[Sampling of cheese for aflatoxins (author's transl)].

Due to the greatly differing incidence of molds on cheese and thus the extremely differing amounts of aflatoxin reliable sampling in cheeses is difficult, particularly if only one semi-hard of hard cheese is available. Experiments were undertaken now to sample--hopefully without losses and suitable for commercial application--in order to be able to ascertain the possible aflatoxin content of a cheese. Based on storage results with artificially contaminated Provolone and Tilsit cheeses as a pretest determination of aflatoxins in scrapings from a 100 cm2 surface are is recommended. At high levels (20-30 microgram/kg) the sampling of several borings at different locations on the cheese is necessary. The aflatoxin content on the surface is not constant, a fact which can be explained by biochemical reactions and by migration of aflatoxins into deeper layers. Washing of cheeses seems not to be of any significant influence on the aflatoxin-content.


Introduction of partographic records in a District Hospital in Zambia and development of nomograms of cervical dilatation.

Partographic records of labour have been successfully introduced in a district hospital in Zambia. Nomograms of cervical dilatation show no significant difference compared to those obtained by other workers in other parts of the world. There was no difference in the duration of the active phase of the 1st stage of labour between multiparous patients (para 1--4) and grand multiparous patients (para greater than 4).


An evaluation of cervical cytological screening in the University Teaching Hospital, Lusaka.

A diagnostic cytology service was started in the Obstetric and Gynaecology Department of University Teaching Hospital, Lusaka in September, 1974. Its primary aim was to diagnose precancerous lesions or early invasive cancer of the cervix. However, the service was offered to other disciplines in the hospital who could benefit from cytology. During the two and a half period, September 1974, to 31st December 1976, 2,877 cervical smears were examined. Of these, 138 smears (4.8%) showed evidence of cellular abnormality consistent with dysplasia, carcinoma in situe, or invasive cancer. Trichomonas vaginalis was diagnosed in 464 cases (16%), Candidiasis in 89 (3.1%), and Schistosomiasis in 19 (0.7%).


[Ankylosing spondylitis (Bechterew) and tissue antigen HLA-B 27. II. HLA-B 27 negativity in classical clinical ankylosing spondylitis: no independent nosological entity].

The question, whether HLA-B27-negative patients with classical ankylosing spondylitis (AS) belong to a separate nosological entity, was studied by a standardized analysis of 12 clinical, 8 radiological and 6 laboratory criteria in 95 cases, including 7 with HLA-B27-negativity, who reinforced international criteria for classical AS. The results showed neither definite clinical nor radiological, or laboratory differences between the HLA-B27 negative and positive group. We conclude, that existence or absence of the tissue antigen HLA-B27 has no influence on inflammatory activity of skeletal or soft tissue manifestations of the disease. The group of HLA-B27-negative patients who fulfill the criteria of classical AS does therefore not seem to form a separate nosological entity.


[Prosthetic management of urinary incontinence following prostatectomy with special reference to Kaufman's prosthesis].

Issuing from the pathophysiological fundaments of the incontinence after operative sanation of the outlet of the urinary bladder the principal surgico-prosthetic possibilities for the removal of this complication are describes: 1. artificial systems of the sphincter with arbitrary increase and decrease of the occlusion pressure of the proximal urethra, 2. permanent compression of the bulbar urethra. On the last mentioned principle is based the incontinence prosthesis after Kaufman, which in its rate of success corresponds to the artificial sphincter systems.


[The so-called transitional-cell carcinoma of the prostate and its oncogenesis].

Report on two cases of so-called transitional cell carcinoma of the prostate. Clinically important differences to adenocarcinoma (above all ineffectivity of estrogen therapy and orchiectomy), histological differential diagnosis and therapeutic possibilities are reported on. Micromorphological similarities to the carcinoma of the cervix uteri allow for conclusions regarding histogenesis and oncogenesis, thereby possibly explaining marked differences of local growth and individual prognosis.


[Ankylosing spondylitis (Bechterew) and tissue antigen HLA-B27. III, Heredity of ankylosing spondylitis (Bechterew)].

A family with known accumulation of ankylosing spondylitis (AS) was examined clinically, radiologically and by HLA tissue typing. Among 17 individuals of three generations there were four carriers of classical AS, all HLA-B27-positive. Five carriers of HLA-B27 were clinically and radiologically healthy, but three of them were below the age of 30, thus still being at risk of developing AS. The numerical relation between first degree relatives with and without HLA-B27 was 10:7. Genotype reconstruction of the great grandparents lead to the conclusion, that they were carriers of two different haplotype combinations, HLA-1/HLA-B27 and HLA-2/HLA-B27. Both haplotype combinations proved to be associated with AS. Among the offsprings of these great grandparents the combination of HLA-2 with HLA-B27 occurred in 3 of the 4 ankylosing spondylitics and in four of the six healthy HLA-B27-carriers. The question whether a haplotype combination of HLA-2 and HLA-B27 leads to an increased risk for AS cannot be decided without further systematic genotype determinations.


[Bacterial prostatitis--therapeutic principles].

The authors examined the possibilities of the treatment of bacterial prostatitis and yielded the following result: A medicament suited for the treatment of prostatitis must fulfil such chemical criteria, as they are at present to be found only in alkaline marcolids (e.g. erythromycin) and trimethoprim. Since trimehtoprim has a good spectre of action against gram-negative germs, it seems to be the suited remedy, for these pathogens are frequent and dominating in the pathogenesis of prostatitis. Gram-positive bacteria should be accessible to a therapy with erythromycin.


[The action spectrum of cytostatics in the management of glomerulonephritis].

It was reported on the results of the cytostatic immunosuppressive treatment during a 6 years' observation time in 100 patients with glomerulonephritis in immunopathogenesis. The diagnosing was made according to the homogeneous opinion: clinical, immunological and histological. Of the 100 patients 33 suffered from SLE and 67 from other nephropathies with immunopathogenesis. In the therapy were used prednisolone, 6-mercaptopurine, azathioprine, cyclophosphamide and their combination, respectively. On the one hand, the therapeutic results were estimated as short-term results, on the other hand as long-term results with regard to the clinical syndromes as well as to the individual histological forms according to the categories of the full remission, the partial remission and also as "unchanged". It was established, whether an optimum result may be achieved in the different clinical and histological types. The best results may be achieved with the combination of 6-mercaptopurine and cyclophosphamide. The cytostatic therapy of the glomerulopathies should be used more aimedly in different clinical syndromes and histological forms.


Effects of situational complexity and repeated testing on rats' behaviour in a light-dark preference situation.

The hypothessis was tested that rats' initial activity in a novel situation represents escape tendencies rather than exploratory behaviour. 30 male albino rats were handled when 90 days old, another 30 rats remained undisturbed. All the animals got 7 trials in a light-dark preference situation. For half of the animals the lighted part contained additional stimuli. Although activity was high, rats did not investigate these stimuli in the first trials. This result seems to favour the escape hypothesis.


[Glycosaminoglycanpolysulfate (GAGPS, Arteparon) for basic therapy of arthrosis. III. Biochemical-diagnostic and clinical studies on the intramuscular use of GAGPS].

Investigations using 3H-Arteparon (3H-glycosaminoglycan polysulfate, 3H-GAGPS) showed that in humans with degenerative joint disease an intramuscular administration of 125 mg GAGPS (0.5 ml Arteparon forte) produces GAGPS concentrations within the joint, which in a biochemical assay inhibit cartilage degrading lysosomal enzymes. The dosage was determined from animal experiments that had indicated the relationship between the applied quantity of the drug and the resulting biological concentrations. Preliminary results of treatment with 0.5 ml Arteparon forte in 15 patients are reported.


[Ankylosing spondylitis (Bechterew) and tissue antigen HLA-B 27. I. Diagnostic value of HLA-typing].

In 95 Swiss patients with classical ankylosing spondylitis (AS) the tissue antigen HLA-B27 was present in 92.6%, compared with 7.7% in healthy Swiss blood donors. Assuming the prevalence of ankylosing spondylitis in Switzerland to be 1.9 promille, the chance of a Swiss carrier of HLA-B27 to develop a classical form of AS would be only some 2.2%. For diagnostic purposes, HLA typing thus seems to be of very little value, as among the 462 000 Swiss carriers of HLA-B27 there seem to exist no more than 10 800 classical cases with clinically manifest AS. Absence of HLA-B 27 does not exclude ankylosing spondylitis, as 7.4% of the classical cases are HLA-B27-negative. However, the crudely calculated risk to develop AS is 160 times smaller compared to a carrier HLA-B27. Corner stone of the diagnosis therefore remains careful case history and radiological features of a bilateral sacroileitis of at least grade II.


[Glycosaminoglycanpolysulfate (GAGPS, Arteparon) for basic therapy of arthrosis. II. Comparative studies, Arteparon forte and physical therapy vs. physical therapy alone; late results].

Five to 9 months after a comparative study of 2 groups of patients with coxarthrosis and gonarthrosis, 69 individuals (group 1) receiving Arteparon forte injections and physical therapy and 46 persons (group 2) with physical therapy only, questioneer with specific questions was sent out. From 72 questioneers mailed 55 were returned to the investigators of the study. 53 questioneers were suitable for evaluation: 40 in the group 1 and 13 in group 2. 62.5% of the patients in group 1 described their condition improved as compared to 30.8% in group 2. In 46.1% of the patients in group 2 the condition had deteriorated; this occurred in only 17.5% of group 1.


[Glycosaminoglycanpolysulfate (GAGPS, Arteparon) for basic therapy of arthrosis. I. Comparative studies, Arteparon forte and physical therapy vs. physical therapy alone].

Glycosaminoglycan polysulphate (GAGPS, Arteparon) is effective as a fundamental therapeutic agent in arthrosis (osteoarthritis). Patients with gonarthrosis and coxarthrosis of activity grade II received intramuscular Arteparon forte injections and physical therapy (group 1, n = 69) or physical therapy only (group 2, n = 46). In group 1 23 patients (33.3%) became free of pain as compared to 3 patients (6.5%) in group 2. No therapeutic success was obtained in 6 patients of group 1 (8.7%) and in 14 individuals (30.4%) of group 2.


[The evaluation of postomortem heart weight (author's transl)].

In 1974  we published the "method of differentiated relative heart weight" for the evaluation of the postmortem heart weight. It is not the simple relation of heart to body weight of 1/200 that is used, but--depending on the body weight--1/175 for normal weight, 1/150 for underweight and 1/200 for overweight. This method is now submitted a test by means of 218 exactly diagnosed cases and the heart weights are compared with the mean values of Linzbach. If the weight of a heart is lower than the weight estimated by our method one can conclude, that the patient did not suffer from hypertension and/or from cor pulmonale. If the heart weight is higher than the estimated value a pathological heart weight is to be supposed, but normotension cannot be excluded, especially in women. In those cases the comparison of the heart weight with the mean values of Linzbach is recommended.


[Fundaments for a classification of CNS tumours (author's transl)].

A general effective classification of tumours of the central nervous system hats to be based on morphologic criteria of tissues. The cells are subordinated to the structure of the tissues. A simple classification according to morphologic structures is not quite satisfying, because each system of tumour types should permit to determine the diagnosis, the prognosis, the therapy, and the aetiology. In each classification of tumours the character of tissue and the biological behaviour should be considered only in mutual relationship. But this does not mean that in tumours of the central nervous system the degree of differentiation and the biological behaviour must agree.


[Investigation on the detection of circulating antibodies in yoshida-sarcoma bearing rats by the serologic-nephelometric method of Hoigné (author's transl)].

Circulating antibodies against tumour antigens were detected by means of the serologic-nephelometric method of Hoigné et al. (1955). Under employment of homogenates of tumour tissue as antigen solutions in 95 per cent of the cases the sera of Yoshida-sarcoma bearing rats reacted positively, while only in 4 per cent of the normal animals a positive reaction was found. 11 per cent of tumour-bearing animals showed in addition positive reactions against the normal muscle tissue, normal rats reacted positively in 2 per cent of the cases. In 93 per cent the sera of tumour-bearing animals reacted with spleen homogenates of sarcoma-bearing rats positively, whereas serum of normal rats showed 20 per cent positive reactions with the same antigen. The results confirm the aptitude of the serologicnephelometric method of Hoigné et al. (1955) and of the employed animal model for investigations of tumour-immunological problems, and they underline the antigenicity of the Yoshida-sarcoma.


[Microscopical and electron microscopical studies of lymphocyte-tumour-cell interaction in monolayer cultures of malignant human tumours (author's transl)].

The interaction of lymphoid cells with isogenic malignant human tumours--cultivated as monolayer--was studies by light and electron microscopy. It was shown that an intimate contact was established between lymphoid cells and tumour cells leading to partial confluence of cytoplasmatic structures. This process is the condition of both tumour cell destruction, and also of lymphoid cells. Quantitative problems of immunological tumour cell destruction are discussed.


[Autopsy-statistical analysis of multiple myeloma (author's transl)].

150 autopsies with multiple meyeloma were analysed. In about one third of the cases the multiple myeloma was diagnosed only at autopsy. Two thirds of the carriers of multiple myeloma were between 60 and 70 years old when they deceased. The osseous foci of multiple myeloma extended predominantly to the central parts of the skeletal system. In 120 patients the multiple myeloma was the cause of death. In half of these cases infections, particularly of the lung, had caused death. The second frequent cause of death was uraemia. 63 of the 150 multiple myeloma have been immunologically classified. The cases in question are 10 IgA-, 2 IgD-, and 42 IgG-multiple myeloma. Extraosseous foci of multiple myeloma appeared significantly more frequent in IgA-than in IgG-multiple myeloma. A haemorrhagic diathesis existed more frequent in IgA-multiple myeloma. Venous thromboses were more frequently to be found in IgG-multiple myeloma. Amyloid deposits and changes of the kidneys characteristic for the multiple myeloma appeared nearly in the same frequency in both types of multiple myeloma.


[Pulse cytophotometric investigations concerning the biological behaviour of laryngeal carcinomas (author's transl)].

25 laryngeal carcinomas were investigated by pules cytophotometry, stained with ethidium bromide after pepsination. The karyograms were interpreted as DNA-distribution curves. In diploid populations the height  of the 4c-peak was taken as a measure of proliferation rate. Aneuploidy and polyploidy were estimated by camparison with human diploid material . In our material we found 13 polyploid tumors (under them 6 aneuploid populations from 7 at all). After dividing the cases into two groups (1: with slow, 2: with rapid progression) the moiety of polyploid and aneuploid tumors and the height of the 4c-peak was significantly higher in group 2. The pulse cytophotometry gives reliable additional informations showing the great variability of biological characteristics of laryngeal carcinomas. Possibly this is a basis of a more differentiated therapy.


[On the behaviour of carcinoma in situ of the cervix uteri (author's transl)].

The biological behaviour, the progression rate and the latency period of the carcinoma of the cervix uteri is discussed. We have tried to find out this by concluding indirectly and evaluating epidemiologically our own material, and considering the literature. Between 1967 and 1975 we bioptically diagnosed 1.933 in situ and 1.014 invasive cervial carcinomata. Among these there were 98 (9.7%) microcarcinomata. The average age of women with a carcinoma in situ in the years 1973-1975 was between 39 and 40 years. The average age of women with invasive carcinomata with the microcarcinoma excluded was 51-56 years. The average age of 98 women with a microcarcinoma during 1967--1975 was 47 years. The carcinoma in situ is a precursor of the invasive carcinoma in almost each case. The progression rate is approximately 30-50%. The latency period for the microcarcinoma is on a average of 7--10 years, till the clinical carcinoma 10--15 years. A reliable prognosis is impossible for the individual case.


[Contribution to the frequency and diagnosis of cardiac metastases in autopsy cases (author's transl)].

At the Karl-Marx-University of Leipzig 12033 autopsies  of adults (15 years and upwards) were registered during the period 1965 to 1969, 3919 malignant tumours were observed. 224 cases showed metastases in the heart arising especially from bronchiogenic carcinomas, carcinomas of the mamma and melanoblastomas. Cardiac metastases in our cases occurred between the age 26 and 90. The localisation of the metastases is reported distinctly. Further 50 hearts of tumour-autopsies without macroscopic finding were investigated after separating 2 min-slices. The microscopical examination showed metastases is 6 cases.


[Congenital heart disease found in autopsies from the University-Institute of Pathology in Leipzig (author's transl)].

Among 6473 autopsies of children from 1963 to 1976 839 cases of congenital heart disease (12.96%) were observed. They were classified into groups. The time of death and the association with other malformations were recorded and compared with findings in the literature.


[Arteriosclerosis and liver cirrhosis (author's transl)].

The degree of arteriosclerosis in 176 autopsies of liver cirrhosis (patients in the age range of 51 to 70 years) was compared with that of controls (without liver disease). It was found that the "protective influence" of liver cirrhosis of the process of arteriosclerosis is only true for normotonic. Associated with arterial hypertension severe arteriosclerosis is predominant in liver cirrhosis. There is even some evidence that arteriosclerosis in hypertonics with liver cirrhosis is more increased than in controls without liver diseases. The factors influencing arteriosclerosis in liver cirrhosis are discussed.


[Studies on the cultivation of isolated murine renal glomeruli (author's transl].

The rate of growth of isolated murine renal glomeruli was studied in vitro. Separation by screening was followed by cultivation in Carrel flacks using Eagle's medium, and the number of utilizable tests was 104. It was possible to cultivate glomeruli for up to 27 days and to observe the growth of cells. These were epithelial capsule cells, endothelial capillary cells and fibroblasts. The existence of mesangial cells not be convincingly demonstrated experimentally. The problems associated with the cultivation of isolated renal glomeruli are discussed with reference to data reported in the literature. Possible uses of this particular model are pointed out in some detail.


[Morphological studies on the formation of oxalate stones (author's transl)].

The present paper deals with experimental and crystaloptical studies on synthetic and native Ca-oxalate. The findings are in favour of a uniform way of formation of Ca-oxalate stones from Ca-oxalate dihydrate crystals as primary crystallization product in urine, developing into the monochydrate phase by dehydratation. Rapid growth and a sufficiently high concentration of foreign ions (Mg) in the urine support the formation and stabilisation of dihydrate stones.


[A method for the preparation and purification of the two blue main components of sudan black B (author's transl)].

Two dimensional thin layer chromatography of four commercial samples of Sudan Black B reveals two blue main components (SSB I and II) and at least 38 further fractions. The quantitative composition of one sample was estimated. SSB-I and SSB-II were isolated and purified by column chromatography supplying amounts for histochemical use. Histochemical experiments are described.


[Long term results of the distal femoral fracture and its special problems (author's transl)].

The technique of internal fixation of comminuted supracondylar and condylar femoral fractures is reported. The results of a multicenter trial covering 6 trauma departments are presented with an analysis of 199 distal fractures and follow-up in 164 cases.


[Operative treatment of the head of the tibia (author's transl)].

Fractures of the tibial head should be treated operatively only in cases in which the result can be expected to be better than by conservative methods. The osteosynthesis should bring stability in order to allow training of the joint. Depending on the type of the fracture, screws or T-plates or L-plates can be used. In cases of depressed fractures it is most  important to restore the level of the joint by underlying the impression by autogen spongiosa.


[Conservative treatment of tibial condylar fractures (author's transl)].

Only part of the tibial condylar fractures may be treated in a conservative way, because they are always in connection with the knee joint. By means of an exact classification of fractures into different types the indication for conservative treatment is determined. The way how conservative treatment has to be performed is described.


[Principles and peculiarities of the therapy of knee  joint fractures (author's transl)].

Some unfavourable and favourable peculiarities and principles have to be recognized in the therapy of intraarticular knee joint fractures. Apart from the self-evident necessity of an exact reconstruction of joint faces (more often than before conditioning the indication for arthrotomy) timely mobility can be reached by only adapting osteosynthesis, as in this region there is virtually no pseudoarthrosis. A defect in the articular face of the tibia can be replaced by a part of the patella. A shattered patella can be partially or totally extirpated and good function can be obtained if the extirpation prevents the remaining parts of the periosteum from developing a neopatella, limiting mobility and causing pain. The distal end of the femur can ideally be fixed with a condylar splint even in those cases where a number of fragments can only approximately be put together under the condition of knee joint face restitution. In order to restore the function, it is sometimes necessary to loosen and prolong the quadriceps tendon to achieve sufficient flexion if this is required by the living and working conditions of the injured person.


[Fractures of the patella, conservative treatment (author's transl)].

56 conservatively treated fractures of the patella with small dislocation are analysed. In comparison with plaster cast immobilisation early functional treatment yields the best results.


[Cartilage joint transplantation (author's transl)].

The present day knowledge and the practical use of cartilage joint transplantation in the knee joint are reviewed. Apart from the refixation of cartilage-bone and pure cartilage fragments, autologous transplantation has not fulfilled the expectation anticipated from animal experiments. Apart from the question of the source of the graft, the final results depends primarily on the problems of the functional adjustment of the grafted cartilage in its new position and its nutrition. Homologous cartilagenous grafting can give extraordinarily good clinical results but they are not equal to those of a truely successful graft. In spite of this, future research in cartilage joint transplantation will be concentrated on homologous grafting.


[Nerve injuries of the knee joint].

Injuries of the tibial nerve in lesions of knee joint are rare, gunshot or stab wounds excluded. Injuries of the peroneal nerve happen more often and are found in fractures of the fibular head, in direct traumata and due to intensive extension to enable nailing of fractures of the femoral neck or of the femur. In open nerve injuries immediate suturing can only be done in so called razor-cut lesions and if no dehiscence or infection is present. All other nerve injuries are treated beginning from the 6th week but not later than 6 month after the accident. The same applies to all blunt nerve injuries failing spontaneous remission. By using the fascicular suture technique and by autologous nerve transplantation the chance of success has been improved.


[Rectocolonic polyps (author's transl)].

After presenting a classification of colon polyps the author comments on a follow-up group of 200 patients. Only genuine tumours have been taken into consideration. The rate of malignant degeneration is very high. Each determined polyp has to be removed totally to achieve prophylaxis. Postoperative control of the patients is an imperative demand for their lifetime.


[Myotomy: surgical treatment of diverticulitis (author's transl)].

Since 1973 myotomy has been performed in 36 patients with sigmoid diverticulosis or diverticulitis. The operation is most suitable for patients with moderate stenosis and clinically recurring symptoms no longer responding to conversative treatment. When widespread inflammation is present, the risk involved in the operation rises: the separation of the intestinal wall layers is difficult and the danger of a mucosal perforation followed by peritonitis will increase. In those cases an exteriorisation resection is less risky. On performing a myotomy operation an early carcinoma developing between the diverticula can remain undetected.


[The responsibility of the surgeon (author's transl)].

Juridical survey upon the special problems of surgical carefulness. Emphasis is laid on the necessity of scientific and practical medical cooperation, respect for the patients life and the professional discretion.


[Information between physicians and justice (author's transl)].

On the basis of the socialist legal system the main connections of information of physicians to the public prosecutor's office, to the people's police and to the courts are elaborated from the viewpoint of these institutions.


[Some remarks on professional accuracy in the borderline between surgery and anaesthesiology (author's transl)].

On the basis of the theses of the Supreme Court of Judicature of the GDR about medical accuracy two main problems are discussed. The first deals with anaesthesia in hospitals without a specialized anaesthesiologist, the second is to define the responsibility between surgeon and specialised anaesthesiologist.


[Blood transfusions in the course of anaesthesia and professional accuracy (author's transl)].

The usual hazards of blood transfusions will increase in the course of operations, thus in the course of anaesthesia as well. A safe system of checking blood transfusions is required, which corresponds to the justified request of the patient to be protected against damages and is coinciding with the professional accuracy. An approved system of arrangements for clinical practice is described.


[Surgical aspects in arterial occlusion (author's transl)].

Acute arterial occlusion was found to be the most frequent emergency (10%) among vascular patients of the Department of Surgery of the University of Düsseldorf. Rheumatic heart diseases receded as etiological factors whereas atherosklerotic obstructive diseases exhibited a clear increasing tendency. Operation is urgent if acute ischemia is present. The best method is represented by embolectomy by means of the Fogarty-catheter, if it is performed within the first 6 to 12 hours after or vascular occlusion. Angiography is only indicated if ischemia is not complete or if the cartoid artery or great visceral arteries are involved. In cases of incomplete occlusion embolectomy may be successful even after days and weeks. Mortality after these operations is found to be 18 to 20%, the rate of amputation being 9%. The final results of operative results are better in arterial embolism than in arterial thrombosis.


[Arteriomesenteric obstruction of the duodenum (author's transl)].

Survey of the clinical and diagnostic treatment of arteriomesenteric obstruction. Report on 4 cases of chronic obstruction and 2 cases of acute occlusion of the duodenum due to the root of mesenteric vessels. Indication of operation. Recommendation of retrocolic side-to-side duodenojejunostomy.


[Surgical treatment of lymphoedema (author's transl)].

Aetiology, pathogenesis, staging and the conservative and operative treatment of the lymphoedema are discussed. Only in 14 to 22% of all lymphoedema an operative treatment is required. Operative treatment is only indicated after the failure of conservative treatment. The latent (stage I) and the reversible (stage II) lymphoedema rarely demand an operation. Only the lymphovenous shunts or lymphadenovenous shunts may be indicated in stage II. In the irreversible lymphoedema (stage III) and in the elephantiasis (stage IV) the following operations have been developed: ligature of ectatic lymphtrunks, peripheral lymphovenous and lymphadenovenous shunts, skin-flap transplantations, free or pediculated transplantation of the greater omentum, lymphangioplastic operations (Thompson-operation) or excisional operations (Servelle-operation). The therapeutic principles of these operations are shown and late results are discussed.


[Surgical management of deep venous thrombosis (author's transl)].

Acute deep venous thrombosis of the pelvis and leg are classified according to their mode of origin and development. Because of the low frequency of pulmonary embolism, operation is preferred to thrombolysis. The surgical procedure referred to includes de Weese's caval clip to prevent pulmonary embolism during and after operation. Thrombolysis may be done in cases of deep thrombosis distal to the confluent point or in cases of May's iliac venous "sporn".


[Male breast cancer (author's transl)].

A report is given on the therapy and results of 16 men with a mammary carcinoma during the last 15 years. The analysis shows the dependence of therapeutic treatment and prognosis of the state of tumour, especially of the metastases in regional lymphnodes. By applying a combined surgical-radiological treatment a survival time of 3 years could be reached in 8 patients and a survival time of 5 years in 5 patients.


[Complications after oesophageal replacement (author's transl)].

The best procedure for substituting the oesophagus is the interposition of colon. Leakage of the cervical anastomosis is the most frequent complication. In our own material this complication was more frequent after anisoperistaltic interposition. There is no criterion for more severity with a second layer. For replacement of the cervical part of the oesophagus we used revascularized jejunal-autografts twice with success.


[Reduction of hospital stay in surgical units (author's transl)].

Reduction of hospital stay increases the surgical efficiency and reduces the danger of bacterial hospitalism. It is to be accomplished by: 1. admittance of patients with regard to the operative capacity; 2. out-patient diagnosis and preoperative anaesthesiologie care; 3. early postoperative discharge; 4. reduction of septic surgery.


[Wound healing in old age (experimental studies on rats) (author's transl)].

Autoradiographic studies on wound healing after experimental myocardial infarction in rats aged 6 weeks, 5 and 21 months gave the following results: 1. The interval between damage, DNA-replication and mitotic activity of the cells is age-dependent. 2. Age does not influence the capacity of the connective-tissue cells to synthesize tropocollagen. However, the number of synthesizing fibroblasts is reduced. 3. The collagen changes occuring during wound healing are not of primary, but of secondary nature; they take place if the mucopolysaccharide content is reduced. As a result, there is a decrease in the ground-substance synthesis in ageing granulation tissue. In cicatricial tissue the content of amorphous ground-substance remains greatly constant. 4. Consequently, the ageing of the collagen is governed by a biologically regulated process whose control mechanism is inherent in the cells.


[Dumping-prophylaxis (author's transl)].

The dumping syndrome is due to a vigorous reflex distension of the jejunum, caused by the stomach violently evacuating its contents. The aim of treatment is to overcome the drastic evacuation by restoring the rhythmic peristalsis of the stomach (eukinetics). This can be achieved by a special diet. Every meal should begin with well chewed solids (pulp) and avoid all fluids. With a well organised medical staff a complete success can be achieved. Surgical measures in Dumping can be avoided.


[Combined surgical procedures in operations of stomach, duodenum and biliary system (author's transl)].

In a period of 4 years in the Clinic of Abdominal- and Transplantation Surgery of the Medical School Hannover in 52 patients with operations of the biliary system 56 combined surgical procedures and in 48 patients with operations of stomach and duodenum 51 combined surgical procedures were performed. In comparison with groups of patients, treated with similar operations as single procedures, the increase of risk was studied. It was found, that combined procedures of medium-sized trauma, which mostly depended on simultaneous injuries of both organs, caused an elevation of operation stress as well as an increase of complications. Small combined procedures indicated no elevation of risk. In accordance with our results, we postulate a very careful reflection on indication of combined surgical procedures together with operations of stomach, duodenum or biliary system.


[Primary carcinoma of the gastric stump (author's transl)].

There was too much delay in detecting these carcinomas. Radical operation was only possible in 10 cases, only 1 patient survived for 5 years. Improvement of these disappointing results can only be achieved by earlier diagnosis. Fiberscopy and biopsy seem to be suited best to better the results.


[Surgical hand disinfektion with a solution of performic acid (author's transl)].

Disinfection with a solution of performic acid has an intensive bactericidal and sporocidal effect. This method is simple and prompt in service, is free from danger, inexpensive and can be used everywhere.


[Morbidity and mortality due to infection in the obstetrico-gynecological field].

The following conclusions were derived from the data on obstetric and gynaecological and urologic morbidity and mortality caused by infection:--A law enacted in 1972, legalising abortion within the first twelve weeks of gestation, changed the proportion of legally induced abortions to all other types of abortion. As the law largely prevents illegally induced abortion, substantial decreases occured in the number of cases of postabortal sepsis and in the mortality from abortion.--In spite of a steady decline, pueral sepsis still accounts for a significant proportion of the maternal mortality. It occurred predominantly after Caesarean section.--Despite its relatively low current morbidity rate, the possible effect of puerperal mastitis should not be neglected.--The high incidence of urinary tract infections calls for wellbalanced, but effective preventive, diagnostic and therapeutic action.


[Expanded indication for caesarean section in breech presentation (authors transl)].

In this paper is investigated, in what a quantity the caesarean section can improve the prognosis for the infant. Two groups (1968 to 1972 and 1973 to 1975) are opposed. The decrease of the neonatal mortality from 8,2% on 5,0% can be subsequently of the widening for caesarean indication during the second time (1973-1975). In spite of other minds we have found, that the birth traumatical loading of the newborn during vaginal delivery of breech presentation is more severe in nullipara than in multipara. Hypothetical estimations show, that if we had carried out in all breech positions in nullipara the caesarean section, we had 7 infants (2,7%) which not had died. But this way had lead to a rise of the section frequence from 24,5% to 72,3% of all breech presentations. Because of the high mortality and morbidity of the caesarean operation most of the authors recommend the expanded indication for caesarean section and not the general indication. Our own screening for expanded indication has been presented.


[Paralysis of the femoral nerve after abdominal and vaginal surgery].

Damages of the femoral nerve during gynaecological operations are more frequent than generally supposed. They are observed after abdominal and vaginal operations caused by pressure on the nerve. During abdominal procedures an unsuitable self-retaining retractor is due to the paralysis. If the legs of the patients are deposited on the shoulder-back-parties of the assistants during vaginal procedures there is the danger of pressing the femoral nerve against the inguinal ligament by strong bending and abduction of the thighs. We report about 3 cases of paralysis of this nerve; recommendations for avoidance are given.


[Clinical experience in the treatment of functional sterility using clomiphene].

Report on further experience in the treatment of functional sterility in 102 patients with clomiphene. Changes compatible with ovulation were present in 71,6%. Pregnancy was obtained in 34,0%. The best results were obtained in patients with secondary amenorrhoea and luteal corpus insufficiency. Adding HCG on 10th and 12th day of treatment had no substantial effect on increasing either the ovulatory rate or the pregnancy rate.


[Preventive version of breech presentation--first results and complications].

In breech presentation near term the prophylactic external cephalic version using tocolytic drugs represents a modern practice. This method needs a critical valuation. Report about 23 external versions with assistance of tocolytic drugs and insufflation anesthesia. In 17 cases the version was successful. In addition to the 3 unsuccessful attempts 3 complications appeared: twice a partial ablatio placentae and once a prolapse of the arm and umbilical cord on intact amniotic sac.


[Does intensive prenatal care during childbirth lead to a greater risk of infection?].

Histological specimens of 196 secundinae were examined. In 57% of cases leucocytic infiltration was founded. A positive correlation exists between the incidence of leucocytic infiltration, premature rupture of the fetal membranes and lowgrade pyrexis at the delivery. At 67 patients controlled with intrauterine diagnostic methods we found no more leucocytic infiltrations as at normal, no-controlled patients. The findings are compared with the results of other authors.


[Regulation of labor and analgesia during childbirth by electroanalgesia].

A new method of electroanalgesia is based on the use of pulse currents of high frequency (150 to above 750 Hz), with the mean current intensity of 1 to 2mA in the course of the session. The electrodes are applied in the frontal area (bifurcated catode) and the neck under the mastoid processes (bifurcated anode). Electroanalgesia was successfully employed in 360 cases to prepare pregnant patients for labour, regulate abnormal uterine activity and anaesthesize labour. Electroanalgesia accelerates cervical dilatation, eliminates discoordinated uterine activity by restoring the triple descending gradient of uterine contractions, and reduces labour duration. The parturient no longer exhibits vegetative shifts developing under the impact of emotional stress when the balance between sympathetic and parasympathetic links of the vegetative nervous system is disordered, and the pulse, arterial pressure and respiration get stabilized. The labour is painless, which favourably tells on the maternal and fetal condition.


[Ultrasonic diagnosis in early pregnancy: method, value and problems of differential diagnosis].

According to strictly defined criteria a differential diagnosis between regular pregnancy, imminent abortion, missed abortion, incomplete abortion or hydatidiform mole is attempted using 385 basic ultrasound tests carried out from the 6th to the 16th week of pregnancy. The diagnostic procedure, its pitfalls, their reasons and possibilities of avoidance are discussed. In spite of the wide area of application the positive score of 92% in all basic tests is stressed. Comparing these findings with HCG tests the ultrasound method is clearly superior.


[Intraamniotic amino acid infusions in chronic placental insufficiency].

12 pregnant women in the gestational weeks 33 to 39 who had symptoms of chronic placental insufficiency received 22 intraamniotic amino acids infusions. 250 ml of a 5 per cent solution of L-amino-acids was infused within 12 hours. During these infusions nearly 80 per cent of the amino acids (according to alpha-amino-nitrogen) were eliminated from the amniotic fluid in 24 hours. The highest elimination rate with 83.4 per cent has been found in cases with intrauterine growth retardation. The smallest rise of urea-nitrogen-level after intraamniotic amino acid infusion has been observed in cases with intrauterine growth retardation and in the second or third infusion. The decrease of amniotic fluid protein content after infusion was on the average about 30 per cent. The interpretation of these results is difficult, because so far not exist examinations of the gastrointestinal resorption and metabolism of amino acids and amniotic fluid proteins by the human fetus. According to our experiences it is possible to supply fetus with severe intrauterine growth retardation with vital substrates on paraplacental way. But the postnatal treatment of the small for dates babies is more effective.


[Evaluation of multidimensional screenings within prematurity-dysmaturity-preventive programs].

Evaluation of multidimensional screenings within the prematurity-dysmaturity-preventive-programmes. We estimated the PDP-programmes recommended in literature. The result is discussed together with the analysis of our 6000 investigated cases. We found, that, the published scores, using many factors and basing on multidimensional regression or discriminant analysis, give not a satisfactory result in predicting birth of a newborn with low weight. If you wish predict right 90% of all low birth weight infants, your risk group contains about 50% of all pregnant women. If you wish to have only a trifling risk group of 10% of all pregnant women, you can predict right only about 50% of all infants with low birth weight. We recommend for practice to go an other way. We find it is better for prophylaxis and therapy of the threatened premature labour to diagnose and treat special risks as placenta praevia, multiple pregnancies, hemorrhage during pregnancy, smoking and anamnestic previous prematurity. The summarizing of risk points is to our opinion of minor importance. Only pregnant women with risks, which need expansive apparatus and specialists, should be sended for a perinatal center (Rh-incompatibility, hydramnious, suspicious malformation, severe intern diseases). Especially the diagnosis and therapy of genetic defects must be carried out in a center. About the possibility with genetic diagnostic to diminute the birth of impaired children of low weight is given a particular explanation.


[Diagnostic conization of the uterine cervix. I. Classification of histological diagnoses].

This study concerns 1000 diagnostic conizations of the uterine cervix performed between 1969 and 1975 and the distribution of histologic findings. 91,3 per cent of the total group demonstrated atypical lesions. 8,7 per cent of the patients had benign disorders; in these cases colposcopic and cytologic screening had been overrated.


[Diagnostic conization of the uterine cervix. II. Comparison of histological diagnoses with cytological and colposcopic tentative diagnoses].

This report presents colposcopic and cytologic misinterpretations in cases with a cervical intraepithelial neoplasia or early invasive carcinoma and benign cervical lesions and the accuracy of these two methods of screening for cervical cancer. The accuracy of the cytology and of the colposcopic impression in predicting the degree of cervical intraepithelial neoplasia and early invasive carcinoma was over 93 per cent. In patients showing benign cervical lesions the cytology is more accurate in predicting the correct histologic change with 94,2 per cent than the colposcopic impression with 63,1 per cent. The suspicious smears (Papanicolaou III) are discussed.


[Results of a mass screening program of cervix carcinoma of the city of Wismar].

From 1.10.1974 to 29.2.1976 in Wismar a cervical cancer screening on computerbase was performed. The participation of the female population (20 to 65 years) was relative high, with 74,9%, results are discussed. In 12702 investigations 12 cases of dysplasia (severe degree), 41 carcinomata in situ and 14 cases of invasive cervical cancer were revealed.


[Value of needle biopsy in the diagnosis of gynecologic carcinoma recurrence].

There are many difficulties in the diagnosis of recurrent carcinoma in the lesser pelvis. A second course of radiation carries a high risk of morbidity and mortality. Therefore histological proof of recurrence must be obtained prior to subjecting a patient to radiotherapy. An attempt has been made to demonstrate malignant recurrence on the pelvic side wall by means of needle biopsy. The results of 181 needle biopsies are reviewed and the sources of error in this method are discussed.


[Determination and assessment of the estrogen proliferation dosage on the human endometrium].

The term, 'proliferation dosage' of an estrogen is defined differently in the gynecologic literature. In this article the authors were concerned critically with the methods of its determination. They came to the conclusion that under standardized conditions sufficiently sure and reproducible results can be received in postmenopausal women. 7 short acting and 3 long acting estrogens, some of which are clinically unknown substances, were examined using the following definition of proliferation dosage: 'Proliferation dosage is the amount of an estrogen which induces the signs of the late proliferation phase after being administered daily in the course of 10 to 14 days to postmenopausal women with atrophic endometrium.' In order to investigate the proliferating properties of 3 depot estrogens a modified test procedure was performed, derived from animal experiments' results and the planned clinical mode of application.


[The importance of hormone examinations in ovulation induction (author's transl)].

Those hormone-determination methods were reported by the authors which help to make the ovary response visible for the experts during the ovulation induction. They also dealt with the determination of basal temperature measuring, oestrogen, pregnandiol, progesterone, oestradiol-17beta, FSH, LH, epimestrol and clomiphen. After the routine determination of the above mentioned parameter a preprinted sheet was done, where every treated case was illustrated graphically. From these cases some of the typical ones were shown and analyzed. The determination of hormonal releasing curves characteristic of hyperstimulation, and the importance of these most dangerous complication was emphasized.


[Errors and hazards in mammaplasties].

Mistakes and dangers on mammaplasty and their possibilities of post correcture are discussed. There is demanded to do such mammaplasties only in special centres respectively by surgeons on gynaecologists who are specialised on it.


[Simplified dokumentation and evaluation in abortion patients using data-based medical records].

Now as ever the carrying out of abortions demands from all clinics concerned measures reducing the expenditure of time for every patient with the medical treatment remaining consistently good. Besides this, certain problems - such as complications and social gynaecological questions - must be registered in a better way than it was till now in order to be able to answer scientific questions on this basis. Therefore, a new printed form for the clinical history--evolved particularly for women wishing an abortion - was introduced into the womens clinic of the Medical Academy. It simplifies documentation which the information being sufficient. By registering them in a computer there are favourable conditions for ascertain the findings and informing central institutions.


[Acute emergency in pregnancy: the vena-cava-inferior syndrome].

Report on symptoms of the vena cava inferior syndrome in two cases with description of the symptoms of danger by misunderstanding the situation. There is especially underlined that the obstetrics, anaesthesist, and the general practitioner can help in the situation with simple measures when he recognises the situation.


[Sideroblast content of the bone marrow at the end of pregnancy or 1st days of puerperium, respectively].

We examine in the last month of the pregnancy, resp. in the first week of their lactation period, the frequency of sideroblasts in the bone marrow of 265 pregnant women without iron or folate supplements. In 69,4% of the cases the frequency of sideroblasts was not more than 10% (in 34,7% of the cases sideroblasts were absent). After previously parenteral administered 0,6 to 0,9 g iron (10 to 15 Amp. Ferrlecit), iron was present in the marrow. In all examined megaloblastic anaemia of pregnancy cases and in 91% of praemegaloblastic cases, the marrow contained sideroblasts. If the number of sideroblasts proved increased (greater than 25%) the serum folate level was decreased (less than 4 ng/ml).


[Fetal hydrocephaly--intracranial and intrauterine pressure values during labor].

Report on a further case of fetal hydrocephalus; during delivery intracranial and intrauterine pressure is registered: an average labour intensity of 56,5 mm Hg corresponds to an average pressure intensity of 63,4 mm Hg in the interior skull. Analogic conclusions concerning pressure conditions in normally developed skulls are discussed.


[Behavior of blood pressure during pregnancy].

In 948 women of the blood-pressure behaviour was registered weekly, from the 12. up to the 42. week of normal pregnancy. The normal range is stated with the single and double dissemination of the blood-pressure values; depending from the number of weeks being pregnant, and dessignation and meening to the pathological behaviour are represented. Desides, the frequency of various course-types of the blood-pressure during pregnancy is given, their possible meaning being discussed. For this purpose, 1337 single courses of the blood-pressure behaviour within pregnancy were explored.


[Clinical experience with Hammacher's "CTG score"].

The cardiotocograms of 340 pregnant women which are recorded ante partum and intra partum were analysed by the score of Hammacher. This score is representative for the intra partum period. We found a direct relation between variations of CTG and the Apgar-score of newborn. In the ante partum period only in pathological score this correlation can be observed.


[A case of thoracopagus with an unusual cardiac anomaly].

A case of Siamese twins is described being especially interesting because of the rare kind of heart  malformation. The joint heart shows in particular a reduction of the heart rooms, a defect of the ventricular septum and a transposition of the big vessels in one of the individuals. Moreover a multilobularity of the lungs, a fusion liver and a partly joint portion of the small intestine is to be seen.


[Value of radiographic studies on the cervix uteri and internal uterine orifice with reference to irregular pregnancies (abortus--premature labor)].

The research concerning a decrease of premature births in the context of the efforts to reduce infant mortality resources an improvement of our knowledge about the causes of preterm delivery. This publication bases on more than 1000 hysterosalpingographies in order to prove the assumed causality between cervical insufficiency, cervix dilation, and the angle between the cervix and the corpus uteri, and uterushypoplasia. The influence of these facts dependent on menstrual rhythm and related to parity, especially the habitual form, is stated by numerical data. Concerning a retrospective analysis of abortions and premature births the x-ray photography of the uterus makes important statements possible and renders a specific and substantiate prophylactic therapy during the following pregnancies feasible.


[Significance of urinary tract infections in gynecologic diseases and in pregnancy].

In search of urinary tract infections 3185 gynaecological patients and 1600 pregnant women were examined by means of TTC-Test. 12.8% of the gynaecological patients and 12% of the pregnant women showed bacteruria. A special disposition to urinary tract infection was found by patients suffering from descensus, fistula of urogenital system and by gravid women with toxaemea of pregnancy and diabetes mellitus. Infection through E. coli was found to be dominating and the germs showed a relatively high sensitivity against Chloramphenicol and Nifurantin now as before. Problems of diagnosis and therapy are discussed. The necessity of most effective screening methods, of early diagnosis and of interdisciplinary team-work is pointed out.


[The "minicatheter"--a possibility for surgical urinary diversion in gynecology].

A report is given on experience gathered in using a new method of postoperative bladder drainage. The advantages and disadvantages of the "mini-catheter", used in 121 women, are detailed.


[Pharmacokinetics of metronidazole during short-term therapy of trichomoniasis urogenitalis].

Serum and urine levels after single oral dose of 1 g Metronidazole were effective against trichomonades and anaerobic bacteria too at least 24 hr p. appl. The mean binding to serum albumin was 20%. The urinary recovery within first 24 hr was about 50% of the administered dose.


[Ambulatory management of cysts and abscesses of the Bartholin gland].

After marsupialisation of cysts and abscesses of the Bartholin's glands the insertion of an intrauterine devices is recommended. The treatment can be performed ambulatorily.


[Menstruation pneumothorax].

Report on the appearance of a spontaneous pneumothorax dependent on the menstruation with a 40-year-old patient. The possible causes and the therapeutic proceedings are discussed here.


[The Allen-Masters syndrome].

In cases where women suffer from chronic troubles in the abdominal region (genital apparatus) it is often difficult to diagnose the causes thereof. The knowledge even of seldom clinical pictures can be useful for considerations of differential diagnosis. On the basis of a case report on a traumatic insufficiency of the uterine supporting apparatus (known as Allen-Masters-Syndrom) the possible causes that may have led to this trouble are being discussed.


[Participation of polyvalent metals in the evolution of oxidoreductases].

The study of the participation of metals in evolution of oxidation-reduction processes is subdivided into two periods. During the first of them, from 1897 to 1937, the significance of manganese, iron, titanium, molybdenum, vanadium and copper in most important processes of metabolism was discovered. The second period, from 1937 to 1977, was devoted to the study of the role of metals in individual representatives of oxidoreductases and their evolution during transition of organisms from anaerobiosis to aerobiosis. In this evolution of special importance were bimetallic enzymes, such as nitrogenase, some nitrate reductases and hydrogenases, carbon dioxide reductase, xanthine oxidase, cytochrome oxidase. Owing to their ability to accomplish conjugated oxidation-reduction reactions, these oxidoreductases were transitional to still more complicated polymetallic systems with whose participation the electron transfer chains in subcellular structures were formed.


[Comparative study of the content of blood group substances A and B in immunoglobulins prepared from placental and donor sera].

Blood group specific substances A and B were revealed in all the samples of immunoglobulin commercial preparations made in the USSR, Bulgaria, and India from the retroplacental, abortion sera, and from the placental extract. Their content varied in different batches of the preparations--from 8 to 64 microgram/ml of substance A, and from 6 to 256 microgram/ml of substance B. In the majority of immunoglobulin batches prepared from donor sera no group-specific blood substances A and B were revealed; only in 3 of 14 batches was there revealed substance A in the amount of 3 microgram/ml.


[Study of the feasibility and conditions for disinfecting materials made of chemical fibers by immersion in solutions of several disinfectants].

The authors studied the disinfection regimens of materials made of lavsan, capron, acetate, triacetate, viscose by the method of immersion into the disinfecting solutions of dichlor-I, chloramine calcium hypochlorite salt, potassium and sodium salt of dichlorisocianuric acid, sulfochloranthin, dichlordimethylhydantoin, catapin, amphocept, sodium metasilicate, hydrogen, peroxide, formalin, phenol, benzylphenol. As revealed, solutions of the following preparations could be recommended for the disinfection of linen made of chemical fibers at the foci of intestinal and droplet infection, except tuberculosis: sulfochloranthin (0.2%), amphocept and chloramine B (1%), sodium metasilicate, formalin, catapin, hydrogen peroxide with a 0.5% of washing solution (2%); these solutions gave a reliable effect in 60 minutes at room temperature, and in 20 to 30 minutes at a temperature of 40--45 degrees C.


[Ionic membrane selectivity of Planorbarius corneus mollusk neurons].

In electrophysiological investigations, relative permeabilities of somatic neuronal membrane in the winkle for K+, Rb+ and Tl+ have been obtained which made it possible to establish the selectivity row for this membrane. This row in principle coincides with similar rows for the membranes of other excitable formations. The difference lies in higher permeability of the membrane investigated for sodium. Permeability coefficients for K+, Rb+, Tl+ and Na+ in this membrane were also determined. In marine molluscs, sodium and potassium permeabilities of the membranes are lower than in fresh-water or terrestrial ones.


[Filtration, reabsorption and secretion in the evolution of renal function].

In all of the vertebrates, beginning from the most primitive ones, an universal principle of structural, functional and chemical organization of the nephron is noted. The main trend of progressive evolution of kidney function (both in phylogenesis of vertebrates and ontogenesis of birds and mammals) is the increase of the intensity of filtration-reabsorption mechanism of urine formation. The development of secretory apparatus is considered as an adaptation to the conditions in which this mechanism is not sufficient to provide the necessary level of excretion. It is suggested that secretory mechanism is formed in close relation to cellular system of reabsorption of sodium and chloride. The presence in lamprey kidney of a loop which is similar to Henle's loop in mammals and birds indicates that the development of the system of osmotic concentration conditioned by the formation in the kidney of the medulla and from a sharp increase in renal arterial blood supply.


[Micropuncture study of sodium chloride and bicarbonate reabsorption in the proximal tubule of the lamprey, Lampetra fluviatilis, kidney].

Proximal tubules of the kidney have been injected in vivo with isotonic solutions (in mequiv./1: 120 NaCl; 120.4 Na, 114.0 Cl, 6.4 HCO3 and 120 Na, 60 Cl, 60 HCO3) and half time (t 1/2) of fluid absorption was measured by shrinking drops technique. The value of t 1/2 was found to be significantly lower for NaCl solution than for NaCl--NaHCO3 (1:1) one. These data suggest that proximal reabsorption of chloride and bicarbonate is provided by separate specific transport systems.


[Development of vasomotor adrenergic innervation during onto- and phylogenesis].

Histochemical, biochemical and electron microscopic studies of vasomotor innervation in onto- and phylogenesis of vertebrates reveal basic trends in evolution of the adrenegric apparatus of the blood vessels. In evolutionary row of animals, together with the development of hemodynamics, constant development of vasomotor innervation takes place, which reveals itself in the increase of the density of the adrenergic plexus and its mediator content. It was demonstrated that nerve-muscle relationships in vascular wall are not constant and depend on the degree of contraction of vascular muscles. Also inconstant are intercellular contacts of plain muscle fibers, their number and total surface being also dependent on the degree of vascular constriction. It is suggested that rearrangement of nerve-muscle and intermuscular relationships within the vascular wall during contraction-relaxation cycle automatically affects functional parameters of the blood vessel and provides for autoregulation purposes.


[Thermostability of the rhodopsins of several fish in the Sea of Japan].

Studies have been made on thermal denaturation of rhodopsin in hotoreceptive membranes of retinal rods of some Japan Sea fishes--Podthecus sp., Enophrys diceraus, Myoxocephalus stelleri, Pleurogrammus monopterygius, Sebastichthys trivittatus, Pheumatophorus japonicus, Gadus morhua, Theragia chaloogramma, Eleginus gracilis and Lepidopsetta herzensteini. It was shown that visual pigments of the species studied significantly differ in their thermostability, whereas with respect to their spectral properties they are rather similar (absorbtion maxima lie near 500 nm). Positive correlation between the thermostability level of rhodopsins and the environmental temperature of the species was found.


[Rational bases for cooperation between epidemiologists and mathematicians].

The authors consider rational foundations underlying creatin of realistic models. The principal condition for the successful mathematical modelling is obtaining of the most full value primary materials on the course of the epidemic process. For this purpose the authors suggest definite principles of the methodical approach to the mathematical modelling. Possibilities of the use of mathematical methods for various groups of infections are consideder. Particular attention is paid to the works on the study of the infection risk in "small" collective bodies.


[Principles for optimizing and guaging several processes in the technology of vaccine production. I. Several problems in guaging and optimizing thermal sterilization of fluids].

Thermal sterilization of fluids--one of the widespread operations in microbiological laboratories and in vaccine production--solves two tasks: provides sterility and maximal preservation of biological value of the sterilized fluid. A possibility and expediency of using some indices for the quantitative assessment of the efficacy of the sterilization regimens, including measurement of the sterilization processes is considered in this work. A possible way of the regimen optimization on the basis of known values of the activation energies of the processes of decomposition of thermolabile components and inactivation of foreign microbial flora is assessed.


[Genetic nature of the bacteriocinogenicity factor of Staphylococcus epidermidis strain No. 259].

Genetic nature of the bacteriogenicity factor of the Staphylococcus epidermidis No. 259 strain was studied by acting upon the strain with ultraviolet irradiation, acridine orange at a temperature of 37 and 44 degrees C, and cultivation of the strain at a temperature of 44 degrees C for 24 and 96 hours. The most effective elimination of the bacteriocinogenicity factor was reached with the action of acridine orange at 44 degrees C and the strain passage at 44 degrees C for 96 hours. A study of 212 subcultures which lost the bacteriocinogenicity factor under the effect of various factors demonstrated that they failed to differ by properties from the initial strain and retained the bacteriocin resistance of the initial strain. A conclusion was drawn that the bacteriocinogenicity factor was an extrachomosomic agent, and was not associated with any other strain properties.


[Staphylococcal plasmacoagulase. III. Use of thrombelastography to study the properties of extracellular staphylocoagulase].

A method of thromboelastography was applied to the study of the influence of supernatents of the S. aureus and S. epidermidis culture fluid on the process of blood coagulation. S. aureus No. 209 P, No. 8325-1 strains and mutants of the No. 209 P strain, resistant to proflavin induced a distinct shortening of the reaction time. In using S. epidermidis (strains D5/240 and D-5/48) and also in control experiments (plasma and medium) no shortening of the reaction period was observed. The data obtained permitted to recommend the use of thromboelastographic method for the purpose of detection of coagulase-positive staphylococcus strains and for the assessment of relative staphylocoagulase activity.


[Formation of antibodies of different classes in salmonelloses and typhoid fever].

A modified method of chromatographic analysis was used to obtain fractions of immunoglobulins classes M, G, and A from the sera of patients suffering from salmonelloses, typhoid fever, and carriers; with the aid of passive hemagglutination test O-, H- and Vi-antibodies were determined in the fractions. In food poisoning of salmonella etiology in adults the antibody formation as a rule occurred by the type of secondary immune response, whereas its intensity depended on the severity of the clinical course of the disease. In case of an uncomplicated affection there was an increase of antibodies of all the three immunoglobulin classes. In formation of prolonged carrier state a deficiency of O-antibodies of the IgM-class was noted; this was, however, combined with the normal production of immunoglobulins of class M of H-antibodies. Immune humoral reaction was practically absent in the transitory carriers.


[Role of several conditionally-pathogenic enterobacteria in group acute intestinal diseases and food poisonings of unestablished etiology].

Results of studying group acute intestinal diseases of obscure (from the point of view of isolation of commonly known pathogenic bacteria of enteric family) etiology coursing by the type of food poisoning, in which conditioned pathogenic enterobacteria (Enterobacter cloacae, Klebsiella) demonstrated that the occurrence of these diseases was connected with ingestion of the same food product infected with the mentioned bacteria due to disturbance of the sanitary-epidemic regimen and rules of food storage. Carrier stage of conditioned pathogenic bacteria identical to those isolated from the patients was noted in contacts by the factor of infection transmission. Accumulation of factual material is necessary to solve the role played by conditioned pathogenic enterobacteria in such diseases.


[Cellular immunity in mice immunized with pertussis vaccine].

The authors studied the developmental mechanism of postvaccinal resistanceof mice (C57BL/6J and CC57Br) to the intracerebral infection with the virulent B. pertussis culture. A model of syngenous transfer of various cells of the immunized donors (peritoneal cells, cells of neuroglia, the spleen, thymus and the lymph nodes) was used. Marked adoptive immunity proved to originate in the use of peritoneal cells which provided protection of 57--100% of the recipients. Preliminary inactivation of the vaccine by heating was accompanied by the loss of the cell capacity of the immunized donors to cause adoptive immunity in the recipients.


[Clinical and serologic diagnosis of measles in children vaccinated against the disease].

At the period of mass immunization of children with live measles vaccine clinical symptoms of measles, their intensity and sequence apparently displayed some changes; therefore, serological diagnosis is more reliable in comparison with the clinical one. Result of serological study of 93 coupled blood sera of children who fell sick with the diagnosis of measles showed that only 54.3% of those vaccinated earlier and 49.2% of nonvaccinated children sustained measles, whereas the rest had had exanthematous disease of other etiology. All the children had fever (the majority not over 38.5 degrees C) and rash; other clinical signs of measles were of different intensity in the vaccinated and nonvaccinated children. Apparently such pathognomonic signs of measles as rash, Filatov's sports and conjunctivitis could not serve at present as a reliable criterion of clinical measles diagnosis. The majority of children vaccinated before who contracted the disease responded to the infection by an earlier and more intensive production of antibodies than nonvaccinated children who contracted the disease, this pointing to the possibility of manifestation in them of the clinically expressed booster-effect. The data obtained indicated a marked difficulty of clinical differential diagnosis of measles.


[Secretory immunoglobulin A in the blood sera of healthy and ill persons].

Sera of healthy and sick persons were tested for the presence of secretory IgA (SIgA) and free secretory component (SC) SIgA was present in the blood of healthy persons in low concentrations (1.07 mg/100 mg), and free SC was absent. Infectious and somatic diseases, in which damage of the epithelial covering of the gastrointestinal and respriatory tracts was possible, were accompanied by increased blood SIgA content. There was also noted a distinct relationship between the blood SIgA concentration and the severity of infectious diseases and pneumonia supervention. In these cases the SIgA level proved to rise.


[Etiology of pneumonias in young children according to data from comprehensive immunomicrobiological, virological and parasitological studies].

Investigations carried out demonstrated acute pneumonia in young children to be characterized by the presence in the sputum from the deep respiratory tract of polymicrobial flora, in some of viral-microbial-fungus flora, and also of pneumocysts. Immunobiological and virological study demonstrated the etiological role of 7 virus species and 2 bacteria species in 70.8% of cases; pneumonia of viral etiology constituted 24.1 +/- 3.0%, of bacterial -- 24.6 +/- 3.0%, and of viral-bacterial -- 22.1 +/- 2.0%. In order to unify the approaches and methods of study of pneumonia etiology in young children complex immunomicrobiological, virological, and parasitological method of study is suggested.


[Characteristics of the morphology and ultrastructure of the typhoid bacteria under limited and excess glucose conditions].

The authors present the results of the study of morphology and physico-biochemical indices of periodic and continuous population of typhoid bacilli under conditions of glucose limit and excess in the medium. Changes in the parameters of cell distribution by length proved to reflect the physiologico-biochemical processes in the population. The results of the study of the ultrastructure of typhoid bacilli of the "aerobic" and "anaerobic" population in continuous cultivation are presented. A possibility of application of morphological tests for the assessment of stability, homogeneity, and viability of the population is discussed.


[Change in the normal microflora of the intestinal tract of rats in the process of their decontamination].

The authors studied a possibility of decontamination of animals by using antibiotics and a sterile diet, and also a combination of both methods. A reduction of the species composition of the intestinal microbial flora was noted in rats on sterile diet kept under conditions limiting the penetration of microbes into the organism from the external environment. Its greatest rarefaction -- practically to individual species -- was observed when the antibiotics were used in combination with a partial gnotobiotic isolation. In studying the action of antibiotics on the bacterial flora it is recommended to use the gnotobiotic isolation chamber to prevent the entrance of vulgar microbial flora from the surrounding environment.


[Epidemiological characteristics of water-borne outbreaks of typhoid in North Africa].

On the basis of analysis of several water-borne outbreaks in Northern Africa the authors came to the conclusion that when the population applies for medical aid rarely hospitalization curve reflected the morbidity curve. Attention is paid to the fact that in late and incomplete hospitalization of the patients at the period of water-borne outbreaks of typhoid fever some of the cases are subsequent and are not associated with the factor causing their primary origination. High morbidity indices in older age groups (15-39 years old persons) are due to their greater applicability for medical aid. The group of children aged from 10 to 14 years old is the one affected the most.


[Spontaneous mutants of S. aureus 209 P resistant to 3,6-diaminoacridines].

Spontaneous mutants of S. aureus 209 P resistant to proflavine sulphate and possessing cross resistance to acriflavine and acridine yellow were isolated. Sensitivity of these mutants to acridine orange, acridines No. 40 and 56 remained unchanged. The phage type and the indices of potential pathogenicity of proflavine-resistant mutants coincided with the corresponding S. aureus 209 P indices.


[Trace element content in comparison with the physiological and immunogenic properties of S. typhi obtained by various continuous cultivation regimens].

The content of trace elements in the S. typhi cells was studied during continuous cultivation in the synthetic nutrient medium. Growing under conditions of complete or incomplete glucose utilization failed to influence the content of trace elements in these cells. The same tendencies were revealed in the changes of manganese, iron, magnesium, calcium, and strontium content with increase of the growth rate. The content of aluminium in the cells altered in parallel with the changes in the immunogenic properties with increase of the growth rate from 0.17 to 0.44 hour-1.


[Comparative determination of Australia antigen in the serum and in the leukocytes in viral hepatitis].

The Australian antigen was more frequently revealed in the leukocytes than in the serum of patients with viral hepatitis. This difference was statistically significant in convalescents and in those who sustained the disease. The incidence of detection of the Australian antigen proved to depend on age and the severity of the disease.


[Quantitative evaluation of the patterns of the mechanism of pathogenic streptococcal transmission].

In the course of a one week observation in the organized collective body with a daily bacteriological examination for streptococcus group A carrier state 20 infections were recorded per 70 risk man-days. Statistical analysis of conditions for the recipients' infection showed bedrooms to be the main site of streptococcus infection in the organized collective bodies. The most important role in the epidemic process belonged to healthy carriers capable of infecting sensitive recipients, with the potency of microbial foci in the pharynx and the nose of about 1000-2000 microbes per standard tampon. The greatest frequency of infection occured at a distance of from 1 to 1.2 m. Consequently, the main direction of prophylaxis of streptococcus infection at the collective bodies should be associated with measures directed to the source of infection (isolation and penicillin therapy of the patients, urgent antibiotics prophylaxis in case of threatening epidemic or at its initial period).


[Lymphocyte reaction in meningitis to the addition of anti-inflammatory preparations to the cell culture].

Microbial stimulation of lymphocytes of patients suffering from meningococcus infection increased primarily under the effect of antiphlogistic preparations in vitro; more rarely it was inhibited. In experiments with lymphocytes of the patients this increase was more than 5-fold, and with those of healthy donors -- not more than 2-fold. With a low initial lymphocyte reactivity the intersification of specific stimulation with the preparations was more pronounced than with the average and the high one. There were differences in the action of pyrasolone derivatives and hydrocortisone -- the latter inhibited this reaction more frequently than amidopyrinum and butadion.


[Study of the conditions for protease formation by Coccidioides immitis].

The authors determined conditions for C. immitis protease synthesis during growing on various nutrient media. Four to five weeks could serve as the optimal period of protease formation. Of six nutrient media tested Saburo's medium, containing peptone, proved to be the most favourable for the enzyme production.


[Diagnosis of seizures of ischemic origin in outpatient practice].

Among the group of 216 patients with cerebral attacks, 40 patients were selected with different syncope-like attacks, epileptic nature of which was rejected or was dubious. On the basis of clinical examinations and analysis of the phenomenology of paroxysms, a group of patients was distinguished where there were attacks of sudden falling in cervical osteochondrosis and a syncopal vertebrogenic syndrome, patients with simple and convulsive syncopes, as well as patients with cerebral attacks of an uncertain origin. It is assumed that there may be an ischemic genesis of syncope-like attacks, on the background of which an inclusion of secondary epileptic mechanisms is possible, especially in some individuals with constitutional or acquired predisposition to epilepsy. This may cause a development of convulsive phenomena and a corresponding EEG picture. Consequently the authors discuss the expediency of including anti-epileptic preparations into the scheme of such patients.


[Emergency medical services for acute cerebral circulatory disorders].

An analysis of annual reports of the station of ambulance and emergency medical aid during the past 6 years demonstrated a significant increase in the number of patients with acute cerebral circulation disorders due to reorganization of ambulance medical aid services. The authors discuss some scientific-methodological organizational problems of neurological emergency medical services, the tasks of specialized neurological teams questions of the diagnosis of brain stroke and the necessary level of eupplementary studies and treatment measures in the prehospital stage. A certain importance is allocated to a continuity of patient treatment in the hospital and perfection of the system of hospital care to patients with acute disorders of cerebral circulation.


[Prognosis of transient disorders of cerebral circulation and risk factors in the development of stroke].

The paper is concerned with the results of a study of 140 patients who had had transient disorders of cerebral circulation. Among these cases 47 were subjected to a prospective observation and 93 to a retrospective one. The authors analyse 32 possible risk factors of brain stroke in patients with transient disorders of cerebral circulation. Their mathematical processing was accomplished with the aid of correlational coefficients and conditioned probabilities, detecting the highest pathogenic importance of these factors (such as disturbance of the rhythm of cardiac activity, arterial hypertension higher than 190 mm, etc). A mathematical evaluation and combination of factors was made. It was demonstrated that there is a diminution of the risk of development of ischemic stroke with development of parkinsonism in patients with transient disorders of cerebral circulation. The authors give recommendations for prophylactic treatment in order to prevent strokes in this group of patients.


[Diagnostic value of determining hemoglobin in cerebrospinal fluid in acute cerebral circulatory disorders].

The results of hemoglobin determination in the CSF by the method of fluorescence microscopy in 195 patients speaks in favor of relative diagnostical importance of hemoglobin in the supra fall-out CSF for establishing the character of the stroke. The following circumstances testify to this fact: 1) in an artificial admixture of blood in the CSF in some cases there may be hemolysis of "passing" erythrocytes; 2) in a genuine admixture of blood, tests of hemoglobin in the centrifugate of the CSF may be negative since in some cases the transition of hemoglobin into bilirubin in the subarachmoid space occurs more rapidly than the hemolysis of erythrocytes. Thus, the hemoglobin does not accumulate in the liquid in quantities, sufficient enough to be measured by the existing methods; 3) in a large amount of artificial blood admixture, even without a hemolysis of "passing" erythrocytes the hemoglobin tests in the centrifugate of the CSF may be positive at the expense of hemoglobin of the blood plasma.


[Extrapyramidal disorders in chronic cerebral vascular insufficiency (clinico-morphologic study)].

On the basis of clinical (150 cases) and clinico-morphological (40 cases) studies of patients with chronic insufficiency of cerebral circulation due to hypertensive disease or atherosclerosis with symptomatical hypertension the following extrapyramidal disorders of a vascular genesis were distinguished: 1) extrapyramidal -- pyramidal; 2) extrapyramidal -- pseudobulbar; 3) extrapyramidal -- cerebellar; 4) extrapyramidal -- thalamic; 5) extrapyramidal -- spinal 6) the syndrome of arteriosclerotic muscular rigidity. It was demonstrated that these syndromes may appear not only in lesions of the striar arteries, but in stenosing atherosclerosis of the carotid arteries and involvement of the vessels of verterbobasillar system. Development of different syndromes depends upon the prevalence of disorders in a certain vascular basin, the characters and severity of the main disease.


[Hemorrhagic infarct of the brain during cardiogenic shock].

The paper deals with the possible mechanism in the development of a hemorrhagic brain infarction during myocardial infarction, complicated by a cardiogenic shock of the III degree. The results of a postmortal study of the brain, its major arteries, as well as the vessels of the Willis circle, permit to assume that the mechanism of realization of this cerebral vascular complication is in a joint metabolic and microcirculatory disorders accompanying the shock. Besides, there is also a stenosing atherosclerotic process, with prevalent lesion of the intracranial part of the magistral arteries, supplying the brain.


[Analysis of the structure of the rheoencephalogram as a biosignal of pulsatile blood-filling].

In connection with an elaboration of a new method of analysing biosignals of pulse repletion, which used a systemic approach to the description of the cardiovascular system and a creation of a corresponding model of its work, the authors made a theoretical study of systematization of the manifold forms of rheograms in different conditions of the vascular tone. An analysis of the rheogram structures on the basis of the model of the cardiovascular system and a consideration of the rheograms as a summation of two components -- the arterial and venous -- permitted to eliminate some new indices of the tone state, elasticity and blood repletion of the arterial and venous bed, as well as the amount of peripheral vascular resistance.


[Thrombotic lesions of the superior and inferior posterior cerebellar arteries].

The authors accomplished a clinico-anatomical analysis of 8 personal cases of a rare vascular brain pathology. In 1 case there was a thrombembolism in the basin of fine branches of the right upper cerebellar artery with a focus of softening in the right hemisphere of the cerebellum in 1 case--thrombosis of the right upper cerebellar artery with a focus of softening in the right cerebellar hemisphere, in 5 -- thrombosis of the left lower posterior cerebellar artery with localization of the focus of softening in the left cerebellar hemisphere. One case was with thrombosis of the same vessel with a focus of softening in the right cerebellar hemisphere in the side olive of medulla oblongata.


[Social and medical rehabilitation of patients subjected to surgery on account of aneurysms of the anterior connecting artery].

The report contains data concerning occupational and social rehabilitation of 46 patients operated on for aneurysma of the anterior communicative artery. It was established that the occupational prognosis depends upon the severity of the hemmorhage, character of surgical operation. Of significance are the conditions of work, time after the surgical operation. The authors mark that in 2/3 of the operated on patients the working capacity is being restored. A spontaneous restoration of diaturbed functions is slow and is not always sufficient. With this purpose it is expedient to repeat courses of a general tonic and special rehabilitative therapy. A favourable factor in the readaptation of patients is their early engagement in working activities. The authors give their recommendations for medical labour expert testimony for this category of patients.


[So-called regional cerebral hypertension].

The theory of regional cerebral hypertension is based on methodological imperfect and indirect studies of blood pressure in superficial temporal arteries. The use of a modified direct oscillographic study of these arteries, as well as of a direct (bloody) study of the figures of pressure in them during catheterization refutes the concept of a significant lower level of this pressure compared to the pressure in magistral arteries in normal conditions. These data served as a basis for the premises of the theory of regional cerebral hypertension.


[Electroencephalographic signs of compensatory reactions following stroke with location of the focus in the right and left cerebral hemispheres].

The authors studied 41 patients with acute disorders of cerebral circulation, a focus in the right hemisphere and 14 with foci in the left hemisphere. The traits of compensatory reactions were studied according to the background and functional EEG, depending upon the severity, stage, localization and lateralization of focal vascular brain lesions. The authors indicate to a rigidity of clinical and EEG changes in patients with right hemispheric localization of the focus which is explained by the authors by disturbances of the higher cortical functions in these patients.


[Clinical features of focal brain lesions in the left-handed and ambidextrous].

On the basis of a study of 31 patients who demonstrated deviations from dextrality (Simistrals and ambidextrals) the authors describe some traits of the nervous and mental changes in focal brain lesions. There are insignificant correlations between the character of nervous and mental changes and the side of a brain lesion. The study demonstrated a wide variability of the clinical symptomatology, a peculiarity of each neurological and psychopathological phenomenon, distinguishing them from similar changes in dextrals. The studied contingent revealed prevalence of a disturbed sensory cognition in the clinical picture; the presence of special phenomena which most likely are not seen in dextrals and which are also related to a pathology of sensory cognition. It is being assumed that these clinical traits may testify to an insufficiency of speech lateralization in sinistrals and that an insufficient speech lateralization is accompanied by other than in dextrals organization of sensory processes.


[Insufficient excitation for speech in focal lesions of non-specific brain structures].

On the basis of a study of 150 patients with focal lesions of the mesencephalo-diencephalic brain areas the authors discuss speech disorders, appearing due to disturbances in the functions of the activating nonspecific systems. They indicate that these speech disorders are conditioned by an insufficiency of speech volition. However, in communicative important situations for the patient they can be overcome. In development of mesencephalodiencephalic pathology the syndrome of insufficient speech volition may be transmitted into a clinical picture of akinetic mutism. The problem of differentiation of insufficiency speech volition is being discussed in relation to lesions on different levels of the activizing nonspecific system and the accompanying drop of speech activity of the motor-aphatic and disarthric disorders.


[Clinico-enzymologic correlations in trophic disorders of the buccal mucosa in patients with peripheral lesions of the facial nerve].

The paper deals with trophic disorders of the buccal mucosa in 30 patients with Bell's paralysis. The character of the found changes was judged by the results of an examination of the mucosa and chemical and histochemical studies of the bioptate, obtained by aspirational biopsy. The examinations demonstrated trophical disorders in the buccal mucosa which was testified to by a slight edema and enzymatic-metabolic disorders in the form of an increased activity of the acid and alkaline phosphotase as well as asparagine and alanine aminotranspherase. These changes to a certain extent confirm the existence of vegetative filaments in the facial nerve, an affection of which leads to metabolic-trophical changes. Such data should be taken into consideration in an attempt to explain the mechanisms of distrophical processes and may be utilized as some indices in the judgment of the dynamics in the process of treatment.


[Effect of schizophrenic patients' serum on DNA synthesis in cultures of PHA stimulated lymphocytes].

The authors studied the influence of the blood sera of schizophrenic patients on the DNA synthesis in a PHA stimulated lymphocyte culture of normal donors. It was established that in 13 of the 15 studied patients the blood sera contained factors, inhibiting the DNA synthesis in lymphocytes in normals. The reactivity of lymphocytes on the PHA was in an inverse correlation with the figure of the cytotoxic index. The assumption is being made that the inhibiting action of the serum is conditioned by the presence of antibodies to thymocytes and T-lymphocytes.


[Schizophrenic outcomes with catatonic disorders in old age].

On the basis of a study of 51 patients with schizophrenia older than 60 years of age with catatonic outcome states the author accomplished differentiation of these conditiones with consideration of the character of the catatonic symptoms, as well as of the whole structure of the state. It was demonstrated that in the elderly the most diverse of the described in literature catatonic outcome states may be encountered. A significant percentage of the studied cases was with outcome states, prevalence of speech disorders and certain restoration of adaptation.


[Clinico-epidemiologic study of the mental state of a group of elderly persons from the general population].

A clinico-epidemiological study of a representative group of individuals older than 60 years of age from the general city population demonstrated that by far not all mental disorders of old age come into contact with a psychiatrist. A study of 1020 individuals (361 males and 659 females) detected 23 patients (2.3% of the studied population), who suffered from psychotic conditions and who were not registered in the neurophsychiatric dispensary: 6(0.6%) with schizophrenia, 6 (0.6%) -- with delusional psychoses of old age, 9 (0.9%) -- with vascular and senile psychoses and 2 (0.2%) -- with exogenous -- organic psychoses. Besides, in 29 cases (2.8%) there were signs of expressed organic dementia. In 38.9% of the studied individuals there were different mental abnormalities not attaining a psychotic level (initial weakly pronounced and mild psychoorganic conditions).


[A model of regulation of several shifts in the circulatory system and prospects for its use in schizophrenic patients].

In 122 patients (81 with schizophrenia and 41 with other mental disorders) and 50 normals the authors studied transient processes of frequency response to an orthostatic deviation. Depending upon the negative or positive acceleration of the pulse, 2 regulation models of this variable were distinguished. The report contains correlations between the regulation models of the palpitation frequency and the clinical picture of schizophrenia. The regulation model of this variable reflects the degree of progressiveness of the schizophrenic process.


[Anterior sacral meningomyelocele].

Anterior sacral meningomyelocele is the rarest and least known form of congenital myelocele. It is not manifested externally, it is usually not attended with changes in the neurologic status, and may be regarded as a presacral dermoid cyst. The authors observed 5 members of one family with similar clinical and X-ray signs of such herniations, in 2 they were verified. The presence of cystic structures in the cavity of the small pelvis in conjunction with a congenital defect in the bodies of the sacral vertebrae is an indication for conducting pneumomyelography so as to make a more precise diagnosis. A study of the hereditary and family history is a necessary trend in the examination of such patients because the disease may be of a familial character.


[Diagnosis of intervertebral disk hernia in patients with discogenic lumbosacral radiculitis using a matrix table].

For a more precise diagnosis of the level of nucleus pulposus herniation in lumbar osteochondrosis, a table has been compiled taking into account 35 signs of the disease. It is based on numerical evaluation of individual symptoms of the disease depending on their topico-diagnostic importance. The table was checked on 108 patients with discogenic lumbosacral radiculitis treated at the neurosurgical department of the clinic in whom posterolateral or paramedial herniation of the nucleus pulposus at the level of L4 or L5 was discovered during the operation. The table diagnosis proved to be correct in 91% of patients, while the preoperative clinical diagnosis--only in 82% of patients. All this provides the grounds for the use of this table in precise diagnosis of the level of nucleus pulposus herniation in discogenic lumbosacral radiculitis.


[Functional activity of blood leukocytes in the presence of traumatic lesions of the spinal cord].

A clinico-immonologic examination of 58 patients with traumatic lesion of the spinal cord was undertaken to ascertain the condition of the phagocytic activity of the peripheral blood neutrophils, one of the indices of natural immunity. For comprehensive appraisal of the leucocyte functional activity, not only the absorptive but also the digestive function of neutrophils was studied. Analysis of the results shows that a severe cerebrospinal trauma leads to diminution of the organism's protective forces. This is reflected in marked and long-term changes in the studied indices of the phagocytic reaction. The changes discovered were particularly conspicuous in patients with generalized infectious complications (urosepsis) and extensive infected bed sores.


[Dynamics of local cerebral blood flow in patients with contusion and compression of the brain in the postoperative period].

Study of local cerebral blood flow and PO2 in 19 patients with contusion of the brain after they had undergone surgery with removal of intracranial hematoma showed that posthypohyperemia developed in the previously compressed area of the brain which led to the formation of multiple hemorrhages along the vessels and consequent decrease in local blood flow later. It was assumed that the level of hyperemia in stability of general arterial pressure reflects the degree of tissue acidosis which grows with an increase in intracranial pressure. Early operative intervention for correcting the brain compression is most effective in such conditions.


[Dynamics of psychopathologic and neurologic syndrome in severe trauma to the skull and brain].

A dynamical clinical psychopathologic and neurologic study of disturbed functions of the nervous system following closed trauma of the skull and brain was conducted on 52 patients. The following three periods could be distinguished: the immediate result of the injury (1 to 2 weeks), recovery (2 weeks to 2 months), and outcome (2 to 3 years after the injury). The clinical forms of the course of psychopathologic and neurologic syndromes in each period were determined.


[Pneumoencephalographic signs of traumatic intracranial hematomas].

Lateral dislocation of the ventricles in relation to the reconstructed line of the septum pellucidum by more than 3 mm in proper positioning of the patient's head and by more than 6 mm in asymmetric positioning (from 5 to 18 mm) should be interpretated as a sign of an intracranial three-dimentional structure which requires surgical treatment. The subarachnoid spaces on the side of the intracranial hematoma or contusion focus are often not filled with the air. Pneumoencephalography conducted by the authors' sparing method with the administration of euphylline (aminophyline) may be employed as an auxiliary diagnostic method when angiography or echoencephalography cannot be performed.