Effect of carbon-disulfide intoxication on the levels of serum copper and ceruloplasmin.

Under the effect of carbon-disulphide intoxication on the experimental animals, a significant decrease in serum copper and ceruloplasmin levels was observed. The decrease was aggravated with prolongation of carbon disulphide intoxication due to loss of appetite, formation of chelating compounds with carbon disulphide metabolites and increased loss of copper in urine. However, reinvestigated at 20 days after stoppage of dosage, most of these derangements started to be alleviated.


[Experimental studies on the effect of incisions with the electric knife on wound healing].

In 114 albino rats the healing of incisions by scalpel and of several kinds of electrosurgically induced skin wounds was studied. The authors used the electrotome Martin 800 RFS. Incisions with the least coagulation which were the most blood-drenched healed best. These wounds were the tightest. Much coagulation distinctly worsened wound healing. That depends not only on the adjustment of the electrotome but also on the electrodes and the velocity of cutting. Proper cutting technique, adequate form of the electrode, and optimal amperage are required to combine the advantages of the less-bleeding non-pressing cut with satisfactory wound healing. The best results of the experiments are reported in detail.


[Studies on the tolerance of the organism to X 5 CrNiMo 18.10 steel (Königsee). I. Detection of chrome and nickel traces in the spleen, liver, kidney and in the tissues surrounding metallic implants (X 5 CrNiMo 18.10 steel) in guinea pigs by means of flameless atomic absorption spectrophotometry].

Small bars of X 5 CrNiMo 18.10-steel were implanted under the dorsal muscles of 60 guinea-pigs, a number of which was preoperatively sensibilized against potassium-bichromate or nickel-II-sulfate. After various times of surviving the traces of chromium and nickel were assessed in the tissue around the graft, in spleen, liver, and kidney. The resulting values ranged widely, there was a tendency to increased values the longer the implantates remained in the tissue. Traces of the elements were also found in the organs of the guinea-pigs. After sensibilization, the animals showed no more aggressive behavior against the implantates than without sensibilization. The quality of the implantates' surface is more important - as to coming-off parts of the alloy by corroding - than the preoperative immune condition of the organism.


[Studies on the tolerance of the organism to X 5 CrNiMo 18.10 steel (Königsee). II. Light microscopic studies of the surrounding tissue of metal implants (X 5 CrNiMo 18.10 steel) in guinea pigs].

The tissue around X 5 CrNiMo 18.10-steel implantates with different surfaces was examined in 72 guinea-pigs. Aside from controls, these animals were preoperatively sensibilized against chromium and nickel. The results can be summarized since the histologic findings showed no different peculiarities. The authors describe an intussusception of the implantate in connective tissue which evidently depends on time and surface. Further the spreading of alien material in the surrounding of the implantate, and morphologic findings are reported. The morphologic evidences are described and discussed in detail, since they are interpreted as signs of cell-mediated immune reactions. The presence of lymphocytes, lymphoblasts, histiocytes (mostly carrying alien material), and granulocytes, as well as proliferations at the arterioles suggest an overlapping of immune reactions.


[Methods of induction of a coronary thrombosis by means of direct current in the closed dog and dwarf swine thorax].

Coronary thrombosis is a perilous disease. Animal experiments may contribute to investigate its pathogenesis and treatment. The development of an experimental model of coronary thrombosis on closed thorax is important. In this report the methodics of such model is entered into, pointing at its dangers and possible complications.


[Changes in the actual oxygen level of the liver in barbiturate-halothane anesthesia].

The changes in acutal O2-level of the liver were studied in 20 dogs under barbiturate-halothane anaesthesia by means of a RADELKIS OH-102 type polarograph. A thread was led under the hepatic artery and the socalled "ligature test" applied. Occlusion of the vessel lasted 60 s in each measurement. A reactive hyperaemia was observed after the administration of barbiturat and halothane amounting to 40 and 75 per cent, respectively. In the authors' opinion the new method opens new prospects to the study of physiological changes taking place in the liver.


[Studies on the tolerance of the organism to X 5 CrNiMo 18.10 steel (Königsee). III. Electron microscopic studies on the tissues surrounding X 5 CrNiMo 18.10 steel implants in the animal experiment].

The surrounding tissue of X 5 CrNiMo 18.10-steel implantates in guinea-pigs was analyzed by electron microscopy. Corroding products of the implantates were marked by sulfide-silver-reaction. Metallic alien material was only proven in the cells of connective tissue covering the implantates. Immediately around the implantates one can not prove products of corroding, evidently depending on their minimal size and amount. In the cells of the intermediate and the vascular zone, however, single or accumulated particles in vesicular or vacuolary organellae, resp. without membraneous cover can be demonstrated. The findings are described and discussed with regard to damages which might arise by means of alloy parts and lysosomal structures.


[Studies on the tolerance of the organism to X 5 CrNiMo 18.10 steel (Königsee). IV. Studies on the tissue surrounding the X 5 CrNiMo 18.10 steel implants by means of an electron x-ray microprobe in the animal experiment].

Electron-x-ray micro-analysis was used for quantitative assess of element concentrations of alien materials in the tissue surrounding implantates of X 5 CrNiMo 18.10-steel. High amounts of iron were found whereas chromium and nickel concentrations were lower in the examined parts of the connective tissue around the metal. These examinations do not exclude that the iron partly comes from destructed erythrocytes. The amounts of chromium and nickel, however, suggest that the deposits of alien materials are sequels of electrolytic corrosion of the X 5 CrNiMo 18.10-steel implantates.


[Comparative mechanical and histological studies of the stable mandibular osteosynthesis].

After application of stable osteosynthesis on 18 experimentally fractured canine mandibles combined mechanic and histologic examinations were carried out at different times during the postoperative period. The preparations revealed relatively fair mechanic stability and in most cases a favorable histologic pattern with primary healing. Single cases, however, showed reverse behavior. There was a direct relation between stability of the mandible and broadth of the fractures' clefts.


[Animal model for the study of the anhepatic state].

Hepatectomy in the pig is impossible without simultaneous removal of intrahepatic caval vein. The authors covered the vascular gap using a siliconized glass prosthesis, completed with rubber tubes. 16 animals were operated upon in this manner and survived between 6 and 34 hours. In only two cases thrombi were found in the prosthesis.


[Pharmacodynamic data on neuro-endocrine effects on the muscle tone of the dog Oddi's sphincter after vagotomy].

The authors examined in 20 dogs the effect of alpha- and beta-receptors blocking pharmaca on the duodenal papilla after truncal vagotomy. In another group bilateral adrenalectomy was carried out in order to clarify the effects of the neuroendocrine system. After vagotomy and adrenalectomy the tonus of the sphincter of bile papilla was lowered. After blocking the alpha-receptors and preceding vagotomy, the pressure in the common bile duct is barely influenced, whereas after blocking the beta-receptors pressure values rise beyond normal. Because of the tonus changes of the sphincter after blocking alpha-, resp. beta-receptors, the adrenergic beta-receptor plays the most important role controlling the pressure in choledochous duct. Consequently, drugs acting on adrenergic beta-receptor yield new valuable contributions to diagnosis and management of bile duct diseases. After vagotomy beta-receptors blocking agents must be avoided since they would favor formation of bile stones.


[The effect of sensitized rabbit lymph node cells on the UVT tumor 15264 in inbred mice XVII/Bln].

The effect of rabbit lymphonode cells sensibilized against the UVT-tumor 15264 was studied and compared with equal tests, in which rabbit lymphocytes sensibilized against normal mouse tissue, resp. non-specific immunocompetent rabbit lymphocytes were used. Although a marked toxicity of rabbits lymphocytes against UVT-tumor 15264 could be proved, the authors observed no significantly longer surviving rate. These results do not correspond with the findings of Symes and Ridell from analogous studies on human individuals. Therefore, in cases with advanced stages heterologous passive immunization without clinical support (combined treatment) ought to be rejected.


[Methods and quality of information from myocardial scintigrams in the diagnosis of myocardial infarct].

There is an increasing importance of scintigraphy for the assessment of microcirculation in the myocardium. In animal experiments advantages and disadvantages of negative and positive representation of ischemic myocardiac areas were tried, after experimental infarction in particular. The results by computer scintigraphy prove that positive representation reveals an information on site and extent of an infarction.


Early biochemical disorders in the hindlimb muscles following femoral artery stenosis in dogs: protein and electrolyte metabolism.

Investigations regarding the metabolism of proteins and electrolytes in the hindlimb skeletal muscles were carried out in dogs with a moderate unilateral stenosis of femoral artery (reduction of almost 65% of its lumen) early after surgery. The results of these investigations were compared with those obtained by investigating the correspondent skeletal muscles of the opposite hindlimb. This comparison has revealed the following findings: (1) ischemia in a moderate form early elicites a remarkable K+ accumulation (not a K+ loss!) in the skeletal muscle without any change in the concentrations of other cations; (2) in this instance, an activation of muscle proteases and peptidases occurs meading to an important production of histamine, which is detectable in appreciable amounts in the ischemic muscle and, especially, in its effluent blood. On the basis of the findings reported in this study, as well as on the basis of our previous findings on the same experimental model, an approach to correlate and explain the early muscular metabolic disturbances induced by a moderate ischemia is discussed. In addition, it is to be pointed out that the presence of histamine in increased amounts in the effluent blood of a skeletal muscle mass could be a reliable laboratory parameter revealing an incipient muscle ischemia.


[Changes in the shape of erythrocytes during use of extracorporeal circulation].

The behavior of red cell shape of circulating blood was investigated following operations using the heart-lung machine by different quantitative methods. It was discovered, that the schistocytes (light microscopy) and echinocytes (scanning electron microscopy) significantly increases. The changes in erythrocyte shape are comprehended as summary effect of erythrocyte damage by the extracorporeal system and discussed in relation to the loss of phospholipid components of the erythrocyte membrane.


[Manometry and gastro-esophageal closure mechanism. An attempt at evaluation (author's transl)].

The registration of resting pressures and motility activity has considerably increased our knowledge of the normal functioning of the esophagus. We have not jet solved all the methodological problems of manometry; however perfusion manometry, which is used today, has enabled us to make an exact cassification of functional disorders and adequate therapy. An understanding of the methodological problems involved is necessary for the correct use of the manometric method and the correct interpretation of its results. This precondition has not always been observed, especially in discussion of the gastro-esophageal closure mechanism, and has thu given rie to much confusion. An attempt at a critical evaluation should be the basis for future discussion.


[A critical account on perfusion manometry in the lower esophageal sphincter (author's transl)].

The evaluation of morphology and functional regulation in the closing mechanism of the terminal esophagus is not yet convincingly stated. Manometry by continuously perfused and withdrawn catheters, as applied in the last years, permits only to record the elevated perfusion resistance in narrow segments. This is elucidated considering the physical principles of the measuring procedure. The closing pressure and its variations can only be determined by measuring the perfusing rate under constant pressure levels. The single conditions and the clinical value are discussed in detail.


[Morphological investigations of extrahepatic disorders after porta-caval end-to-side-anastomosis in rats (author's transl)].

Disorders of the central nervous system were found in 150 rats five monthds after en-to-side-porta-caval anastomosis consisting of vacuolisated cytoplasma of gangliacells and reactions of the glia comparable with the Alzheimer-glia-type II. Since these disorders are consistent with those in patients with liver cirrhosis but induced in these experiments by a porta-caval anastomosis alone, they are proposedly independent from liver disease itself. It is discussed whether disorders in glucose homeostai may be of pathogenetic relevance. Atrophy of tests, found in the late postoperative phase and erosions or ulcers of gastric mucosa as well as nephrolithiasis with hydronephrosis as consequence, the latter occuring independently from the time after operations, are proposedly due to the porta-caval anastomosis, too.


[Levamisole in the treatment of therapy-resistant folliculitides].

Report on two cases with chronic folliculitis of the face, resistant to antibiotic therapy. In both cases Staphylococcus epidermidis was the only organism that could be isolated. After a comparatively short treatment with levamisole (150 mg on two successive days weekly) the lesions cleared completely.


[Relationship between coronary angiographic findings and exercise Ecg in patients without transmural myocardial infarction (author's transl)].

In 311 patients (269 men and 42 woman, 20 to 65 years old) without transmural myocardial infarction the results of exercise tests in supine position were compared with the results of coronary angiography. 1. Patients having ischemic ST-segment depression (greater than or equal to 0.1 mV) and angina pectoris during exercise (n = 108) showed a greater than or equal to 50% stenosis of at least one vessel in 86.1%. In men the number of a greater than or equal to 50% stenosis was significantly higher than in women (91.3 vs. 56.2%). In patients without digitalis agreement with coronary angiographic findings is higher than in patients with digitalis (92.7 vs. 79.2%). After excluding women, patients under digitalis and those with an intramural myocardial infarction, agreement was 96.8%. 2. In patients having ischemic ST-segment depression agreement was 30% and in those with angina pectoris 36.8%. 3. In patients having neither ischemic ST-segment depression nor angina pectoris during exercise up to a heart rate of 80% of the age-dependent heart rate limit a coronary angiogram without a greater than or equal to 50% stenosis was found in 87.6%. After excluding patients with an intramural myocardial infarction, women and patients under digitalis, agreement increased to 97.9%. 4. In patients having both ischemic ST-segment depression and angina pectoris during exercise a 2- or 3-vessel disease was more often found than in patients having either ischemic ST-segment depression or angina pectoris, or in those having neither ischemic ST-segment depression nor angina pectoris respectively (57.5% vs. 16.6, 8.9 and 1.9%). 5. The number of positive coronary angiograms, especially of 2- and 3-vessel disease, increases with the degree of an ischemic ST-segment depression and the reduction of exercise tolerance.


[Parallel and opposite mitral leaflet motion in mitral stenosis. An echocardiographic study (author's transl)].

In 45 patients (pts.) with mitral stenosis (MS) multiple echocardiographic recordings of the posterior mitral leaflet (PML) were obtained and its motion pattern was carefully analyzed. 25 pts. showed only parallel motion (PM), one patient only opposite motion (OM) of the leaflets during diastole. In 19 pts. PM as well as OM (defined as backward movement of the PML immediately after the D-point and as forward motion during mitral closure, respectively) could be recorded at least two times. In most of these cases PM was impressive while OM could be demonstrated only by careful analysis of numerous recordings. In 4 of the 19 cases with PM and OM, however, the reverse was true. We conclude that OM should only be taken as evidence against MS when multiple recordings of the mitral leaflets have failed to reveal PM and when other echocardiographic signs of MS are missing. Possible explanations of the PM-OM combination are discussed.


[Importance of the inheritance in non-ejection-click and click-murmur-syndrome (author's transl)].

In a recent examination of the kindreds of 60 patients with a systolic non-ejection-click or click-murmur-syndrome we were able to demonstrate that the findings in 36 kindreds are inherited, although in most of the families not all the members could be seen. This means about 60%, a quote that might be even higher if all the members of a kindred could have been examined. Our observation suggests an autosomal dominant inheritance. This makes it worth while to look for the genetic defect causing this finding.


[Functional studies in children and adolescents with congenital complete heart block (author's transl)].

In 5 children and adolescents with congenital complete heart block functional studies were performed at rest and during submaximal and maximal work load. With reference to height standards the mean values of aerobic capacity and maximal cardiac output were reduced to 86% and 81%, respectively, whereas stroke volume during maximal oxygen uptake was elevated to 150%. Ventricular rate increased from a mean value of 50 min-1 at rest to a mean maximal value of 112 min-1 by the factor 2.2, atrial rate from 84 min-1 at rest by the factor 2.3 to 192 min-1 at maximum. The mean value of maximal arteriovenous oxygen difference was 14.5 ml/100 ml, the mixed venous oxygen content at maximal oxygen uptake was 4.3 ml/100 ml. The results show that compensation of the reduced ventricular rate not only at rest but also during work was mainly achieved by the increase of stroke volume. The compensatory elevation of stroke volume was, within certain limits, the greater, the more maximal ventricular rate was reduced. As an additional but considerably less effective compensatory mechanism the arteriovenous difference could be evaluated, whose maximal value was about 10% higher than normal.


[The electrophysiologic constellation of the so-called "sick sinus syndrome" (author's transl)].

A comparative investigation of the electrophysiological properties of the sino-atrial node, the right atrium, the AV-node, and the intraventricular conduction system was performed in 37 patients. 18 patients had a sino-atrial block, 8 a persistent bradycardia and 11 a brady-tachy syndrome. There are the following conclusions: 1. The greatest dysfunction of the sino-atrial node was observed in the group of patients with sino-atrial block. This can be derived from the determination of the sinus node recovery time and from the occurrence of secondary pauses. 2. The vulnerability of the right atrium, investigated by the extra-stimulus-technique, is enhanced in the brady-tachy syndrome. Measuring the duration of the P-wave and the PA-interval does not give any information about the atrial dysfunction. 3. Patients with a sino-atrial block often have a disturbed AV-node conduction. In most patients it is latent only and easily can be detected by atrial incremental pacing. 4. A hemiblock or bundle branch block is found more often in patients with sino-atrial block and sinus bradycardia than in patients with the brady-tachy syndrome. By the registration of a His-bundle-electrogram a trifascicular block can be uncovered in half of these patients. 5. In the sick sinus syndrome, there is always the possibility of additional dysfunctions in the conduction distal to the sino-atrial node. With special regard to therapeutic measures, a complete evaluation can only be made by of both endocardial recording and stimulation methods.


[Probability of electrode dislocation: the importance of threshold measurements during pacemaker implantation (author's transl)].

Myocardial stimulation thresholds were measured during 774 pacemaker implantations with endocardial electrodes. It was found that myocardial thresholds were higher when using electrodes with greater surface area and bipolar ones. Early electrode dislocations were more frequent at higher myocardial thresholds. There was no relationship between frequency of late electrode dislocations and the value of myocardial thresholds. The importance of measurement of myocardial stimulation threshold - as a guarantee of successful pacemaker therapy - is emphasized.


[The prompt squatting in the ambulance of pediatric cardiology (author's transl)].

The result of prompt squatting is an increase of the venous return and of the arterial resistance. Consequences are increasing of the end-diastolic and systolic chamber pressure, stroke volume, average arterial blood pressure as well as decreasing of the frequency of the pulse controlled by baro-receptors. The regulatory mechanism both change the intensity of heart murmurs of various cardiopathies and of functional heart murmurs in children. Only the systolic murmur of muscular subvalvular aortic stenosis softens. The experiment is most valuable for the recognition of mild insufficiency of semilunar valves.


[Acoustic transmission characteristics of the human thorax at various frequencies (author's transl)].

The acoustic transmission characteristics of the human thorax in the frequency range of 100 to 2000 c.p.s. were studied in nine corpses. Using a logarithmic scale for frequency, the sound pressure level measured on the chest wall showed a linear attenuation between 100 and 1000 c.p.s. with a mean reduction in sound pressure level of 77 dB.


[Automatically controlled angiological tilting table for standardised plethysmographic evaluation of partial functions of the veins of the leg: method and normal values].

A preadjustible, electrically driven, automatically controlled tilting procedure is prevented by fixing them below with an adjustible bicycle saddle (passive orthostasis during the measurement) and above with shoulder pads. Automatic standardized tilting by means of this table with simultaneous plethysmographic registration (strain gauges or air-filled plethysmographs) of the volume changes of the calf or/and the forefoot results in objective quantitative parameters of the following venous partial functions: A) Efficiency of venous outflow (tilting from head up 20 degrees to head down 60 degrees) and B) Venous insufficiency (swelling more than normal arterial inflow during tilting from head down 20 degrees to head up 60 degrees). The very good reproducibility of this method is shown. The range of normal values in healthy subjects is compared with those of patients suffering from different venous diseases of the legs. The method enables long-time observations by means of objective functional parameters.


[Experimentally induced alterations in wedge pressure and O2-partial pressure during acute hypoxia].

Suprarenal occlusion of the aorta by means of a balloon catheter results in an increase in wedge pressure, alterations in blood flow in the pulmonary circulation, and an increase in O2 partial pressure in the arterial blood. It is demonstrated that these changes take place after occlusion of the aorta during normoxia or hypoxia (Pao2:43 mmHg) in anaesthetized normotensive or spontaneously hypertensive mongrel dogs.


[Site and shape of the most severe stenoses in coronary arteries and their relationship to the risk factors. Postmortem findings (author's transl)].

Out of a great number of hearts investigated post-mortem by coronary arteriography and quantitative histology, 437 coronary arteries of 202 hearts had severe stenoses with a lumen reduction to less than 50 per cent. Mainly these most severe obstructions lay between 2 and 5 cm behind the aortic ostium. In the right coronary artery the frequency curve showed a smaller peak, a smaller decrease, and an inconsiderable second peak in the periphery. Perhaps the slow calibre reduction of the right coronary artery is significant for these findings. The narrowed lumen mostly lay a little eccentric and had an oval shape. A slit-like shape was a rare finding. Only in 20 per cent of the severe stenoses a normal intima was preserved in parts of the circumference of the coronary artery. Among 113 patients the following risk factors were known: hypertony, diabetes mellitus, cigarette smoking and hypercholesterinemia. Significant differences in the localisation of the most severe stenoses were not recognizable under the influence of these risk factors.


[New experiences in the diagnosis of the sick sinus syndrome (correlation between clinical symptoms, long-therm ecg monitoring, atropine- and exercise testing and sinusnode recovery time) (author's transl)].

The tests recommended for establishing the diagnosis Sick Sinus Syndrome (SSS) were carried out on 36 patients with non-drug-induced Sinusbradycardia (16 symptomatic, 20 asymptomatic) and their resp. diagnostic value was then analysed. Contrary to previous publications, response of heart frequency to exercise testing was normal in all subjects as well as response to intravenous Atropine administration with the exception of 3 cases. A good correlation was found between typical arrhythmias in long-term Ecg monitoring and clinical symptoms. A pathologically prolonged Sinus Node Recovery Time (SNRT) is found in the same number of symptomatic and asymptomatic subjects, frequency-corrected SNRT shows the same results. Shortening of SNRT after Atropine is the more pronounced, the longer SNRT was before Atropine administration. Non-normalization and paradoxical prolongation of SNRT after Atropine have also been observed. In 8 patients stepwise progressive atrial pacing beginning with pacing-frequencies of 70 p.m. was performed before and after Atropine administration. Observation of the effect of Atropine on SNRT may prove to be more important for prognosis and treatment of the SSS than the finding of a prolonged SNRT for establishing the diagnosis. The diagnosis "SSS" should not be based on a pathologically prolonged SNRT alone. Analysis of long-term Ecg monitoring and clinical symptoms should be the main diagnostic tool.


[Pulmonary atresia with ventricular septal defect. Follow up and surgical results from 1963 to 1976 and diagnostic measures with special reference to large systemic-pulmonary collaterals (author's transl)].

Clinical course, surgical results, and diagnostic procedures of 76 patients with pulmonary atresia and ventricular septal defect between 1963 and 1976 were reviewed. 50 patients had bilateral intrapericardial pulmonary arteries with confluence (group A) and 4 patients had a unilateral intrapericardial pulmonary artery (group B). In 22 patients intrapericardial pulmonary arteries could not be demonstrated (group C). 11 of 20 patients in group A with no surgical intervention died at a mean age of 1.4 years, 9 of 30 children died after operation at a mean age of 3.4 years. 2 of 6 patients died after Rastelli procedure. The additive mortality of the palliative procedures in this group was 22%. There are no deaths after the two Rastelli procedures in group B. 81 collaterals originating from descending aorta and 8 from subclavian artery or brachiocephalic trunc which supplied the lung were outlined. 20 collaterals from descending aorta and 4 from subclavian arteries had connections with the intrapericardial pulmonary arteries. In 17 of the former 20 stenoses were demonstrated. Stenoses were also present in 37 of 61 collaterals without connections with the intrapericardial pulmonary arteries in patients belonging to group A, B and C.


[Intravascular hemolysis following prosthetic heart valve replacement: influence of type and position of artificial valves (author's transl)].

The present study reports a comparison of the incidence and degree of intravascular hemolysis between patients with disc prosthesis (Björk-Shiley tilting or Lillehei-Kaster pivoting) and patients with Starr-Edwards ball valves (types 1260, 6120) in mitral and aortic position, examined 7 to 30 days and 2,5 to 71 months postoperatively. Malfunction or paraprosthetic valve regurgitation could be excluded. Estimation of serum haptoglobin and serum lactate dehydrogenase activity as the most sensitive parameters indicated clinically inapparent hemolysis in all 4 groups, especially in patients with Starr-Edwards ball valves in aortic position (type 1260).


[The relation between the density of blood and the arterial pressure in animal experiments and in patients during hemodialysis (author's transl)].

The density of arterial blood was measured continuously in animals and in human beings with an accuracy of 10(-5) g/ml by the application of the so-called mechanical oscillator technique. The density measuring device is inserted into an arterio-venous shunt. The continuous reading of the density of arterial blood allows to observe the effect of fluid shifts between the interstitial space and the plasma space. For example, lowering of the capillary pressure by the constriction of the precapillary resistance decreases the blood density by the inflow of interstitial fluid. Strong vasoconstriction apparently increases the capillary pressure and thus raises the blood density by the loss of plasma-ultrafiltrate. During hemodialysis the fluid loss into the dialysator tends to increase the blood density. However, the regulatory mechanisms of the circulation are able to keep the density of the blood at a constant value as long as possible. An increase of the density indicates a decrease of the blood volume. The new method thus allows a continuous control of the course of hemodialysis, and to avoid a critical decrease of the blood volume and of the blood pressure.


[Agranulocytosis after antiarrhythmic therapy with ajmalin (author's transl)].

A case of agranulocytosis (min. leucocyte count 980/mm3) after 4 weeks of treatment with an ajmalin derivate is reported. Recovery could be achieved by taking away the antiarrhythmic drug. It appears that these agranulocytoses only happen after a dosage of more than 300 mg/die, and that they have an intermediate position between allergic and toxic agranulocytosis (phenothiazine type).


[Isotopic study of cardiac hemodynamics after multiple valve prothesis (author's transl)].

The radiocardiography of the minimal transit times (MTTs) produces cardiologically useful hemodynamic data also in such instances where invasive techniques with the cardiac catheter are technically difficult, as is the case in patients with multiple valve prothesis. The present study reports on MTT measurements in 9 patients with tricuspidal prothesis, 8 of which had additional mitralvalve prothesis and 2 additional aortic valve prothesis. The measurements were made with Tc-99m Pertechnetate, and an Anger camera with electronic data processing was used as detector system. The results indicate that following implantation of valve prothesis the hemodynamic state remained essentially disturbed. The pathologically altered transit times are an expression of disturbed volume ratios. The transit times in the atria remained prolonged by an average factor of 4-5. The ejection of the left ventricle stayed diminished more pronounced than on the right. The values of one patient who was examined before and after implantation of the prothesis in mitral and tricuspidal position, also showed a worsening of the data especially in the atria. Because the cardiac function study with radioisotopes is non invasive, simple, and fast, and leads to only a minor radiation burden, the method  may be repeated and without hazard used for control follow-ups.


[Heart diagnosis using m-mode-echography. Continuous registration of transverse left-ventricular internal diameters. IV. Patients with coronary artery disease (author's transl)].

"Relative Cross-sectional area Differences" (RCD) and "Relative mean Velocity of Contraction" (RVC) can precisely be determined by means of impulse-reflected ultrasound. They are highly invariant under physiological conditions and closely related to the degree of non-ischemic myocardial disorders. To evaluate the diagnostic information of these parameters in coronary artery disease (CAD), echocardiographic examinations were performed on 105 subjects. The results were compared with the angiocardiographically determined ejection fraction and with minimal cardiac transit times. The heart-dynamic data were grouped according to the manifestation of CAD and correlated to each other. Furthermore the parameter's capability in identifying differences in hemodynamics in normals and in patients with CAD was tested. In more than 90 per cent of patients with CAD, RCD and RVC exceeded the normal range. For clinical diagnosis the results lead to certain limitations in the validity of the echocardiographic parameters. In cases of infarction localized at the apex and in myocardial aneurysmas, RCD and RVC reflect the function of the whole myocardium, not the ejection fraction of the left ventricle. In those cases of infarction of the posterior or posterolateral wall, the value of RCD and RVC could not be verified. If infarction occurs at other localizations (septum, anterior wall), RCD and RVC show the degree of reduced myocardial function without any limitation.


[M- and real-time b-scan diagnostic criteria and pit-falls in right ventricular volume overload (author's transl)].

The observation of a characteristic "see-saw" motion of the interventricular septum (IVS) in real-time B-scan (RTBS) in right ventricular volume overload (RVVO) reveals features which have not been taken into account in diagnostic M-scan echocardiography. From an investigation of 20 patients it became apparent that the criteria (1) increase in right ventricular internal diameter and (2) "paradoxical" septal motion, so far used for the M-scan diagnosis of RVVO, should be complemented by further criteria: (3) hypertrophy of the IVS in longstanding RVVO, (4) increase in septal amplitude of motion towards the cardiac apex, (5) selective increasing apical septal hypertrophy and (6) an apparent random septal motion without any resultant main direction as an indication of a displaced fulcrum of the septal "see-saw". All features may be visualised by carrying out a continuous sweep in M-scanning. The criteria 2-5 may be understood as a result of increased apical work load compensating for the haemodynamic loss of the reversed upper septal motion ("RUSM"). The diagnosis of RVVO can be made more readily and reliably with RTBS echocardiography, underlining the utility of a combined use of one- and two-dimensional ultrasonography in diagnostic cardiology.


[A study to the analysis of systolic time intervals (author's transl)].

For evaluating the degree of accuracy of the STI, a study on 120 healthy young male volunteers was performed. Under standardized conditions ecg, phonocardiogram and carotid arterial pulse were recorded. The following variables were measured: heart cycle interval (RRI), electrical systole (QT), electromechanical systole (QS2), and left ventricular ejection time (LVET). The arithmetic mean was utilized for the consecutive beats 1--5, 1--10, 1--15, and 1--20. The mean of the beats 1--20 was assumed as reference. The increase of the analysed heart cycles from 5 to 20 lead to a decrease of the standard error of RRI, which raised the degree of accuracy. The standard error for RRI decreased from 27.9 to 9.9 ms. Already the analysis of 5 consecutive beats for QT, QS2, and LVET reached the line of identity of the correlation slope compared to 20 analysed heart cycles. The standard error was very small (2.0; 2.9; and 3.0 ms). For clinical-pharmacological studies, the evaluation of 5 consecutive heart cycles for measuring STI leads to a very high degree of accuracy. For an exact measuring of RRI, it is necessary to analyse at least 20 heart cycles.


[Paroxysmal ventricular tachycardias complicated with Adams-Stokes syndrome during lidoflazin treatment (author's transl)].

A case is reported of ventricular extrasystole occurring during Lidoflazin treatment. It is considered that Lidoflazin is an effective pharmacon, but that it may enhance the ventricular irritability. Attention is drawn to the necessity of the frequent control of Lidoflazin-treated patients.


[Experiences with transvenously implanted pacemaker electrodes with special remarks on the treatment of leads out of function (author's transl)].

From 1965 to 1976, implantations of 502 pacemaker electrodes were performed. In 59 patients the first lead had to be changed. In December 1976, 355 patients were under our control. At this time, 11.7 percent were no longer paced via their first lead. Dislocations of the lead, increased threshold, insulation defect, skin perforation of the lead, myocardial perforation, adaptor defects, fracture, infection, and loops of the electrode were the reasons. In cases of exit block alone, you should try to take a high output pacemaker. In cases of entrance block, a pacemaker with increased input-impedance will do its work. If those two kinds of treatment will fail, you may speak about a lead out of function. Considering extraction of the electrode, except in cases of infection, you should exercise restraint, for severe complications may result. An electrode out of function has to be protected against disappearing in a safe way. A synopsis of electrode complications including cause, therapy, and prevention is given.


[First clinical experiences with a new transvenous endocardial screw-in lead (author's transl)].

From November 1976 to January 1977 a total of 10 patients were served with a new transvenous endocardial screw-in lead. In every 5 cases the lead was anchored in the right atrium respectively in the right ventricle. The lead presented itself by good biomechanical (flexibility, tension resistance) and bioelectrical properties. Because of its constructural features it was to insert easily and without any complication. Moreover, it could be placed anatomically stable by choice either in the right atrium or ventricle.


[Effect of sublingual isosorbide dinitrate on hemodynamics in coronary patients with and without congestive heart failure (author's transl)].

In 17 patients with coronary heart disease, hemodynamic measurements were performed before and after sublingual application of 10 mg isosorbide dinitrate (ISDN). 10 patients showed signs of heart failure with pulmonary congestion and a left ventricular filling pressure above 15 mmHg, resting hemodynamics were normal in 7 patients. Eight of the patients with left ventricular failure had sustained acute myocardial infarctions the size of which was assessed by serial determinations of serum creatine phosphokinase. Application of ISDN resulted in a significant decrease of systemic and pulmonary artery pressures and pulmonary capillary wedge and right atrial pressures of patients both with and without left ventricular failure. Cardiac index and stroke index as well as systemic and pulmonary resistances did not change significantly. ISDN did not affect left ventricular stroke work in patients with elevated filling pressures; however, a decrease of normal filling pressures was associated with a decrease of stroke work. Thus, in coronary patients with chronic congestive heart failure, sublingual application of nitrates results in a beneficial hemodynamic unloading. However, if the acute infarct size is taken into account, it can be demonstrated that hemodynamic improvement after ISDN--judged by the relation stroke work/filling pressure--becomes less pronounced with increasing infarct size.


[Mechanism of participation of neostriate nuclei in the organization of a conditioned reflex].

Formation and manifestation of classical and instrumental conditioned reflexes were studied in dogs under the action of electrical stimulation of the caudate nucleus and the putamen or after their electrolytic ablation. The extent of higher nervous activity changes depended on the localization of the electrodes in the nuclei and on the complexity of the tests used. Ablation of the caudate nucleus body elicited graver and longer disturbances in the system of conditioned reflexes than that of the head. Under the action of the neostriate nuclei delayed reactions changed to a greater extent than simple forms of conditioned reflexes. Proceeding from the data obtained, it has been assumed that the mechanism of neostriate influences on conditioned reflexes dependes on their comparatory function, the mechanism of comparing cortical and subcortical impulses at the striate level.


[Organization of integrated systems of conditioned reflexes in dogs with a damaged temporal cortex].

By means of the classical alimentary secretory method, a study was made of the characteristics of formation and preservation of complex systems of conditioned reflexes in dogs with a preliminarily lesioned cortex of the auditory analyser. It has been shown that a rhythmic-mozaic stereotype of conditioned reflexes to acoustic signals can be elaborated in the operated dogs, although conditioned activity is on a very low functional level. However, integration of two complex stereotypes into one single system is not achieved. The formation of a new stereotype in the operated dogs, in contrast to the intact animals, is not accompanied by an enhanced functional state (tone) of the brain, which points to an insufficiency of the self-regulating mechanisms of the cerebral cortex. It is suggested that special activating mechanisms which participate in controlling the functional state of the auditory system, are present in the cortical structures of the auditory analyser.


[Neuronal correlates of forward and backward conditioned connections in a food-getting reflex formed to electrical stimulation of the lateral geniculate body].

Neuronal activity of the visual cortex was studied in unrestrained cats with a stable food-procuring conditioned reflex to electrical stimulation of the lateral geniculate body (LGB), and in tests with presentation of a feeding trough to detect neuronal signs of backward conditioned connections. Two types of responses of the visual cortex neurones were established during manifestation of a forward conditioned connection: conditioned-inhibitory and conditioned-activating responses. Extinction of the conditioned reflex destroyed the neuronal pattern formed in the visual cortex; this correlated with the behavioral reflex extinction. It has been shown that neuronal signs of the backward conditioned connection are similar to the neuronal responses in the examined cortical areas corresponding to the forward conditioned connection.


[Dynamics of evoked potentials at different points in the cat somatosensory cortex during elaboration of conditioned reflexes].

In chronic experiments on cats a study was made of the spreading of evoked potentials (EP) in the somatosensory zones S1 and S2 in response to biologically significant tonal stimuli. The formation of conditioned connections enhances the capacity for polysensory reactions in different cortical somatic fields outside the zones of local projection of the unconditioned stimulus. As stable conditioned connections are formed, this capacity diminishes in relation to reinforced and, particularly, easily differentiated sounds: EP are more localized in response to the former, and disappear altogether when the latter are presented. The wide EP spreading in zones S1 and S2 is the longest in response to medium and fine differentiation tones, which points to the involvement of these zones in the integrative analysis of signals by their biological quality.


[Effect of switching off the globus pallidus on alimentary and electrophysiologic responses induced by stimulation of the hypothalamus].

In chronic experiments on eight cats a direct electrical stimulation of the lateral hypothalamus evoked: 1) food eating in a state of satiation and 2) a reproduction of a conditioned food-procuring reflex, preliminarily elaborated to an acoustic signal. Bilateral electrolytic ablation of the globus pallidum abolished both reactions, but for different time periods. The first one was restored spontaneously on the 20th to the 46th day; the second disappeared for 2.5 to 8.5 months without spontaneous restoration. Stimulation of the lateral hypothalamus alimentary zones brought about a statistically significant rise of the thresholds of desynchronization reactions in the ipsi- and contralateral sensorimotor cortex. The activating role of the globus pallidum in the organization of a motivational alimentary excitation is discussed.


[Dynamics of elaboration of an active defensive reflex after combined section of the visual tract and different commissural systems].

Elaboration of an active defensive reflex (ADR) was studied on intact animals (I) and on cats after a combined section of the optic tract and the commissural systems of the midbrain (II) and after a combined section of the optic tract and the commissural systems of the telencephalon and the diencephalon (III). On the first days of elaboration, the correlation between active and passive defensive reactions changed in the animals of the III group as compared with the intact cats. The greatest difference in ADR elaboration between the intact animals and cats of the II and III groups was observed on the first day. On the subsequent days of elaboration the differences diminish and by the 4th to 6th day do not exceed the variations in the intact animals behaviour. The operated animals on the whole achieve higher parameters in differentiation training than the intact ones. In the course of ADR elaboration, against the background of a flickering light, a driving response is recorded in the visual cortical areas of all the groups during the achievement of the active defensive conditioned reaction.


[Analysis of inhibitory influences of the frontal regions of the cerebral cortex on alimentary responses in rabbits].

Neurophysiological and neurochemical mechanisms of inhibitory influences of the frontal cortex on feeding both natural and evoked by electrical stimulation of the lateral hypothalamus were studied in experiments on rabbits. It was shown that frontal cortical inhibition of feeding was eliminated by ipsilateral coagulation of the dorsal hippocampus. Different effects of some drugs on the threshold of evoked feeding and on the cortical inhibition were observed. Atropine (1 mg/kg) and Droperidol (0,3 mg/kg) abolished the inhibitory influences of the frontal cortex. Chlorpromazine (2 mg/kg) increased the threshold of feeding elicited by the stimulation of the hypothalamic "feeding centre" and had no effect on frontal cortical inhibition. Different influences of chlorpromazine on natural and evoked feeding were shown. A conclusion is drawn about different transmitters in brain structures involved in functional architectonics of feeding. Mechanisms of drugs' action on feeding are discussed.


[Effect of pharmacologic substances on the avoidance reflex in a group experiment on rats].

It has been established that the avoidance reflex is disturbed in rats when performed in the presence of a group of non-learned rats. The degree of the disturbance depends on the number of non-learned animals present and the extent if their emotional excitation. Tranquilizers: diazepam, chlordiazepoxide and benactyzine; neuroleptics: chlorpromazine, trifluoperazine and galoperidol; antidepressants: amitriptilin and imipramine in certain doses, while improving the avoidance reflex in the presence of a group of excited rats, do not affect the disturbance of avoidance in the presence of a group of calm rats. It has been assumed that these drugs prevent the appearance of emotional excitation in learned animals in response to that in the non-learned animals surrounding them.


[Short-term spatial memory in mice].

White mice were presented with two visually identical small cups, one containing a sugar solution, and the other a salt solution. After having once rejected in the course of search for sugar the cup with salt, the mice did not as a rule inspect it the second time, as is usually done by melliferous bees. With three of four cups, of which one contained a sugar solution, and the rest of salt solution, the number of repeated examinations sharply increased, still it did not attain that made by melliferous bees with the same number of objects. Hence, for the given class of problems, the behaviour of mice is superior to that of bees.


[Command neurons in the unconditioned reflex arc of the grape snail].

Independent intracellular activation of any one of the five identified neurones elicits a behavioral act of pneumostome closing. Similar closing is evoked by adequate stimulation of different modalities. Comparison of unconditioned reflex properties and characteristics of responses of the studied cells leads to the conclusion that neurones under discussion are command elements for the unconditioned reflex. Command neurones respond to all sensory stimuli which can evoke reflex closing. There is a lot of synchronous EPSPs in their spontaneous activity, but no action potentials. A spike discharge of command neurones evoked by an adequate stimulus always precedes the effector movements but there is no action potentials during the pneumostome closing. Conclusion is made that the functional role of command neurones in the unconditioned reflex arc consists in evaluating the sensory input and in triggering motor programmes.


[Off-effect in visual cortex evoked potentials of humans under several conditions of photic stimulation].

Visually evoked potentials (EP) to light were recorded from the occipital cortical area under conditions of changes in stimulus duration and of different intensity of retinal illumination. The work was aimed at establishing the appearance and development of the EP off-effect in humans at these conditions of photic stimulations. This was necessitated by the large dispersion of data obtained in establishing the conditions of photic stimulation, which many authors consider essential for recording the off-effect. The off-effect was studied in greater detail also to elucidate its role in EP generation to a high-frequency photic stimulation. The data recorded are discussed and compared with those of other authors, obtained in studying electrical responses of the retina and the cerebral cortex.


[Asymmetry of visual perception].

In healthy adult subjects recognition was studied of geometrical figures presented unilaterally, and of separate letters presented unilaterally and dichoptically to the right and left visual fields. At near-threshold exposition, separate letters are better recognized in the right visual field, than in the left one, regardless of the method of presentation. There is no asymmetry in recognition of geometrical figures. In conditions of backward masking asymmetry of perception of separate letters is likewise observed, but they are better recognized in the left visual field. This suggests that the perception time of separate letters is shorter when they are addressed "directly" to the right hemisphere.


[Interrelationship between spatial synchronization and rhythmic components of the human EEG].

The main object of the work was to elucidate the functional significance of different human EEG rhythms. Cross-correlation and spectral characteristics at the background and during mental work were studied in thirteen subjects by recording from four points of the left hemisphere. During intellectual load, spatial synchronization is enhanced between the biopotentials of most areas: interrelations between remote points are intensified which leads to the smoothing of the synchronization gradient existing in a state of rest. The alpha-rhythm becomes less pronounced everywhere in parallel to the decrease in synchronism of its fluctuations in different zones; at the same time low-frequency activity (delta-theta) increases both by the amplitude of oscillations and the capacity for its unidirectional shifts over the whole cortex. The least distinct change is observed in the beta-rhythm.


[Functional interhemispheric asymmetry in the motor cortex following stimulation of forelimb nerves].

It has been shown that in most animals electrical stimulation of the brachial plexus nerves results in a functional interhemispheric asymmetry in the motor cortex. It weakens after section of the callosal body. The asymmetry is characterized by a mosaic pattern. The data obtained are discussed as related to the role of dominant interhemispheric relations in contrasting the functional interhemispheric asymmetry and in the formation of a relatively homogeneous functional mosaic.


[Non-specific facilitating influences on the responses of rabbit visual cortex neurons].

A study was made of neuronal responses in the rabbit visual cortex to patterned visual stimuli and their change during non-specific activation reaction. Non-specific activation while only slightly affecting the background neuronal activity, enhances the responses of most units to patterned visual stimuli. A comparison of responses with a different degree of inhibition participation shows that the depression of inhibitory processes may act as a mechanism of facilitation of the responses during non-specific activation. After facilitated responses evoked by the action of the stimulus during non-specific activation, the neurones retain a state of enhanced excitability. Repetition of stimuli not attended with non-specific activation leads to the diminution of excitability. The possible connection of the indicated effects with extinction processes is discussed.


[Changes in the functional characteristic of motor cortex neurons following their rhythmic polarization].

The study was devoted to the effect of rhythmical extracellular activating polarization on spontaneous and evoked (by stimulation of the ventroposterolateral nucleus of the thalamus) unit activity of the motor cortex, preliminarily sensitized by application of an epileptigen (penicillin or strychnine solution). The experiments were carried out on alert unrestrained rabbits. A 3-5 minutes rhythmical polarization of the neurons (0,12, 0, 10 c/s, 200-600 msec pulse duration) resulted in following aftereffects: 1) changes in the mean spike frequency in 58% of neurons; 2) increase of grouping of firing in units with an initial group-type spontaneous activity (21%); 3) assimilation of the polarizing rhythm (10%); 4) facilitation of excitatory phases of thalamically evoked unit responses that occured simultaneously with an increase of mean discharge frequency (18%). The results are discussed from the point of view of the hypothesis of excitatory reverberation in the microsystem of interconnected neurons.


[Multineuronal activity of the basolateral portion of the amygdala in rabbits under conditions of NaCl microinjections into the lateral preoptic field and water deprivation].

A study of the multineuronal activity of the rabbit basolateral amygdala has shown that both a microinjection of NaCl solution into the lateral preoptic field and water deprivation result in the appearance of high-amplitude spikes in the pattern of recorded activity. After microinjection these spikes proceeded with a high frequency. Consumption of water blocked this activity not immediately, but only in a day to three days under conditions of the animal's unrestrained access to water and food. The data obtained point to the arrival of information on drinking to the amygdala; they also imply the formation of certain relationships between LPF and the amygdala.


[Functional characteristics of the hippocampus after switching off visual afferentation in early ontogenesis].

EEG reactions to afferent stimuli and the driving responses (DR) to photic flickering with 1-15 sec frequency were studied in different brain structures of rabbits lacking visual experience (from the 8th to the 23rd and from the 57th to the 90th day of life). The orienting reaction in the first few days of the light regime is characterized by enhanced motor and respiratory components and is not extinguished for a long time when the stimulus is repeated. It is attended with theta-rhythm in the hippocampus EEG and desynchronized activity in the neocortical areas. DR is characterized by spatial-temporal dissociation; its development is markedly retarded in the cortical projection zone of the visual system, and of the archicortex structures, in the dentate fascia, as compared with the hippocampus proper, the midbrain reticular formation and the auditory cortex. The DR index equals the level of that of the control animals after nine to twelve days of their life in the light. The results obtained attest that the observed differences in the changes of the functional characteristics of the hippocampus and other brain structures depend on the mode of the central organization of the reaction, whose correlate is the studied EEG-parameter.


[Identification and properties of callosal neurons of the sensomotor region of the rabbit cerebral cortex].

Antidromic unit responses to the stimulation of the homotopic area of the contralateral hemisphere were specified in the cortical sensorimotor area of the unanaesthetized rabbit. The response latencies and their variability, the maximal reproduced stimulation frequencies, stability of the response, presence of certain contesting relationships between the background activity and the tested action potentials are as a whole reliable criteria for identifying extracellularly recorded callosal neurons. The criteria of certain relationships between the background and evoked action potentials allowed to disclose callosal neurons with slow conduction.


[Effect of motor training on evoked potentials and synaptic organization of sensomotor cortex neurons in rats during ontogenesis].

A 30-day motor training of rats started at a month's age does not reduce the duration of the excitability recovery cycles of neuronal populations in the sensorimotor cortex. A three-month training is accompanied by a considerable reduction of excitability recovery cycles. This coincides with a pronounced increase of the average density of spines on the apical and oblique dendrite branches of the pyramidal cells in the cortical layer V, which exceeds that observed after a 30-day locomotor training. In 30 days, the rats with a three-month training reveal a partial recovery of functional and structural parameters, and in two months, approach their initial values.


Experience in epilepsy in Lusaka.

In one year experience in epilepsy in the Lusaka University Teaching Hospital, 120 patients were found to have combined clinical and electroencephalographic evidence of seizures. A higher incidence of family history was shown in the unlocalised or centrencephalic types and the cause of the epilepsy was undetermined in the majority. The problems encountered in the management of epilepsy are described and plans are discussed for the future approach to the problems.


Normal values for the nitroblue tetrazolium test (NBT. test).

The mean count of positive neutrophils in the NBT test was found to be 10.9 + 1.2 SE (29). The mean count for neutrophils stimulated with heat killed bacteria was 51.6 + 2.2 SE (29). The values are essentially the same as those reported for other populations and laboratories. The number of positive cells was found to decrease logarithmically with time. This relationship forms a basis for the development of a normogram which can be used to interpret NBT test results obtained from blood which has been stored for several hours.


Psychiatric status and the disorders of thyroid function. I. Prevalence of goitre in a group of psychiatric patients. I. The prevalence of goitre in a group of psychiatric patients.

All (478) indigenous Zambian patients who were in hospital on a particular day in January 1976 were examined by the authors for goitre. 34.4 per cent of all adult female patients and 23.2 per cent of all adult male patients had goitre. However, 57.6 per cent of all female patients with effective illness and 77.0 per cent of all male patients with paranoid psychosis were found to have goitre. The association between affective illness and paranoid psychosis on the one hand and goitre on the other was found to be statistically significnat at the 0.1 per cent level. It is suggested that further work should be done to find out what proportion of patients with depression or pananoia have sub-clinical or borderline hypothyroidism.


Blood group genotypes in Zambia and linkage to sickle cell disease.

A number of normal Zambian individuals, Sickle cell heterozygotes and homozygotes, of different tribes living in Livingstone, were studied for Rh and MNSs genotypes. The purpose of this study was to establish the frequency distribution of these antigens in the normal Zambian. An attempt was also made to find the degree of linkage between Rh, MNSs with Sickle cell genes. cDe genes were found to bear a linear relationship amongst normal Zambians, heterozygotes and homozygotes, thus making the cDe antigen very prevalent in Zambia. MN antigens are however unevenly distributed. There is also a positive straight line relationship in the absence of S and s antigens amongst normal individuals, heterogygotes and homozygotes. Su, an allele of Ss system commonly found in Africa is also prevalent in Zambia. The linkage between cDe, MN, Ss genes and Sickle cell genes seems to be insignificant (P = 0.1 or greater than 0.1). The finding of a high percentage of cDe genes in normal Zambian individuals should help the clinicians in solving medico-legal disputes in the study of various genetic and anthropological problems.


Continuous methotraxate intra-arterial infusion in the treatment of head and neck cancer.

Fifty-nine patients with malignant tumours on the head and neck area, were treated with continuous intra-arterial infusion of methotrexate into the external carotid artery from a catheter introduced through the superficial temporal artery. Each patient received intramuscular injections of folinic acid in a dosage of 6mg every 6 hours, and a total dose of 250mg of methotrexate during a five day treatment period. The patients had received no previous chemotherapy, radiotherapy nor surgery. Forty-four of the fifty-nine patients (74.5%) responded partially to treatment and three had complete remissions. No recurrence was observed after a follow-up of more than eight months. Twelve patients showed no response at all.


[Decrease of mitogen stimulation of lymphocytes in rheumatoid arthritis].

Peripheral blood lymphocytes of 51 patients with rheumatoid arthritis and of 14 healthy blood donors were cultivated in autologous and homologous normal pool-serum and stimulated with phytohemagglutinin (PHA-P), concanavalin A (Con A) and pokeweed mitogen (PMW) in different doses. In autologous as well as in homologous pool-serum the 3H-thymidine uptake of stimulated lymphocytes from patients with rheumatoid arthritis was significantly depressed independent of the mitogen concentration used. Serum from patients with rheumatoid arthritis depressed the activation of blood donor lymphocytes by Con A and PWM. The depression of lymphocyte activation was not related to the presence of rheumatoid factors in the serum, the severity of the disease and the anti-rheumatic therapy.


Achilles reflex time in euthyroid, non-goitrous Zambian Africans.

The Achilles Reflex time (ART) was recorded in 80 euthyroid, non-goitrous Zambian Africans aged 8-69 years (mean 32.7 years) using the thyrochron. The reflex was measurable in 62 subjects (77.5% of total) but not obtainable in 18. No significant difference in ART was found between females and males, but there appeared to be difference between the right and left ankles. ART was significantly shorter in the right ankle (309.9 + 5.8 msec) than in the left ankle (321.3 + 5.9 msec). Diagrams of "reflex chronograms" revealed three types of response namely: stable, relatively stable and scattered varieties.


Selective changes in size and distribution of fibre types in vastus muscle from cases of different knee joint affections.

Different knee joint affections are apt to initiate different specific atrophy forms in quadriceps muscle. By  a biopsy-technique using the histochemical demonstration of ATPase and succinate dehydrogenase fast twitch fibre atrophy can be correlated with increasing age and a moderate impairment but still ambulatory condition. Fast twitch and slow twitch fibres together show atrophy in those cases which are severely impaired and nearly immobilized. An isolated atrophy of slow twitch fibres was found in three patients suffering from frequent sudden short-lasting pain in the knee joint, although this condition may not be alone the cause for slow twitch fibre atrophy. The mechanisms leading to a selective atrophy of muscle fibre types are not fully understood. Nevertheless, a more clear understanding of the nature of skeletal muscle atrophy brought about by joint affections should be of benefit for a better concept of physiotherapeutical approaches: In fast twitch fibre atrophy maximal short lasting contractions followed by rather long periods of recovery should be performed (30). Slow twitch fibre atrophy should be influenced beneficially by chronic submaximal activity (46), whereas both fibre type atrophy should be treated by a combination of isometric techniques and chronic submaximal activities.


[Globulinopathy and hyperuricemia].

Investigation of the locomotor system of 20 patients is reported. One patient with arthrosis of the hip joint and concomitant osteonecroses had a myeloma. In 5 RA patients the manifestations of secondary amyloidosis are described. Among the patients with monoclonal gamma globulinemia two had polyarthritis and RA could not be excluded in one of them, one had arthritis of the ankle and foot joints, and one had a vasculitis characteristic of polyarteritis nodosa. Among those with polyclonal immunoglobulinemia one had RA, two had arthrosis of knees and hips, and two had ankylosing spondylitis. Furthermore four patients with alpha2-hyperglobulinemia which is important in evaluation of the alpha2-globulin peak in amyloidosis, are described. Three patients had cryoglobulinemia. In 10 patients hyperuricemia was found repeatedly (by the uricase method). Consequently in these diseases it is necessary to search clinically for crystal induced synovitides and arthropathies. The classification of globulinopathies and the method of their determination is indicated and particular investigations are recommended for such diseases, where the activity of the joint process does not correlate with laboratory findings.


[Urine cytology studies in bladder tumors].

The stained urine smears of 151 patients were cytologically examined. The correspondence between histological and cytological diagnosis of the urine was 72.3% in 101 tumours of the urinary bladder. 5 of 11 patients with histologically benign papillomas of the urinary bladder showed malignant cells in the sediment. After four weeks 3 of them could histologically be ascertained as papillary carcinomas. Cytological investigations of the urine are suited for the early recognition of tumours of the urinary bladder, but also for the period between operation and radiotherapy as well as in the dispensary care.


[Priapism--clinical aspects and treatment].

After references to definition, anatomic and physiologic foundations the author deals with the pathology of priapism. A clinical systematization of the diseases occurring together with priapism according to causal points of view is no more worth being advocated. It is completely unclarified to which extent the disease actually participates in priapism. After the description of the possibilities of a conservative medical treatment to the heparin and fibrinolysis therapy it is referred to the importance of the continuous drainage of the corpora cavernosa after Grayhack and Quackels. It is reported on two patients operated according to Grayhack. Results of surgical therapy reported in publications of the last time refer to an essential improvement of the prognosis of priapism.


[Mode of action of D-penicillamine on collagen metabolism].

The effect of D-penicillamine, given for 14 days in doses of 100 mg/kg and 225 mg/kg, upon the collagen metabolism of skin and bone tissues was studied in rats. The smaller dosage of D-penicillamine did not effect the collagen synthesis in skin or bone. When the higher dosage was used, however, an increase of collagen synthesis was observed in bone marrow. Simultaneously there was a higher rate of bone collagen degradation.


[Roentgenologic determination of degenerative joint diseases in a new animal experiment arthrosis model].

Our previous experiments have shown that intraarticular injections of sodium iodoacetate or phenylbutazone into the knee joint of animals (hens) induce degeneration of the articular tissues. This method proved to be a useful model for experimental osteoarthrosis. After autopsy degenerative processes in the joint can be evaluated by macroscopical, histological and biochemical techniques, and show good correlations with osteoarthrosis in humans. To study the onset and progress of experimentally induced osteoarthrosis in living animals we developed a new X-ray method using special mammography-film (Kodak Definix Medical). By this technique also changes of the joint space can be measured quantitatively. Comparison between the degenerative lesions of cartilage as seen macroscopically during autopsy and the data obtained from the living animal by X-ray techniques show excellent correlations. By using X-ray mammography film in our studies of experimental model it is possible to observe the pathological alterations of the knee joint of the living animals and to investigate the effect of pharmacologically active compounds for the treatment of osteoarthrosis.


[Use of Sulprim in ambulatory urology--experiences and results].

104 patients, according to the character of the diseases subdivided into 2 groups, were treated with Sulprim. Secondary infections of the efferent urinary passage are particularly taken into consideration. Apart from the antibiogram also clinical state, findings of the sediment and references to literature are regarded as criteria for the use of medicaments. The therapeutic success is judged considering the asepsis, the findings of the sediment and the improvement of the subjective condition. Several selected groups of disease show that the application of the medicament must be aimed and must be done critically. Side effects are described.


[Kidney circulation in chronic parenchyma diseases and in kidney insufficiency].

In 38 patients with glomerulo- (20 patients) and pyelonephritis the renal blood flow was measured with radioxenon. Despite normal creatinine clearance in chronic diseases the blood flow is already reduced. The correlation to the creatinine clearance is loose. In glomerulonephritis above all a reduction of the blood flow of the cortex appears, in pyelonephritis the participation of the cortex is reduced. Correlations of blood circulation and blood pressure are to be found in no stage of the disease. Concerning the renal insufficienzy there does not exist a disease-specific pattern of blood flow. In renal insufficiency the diuresis is independent of blood flow.


[Highly effective short-term dialysis with two parallel-connected capillary dialysators type C-DAK4. 2. Clinical parameter, subjective symptoms and performance control of patients compared to conventional dialyses].

8 male patients with chronic dialysis (5 of them with binephrectomy) were thrice a week dialysed in 2 groups alternately 2 months conventionally for 6 hours with a capillary dialysator C-DAK mod. 4 and 2 months for 3 hours with 2 parallel connected C-DAK 4. In a constant square metre-hour-product (23.4 m2h/week), homogeneous criteria of treatment and, as a rule, four times repeated use of the C-DAK 4 clinical parameters, subjective complaints and efficiency of the same patients were compared.


[Comparison of repeated use of capillary dialysators model C-DAK 4 and C-DAK 5].

18 dialysators C-DAK 5 and 4 each were again used in the same patients with chronic dialysis under the same conditions of dialysis and regeneration (short-acting dialyses of more than 3.5 h with 1 C-DAK 5 or 2 parallel acting C-DAK 4, respectively). A volume of the blood compartment of more than 70% of the initial value was regarded as criterion for the further usability. Thus, model 5 could be used on an average 3.7 times, model 4, however, 6.3 times (p less than 0.0001). Already at the end of the 3rd use in model 5 the capillary volume decreased below 63%, in model 4 only below 88%. The volumetrically determined ultrafiltration showed a decrease parallel to the volume of the blood compartment -- with the same differences between the two models of the C-DAK. In model 15 the effectiveness concerning the elimination of creatinine and urea clearly decreased after the 2nd use, whereas it did not reveal a change also in an application four times repeated. The larger coagulation processes in a more than once repeated use of the C-DAK 5 -- with adequate losses of blood -- are explained with the large length of the capillary and the other distribution of blood with regard to the cross section of the capillary. Summarizing we can say that in chronic routine dialyses -- without testing the individual exemplars -- model 5 of the C-DAK can be used twice, model 4, however, four times.


[Effect of nutrition on composition of calculi in the animal experiment. III. Cation exchangers, anthraquinones, diphosphates, methylene blue].

Medicamenty and compounds used in the metaphylaxis of urinary calculi were tested on an animal model for objectifying the effect. Kation changers, anthrachinones, diphosphates, and methylene blue were used.


[Coronary atherosclerosis, coronary thrombosis and myocardial infarction in autopsy cases. VII. Communication: Complications in myocardial infarctions (author's transl)].

2393 cases of myocardial infarctions autopsied during the period from 1.1. 1951 until 31. 12. 1969 in our Institute were scored for aneurysm and rupture of the cardiac wall as well as for partietal thrombosis and endocardial fibrosis, and analysed concerning frequency and distribution of sex. Aneurysm of the ventricle walls was present in 23.94 per cent of myocardial infarctions. Most of the aneurysms were found in the posterior wall of the left ventricle. Callous infarctions showed more aneurysms than fresh myocardial lesions. A rupture was present in 31.82 per cent of acute aneurysms and in 4.53 per cent of old aneurysms. Parietal thromboses we found in 13.92 per cent of all infarctions. In 14.21 per cent of all myocardial infarctions endocardial fibroses were present. Parietal thromboses and endocardial fibroses were significantly most frequent in infarctions of the right ventricle.


[Biopsy findings of liver parenchyma in presence of metastasis (author's transl)].

In 107 liver biopsies with metastatic tumor infiltration morphological changes of liver tissue are demonstrated. Observance of these lesions yields particular directions especially for pathologists, with regard to handling and interpretation of biopsy material. The knowledge of these changes is of interest because unperceived metastatic lesions of the liver are relatively common.


[Primary fibrosarcoma of the right atrium (author's transl)].

A case of a primary fibrosarcoma of the heart from a 32 year old man is reported. The site of origin of the tumor was the right atrium, and death was caused by cardiac tamponade. Metastatic foci were not present.


[Ultrastructural results in liver biopsies of patients with hyperlipoproteinaemia (author's transl)].

Electron microscopic investigations were performed on liver biopsies of 24 patients with endogenous hyperlipoproteinaemia (HLP) of the types IIa--V, classified by lipid- and lipoprotein-fractions, as to Frederickson et al. (4), as well as on biopsy specimens of 6 control persons without histological alterations, and on 7 biopsies with staetosis hepatis. In type IIa we found a typical proliferation of the smooth endoplasmic reticulum and a slight alteration of the mitochondria. Types IIb--V are characterized by increasing fatty degeneration of the liver cells as well as by quantitative and qualitative alteration of the endoplasmic reticulum and the Golgi areas. Giant mitochondria, organelles with atypical membrane structures and paracrystalline matrix inclusions occur more frequently, especially in patients with additional diabetes mellitus. There are scarcely differences between steatosis hepatis without HLP and steatosis with combined HLP, resp., except the more distinct alterations of mitochondria, endoplasmic reticulum, and Golgi areas in the latter. The morphological changes are especially restricted to those liver cell structures, involved in the metabolic disregulation.


[Endocarditis parietalis fibroblastica (Löffler) combined with osteomyelofibrosis (author's transl)].

An autopsy case with coincidence of endocarditis parietalis fibroplastica (Löffler) and osteomyelefibrosis is described. The osteomyelofibrosis in this case is considered as a complication of Löffler's endocarditis and therefore as a secondary event. The case demonstrates a possible development of the osteomyelofibrosis by allergo-toxic damage of bone marrow or in consequence of arteriitic circulation disturbances. Our findings speak against the exclusively tumourous or leucotic nature of this process.


[Pathologc findings in megakaryocytic myelosis (author's transl)].

From 1969--1975 patients with predominantly megakaryocytic myelosis were observed. Diagnosis was made up after histologic examination of iliac crest bone biopsy specimens embedded in methacrylate. From 6 patients rebiopsies and from further eleven ones the removed spleens were available. Autopsy was performed in 12 cases. In our material predominantly megakaryocytic myelosis was especially observed in male patients of advanced ages. The course of the disease was rarely acute, most often chronic and associated with the development of an extreme splenomegaly. Transition into osteomyelofibrosis or osteomyelosclerosis was frequent, the latter condition tended to develop a so-called myelosarcoma. The cause of death often was a generalized hemorrhagic diathesis with gastrointestinal hemorrhage or an fatal infection.


[Pathophysiology after resections of the lung (author's transl)].

Measures of preventing postoperative lung atelectasis are discussed. The importance of total pre-operative smoking prohibition is stressed. Formula for pre-operative prediction of postoperative ventilation and pulmonary artery pressure are presented. Lung distention is not to be compared to lung emphysema. Lung distention may even improve ventilation as well as circulation of the remaining lung tissue.


[Haemodynamic and respiratory changes after lung resection (author's transl)].

After lobectomy a slight increase of pulmonary arterial pressure can already be observed in the state of rest. The resistance of the pulmonary vessels reveals a marked dependance on the date of operation, it increases moderately on strain, but more significantly in the state of rest. At the same time cardiac output is decreased due to the exhaustion of the myocard after straining. Cardiac insufficiency developing postoperatively is due to the reduction of pulmonary hypertension. The reduction of VC and a slight increase of resistance do not cause the arterial PO2 pressure to be lowered under conditions of strain or rest.


[Cardiopulmonary insufficiency after lungresections (author's transl)].

Among 1248 patients with lung resections (1964 to 1974) 76 developed cardiorespiratory failure and had to be managed by PEEP respirator care. Only 18 (23%) survived. These cases were thoroughly analyzed, and a formula was derived. By using ventilatory function, blood gas values, age, ECG it permits to evaluate the probability of cardiorespiratory failure in case of pulmectomy or lobectomy respectively. This evaluation was found to be correct in 99% of the cases.


[Anaestesiologic problems after lung surgery (author's transl)].

Important complications after lung surgery are alveolar hypoventilation and post-operative haemorrhage. Measures to prevent the first are intermittent PEEP-aerosol respiration and thorough bronchial toilet. The diagnosis and management of postoperative haemorrhage are outlined. Cardiorepiratory failures may be prevented in most cases.


[Physiotherapy after lung resection (author's transl)].

Physiotherapy for lung resection begins well before the operation and should serve to improve the respiratory function and to prevent complications. The whole training programme should be carried out in an automated manner, this is especially important for the time immediately after the operation. Postoperative physiotherapy aimsat thorough cleaning of the bronchi, adaption of the ventilation, good peripheral circulation and helps to diminish would pain. In a later period physiotherapy should help to rehabilitate the patient's external respiratory function to train the respiratory stereotype and to improve cardiopulmonary effiency.


[Indication of tracheotomy after lung resection (author's transl)].

Today tracheotomy is not often performed after resction of the lung. This is caused by better postoperative care and also by the well known complications following tracheostomy. Indications for tracheostomy are as follows: 1. The necessity for long term ventilation.--2. The necessity to perform bronchus-toilet in short intervals in patients unable to cough.--3. In patients with respiratory insufficiency after pneumonia or other reasons.


[Postoperative treatment after lung resection in old age (author's transl)].

177 lung cancer patients over 70 years old treated during the period from 1961 to 1975 were analyzed and evaluated for surgical resection. 109 cases were lobectomies, 39 nontypical resections and 29 were pneumonectomies. The postoperative mortality was 6.2%. Our concept of surgical treatment for patients with lung cancer over 70 years of age is as follows: Avoid pneumonectomy, prefer lobectomy or non-typical resection. The five years survival rate among 77 elderly patients amounted to 35%.


[Postoperative abdominal complications after thoracic surgery (author's transl)].

Between 1964 to 1974 2940 patients underwent chest operations. 15 cases with abdominal complications among them are analyzed. 10 patients had bleeding gastric or duodenal ulcers with a high mortality rate. Postoperative gastric distention was one of the most important causes. A gastric tube should be introduced whenever such a complication is likely to occur.


[Prevention of complications after lung resection (author's transl)].

Experiences with prophylaxis of postoperative complications in 1179 lung resections (1960 to 1974) are discussed. Preoperatively exercises in breathing, inhalations with mucolytic and proteolytic drugs, in some cases therapeutic bronchosopy are used. An atraumatic thoracotomy with minimal cutting of muscles is preferred. In the postoperative course early mobilization of the patients and substitution of large amounts of fluid are used. The number of postoperative complications was reduced from 15,2% (1960 to 1966) to 2,6% (1971 to 1974). Artificial respiration or postoperative therapeutic bronchoscopy were not necessary during the last 6 years.


[Problems of postoperative respiratory insufficiency (author's transl)].

Postoperatively patients are particularly endangered by the development of respiratory failure. All parts of the gas-exchange between the atmospharic air and the metabolizing cell are to be considered as a unit. The increase of dead-volume-respiration and intrapulmonary shunting is of great importance for the development of arterial hypoxaemia. Early diagnosis of impaired gas-exchange and an adequate treatment are emphasized. CPAP and intermittent mandatory ventilation are therapeutic methods, well approved in clinical practice.


[Postoperative complications following pulmonary surgery (author's transl)].

Postoperative complications occurring in a series of 177 patients undergoing lung surgery are discussed in detail according to their pathogenesis. In all, 68 serious complications were observed in 54 patients (30.5 per cent). 9 patients died as a result of these complications (letality rate of 5.1 per cent).


[Bronchial insufficiency after lung resection (author's transl)].

A fistula of the bronchus developed in 48 (3.3%) of 1466 patients with lung resection for non-tuberculous disease operated between 1948 and 1974. Only 1 (0.55%) of the 181 patients operated between 1972 and 1974 developed a fistula. In this last series we used atraumatic needles only and handled the bronchial stump with utmost care. The stumps were always covered with good vascularized tissue. Antibiotics were instilled in the pleural cavity.


[Bleeding complications after lung surgery (author's transl)].

Bleeding complications after lung resection are mostly due to surgical causes, seldom to coagulation disorders. Own experiences in 8 cases (= 0,59% of all lung operations) are reported. The early rethoracotomy prevents additional coagulation disorders which may arise following large infusions of plasmaexpanders and blood. An analytical program for quick detection of coagulation disorders is given. Treatment of consumption coagulopathy and hyperfibrinolysis is discussed.


[Early rethoracotomy after lung resection (author's transl)].

Certain complications after lung resection require rethoracotomy. In such cases it should be done soon to prevent more damage that may be difficult to manage later. The patient tolerates the operation better and recovers more rapidly. Often it is difficult to recognize complications, so it is important to supervise the patient carefully and to interpret all observations correctly. The indication for rethoracotomy among our patients is discussed.


[Atrial myxomas of the heart; diagnosis, therapy and morphology (author's transl)].

Atrial myxomas imitate several other clinical entities. The intravital diagnosis may still appear as a surprise. Myxomas can present themselves in 2 ways: by obstruction of intracardiac blood flow and by embolization. Early diagnosis should be established by utilizing angiography. Immediate resection under total cardiopulmonary bypass should be performed before catastrophic complications occur.


[Further electron microscopy studies on early development of endocervical epithelium in human fetuses].

Electron microscopical investigations of the cylindrical epithelium of the human cervix uteri demonstrate in the cytoplasm of the secretory cells tubular precoursers of secretory granules which become granular during the differentiation process of the epithelium. In the seventh fetal month mucous granules occasionally show a confluence. In the eights fetal month, typical cuboidal reserve cells are detected near the basis of the epithelium between the secretory cells and the ciliar cells. Under maximal increase of the rough endoplasmatical reticulum the production of secretory granules proceeds. By mitosis a functional adaptation of the epithelium to the growth of the cervical canal is achieved. The differentiation of the endocervical epithelium is nearly finished in the middle of the ninth month. At this time, merocrine extrusion processes become evident.


[Cardiorespirography in normal and hypoxic children].

10 physiological and 16 pathological--mostly premature--newborn were investigated by means of cardiorespirography. For heart frequency records of physiological newborn the undulatory zone (by disturbance or waking) and the narrowed undulatory zone (by sleeping) were typical, while in pathological newborn the silent zone predominated. In physiological newborn the respiratory curves type I and type III were typical; in the pathological ones types II, IV und V were most frequent. No correlation was found between pathologocial findings on cardiorespirograms and the clinical diagnosis. Nevertheless, oscilatory types of curves correlate well with pH values of blood.


[Multi-channel-monitor for registration of fetal heart sounds (WMTSP-2)].

A multicanal-monitor for the registration of fetal heart beats (WMTSP-2) is described. The method based on the Doppler-principal. The advantages and disadvantages are discussed.


[Postnatal monitoring of the newborn infant using cardiotachography. 1. Normal cardiotachogram in the newborn].

Cardiotachograms in a group of 30 vigorous newborns have permitted the study of the typical signs of the regulatory mechanism of neonatal circulation during the first minutes of life. Immediately after birth neonatal heart rate rise to a peak heart rate of 177 bpm at the age of two minutes. Thereupon neonatal heart rate falls gradually and reaches a stabil level in the 13. minute after delivery. In the phase of gradually fall in neonatal heart rate many brief episodes of cardiac deceleration ("spikes") were observed.


[Prevention of respiratory distress syndrome prior to delivery using steroids].

Dexamethason in a total dose of 15 mg was given in 125 cases of premature labour 48 hours before delivery to prevent the development of respiration distress syndrome. Clinically, the incidence of RDS was 14,5% (18 cases) in the treated group, while in the control group it was 27,7% (32 cases out of 119). Owing to RDS two prematures died in the treated group, and 14 in the control one. Steroid prophylaxis was applied prenatally with 69 pregnant women at term who were predisposed to give birth to infants developing RDS (retardation, diabetes mellitus, elective section caesareas, etc.). Five neonates developed RDS and one died of hyaline membrane disease. The authors studied the effect of steroids on carbohydrate metabolism and total oestrogen excretion in the urine. From profile examinations of blood sugar it was concluded that no pathological alterations take place in maternal carbohydrate metabolism due to intravenous or intermittent prolonged administration of Dexamethason. After one single large dose (15 mg) of Dexamethason a reduction of 30-40% was noted in total oestrogen excretion. Return to the initial value was noted on the 11th-12th day. No appreciable changes were observed with prolonged intermittently given Dexamethason. On the basis of their observations the authors consider that steroid therapy applied during labour is efficient in preventing neonatal RDS.


[Considerations regarding two cases of macromastia (author's transl)].

Two cases of macromastia have been shown; one which appeared during puberty, the other during menopause. Histopathological examination has demonstrated for the both cases a cystic degeneracy of the glandular tissue with a hyperplazia and hypertrophy of the conjunctive tissue. The pathogeny of macromastia is being discussed and it is demonstrated both the role of hypophysis hormones (prolactine and growth hormone) and of ovarian hormones (estrogens). The treatment was surgical for the both cases.


[Increasing the effectiveness degree of ovulation induction using clomiphene in combination with HCG in cases of functional sterility].

The authors gave functionally infertile women a combined treatment, of Clomiphen + HCG whom 19 had already been treated with Clomiphenor Epimestrol without success. If the number of ovulations considerably increase in consequence of Clomiphen + HCG treatment or the periods of ovulations, aphysiological periods, are of physiological duration the treatment may be successful. In these cases the effectiveness of Clomiphene induction can be intensified with HCG administration


[Investigations of the human isolated nonpregnant uterus contractility in the course of the menstrual cycle by measuring intramyometrial pressure (author's transl)].

In this work, the behaviour of the intramyometrial pressure, registered in the wall of the myometrium of the human isolated nonpregnant uterus, has been followed up. Intramyometrial pressure measurements were performed in 33 uteri. Simultaneously the intravascular pressure was monitored. The values of the intramyometrial pressure correspond with the intrauterine pressure, and the pressure  in the uterine cavity, measured with the use of inserted balloon, was a resultant of the intrauterine pressure measured in the corpus uteri and isthmus at the same time. It has been found that in the course of the sexual cycle, nonpregnant human uterus shows irregular contractile activity. The contractile activity of the nonpregnant human uterus is characterized by the lack of coordination of contractions among particular uterine regions registered simultaneously. During the course of the menstrual cycle the isthmus region  was dominating and revealed a pacemaker properties and during menstrual bleeding corpus uteri dominated. The results were discussed and the close relationship between uterine contractility and intravascular pressure was underlined.


[Cytological finding in the pre- and early stages of cervix carcinoma--a contribution to the evaluation of Papanicolau III].

Cytologic findings and the histologic diagnosis are compared in 326 cervical cones. We have found following ratio of the groups Papanicolaou (Pap) III: Pap IV--in dysplasia 1: 1: 1, in "more dysplasia than carcinoma in situ (CIS)" 1:2:2. The Pap IV dominates in "pure" CIS and in cones with "more CIS than dysplasia". We take out of the Pap III ("with cytologic control") cases named "Pap III with necessity for histologic diagnosis". We have found in this subgroup of Pap III prestages or early stages of cervical carcinoma.


[Differential diagnosis of cystic vaginal tumors].

A rare case of uterus duplex, atresia of the right vagina and a fistulisation of a praevesical and parametral absessus is reported. The importance of special gynaecological and urological investigations is stressed, especially if the cystic formation is located in the upper part of the vagina.


[Quantitative changes of glyco- and mucoproteins in the serum of patients with carcinoma of the uterus during treatment].

The mutations of serum glycoproteid and mucoproteid levels were examined in 40 patients with uterine cancer before, during and 4 years after treatment. In all the patients having become symptom-free the glycoproteid and mucoproteid concentration, that had shown an initial increase before, returned to normal in the course of successful treatment. There could be found no connection between the tumor extension and the otherwise increased serum values in carcinoma of cervix and uterus of stage I. and II.


[Determination of urinary estrogen in glycosuria].

The total urinary estrogen values of women with glucosuria were studied by 5 different methods in 287 samples. The spectrophotometry values obtained by Ittrich's reaction have been influenced by urinary glucose concentrations. An increased glucose content appeared to be connected with a decrease of the hormone values if the hydrolysis of conjugates was performed by mineral acids. The most effective method was enzymatic hydrolysis used also for the determination of the acid labile fractions. The determination of total estrogen excretion is necessary for evaluating intrauterine fetal well-being in diabetic mothers.


[Beta-glucuronidase activity in human ovarian tissue during the life- and cycle-phases of the woman].

The behaviour of the beta-glucuronidase activity during the life phases and the phase of the cycle of a woman has been studied in 51 human ovaries after the Dohrmann method. The study clearly indicates a dependency on age, that is demonstrated by a rise in beta-glucuronidase activity from 536 microgram Ph/h/g ovarial tissue during full functioning to 705 microgram Ph/h/g ovarial tissue in the premenopause and by dropping to 529 microgram Ph/h/g ovarial tissue in the menopause and the senium. The premenopause values are significantly higher compared to that of the other two functional phases. The activity of the beta-glucuronidase is significantly higher in the secretory phase than in the proliferation phase. Existing relations between the beta-glucuronidase of the ovary and the gonadotropic hormones of the hypophysis and the oestrogen metabolism are discussed.


[Incarceration of the ovary as an unusual cause of chronic adnexal process].

Report on a rare cause of a pelvic mass. This resulted from an early stage of incarceration of one of the ovaries in a deep-edged fossa below the bifurcation of the common iliac artery and the ureter (fossa ovarica). The complaints of the patient had been intensified by a major of the uterine and ovarian veins on either sides.


[Dynamic tests of the placental efficiency (author's transl)].

The paper presents a cycle of clinical investigations concerning an early detection of placental insufficiency states. It has been found that in cases of placental changes of a decreased function type, the transport of atropine through the placenta becomes difficult or inhibited, which is manifested by a decrease or lack of a reaction from the fetal side. In cases of the positive test, the fetus responds with tachycardia following atropine administration, which testifies to the normal atropine transport from mother to fetus and to the normal placental function. It has been pointed out that owing to its simple principle, atropine test should find a wide application in obstetric clinic in detecting an early placental insufficiency.