour was unknown in 48.2 percent of cases. The major known associations with low birthweight labour and delivery were twin birth, antepartum haemorrhage, premature rupture of the membranes and toxaemia of pregnancy. Nutritional factors were considered to be of significance in the incidence of low birthweight. The earlier attendance of mothers at ante-natal clinics and the availability of experienced medical and nursing personnel with adequate facilities are necessary for perinatal mortality to be significantly reduced in the low birthweight group.


Cervical cytology in Zambia.

The problem of cervical cancer in Zambia is discussed. The pathogenesis of carcinoma of the cervix is described and the benefits of cervical cytology are highlighted. The role of cervical cytology in the context of a developing country is also discussed and a plea is made for a selective mass screening programme, the objective of which will be to limit and prevent cancer of the cervix. The establishment of a Central Cytology Laboratory at the University Teaching Hospital is described in some detail. This service could be extended in stages until it is possible to screen all women over the age of 20 years, at least every 3 years.


[Extraction method for the simultaneous determination of sodium, potassium, calcium, magnesium, iron, copper, zinc and manganese in organic material using atomic absorption spectrophotometry (author's transl)].

Determination of sodium, potassium, calcium, magnesium, iron, copper, zinc, and manganese in organic material is possible with one digestion using the described extraction method. Data for sodium, potassium, calcium, magnesium, iron, and manganese agree well with those obtained by conventional methods [1, 2, 4]. For quantitative determination of copper and zink the extraction method is superior to dry ashing at 450 degrees C [1, 4]. In general the extraction method ist preferable to dry assing, because the amount of sample, time and costs can be reduced essentially using the described method.


[Carbonyl compounds from the reaction of barley isomerase with linoleic acid hydroperoxides. Their development from the 9- or the 13-hydroperoxide-isomer (author's transl)].

Hydroperoxid isomerase from barley was incubated with linoleic acid hydroperoxides (LHPO), containing nearly exclusively the 13-LHPO or the 9-LHPO isomer; the volatile reaction products were isolated, concentrated and investigated by means of gas and radio-gaschromatography. Thus it was possible to establish the precursors of the volatile compounds hexanal, 2-trans-heptenal and 2-trans-octenal, which develop during formerly described reactions of isomerase with substrates, containing 9- and 13-LHPO in equal amounts. 13-LHPO was found to be a precursor of hexanal and 2-tr-octenal, while the 9-LHPO isomer in the barley isomerase LHPO breakdown reaction obviously cannot be accepted as precursor of volatile components. The origin of 2-tr-heptenal could not be clarified; it occured neither in the experiments with predominating 9-LHPO nor in those with predominating 13-LHPO. Perhaps 2-tr-heptenal is only produced in the presence of a defined ratio of both isomeric hydroperoxides. 13-LHPO = 13-hydroperoxy-9-cis, 11-trans-octadecadienoic acid. 9-LHPO = 9-hydroperoxy-10-trans, 12-cis-octadecadienoic acid.


[Influence of water activity on the enzymatic changes in freeze-dehydrated muscle III. The breakdown of muscle lipids (author's transl)].

During storage of freeze-dehydrated bovine muscle triglycerides and cholesterolesters are slowly hydrolyzed even at 25% relative humidity (r.h.). The extent of lipid hydrolysis in the tissue increases with rising water activity, the final degree of hydrolysis being dependent on water activity. It has been demonstrated that these changes are due to the effect of muscle enzymes. Phospholipids are not hydrolyzed even at 65% r.h. This might be due to an association of the phospholipids with membranes or to a lack of phospholipase activity in the freeze-dehydrated tissue. The fact that lipids in muscle tissue are hydrolyzed at water activities at which water soluble substrates are not split by hydrolyses agrees well with general ideas about the influence of water activity on the enzymatic breakdown of lipids. Freeze-dehydrated beef should not contain more than 3% moisture in order to prevent undesirable flavour changes caused by lipid changes during storage.


The rate of nitrosation of sarcosine in the presence of hydrophile and lipophilic antioxidants.

A procedure is described whereby the nitrosation of sarcosine can be followed spectrophotometrically in the presence of either hydrophilic or lipophilic antioxidants. Using this technique, a number of antioxidants of both classes at a concentration of 2.0 mmol have inhibited strongly the formation of N-nitrosarcosine from 25 mmol-sarcosine and 25 mmol-nitrite.


[The quantitative composition of natural and technologically changed aromas of plants. IV. Enzymic and thermal reaction products formed during the processing of tomatoes (author's transl)].

After the qualitative and quantitative investigation of the flavor compounds of tomatoes, the flavor compositions of tomato juices treated by different technological methods were determined. 80 aroma components were identified by gas chromatography and mass spectrometry. The quantitative comparisons showed that during the processing of juices unsaturated fatty acids acted as precursors for a series of C6-compounds, especially 1-hexanol, and cis-3-hexen-1-ol and that on the other hand some aroma compounds derived from carotenoid like structures, e.g. 6-methyl-5-hepten-2-one, geranyl- and farnesylacetone and beta-ionone were formed. As reaction products of thermal treatments among other increased amounts of acetoin, furfural, 5-methylfurfural and 6-methyl-5-hepten-2-one were established. The distribution of the aroma compounds dissolved in the serum or bound on the pulp was determined quantitatively by employing gaschromatographical methods.


Treatment of acute pelvic infections with alphacillin (pivampicillin Hcl).

Fifty patients with acute pelvic inflammatory disease were treated with Alphacillin (Pivampicillin Hcl). The total daily dose consisted of 1050mg, given in three divided doses. Treatment was continued for six days. Full bacteriological investigations were performed. Therapy was continued so long as the condition of the patient improved. In case of failure change to other antibiotics or surgery were considered. The clinical response to Alphacillin was considered successful in 92% of patients. A significant observation in the trial was the low rate of residual pelvic pathology especially in patients with Acute/Chronic pelvic infection. The drug was found to be free from complications or any serious side effects. Mild epigastric discomfort was noticed in only 3 patients.


[Analysis of dithiocarbamate pesticide residues a comparison of the head space and the colorimetric method (author's transl)].

The colorimetric method of Keppel [1] has been used. To be able to analyse 20 and more samples we slightly changed the head space method of McLeod [3]. To cutted lettuce which is brought into a penicilline flask, we add HCl and a reducing agent (SnCl2), and close the flask. After overnight heating on a waterbath the liberated CS2 is injected into a gaschromatograph with a flame photometric detector. The results are compared with known quantities of zineb, added to lettuces. A correlation factor r = 0.9903 has been found.


[Photometric micro-determination of the residues of disinfectant quaternary ammonium compounds in milk. 3. Improvement and adaption for milk products (author's transl)].

The photometric method for the quantitative micro-determination of the residues of quaternary ammonium compounds (QAC) in milk was improved. The casein has proved as an essential interfering substance and it was largely eliminated. Furthermore the bond of QAC on casein in discussed. The minimum level für determination for QAC in milk was reduced to 0.2 ppm. By modifying the photometric method for  some milk-products as cream, joghurt, and quarge QAC can be determined at minimal concentrations of 1 ppm.


Wuchereria bancrofti: the staining of the microfilarial sheath in giemsa and haematoxylin for diagnosis.

Indigenous cases of bancroftian filariasis have recently been identified in the country for the first time. The diagnosis of such infections depends on demonstrating the characteristic sheathed microfilariae of Wuchereria bancrofti in the blood. Giemsa, a stain recommended by many authors, was found to be unsuitable as the microfilarial sheath, an important distinguishing feature, does not take up the stain. In contrast, the sheath stains clearly in haematoxylin. The differences in the staining reaction of the microfilariae in the two stains is demonstrated. The need to establish the presence of the sheath is emphasized, especially since the microfilariae of Dipetalonema perstans, the widespread filarial infection in the country, are unsheathed.