[Immunological reactions of skin melanoma patients to nonspecific and adaptive immunotherapy].

Patients with malignant skin melanoma were given different kinds of immunotherapy; nonspecific immunotherapy with BCG vaccine, adaptive immunotherapy with methotrexate or phytohemagglutinin activated autolymphocytes, and also a combination of polychemotherapy with BCG. The state of cell immunity was determined prior to, during and at the end of the therapy, in accordance with the courses. As a result of the conducted therapy an increased level of cell immunity was observed, that usually corresponded to clinical development of the disease. At the same time, the increase in immune response indices due to continuous administration of BCG vaccine is not related with the clinical course, while the persistent anergy or reduced level of cell immunity during this kind of therapy is a poor prognostic sign.


[Phenformin elimination of the immunodepression caused by 1,2-dimethylhydrazine in rats].

Treatment of rats with 1,2-dimethylhydrazine (SDMH) with the doze of 21 mg/kg per body weight once a week during four weeks caused the decrease of biogenic amine level, particularly, of dopamine in the hypothalamus, the decrease of glucose tolerance, the increase of the blood level of insulin and triglycerides. According to the previously achieved data SDMH causes the elevation of the hypothalamic threshold of sensitivity to the inhibitory action of estrogens. At the same time SDMH provides considerable suppression of lymphocyte blastogenic response to phytohemagglutinin and lipopolisaccharide, the decrease of the level of antibody produced against sheep erythrocytes, and the decrease of phagocytic activity of macrophages. Thus SDMH provides the syndrome of intensified aging. Recently our laboratory achieved the data, that antidiabetic drug-phenformin-improves cell-mediated immunity indices and the activity of phagocytosis in middle-aged subjects, as well as in patients with atherosclerosis and cancer (Vopr. Oncol., 1976, N 2, p. 13). On the basis of these findings phenformin (2 mg/day per os) was administered in rats in combination with SDMH. This resulted in restoration of all the abovementioned immunologic indices. It may be suggested that SDMH causes metabolic immunodepression, similar to the immunodepression, inherent to normal aging, pregnancy, stress and specific age-associated pathology--diseases of compensation (Vopr. Oncol., 1976, N 8, p. 3). If immunodepression is one of the components of cancerogenesis, then the elimination of metabolic immunodepression, which arises in course of normal aging or under the influence of cehmical cancerogens, can provide an anticancerogenic prophylactic effect.


[Stomach adenocarcinoma induction in rats by the combined administration of N-methyl-N-nitroso-N'-nitroguanidine precursors].

N-methyl-N'-nitroguanidine and sodium nitrite were administered as drinking water to non-inbred male rats at the level of Img/ml for over two years. Gastric adenocarcinomas were produced in 43.7% of rats surviving for 15.5 months when the first tumor was noticed. Gastric mucous membrane of other rats had morphological changes analogous to those induced by N-methyl-N-nitoroso-N'-nitroguanidine (MNNG). The results obtained indicate endogenous synthesis of MNNG from precursors in the stomach of rats.


[Immunostimulation of the growth of a syngeneic sarcoma primarily induced in mice by simian adenovirus SA7(C8)].

Transplantation of splenic cells from CBA mice bearing primary sarcoma SA7(C8) together with autologous sarcoma cells (in the ratio 1 : 1 and 10 : 1) into syngeneic recipients, irradiated with 600 rad, resulted in a marked decrease of the latent period of tumor development. Syngeneic splenocytes of normal mice would enhance the tumor growth with the ratio 10 : 1. Preliminary treatment of tumor-bearing and normal mice with hydrocortisone in the dosage of 6 mg per 100 g of weight fails to reduce the capacity of splenic cells to induce immunostimulation of tumor growth.


[Effect of BCG on the growth of Krebs-2 carcinoma].

BCG vaccine inhibits the growth of intramuscular transplants of Krebs-2 carcinoma, when given in mixture with the tumor cells, and stimulates it in contralateral administration. When BCG and the tumor cells are injected separately in the region, drained by one and the same lymph node, no antitumor effect of the vaccine is observed. It is suggested that BCG effect on experimental tumor growth is mainly based not on the immunological mechanisms, but is the result of redistribution of cells participating in nonspecific antitumor resistance.


[Tumor angiogenesis factor and its possible utilization].

A brief survey of the literature data on tumor angiogenic factor stimulating intratumor growth of new vessels is given. Under consideration is the possibility to use inhibitors of the factor, in particular antibodies against it, to suppress tumor growth. Also, it is suggested to use tumor angiogenic factor for revascularization of infarction and ischemic tissues, especially in myocardial ischemia.


[Assessment of the danger of bronchological studies under polyclinic conditions].

In 176 ambulatory patients with cancer and inflammatory diseases of the lung the initial parameters of acid-base balance and blood gases were studied. Metabolic acidosis was found in 29.5%, alkalosis--in 54.5%, the values of acid-base balance and blood gases were normal in 15.9% of patients. The degree of bronchoscopy risk under narcosis in ambulatory patients is directly proportional to the kind, character and intensity of disorders in oxidation-reduction processes. Deep, hardly compensated or decompensated disorders in acid-base balance and gas metabolism in pH values higher than 7.54 and lower the 7.26, BE (buffer base shift)--higher than 4.0 meq/1 and lower than 6.0 meq/l, and pO2 lower than 65 mm Hg are the criteria of high risk of bronchological investigation under anesthesia in ambulatory oncological patients.


[Effect of the fatty component of the food ration on the ionic permeability of bilaminar phosphatidylcholine membranes].

Five molecular types of phosphatidyl-cholines, viz. that of the chicken egg and of four others, isolated from the liver of rats fed on rations with qualitatively different fats, were used in forming double-layer membranes. A gas-chromatographic analysis established distinctive differences in the fatty acids composition of phosphatidylcholines obtained from the rat liver. The degree of their oxidation was controlled by determining the level of dienic conjugates. No relationship between the permeability for inorganic ions and the composition of the phosphatidyl-cholines fatty acids could be established. It appears that in phosphatidyl-choline membranes at the basis of ionic permeability there lies some other mechanism than in the case of uncharged low-molecular substances.


[Effect of antibiotics on cholesterol metabolism under conditions of a varying protein content in the diet].

In tests on rats subject to study were the effects of native tetracycline, thermally treated and used in doses of 100 mg/kg, of tetracycline in a dose of 20 mg/kg and of penicillin on the secretion of bile and generation of free and conjugated bile acids and cholesterol, as well as upon the cholesterol content in the blood and liver tissues with complete and protein-deficient rations. With complete ration tetracycline in its native and thermally treated forms provoked a fall in the cholesterol content in the bile and hepatic tissue, a rise in percentage of free bile acids and a decline of the tauroconjugates percentage. With a protein-low ration tetracycline called for an increased concentration of the bile cholesterol with simultaneously increasing concentration of cholic acid.


[Effect of meat prepared by SHF energy and infrared rays on the secretory function of the stomach].

Tests set up on dogs with isolated Pavlov's pouch showed that meat treated with UHF, IR, UHF+UR-energy causes a more abundant gastric secretion than does cooked meat, and when processed with the UR-radiation the ensuing secretion is even superior to that in response to fried meat. In dogs with an isolated Heidenhein's pouch the secretion in response to meat processed with IR and IR and SHF+IR-energy is more intensive than in the case of cooked meat. There was no such difference in the case of the SHF-treated meat. Under the effect of the SHF, IR and SHF+IR-energy processed meat it is chiefly the I phase of the gastric secretion that gains in intensity with a tendency towards an increase in the II phase. The total acidity and the free HCl content in the gastric juice secreted in response to this meat did not undergo any substantial changes. The secretion of total proteinases with the gastric juice per unit time (1 hour) increases over that in the case of cooked meat.


[Method of calculating endogenous protein losses by the human body].

Investigations conducted with participation of 30 examinees in whom the state of proteinic deficiency or protein fasting was provoked by different protein content in their diets a general regularity in the nature of passage of total nitrogen with urine, faces and summarily through other routes was educed and described mathematically. The endogenous excretion of total nitrogen with urine in young males was found to comprise 2.5 +/- 0.08, with feces--0.75 +/- 0.03 and summarily via other routes--0.59 +/- 0.36 g per day. The mentioned results correlated closely enough with corresponding figures in pertinent literature sources.


[Disc electrophoretic characteristics of the serum proteins of "Vitalact"-type "humanized" milk].

Disc-electrophoreograms in the polyacrylamide gel of the cow milk serumal proteins show 11 peaks belonging to immune globulins, the poteose-peptone fraction, the serum-globulin, alpha-lactoalbumin, beta-lactoglobulin and to glucoproteids. Under a high-temperature treatment of humanized milk (105 degrees----10 minutes) a significant denaturation of the serumal proteins, re-distribution and a fall in the amount of proteinic fractions were noted. Beta-lactoglobulins and immune globulins are most sensitive. With disc-eletrophoresis in the polyacrylamide gel of the human milk serumal proteins the densitograms distinctly demonstrate the presence of peaks that correspond to immunoglobulins, proteose-peptones, serum-albumins, alpha-lacto-albumins in the absence of the beta-lactoglobulins fraction. The cited data allow the method of disc-electrophoresis in the polyacrylamide gel to be employed for improving the fractional composition of the serumal proteins in the nutrients intended for nurslings and infants of the first year of life.


[Amino acid metabolism in liver tissue].

Following determination by the method of ion-exchange chromatography of free amino acids in the blood drawn from the portal and liver veins and the abdominal aorta 30 minutes after introduction of a casein suspension to rats it was found that only 50 per cent of amino acids with ramified chain are retained in the liver. Most of the other amino acids, however, become metabolized largely in the liver and it is only their insignificant part that goes into the general circulation. These data may be of use in considering problems related to the peculiarities of metabolism of amino acids with ramified chain.


[Nutritional regimen of students].

Data derived from study into the dietary pattern of 354 students at the Mogilev Technological Institute are presented. From pertinent questioning it follows that not a small number of students fail to observe the standard nutritional regimen, this being the case more often among students living in hotels or hiring private flats than among those who live with their families. The results of these investigations helped introduce a number of proposals on rationalization of the students dietary.


[Use of the specialized protein product, SP-11, in the nutrition of highly trained sportsmen in heavy athletics].

In research work involving participation of highly trained sportsmen-heavy athletes subject to studies was the effect of the proteinic product CII-11, developed at the Nutrition Institute of the AMS of the USSR, on the body mass gain, as well as on individual aspects, of the protein and catecholamines metabolism. Under the effect of the CII-11 intake for 7 days in an amount of 100.0 g per day all the sportsmen under examination demonstrated a gain in the body mass, growing diurnal passage of total nitrogen and urea with urine and reduced excretion of amino nitrogen. No changes in the ammonia and creatinine content in the diurnal urine occurred under the effect of the CII-11 product. The ingestion of the latter promoted activation of the mediator and hormonal members of the sympatico-adrenal system. The results of the CII-11 application in training rallies with participation of sportsmen-heavy athletes and members of the combined USSR team also bear witness to the favourable action of the product on the study aspects of the protein and biogenic amines metabolism, the body mass gains and also on the results of sporting events.


[Biorhythm bases for structuring the human nutritional regimen].

Individual rhythm of physiological function and nutritional regimen were investigated in 194 persons and in 112 of them concordance between the time-periods of emerging requirement for ingestion of food and its actual satisfaction was studied additionally. The rhythm of nutritional requirement is significantly different in representatives of the "morning" and "evening" groups, whereas the satisfaction of this requirement is conditioned by microsocial factors. This implies the need for framing nutritional patterns on the biorhythmological basis.


[Secretory and morphological state of the stomach in alimentary obesity patients kept on a low-calorie diet].

The authors studied gastric secretion in 117 persons with alimentary obesity of degree II and III along with the morphological picture of the gastric mucosa. The secretion was investigated by the fractional method, pH-metry and without tubage. In the majority of patients with alimentary obesity gastric secretion proved to be normal. In these patients a greater appetite was not associated with an intensified secretion. In all of the cases under examination the morphological picture revealed the presence of chronic gastritis.


[Characteristics of the motor function of the gallbladder in the dumping syndrome and their importance in establishing a therapeutic diet].

In 76 patients suffering from the dumping syndrome following gastric resection in connection with peptic ulcer the motor function of the gallbladder and gastric stump was studied. Investigations ascertained the existence of a direct relationship between the type of the gallbladder dyskinesia and evacuation periods from the gastric stump. The authors consider the hypermotor dyskinesia of the gallbladder combined with an accelerated evacuation from the stump to be an optimal combination after excision of the stomach. On the other hand, the hypomotor dyskinesia of the gallbladder with an accelerated emptying of the gastric stump was regarded as am explicit pathology demanding persistent curative measures. Principles of pathogenetic dietotherapy have been evolved.


[Detection of DNA in the composition of influenza virus].

When influenza virus multiplies in chick embryos, incorporation of 3H-thymidine into virus particles is observed. The radioactivity is localized in influenza virus nucleoprotein. The analysis of 3H-thymidine-containing structures in cesium chloride density gradient permits to qualify them as DNA. Isodensity centrifugation of in vitro 125I-labeled preparation of nucleic acid from influenza virus in cesium sulphate gradient also reveals DNA molecules, in addition to RNA. A high hybridization rate of influenza virus 125I-DNA with virion RNA has been demonstrated.


[Dynamics of antihemagglutinine (inhibitors and antibodies) to influenza virus in children with acute leukemia concurrently with influenza].

The study on the dynamics of some aspects of humoral immunity to influenza in children with acute leukosis in the presence of intercurrent influenza infection revealed two kinds of changes: a decline of a comparatively high initial level of antibody and inhibitors, and a rise in their titres when the initial level was lower. Both kinds of changes are characteristic both of the acute stage and the remission of acute leukosis. The chemotherapeutic treatment exerted no visible effect either on the level of the dynamics curve or on the pattern of serological shifts after influenza infection. These results suggest that in children with acute leukosis the response to influenza infection, being no different in nature from that in subjects not suffering from leukosis, is still poor quantitatively.


[Discovery of natural foci of Newcastle disease virus in the USSR].

In examination of colonial birds in the Volga delta in the Astrakhan region (188 bioassays from 229 birds) and in the Komandorskie Islands of the Kamchatka region (244 bioassays from 208 birds) in 1974, 15 strains of Newcastle disease virus (NDV) were isolated (8 strains from 7 birds and 7 strains from 12 birds, respectively). The strains were isolated from Egretta alba and Ardea cinerea, and Phalacracorax carbo in the Astrakhan region and from Lunda cirrhata and Uria aalge in the Komandorskie Islands. The isolates were obtained from tracheal and cloacal washings and from pools of viscera. These data are the first evidence of the existence of Newcastle disease virus foci in the USSR.


[Immunogenic activity of cultural antirabies vaccine inactivated by gamma-rays].

Experimental lyophilized tissue culture rabies vaccine inactivated with gamma-rays was prepared from the Vnukovo-32 strain and showed a sufficiently high immunogenic activity. Complete inactivation of the virus and the immunogenic potency of the vaccine depended upon the dose of irradiation and temperature during irradiation. The virus lost infectivity at 18 degrees C when irradiated with 2.6 X 10(6) r and at --70 degrees C with 4.55 X 10(6) r. However, the immunogenic potency of the vaccine inactivated at minus temperature without thawing was significantly higher.


Antituberculous therapy in pregnancy. Risks to the fetus.

A total of 1,939 reported births to mothers who received isoniazid ethambutol, rifampin and streptomycin alone or in combination, for all or part of their pregnancies, were surveyed to determine teratogenicity of these agents. There was no significant increase in birth defects with isoniazid, ethambutol and rifampin, in contrast to the use of streptomycin which was associated with mild auditory and vestibular defects. Guidelines for the treatment of active tuberculosis in pregnancy are therefore established.


Electrographic exercise stress testing and coronary arteriography. Correlation among 114 men with chest pain.

The electrocardiographic response to exercise stress testing (EST) was compared with coronary arteriographic findings in 114 men referred for evaluation of chest pain. The men were divided into two groups: group A (69 men) in whom the coronary arteriograms showed at least one major vessel with greater than 70 percent reduction in cross sectional area, and group B (45 men) in whom there was no evidence of coronary arterial narrowing. In both groups A and B the description of chest pain was judged to be at least consistent with the diagnosis of angina pectoris if not always representing classical angina pectoris. Only men with a positive finding to EST and those with a negative EST response after achieving at least 90 percent of predicted maximum heart rate were included in the calculations. Our results were strikingly similar to those obtained from an extensive review of the literature and showed the following: sensitivity, 80.4 percent; specificity, 88.6 percent; predictive value of a positive test result, 91.1 percent; predictive value of a negative test result, 75.6 percent, and efficiency of the test 83.7 percent. The maximal EST is a useful predictor of coronary artery disease when a male population is evaluated for chest pain. When a population is selected on some basis other than chest pain (such as elevated lipids or age), EST is a much less useful predictor of coronary artery disease.


The new health practitioner--the past as prologue.

The training and utilization of New Health Practitioners (NHP's) has moved within a decade from a small tentative beginning in the mid-1960's to a major health manpower policy issue. Its discussion transcends a number of important and emotionally charged areas including the role of various professions in providing health care services, the renaissance of primary care, the geographic and economic maldistribution of medical services, and the cost of care. It is valuable to highlight what is known, what is professed and what needs to be studied further about this issue.


Where is the malpractice crisis taking us?

There have been several approaches taken to solve the malpractice insurance problem in this country. However, since the cost of malpractice insurance continues to climb, the changes so far have not solved the problem, and more changes seem inevitable. A major change could be the development of a patient insurance plan that would provide compensation for certain injuries related to medical care. The insurance coverage would be centered on hospital care. If certain requirements are met, the plan may not be more expensive than the current tort liability system, and would offer several advantages. In addition to the patient injury insurance, there could be federal assumption of liability for national immunization programs.


[Diabetes and pregnancy: treatment and results (author's transl)].

Pregnancy and delivery in 190 diabetic women are described. Obstetric, medical and neonatal guidelines for treatment are outlined and the following results are reported: 1. The delivery dates suggested by P. White were generally exceeded by 2 weeks. Group A was delivered at term, group B generally in the 38th week, group C between the 37th and 38th week and group D mostly in the 37th week of gestation. 2. Spontaneous delivery was achieved in 60% of the cases; Caesarean section was necessary in 33%, whilst the incidence of vacuum extraction was 5%. 3. The perinatal infant mortality rate in diabetic pregnancy decreased from 22.9% in 1970/71 to 2.7% in 1972/1976. 4. Perinatal mortality was related to the degree of severity of diabetes according to White's classification. 5. The percentage of PBSP cases was lowered from 32% to 24%. Perinatal mortality in the PBSP group decreased from 50% in 1970/71 to 19% in 1972/1976. 6. Hypoglycaemia occurred in 70% of 74 newborn infants submitted to intensive neonatal care. A true glucose value of less than 25 mg% was recorded in 30% of these cases. Hypocalcaemia was present in 16% cases, whilst 62% of the newborn infants suffered from respiratory distress syndrome. Cardiomegaly occurred in 28% of infants. 7. Development and prognosis are judged to be favourable in children of diabetic mothers.


[Platelet retention and hypothyroidism: an investigation in patients with thyroid carcinoma treated by total thyroidectomy (author's transl)].

Platelet retention was investigated using a standardized technique with a glass pearl column in 18 patients with malignant thyroid disease treated by thyroidectomy before and after high-dose radioiodine treatment (80 or 150 mCi). As compared with the normal controls platelet retention was significantly lower in 13 hypothyroid patients in whom thyroidectomy had been undertaken at least 6 months previously and hormone substitution therapy had been interrupted 3 weeks before the period of investigation. The remaining 5 patients, studied about 18 days following thyroidectomy, were euthyroid and displayed platelet retention values within the lower limits of the normal range except for one patient with markedly reduced values. Thyroid substitution therapy with synthetic preparations induced recovery of platelet retention in both groups examined over a 4 week period, the increase being highly significant in the group of hypothyroid patients. A transient increase in platelet retention was observed 24 hours after a therapeutic dose of radioiodine, and initial values being regained after a further 24-hour period. This phenomenon was found in both, the euthyroid and hypothyroid group, however, it was more pronounced in the latter patients. Our results indicate a dependence of platelet retention on thyroid hormone concentration. The observed transient increase after radioiodine may be due to a radiation effect.


[The clinical application of serum sialyl transferase determination as criterion of malignant transformation of cell surface structure (author's transl)].

The activity of a specific glycosyl transferase, namely, sialyl transferase was determined in a sera of patients with malignant disease. Increased serum sialyl transferase activity was observed in a high percentage of examined cases. The serum enzyme activity was also correlated to the clinical state of the patients and was found to depend on the tumor size. The enzyme activity decreased following surgical removal of the tumor mass and increased an appearance of metastases. These findings may be the basis for possible clinical application in the follow-up of patients with malignant disease, because the diagnostic value of serum sialyl transferase determination is greater than that of other serum analyses.


[Demonstration of erythropoiesis inhibiting factor (EIF) in serum of normal human subjects (author's transl)].

Erythropoiesis inhibiting factor (EIF) has been described for the first time in the serum of normal human subjects. EIF seems to be a physiological factor regulating erythropoiesis and the antagonist of erythropoietin.


[Transport of salicylates from blood to joint fluid (author's transl)].

Samples of blood and joint fluid from thirty patients who had taken acetyl-salicylic acid were examined for occurrence of salicylates. The data were arranged in groups according to the diagnosis of the joint disease and did not show significant differences in the kinetics of salicylates into blood; the time of the first appearance averaged 6.4 minutes, and levels "close to maximum concentration" averaged 23 mg/l. In joint fluid, the time of first appearance of salicylates ranged from 10 to 31 minutes, and levels of maximum concentration of salicylates averaged 14.8 mg/l. Transport of salicylates from blood to joint fluid showed a pattern consistent with the type of joint disease. Support was found for the assumption that diffusion was the major factor in the movement of salicylates from blood to joint fluid.


[Immunology and therapy of malignant melanoma (author's transl)].

Immunological investigations in malignant melanoma have demonstrated the important role of immunological defence mechanisms in the control of tumour growth and tumour spread. On the basis of the different test systems for investigation of immunecompetence and tumourspecific immunity it was possible to demonstrate that patients with melanoma, especially of clinical stages II and III, have a weak, sometimes an anergic immune reaction against their own tumour. The information obtained from in vitro and in vivo studies in human on tumour immunity formed the rational basis for immunotherapy in malignant melanoma. Increasing evidence suggests that active non-specific immunotherapy and, especially, active specific immune-stimulation with inactivated melanoma cells can delay the appearance of distant metastases and result in an improved survival rate for patients with involved regional lymph nodes. At present the use of involved chemotherapy is mostly confined to patients with disseminated malignant melanoma. The most extensively used chemotherapeutic agent for treatment of melanoma is the DTIC (dimethyl-triaceno-imidazole-carboxamide). The objective response rate with this monotherapy has been reported to be up to 25%. Nitrosoureas (BCNU, CCNU, MECCNU) have also been widely used and have brought clinical responses similar to DTIC. Experimental studies in animal models and investigation in human have demonstrated that chemotherapy can be combined successfully with immunotherapy with a potential additive, perhaps synergistic, effect.


[Functional indications for stripping in the treatment of varicose veins (author's transl)].

The venous pressure was measured in a dorsal foot vein with the aid of a Statham transducer and the foot volume was simultaneously registered by a water plethysmograph in 37 legs of patients with varicosis of the internal saphenous vein. 17 legs showed signs of chronic venous insufficiency of post-thrombotic syndrome. These measurements were carried out in the standing position and during standardized knee-bending exercises. They were repeated after elimination of the varicose veins by a tourniquet on the distal thigh and lower leg and between 2 and 6 weeks after a stripping operation. There was a statistically significant correlation between the functional improvement after elimination of the varicose veins by tourniquet and by operation. It is concluded that the elimination of varicose veins by compression allows a reliable prognosis of the functional gain obtained by the operation (accuracy of the prognosis for the pressure measurements: 95%, for volume measurements: 80%). The results were compared with the values in a healthy control group (n = 17), a non-operated group of patients with chronic venous insufficiency (n = 30) and a group of patients with post-thrombotic syndrome (n = 30). The investigation of the function of the calf-muscle pump and the amelioration obtained by compression of varicose veins is a helpful guide in the decision whether to operate or not on patients with chronic venous insufficiency or with post-thrombotic syndrome. A significant functional gain can be sometimes obtained in such patients after stripping, whilst in other cases, which cannot be differentiated on a merely clinical basis, bad results are reported. The described functional investigations allow a better differentiation of these alternatives than phlebography and are, therefore, recommended as routine methods in such cases.


Hypertension in pregnancy: the use of ultrasound.

Great advances in ultrasound instrumentation have enabled the physician to delineate subtle intrauterine changes. Not only can specific measurements of the fetal body be obtained but tissue textures within fetal organs can be appreciated. The perinatologist is constantly searching for ways to learn more about the fetus, and ultrasound has clearly become a major implement in this search. The following discussion will focus on information made available by ultrasound for aid in the modern management of hypertension, one of the most challenging conditions complicating pregnancy.


Clinical results of real-time ultrasonic scanning of the heart using a phased array system.

This report describes the operating characteristics and initial clinical results of a new echocardiographic system that produces real-time, high resolution, cross-sectional images of the heart. This system relies upon phased-array principles to rapidly steer and focus the ultrasound beam through the cardiac structures under investigation. A hand-held, linear array of 24 transducers is manipulated on the patient's chest to direct the interrogating plane at various cardiac structures. Images of high line density are presented in selectable sector arcs to a maximum of 90 degrees. This imaging system has been used clinically in over 2,000 patients in the past two and one-half years. Its use in the detection of altered states of ventricular and valvular pathology has been described.


[Investigations on acceleration of processes of differentiation and aging in rats after influence of x-ray (author's transl)].

On the basis of the hypothesis of a relation between the processes of differentiation and aging in connection with the assumption, that ionizing radiation accelerates the aging of organism, the authors investigated the changes in the cellular reaction in organ cultures of the spleen and the kidney, in the pattern of enzymes in the kidney and the liver and moreover the behaviour of the serum protein level. In dependence of the x-ray dosis and the length of time after radiation an acceleration of the processes of maturation and differentiation could be observed with the three above mentioned methods. Changes could be found which were similar to those, observed in adult or senile rats. The latent phase or organ cultures was prolonged as well as the morphology of cells migrating out of the explants did not differ from that of senile donor animals. The chemical differentiation of the kidney is accelerated after radiation. The detected changes were similar to those in adult or senile rats. The increase in the albumin, haptoglobin and transferrin concentrations of juvenile rats following radiation mean an acceleration of development, for these concentrations are attained during normal development. The authors discuss their results with reference to the existing theories of aging.


Determination of the pressure drop across an arterial stenosis utilizing angiocinedensitometry.

A method is presented for an evaluation of the hemodynamic significance of a stenotic lesion in the arterial tree.Twenty-three patients were examined with arteriosclerosis obliterans and intermittent claudication of the same severity. Flow velocity data obtained by angiodensitometry and viscosity values calculated from the hematocrit were inserted into the Poiseuille's flow formula to obtain the pressure drop across a stenotic lesion in the left external iliac artery. By the same way, the pressure gradient was calculated in 33 "normal" subjects.The normal pressure gradient along the external iliac artery varied between 23 to 110 dynes/cm(2) (52 ± 24 dynes/cm(2) for mean and S.d), and the normal resistance to flow was 6.08 ± 4.1 dyne sec/cm(5)).Stenotic lesions of similar dimensions gave widely varying pressure drops (114-4,736 dynes/cm(2)) (mean and S.d 1,309 ± 1,224 dynes/cm(2)) indicating a difference in the hemodynamic significance of the various lesions. These values were significantly different (p(t) < 0.001) from the normal values. The resistance across these stenotic lesions ranged between 21 to 768 dyne sec/cm(5) (196 ± 192 dyne sec/cm(5)) for the mean and S.d and this was significantly different from the normal group; p(t) < 0.001.Direct measurement of blood viscosity coupled with angiocinedensitometry at rest and after forced vasodilatation should provide an accurate means of determining the relative significance of a stenotic lesion and distal vessel disease in a given patient on blood flow to the leg.


[Molecular biology of aging. Part 9: Age-dependent effects of 2-mercapto-ethanol on protein synthesis in the cell-free system of the rat liver].

1. 2-Mercaptoethanol increases the incorporation of 14C-leucine in a microsomal system of rat liver. 2. This effect is causes by a direct influence on protein synthesis. 3. The microsomes of older animals are more stimulated and therefore the age differences are reduced.


Correlates of adolescent marijuana use as related to age, sex, and ethnicity.

This study examines the interactive effects of background factors and personality/attitudinal and perceived environmental dimensions on adolescent drug behavior. Data were collected during home interviews using a structured interview schedule. The sample consisted of 403 British West Indian black, American black, and white adolescents, ranging in age from 13 to 17. Results suggested that two processes, nonconformity to conventional middle class values at both the personality/attitudinal and institutional level, and modeling of familial and peer drug use account in large part for adolescent drug behavior. The majority of correlates of adolescent drug behavior were similar in different sex, age, and ethnic groups.


[Passive electrical investigations on erythrocytes in dependence of age donars (author's transl)].

It was shown by passive electrical investigations, that the behavior of electrical relaxations of red cells depends on age. With increasing age of the human the relaxation time as well as man the exchange effect stability be increased. This results are due to the increasing of the volume and the contents of haemoglobin of the erythrocytes, and may be due to the changing of the charge of the membrane.


A clinical study of the role of enterococci as sole agents of wound and tissue infection.

Patients who had enterococci isolated from wounds or tissues were identified from laboratory records. The charts of patients with pure cultures of enterococci were reviewed to determine the degree of clinically significant infection. We found that the frequency of infections in patients with pure cultures of enterococci was not significantly different from the frequency of infections in a control series of patients with negative cultures, but that it was significantly different from the frequency of infections in a series of patients with pure cultures of Staphylococcus aureus. Our conclusion that enterococci are not by themselves significant pathogens in wound or tissue infections is supported by a few experimental studies of other authors.


[The resonance frequency of the radial artery in healthy untrained and endurance-trained older men].

There are examined 2 groups of two at a time men over 55 years old, different only in their training state, regarding the reaction of the resonance frequence. It would be established, that the resonance frequence of the A. radials in non-trained is more than the double as in trained probands. The middle resonance frequence increases continuous with the age in both groups. A high resonance frequence in thong-minded trained was not observed, only one time a normal, 63 times a reduced arterial resonance frequence. Under the condition, that the arterial resonance frequence can be regarded as an arterial index, the differences between the resonance frequence of both groups mean, that the biological age of the arteries in trained is on an average younger as in non-trained.


[Lupus erythematodes visceralis and age (part II) (author's transl)].

The authors investigated: 1. The rheumatic status and the joint participation in lupus erythematodes visceralis in several age-groups. 2. The myocard-reactive antibodies in lupus erythematodes visceralis and in ischaemic heart diseases. 3. The antistreptolysine liter in lupus erythematodes visceralis. 4. The border cell antibodies in lupus erythematodes visceralis and "non-collagenosis" diseases. 5. The DNA-antibodies in lupus erythematodes visceralis and in normal persons.


Transient warm autoimmune hemolytic anemia and cryoglobulinemia associated with seminoma.

A patient with a pure seminoma presented with severe IgG-mediated warm autoimmune hemolytic anemia. Monoclonal IgM-kappa cryoglobulinemia and a biological false positive test for syphilis were also found. Treatment directed at both the seminoma and the hemolysis resulted in the complete disappearance of these antibodies. It is possible that these immunological phenomena occurred in response to the tumor. The occurrence of warm autoimmune hemolytic anemia and monoclonal paraproteinemia in association with solid tumors is reviewed.


[Lupus erythematodes visceralis and age (part III) (author's transl)].

The authors investigate the serum protein fractions in lupus erythematodes visceralis. 1. The several serum protein fractions in lupus erythematodes visceralis in several age-groups. 2. The immun-globulins in lupus erythematodes visceralis in several age-groups.


[Problems und results of treatment of urinary bladder carcinoma in old age (author's transl)].

The present paper reports on problems and results of treatment of urinary bladder carcinoma in 160 patients over 70 years of age. The 2-year survival rate was 44%, the 5-year survival rate was 19%. According to our results transurethral electroresection followed by high voltage radiation proved to be superior to other procedures in patients over 70 years of age.


[Short report on longevity of male home inhabitant (author's transl)].

Casuistry of an one hundred and two years old male home inhabitant. Contribution to studies on centenarians.


[Epidemiology of obesity].

In the GDR about 20% of the males and 40% of the females were estimated to be obese. In the country obesity is more spread than in the town. Increased disablement of obese persons leads to reduction of the national income. With higher expenses for nutrition the frequency of obestiy increases. Hypophages and hyperphages are differently distributed in persons with normal weight and obese ones, so that the average establishments do not reflect the differentiated situation in nutrition. Obesity correlates with the type of structure; with increasing obesity dominate pyknomorphous tendencies of growth. Also in normal weight pyknomorphous persons have a higher proportion of fat. We should speak of obesity in such a case, when, taking into consideration biological differentiations, the normal proportion of the fat in the body is increased by more than 1/3. For epidemiological serial examinations the degrees of relative weight basing on optimum weight are a favourable basis for the classification of obesity.


[Obesity as a metabolic risk factor].

On the basis of the results of clinico-experimental examinations and of animal experiments the importance of obesity as metabolic factor of risk is confirmed and hereby the diabetes mellitus as well as cardiovascular effects are particularly taken into consideration. Conclusions are made relevant to practice and it is particularly referred to the central position of the B-cells for the pathogenesis of diabetes as well as to prophylactic and early therapeutic measures.


[Metabolic diseases and fatty liver].

Issuing from the first observations which gave rise to suppose a connection between the fatty degeneration of the liver and the diabetic disturbances of metabolism the at present existing opinions on the development of the fatty degeneration of the liver, its frequency and treatment are demonstrated. According to recent investigation there is a fundamental difference in the regulation of the accumulation of the triglycerides between the healthy persons with normal weight and diabetics as well as the persons with overweight after addition of carbohydrate. While in persons with normal weight the accumulation of triglycerides is reduced by carbohydrates, on account of the overweight a disturbance is produced in the liver which is characterized by inversion and decrease of the elimination activity of triglycerides. Neither the diabetes nor the fatty acids in the blood nor the carbohydrate or fat accumulation primarily cause a fatty degeneration of the liver. The disturbance of the elimination activity is evoked by the overweight. In dependence upon the body-weight the metabolism of the diabetics with overweight and underweight also differs concerning the insulin secretion and by the size of the glycogen accumulation and the behaviour in the degradation of the glycogen of the liver (decreased degradation in diabetics with overweight). The fatty degeneration of the liver as an expression of a disturbance of the regulation as a consequence of the overweight justifies the old classification of the diabetes in an insulin deficiency diabetes and a counter-regulation diabetes.


[Therapy of obesity--indication and effectiveness of calorically-reduced mixed diets].

Extreme caloric reduction diets with a daily content of calories of less than one third of the calories calculated with regard to the optimum weight (per kg optimum weight 30 kcal are used) lead principally to the same changes as the initial diet. Only in a daily addition of calories of at least one third of the calories calculated to the optimum weight no further loss of protein takes place, and scarcely appear side-effects. Thus the limit of the riskless reduction for adults is marked, when at the same time all essential constituents of nutrition are given in a sufficient quantity. A diet called metabolic basic diet (protein 20 kcal%, fat 35 kcal%, carbohydrates 45 kcal%, linoleic acid 20% of the total proportion of fats, cholesterol 400 mg a day, purine-N 200 mg a day, dissaccharides 10% of the carbohydrate addition) decreases or normalises risk factors depending on nutrition such as hyperlipoproteinaemia and hyperuricaemia in a constancy of body-weight. In simultaneous caloric reduction the effect on risk factors depending on nutrition is practically identical with that one of a normal diet calorically reduced in the same extent.


[Various problems in urinary calculi].

After evaluation of the essential parameters concerning urinary calculi and patient with the help of adequate computer programmes in more than 30,000 persons some conspicious trends could be established. The necessity of operative removal of calculi is still relatively high in the most frequent species of calculi whewellite, weddellite, uric acid, struvite and carbonate apatite. Thus nearly 65% of all struvite and carbonate apatite calculi must be operatively removed in women. For individual species of stones with statistical certainty (alpha=0.01) the preference of the right kidney in women and of the left kidney in men is established. The summer months bring an increased risk of stone formation. The spontaneous passages show a highly significant increase from July to October (alpha=0.01), compared with the winter and spring months.


[Pulmonary metastasizing of prostatic carcinoma--source of errors in the ambulatory x-ray examination of lungs].

It is reported on eight patients with a primary carcinoma of the prostatic gland who were admitted to the hospital for clinical clarification of conspicuous pulmonary findings. The radiological findings of a general radiograph of the thorax are multiform and for themselves alone they do not permit an etiological coordination. For this reason the demand can be derived in patients of the adequate age group with tumour symptomatology can also be thought of a carcinoma of the prostatic gland and already during the examination in the outpatient department to carry out a palpatory examination and, if possible, to make a general radiograph of spinal column and pelvis, since in these cases the diagnosis can be made already before admission.


[Behavior of cardiopulmonary function in hypertonics under ergometer load].

In 56 male hypertensive patients a complex cardiopulmonary functional diagnosis was performed in rest and under ergometer load. The total functional capacity of the hypertensive patients is decreased already in the early stage and also in juvenile age, compared with healthy persons. Furthermore disturbances of the regulations of the minute output of the heart, hypertensive stress reactions, disturbances of the coronary blood supply and disturbed functions of the myocardium are provable.


[Development of collateral circulation in the Paget-Schroetter syndrome].

An eleven years' clinical treatment of a 28-year-old tractor-driver with Paget-Schroetter's syndrome is described. The development of the collateral circulation was pursued during 6 years or 11 years, respectively, after the occurence of the vein thrombosis and the importance of phlebography in this rare disease is emphasized for the judgment of the prognosis. Phlebographic procedure is recommended for the reliable evaluation of the pathomorphological changes of the veins and of the developed collateral circulation.


[Diagnosis of primary hyperlipoproteinemias].

The diagnostics of hyperlipoproteinaemias is essentially based on the proof of biochemical parameters. The simultaneous determination of triglycerides and cholesterol in the serum is the most important measure for establishing disturbances of the lipid metabolism. The behaviour of these two lipids, the consideration of the serum and the lipoprotein electrophoresis in most cases make possible a classification according to the distributed all over the world and clinically relevant division according to Fredrickson. Loading tests for the early recognition of hyperlipoproteinaemias - analogus to protodiabetes - are hitherto not yet known. Within the diagnostics shoude be taken into consideration that hyperliproproteinaemias are frequently associated with other metabolic diseases (obesity, gout, diabetes mellitus, hypertension) as so-called metabolic syndrome.


[Diet therapy of hyperlipidemias (hyperlipoproteinemias)].

The therapy of hyperlipidaemias is based on the realisation of few principles of nutrition. Reduction of the weight and energy-controlled permanent nutrition, respectively, has in a distinctly marked degree influence on the majority of the hypertriglyceridaemias. Also mixed hyperlipidaemias as well as hypercholesterolaemias if associated with overweight, show a good reactivity to calorie-restricted forms of diet. Increased bodily motion, also negativation of the energy balance by influencing the consumption of calories is also an excellent measure for the quick decrease of the triglyceride levels. Specific mechanisms increasing the triglyceride concentration can be excluded by a restriction of the sugar and alcohol consumption. Primary hyercholesterolaemias in normal body-weight can be influenced by a decrease and/or changing of the fat consumption in the sense wanted. Since there have been possible comparable decreases of the cholesterol level by forms of diet of different fat content, when the relation of repeatedly unsaturated to saturated fatty acids furthermore exists, here is the possibility for the adaptation to individual habits of nutrition. However, own investigations allow the conclusion that the total addition of fat should lie below 35 kcal %. Whether the coronary risk can be diminished by a nutrition decreasing lipids, was investigated in a number of studies during the last 20 years. Summarzing, a primary prevention by changing the nutrition seems to be possible; chances of success for the secondary prevention - the prophylaxis of the reinfarction - are less well confirmed.


[Drug treatment of hyperlipoproteinemias].

If by regulation of the ideal weight, by type-optimated diet and physical conditioning we do not succeed in a satisfying regulation of the hyperlipoproteinaemias, the indication to the medicamentous therapy is given. For the treatment of type IIa in the first place cholestyramine and essential phospholipids are taken into consideration, in unsatisfying effect the combination cholestyramin-regadrin. For the types IIb-V regadrin and preparations of nicotinic acid are the remedies of choice. In an unsatisfying decrease of lipids the combination regadrin-nicotinic acid and regadrin-buformin-respectively, should be used. To what extent by a medicamentous decrease of lipids a primary or secondary prevention of ischaemic vascular diseases is possible, at present cannot be answered definitively.


[Clinico-endoscopic problems in malignant changes of the gastric stump].

The authors give a report on occasional difficulties concerning the radiological and endoscopic clarification of the malignant changes at the gastric stump after treatment of resection. Four relevant cases are stated and explained. The endoscopy (glass fibre gastroscopy) together with the biopsy is at present the most reliable method for the diagnosis of the pathological processes in the remaining part of the stomach. A regular endoscopic and radiological control of patients with gastric resection is desirable.


[Instable angina pectoris and the pre-infarct condition].

The instable angina pectoris belongs to the prodromes of an acute transmural my ocardial infarction, to which we refer every fresh angina pectoris, increase and prolongation of the anginous pain after stress and the appearance of pain in rest. Retrospectively we established the instable angina pectoris in 45% of the cases of a transmural myocardial infarction. Prospectively the syndrome of the instable angina pectoris was followed by a transmural myocardial infarction in 18%. In 14% of the cases with instable angina pectoris without provable transmural myocardial infarction a sudden heart death took place. In the discussion the author deals with questions of the not clarifyed pathogenesis and therapy. The instable angina pectoris is, indeed, an important clinical syndrome, but from the point of view of the short-time prognosis in our opinion it has not the presumed significance for the development of the transmural myocardial infarction and the sudden heart death.


[Arthropathy in the Weber-Christian disease].

It is reported on five cases of Weber-Christian's syndrome which were observed in our institute during the last years due to difficulties involving motion organs. In three of the cases short-term arthritis was found and in one of the cases erosion arthritis of rheumatoid type was found, too. As far as the last case is concerned detailed information on the system manifestation of the patient is given; the disease started in her young days with regular relapses and visceral manifestation. At the same time typical morphologic changes in the subcutaneous fatty tissue and in the liver as well as clinical findings of diabetes, pericarditis and focal myocarditis were observed which proved a general disorder of the lipid metabolism.


[Halothane and antituberculous drugs--a hepatotoxic combination? (author's transl)].

A case report is given on two patients receiving halothane anesthesia while beeing treated with isoniacid, ethambutol and rifampicin. Following halothane anesthesia, both patients developed a severe liver disease with encephalopathy grade III. We observed a moderate increase of bilirubin and SGOT and a more severe increase of serum ammonia. Histologically, both patients had alterations compatible with drug hepatitis. Within 14 days remission occurred spontaneously. The two case reports do not fit with typical isoniacid hepatitis or typical halothane hepatitis. The possibility of combined drug toxicity on liver during halothane and isocianid treatment is discussed.


[Insulin resistance and blood glucose replacement rates in liver cirrhosis. Studies with 14C-glucose (author's transl)].

In 21 patients with liver cirrhosis, 35 normal subjects, 8 patients with chemical and 11 with manifest diabetes 0.5 g glucose/kg together with 14C-glucose were injected intravenously. 71% of the cirrhotics showed an impaired glucose tolerance. IRI response was exaggerated. The insulinogenic index was elevated in patients with liver cirrhosis and normal glucose tolerance and normal or subnormal in those with carbohydrate intolerance, as well as in diabetics. Decrease of the specific activity of glucose, expressing supply of non-labelled glucose to the body pool, was much more rapid in patients with carbohydrate intolerance, either hepatogenic or not, when compared at equal glucose concentrations. Moreover all groups with deteriorated glucose tolerance exhaled less 14CO2. Consequently, diabetes in chronic liver disease displays the same abnormalities as diabetes in obesity with respect to liver glucose supply and glucose oxidation. In both conditions diminished glucose assimilation is usually the result of reduced removal and increased supply. Therefore it is concluded that impaired hepatic uptake of glucose cannot be implicated as a single cause of hepatogenic diabetes.


[Changes in the structural localization of glycogen during glucose resorption].

Quantitative changes in the glycogen granula contents of the dog's small intestinal mucosa were investigated with light microscopy using Best-carmin dying. In fasting animals the glycogen could be detected in a patchy arrangement in the supranuclear cytoplasmic region of the enterocytes. During glucose abasorption glycogen appeared in continually increasing quantities also in the lamina propria. Injecting Glucagon (50-100 microgram/15') into the artery of the intestinal loop during glucose absorption, glycogen totally disappeared from the enterocytes, while it remained unchanged in the cells of the lamina propria.


[Resections of the pancreas: their effects on bone and calcium metabolism (author's transl)].

Four to ten years after partial or total resections of the pancreas calcium and bone metabolism was investigated. A high-turnover osteoporosis is proved by bone histomorphometry. There were no signs of osteomalacia or secondary hyperparathyroidism. Radiocalciumkinetics in all cases showed an increase endogenous fecal loss of calcium. Both, intestinal absorption and renal excretion of calcium were normal. Pathophysiologic relationship between resections of the pancreas and their influence on calcium and bone metabolism has not been sufficiently explained until now. Further investigation will be necessary.


[The effect of caerulein on intraluminal pressures of the common bile duct and duodenum in man (author's transl)].

Caerulein is a dekapeptide related to gastrin and cholecystokinin with profound effects on gastrointestinal motility. In the present study we examined the effect of intravenously administered caerulein (0.1 microgram/kg body weight) on the intraluminal pressure of common bile duct and duodenum in 12 patients. The pressure recordings were obtained by endoscopic perfusion manometry. The tip of the perfused catheter was positioned under radiological control and the measurements were carried out under standardized conditions. Following the injection of caerulein there was a rise in pressure in the common bile duct and the mid portion of the duodenum. The pressure increase in the common duct appears to be predominantly due to contraction of the gallbladder as it is considerably less pronounced in patients with cholecystectomy. The problems inherent to endoscopic pressure recordings under pharmacological stimulation are discussed.


[Uterus myomatosus and pregnancy (author's transl)].

Using a summary of the literature as well as our own cases, a survey of the current state of research in regard to the diagnostics, case control, prognosis, and therapy for uterus myomatosus graviditatis is presented.


[Investigations regarding the validity of estrogen-creatine quotients from morning urine compared with those from 24-hour urine in high risk pregnancies (author's transl)].

An automated method for determining total estrogen in 24-hour urine was reported. The "estrogen-creatinine quotient" was computed in order to make the results of collective errors as independent as possible. This numerical value also makes possible comparative studies of 24-hour urine and morning urine (6:00 a.m.) as well as of urine specimens taken every two hours between 6:00 a.m. and 6:00 p.m. A total of 1000 analyses were made in 110 pregnant women; in addition, 82 daily profiles were studied. A high correlation was found between the E/C from 24-hour urine and from morning urine. In approximately two thirds of the cases, the deviation between morning urine and 24-hour urine did not exceed 10%. In the daily profiles, however, a wide variation in the daily rhythmn of some patients could be observed. According to our results, the determination of E/C in morning urine is well suited as a screening method for quick detection of estrogen elimination, particularly in high risk pregnancies.


Gestational meconium: a sign of poor neonatal prognosis.

Seventy five pregnancies where the presence of antepartum meconium was detected by transabdominal amniocentesis, were compared with 224 cases showing clear amniotic fluid (A.F.). The statistical differences were analized in terms of data of anamnesis, diseases complicating pregnancy, gestational age, fetal maturity diagnosis from the A.F. study, oxytocin test, labor characteristics, perinatal mortality and neurologic morbidity during the first nine months of life. The results suggest that the presence  of antepartum meconium implies an increase in fetal risk, demanding an adequate analysis of the obstetric solutions, which is discussed.


A new modification of spectrophotometry in the investigation of amniotic fluid by amnioscopy.

A new spectrophotometric application to amnioscopy for the estimation of the colour of amniotic fluid is presented. Three light-emitting diodes (LEDs) with peak wavelengths of 565 nm (green), 581 nm (yellow), and 645 nm (red) act as the light sources, and the light reflected from the amniotic fluid is measured using a photodiode. The greatest advantages of our new application are the short recording time of about 15 s. and the simplified mechanical performance of the measurement, which reduce errors. Preliminary clinical results show that green colouration can be easily discriminated from yellow and clear amniotic fluid. Sources of error and improvements to the method are discussed.


Steroid profiles in hydatidiform mole associated with theca-lutein cysts.

Neutral steroids in urine were determined quantitatively with gaschromatography on capillary columns in a case of benign hydatidiform mole associated with bilateral theca-lutein cysts. A remarkable finding was the very high levels of 17-hydroxypregnanolone and pregnanetriol, which continued to rise until the 15th day after molar evacuation.


[Antenatal diagnosis of a foetal heart block in the 33. week of pregnancy (author's transl)].

In a pregnant woman of 20 years is recorded a foetal bradycardia of 60 beats per minute in the 33. week of pregnancy. The woman too had an influenza. The cardiological examination shows a congenital complete heart block. After spontaneous delivery of a male infant at date the heart block persists for more than 7 months. There are are no malformations; a interdependence with influenza-infection of the mother is not to be proved. The diagnosis of the congenital heart block is rare. Of 40 cases pointed out in the literature only 3 cases has been diagnosed before the 35. week of pregnancy.


[Determining the effectiveness of therapeutic interventions in a time series of examination plans].

Some typical effects of therapeutic intervention in time series designs are considered and suggested for heuristic evaluation by Kendall-tests. The pre-intervention phase is assumed to be stationary as to an indicator variable and the post intervention phase is assumed to change in level or direction. According to the effects assumed, anchor series of ranks are constructed and compared to rank-transformed time series observations. Large Kendall-scores indicate agreement between assumed and observed series of ranks, i. e. either change in level and/or in direction.


[Relationship between Eysencks personality types and intellectual performance].

This study tests Eysenck's psychophysiological hypotheses concerning the relationship between intellectual performance and personality type. The data originated from two partial samples with N = 314. The personality types were distinguished with the ENNR-Questionnaire. The intellectual performance was tested using items which are based on Jäger's factor analytic studies. 23 differentially complex items stemed from the main intelligence factors, and separate measures for speed and quality were used to test the hypotheses. The results of all analyses of variancy falsify Eysenck's hypotheses. The "neurotic introverts" showed the worst results in both quality and speed by most of the items, independent of complexity and intelligence factor (chi-square-test of positional frequency). The "stable" and "neurotic extraverts" showed the best results.


[Oedipus - anthropology of enlightenment and interpretation].

The myth of oedipus follows - from an anthropological-phenomenological point of view - an interpretation as a tragedy of enlightment. Oedipus solves the riddle of the sphinx concerning the finality of human life. By this he has done the step from the cyclical conception of life, essential for early humanity and childhood, towards the causal and teleological thinking of modern man. But by this step he looses the instinctual-prelogical knowledge of early humanity - still observable among so called "savages" - about the ties of blood and the signification of incest. The loss of this knowledge throws him into the fateful marriage of his mother. Only after blinding himself he gains insight into the relations that are hidden to the "enlightened" thinking.


[Possibilities and dangers of group psychotherapy].

The author points out that in every group - also in groups put together for psychotherapeutic purposes - attention must be paid to the inherent sociodynamics. The knowledge of the sociological aspect connected with it is on this account important, because the individual is entangled in generally groupdynamic processes (e. g. the normative effect of the group, the emotionally relevant interactions that increase overproportionally with the growing density of interactions and simultaneous decrease of the emotionally neutral interactions, the amplifying effect of the group, etc.). Besides, the knowledge of the psychological aspect is important, e. g. the consideration of the development of a narcissistic group-self in the individual or in several persons, the mutual identification processes, etc. To comprehend the therapeutic process the knowledge of the usual movement of the group events is above all important. The differentiation of the five following phases may, however, only be taken as a scheme: (1) explorative contact, (2) regression, (3) catharsis, (4) insight, (5) social learning.


[A group-behavior-psychotherapy concept: treatment of psychosomatic disorders].

The paper concerns with group-behavior-therapy with patients having psychosomatic disorders. The therapy was applied to two groups. The therapy has not been fully standardized but individual differences of each client's behavior-analysis was taken into account. The clients were to learn the understanding of the development of their symptoms and the conditions under which the symptoms remained and changed. Clients should help each other as co-therapists. The group-therapy was divided into three parts: (1) communication-training in the group, (2) introduction to the basic principles of learning, (3) application of special therapeutic methods. The therapy procedure as well as the results of the first follow-up are reported. The concept of group-therapy is discussed.


[Intellectual decline in alcoholics].

161 alcoholics with an average abuse of alcohol of about five years who had volunteered to undergo treatment were given the IST (Amthauer). The average age for the 90 male and 71 female patients was 39 years. The results of the investigation indicated a decrease in intelligence, some functions of intelligence being more affected than others, especially in women. In addition a significant fixture of intelligence ("Verfestigung" according to Amthauer) was found. It may be assumed that the impaired intelligence performance can be attributed to disturbed attention and drives rather than to brain lesions. The possibility of restitution and modification of personality by psychotherapy is being discussed.


The significance of cytotoxicity of lymphocyte populations in coloncarcinoma patients in comparison to normal controls using a new statistical method of evaluation.

Lymphocytotoxicity was studied in patients suffering from colon carcinoma. 125Iododeoxyuridin-labeled established colon carcinoma cells were used as target cells in a cytotoxicity assay according to COHEN et al. (1). They were incubated with unfractionated lymphocytes of the peripheral blood, purified T cells or adherent cells as effector cells. The cytotoxic effect was measured in cpm, i. e. the radioactivity released from the target cells into the supernatant. The cpm were adjusted by eliminating the variables of spontaneous release and for maximal incorporated radioactivity of the target cells. The cytotoxic activity of lymphocytes to colon carcinoma target cells was dose-dependent. It was demonstrated for lymphocytes from colon carcinoma patients as well as for lymphocytes from healthy controls. Although adjusted cpm values were used for statistical analysis lymphocytes from the 20 colon carcinoma patients did not show a higher cytotoxic effect than lymphocytes from the 20 healthy controls. However, when the results were compared separately for each experiment consisting of 2 colon carcinoma patients and 3 healthy controls, statistical significant specific lymphocytotoxicity was demonstrated for lymphocytes from colon carcinoma patients. The plot diagram of the results and the statistical evaluation by the multivariate analysis of variance (Manova) offer a clear and comprehensible representation of the results. Particularly for statistical reasons, this representation is superior to the usual calculation of percent specific lysis. It was demonstrated in this study that the cytotoxic activity in the absence of autologous serum is a function of T cells of the peripheral blood. Adherent cells have a high cytotoxic activity regardless whether the cells were obtained from colon carcinoma patients or from healthy controls.


A simple technique for measuring leucocyte chemotaxis in reversible Boyden chambers.

A technique for assay of leucocyte chemotaxis in Boyden chambers is described. A set of up to 12 closed chambers with 2 compartments is formed from commercially available migration plates. The set can be turned during the incubation and thus the detachment of cells from the filter, a major source of variation in classical type of chambers, can be prevented. The technique is simple and so inexpensive that it allows the use of the material as disposable if preferred.


The efficacy of praziquantel against cestodes in animals.

Praziquantel (EMBAY 8440, Droncit) is a new type of acylated isoquinoline-pyrazine. A single oral or subcutaneous dose of the compound is reliably effective against juvenile and adult cestodes in mice and rats. For the first time, with praziquantel a compound is available that is also effective on cestodes in the bile-duct. Using Hymenolepis nana in mice we were able to show that age, sex, strain and intensity of infestation of the host have no influence on the efficacy. The onset of the effect of praziquantel in vivo is rapid. Within 10 min the parasites were immobilized and contracted and excreted within a few hours with the faeces.


Physiology of host parasite relationship: effects on serum alkaline phosphatase levels of fish hosts parasitized by trypanosomes.

Serum alkaline phosphatase levels of five species of fresh water fish hosts were altered by trypanosome parasites. The loss in enzymatic activity ranged from 3.91% to 69.91% in the five species of infected fishes as compared to normal level in the healthy hosts. The maximal reduction in the enzymatic activity caused by trypanosomes was observed in the herbivore carp fish Cirrhina mrigala and the minimal loss in the fresh water shark Wallago attu.


Studies on ecophysiology of fish parasites: effect of trypanosome infection on the serum cholesterol levels of fishes.

Serum cholesterol levels of six species of fresh water fishes were lowered due to trypanosome infection. The percentage of infection in the different species of hosts ranged from 3.27% in Clarias batrachus to 16.66% in Wallago attu. Loss in serum cholesterol level was highest (42.39%) in the spiny eel Mastocembelus armotus and lowest in the carp Cirrhina mrigala (4.56%). Thus hypocholesterolemia was evidently caused in the fishes by trypanosomes.


Changes in the generation cycle of duodenal crypt cells in chickens infected with Eimeria acervulina.

Changes in the duration of the progenitor cycle and its four phases were determined for duodenal crypt cells in chickens infected with Eimeria acervulina. Metaphase curves were constructed using percent labelled metaphase nuclei in duodenal crypt cells at short intervals after the injection of [3H]thymidine. The duration of the progenitor cycle and its four phases were calculated using the synthetic index and data obtained from the metaphase curves. The cycle time was reduced from 14 h in control birds to 10.2 h at 2 days and 10.6 h at 4 days postinfection. The change was attributable entirely to a reduction in G1 or the presynthetic phase. In addition, the population of dividing cells within each duodenal crypt was almost doubled in infected birds. These increases in cell production precedes all the histological changes observed earlier in the intestines of E. acervulina infected chickens. At least in this instance, changes in crypt morphology seems, therefore, to result from an induced change in the functional activity of the crypt.


Larval and post-larval development of Ergenstrema mugilis Paperna, 1964 (monogenea, ancyrocephalidae) parasite of Liza ramada (Risso, 1826) (teleostel, mugilidae).

The ciliated cells, chaetotaxy and excretory system of the oncomiracidium are fully described in Ergenstrema mugilis Paperna, 1964. The study of the post larval development shows a phase of cutaneous infestation in the fish host and the mode of transmission is discussed among Dactylogyroidea. The morphogenesis of the parasite haptor is described. The origin and migration of the hamuli in Dactylogyroidea are discussed.


A differential diagnostic criterion for Babesia major and Babesia bigemina vermicules from tick haemolymph.

Babesia major mature and immature vermicules in the haemolymph of Haemaphysalis punctata were measured and found to be significantly larger than vermicules of Babesia bigemina. Mature B. major vermicules had a mean length of 15.53 micrometer and mature B. bigemina vermicules had a mean length of 11.79 micrometer. This difference provides a new criterion for the differentiation of the two species.


Effect of 2-deoxy-D-glucose on Herpetomonas samuelpessoai.

The effect of 2-deoxy-D-glucose (2-DG), a carbohydrate analogue, on growth, respiration and fine structure of Herpetomonas samuelpessoai is described. In a glucose-free medium, 2-DG inhibited growth down to 7% that of the control. In presence of equal concentrations of glucose, the inhibition by 2-DG was 55%. With 5 times as much 2-DG as glucose, the inhibition was 88%. Increase in 2-DG in relation to glucose resulted in a progressive inhibition of H. samuelpessoai. Only glucose, fructose of glycerol reversed the inhibition caused by 2-DG in H. samuelpessoai. Glucose was more active than glycerol and fructose. Protection against 2-DG toxicity was confirmed by respirometry experiments. Oxidation of glucose was less affected by 2-DG than that of fructose and glycerol. In presence of 2-DG the cells became round to oval and showed some granules in the cytoplasm. In control cells the mitochondrial cristae were short and straight while in cells treated with 2-DG they were longer and curved. Morphometric analysis of electron micrographs showed that the mitochondrial relative volume of normal cells was 0.084 +/- 0.018 while in treated cells were 0.166 +/- 0.030. Results are discussed in relation to the carbohydrate metabolism and the mode of action of 2-DG.


Fibrinogen and fibrinogen/fibrin degradation products in the urine of rabbits infected with Trypanosoma (trypanozoon) brucei.

Studies have been carried out on the urine of rabbits infected with Trypanosoma (Trypanozoon) brucei to determine whether fibrinogen or fibrinogen/fibrin degradation products (FDP) could be detected. No fibrinogen was found but during the last two weeks of this 7-week infection low levels of FDP were present in the urine which did not exceed 5 microgram/ml. Rabbit urine was shown to contain a potent proteolytic enzyme capable of breaking down rabbit fibrinogen and both early and late FDP were present in the cleavage products. No deposits of fibrin were detected in the kidney, but casts were present in the urine suggesting renal damage. The most likely explanation of the urinary FDP is that either an increase in the glomerular permeability occurs allowing filtration of plasma FDP or a local fibrinogenolysis in the kidney tubules.


The effect of cortisone acetate on the metabolism of Hymenolepis microstoma (cestoda:cyclophyllidea).

Hymenolepis microstoma grown in mice, treated with 1.25 mg cortisone acetate every second day, are heavier and have a significantly higher glycogen content than those in control mice. The dry/wet weight ratio and protein content however are unaffected. It is suggested that the increase in glycogen reserve and weight in H. microstoma from cortisone-treated mice is due to an immunosuppressive effect and better nutritional environment rather than hormonal action. Inclusion of 0.1 mg of cortisone per 100 ml of culture medium produces no change in worm weight in vitro. Single worm infections result in 100% recovery, but 30 worm infections provoke a rejection process which can be suppressed partially by administration of cortisone acetate.


A marine Diphyllobothrium plerocercoid (cestoda, pseudophyllidea) from blue whiting (micromestius poutasson).

A type of Diphyllobothrium plerocercoid found in blue whiting, Micromestius poutasson, caught near the north edge of the Faeroe Banks, is described. The most dominant characters of these larvae are their typical dorsoventrally flattened body and their fully extruded and "adult"-like scolex. A morphological comparison with perocercoids of D. dendriticum, D. ditremum and D. latum is given.


[Cercaria ogunis n. sp. (echinostomatidae) from Bulinus globosus in West Africa (author's transl)].

Cercaria ogunis n. sp. (Echinostomatidae) is described. The cercaria has 47 collar spines, 2 X 15 flame cells, a small dorsal and a small ventral finfold near the tip of the tail. A peculiar organ located dorsally next to the brain is explained, hypothetically, as a statocyst. In the behaviour of the cercaria there are some conspicuous features, i.e. a rapid swimming-velocity, a striking positive geotaxis and a positive phototaxis. Second intermediate hosts are gastropods and amphibians. The metacercarial cysts exist in two distinct modifications: Cysts from Bulinus are globular, cysts from amphibians are elongated-ellipsoid. The Bulinus population of the habitat shows at the same time a high prevalence of Schistosoma haematobium. C. ogunis has never been observed as being involved in double infections. This seems to suggest that the rediae of this species are incompatible with other trematodes in the snail.


Studies on the embryogenesis of the tapeworm Shipleya inermis Fuhrmann, 1908 using transmission and scanning electron microscopy.

Scanning electron micrographs (SEM) are shown of the scolex, microtrichs, and the submucosal capsule formed by the worm. The course of development of the outer capsule and the outer envelope from the early preoncosphere to the mature oncosphere is followed by SEM and (in part) transmission electron microscopy. Three phases of development of the outer envelope (OE) were noted: (1) early preoncosphere with OE with a relative smooth outer surface, (2) the development of surface lamellae and (3) the formation of a dendritic area distal to the lamellae; all of the organelles appear to be secretory. Stereoscopic pairs of cryofractured developmental stages are used to aid understanding of the OE. Transmission electron micrographs are used to corroborate the SEM micrographs.


[A trial for the determination of the age of intracranial hematomas by means of measurements of water concentrations (author's transl)].

We determined the water concentration in intracranial hematomas and in blood in 43 cases. The water concentration of the blood of hematomas has some significance to estimate the age of hematomas and therefore the survival time.


[Demonstration of hemoglobin using the porphyrin test (author's transl)].

The demonstration of hemoglobin after its transformation into Porphyrin is specific and extremely sensitive. It is possible to detect amounts as small as a microgram. The use of sulphuric acid as a reagent is superior to the hydrochloricthioglycol acid method. After obtaining a speciman from a blood stain (usually through soaking) it is recommended that it be concentrated by allowing the speciman once again to dry out. Prejudicial effects due to the extreme sensitivity of this test are therefore avoided.


[Morphology of injuries by "humane killer" (livestook stunner) (author's transl)].

1 short synopsis deals with the general features peculiar to injuries by captive bolt "humane killer" (specifically the types with two opposite outlets for the explosion gases). When the bolt strikes the body at an acute angle, both the wound and the adjacent skin usually show some particular signs: normally the entrance hole is accompanied by two roundish or elliptic zones of blackening due to the diverging smoke conduits. Variations in shape and location of the foulings indicate an oblique holding of the instrument and often even reveal the degree of inclination. Another characteristic is caused by the conically grooved end of the steel bolt: the asymmetric sickle-shaped broadening of the "abrasion collar" reliably points out the direction of fire. Sometimes the entrance hole in the skull is accompanied by semicircular frame-like fracture lines which mostly are situated on the same side as the unilateral abrasion. The cauistic part includes one homicide and eight suicides. Among the latter group one case deserves special attention because the man in question was capable of shooting a second time into his forehead. Three persons tried to ensure the fatal outcome by combining the "humane killer" - injury with concommitant hanging.


[Blunt abdominal trauma and injuries of the great omentum (author's transl)].

A 81 years old man died four weeks after a traffic accident with blunt abdominal trauma. The cause of death was a mechanical ileus as a result of an incarceration of a loop of the small intestines in a rent of the great omentum. Since no criteria for a traumatic tear of the greaten omentum was found the developmental mechanism of a fissure in the great omentum was explained as an exaggerated process of aging.


[Experiences and results of retroperitoneal lymphadenectomy in teratoid testicular tumors].

Examinations of 69 patients with teratoid tumours of the testicles who underwent the expanded operative and cytostatic treatment usual at present emphasize that the prognosis apart from the histological structure decisively depends on the stage of tumour at the beginning of the treatment. Nothing has changed in this respect. Under the treatment mentioned of the carriers  of metastasized tumours 28% survival who had no chance before this. Compared with that the survival rate of patients free from  metastases is 81%. A differentiation between regional metastases, progressed subdiaphragmatic metastases and metastases distant from the primary tumour may contribute to the prognostic judgment.


[Development of sigmoid carcinomas after ureterosigmoidostomy].

It is reported on a case of sigma carcinoma 15 years after ureterosigmoidostomy. A survey table contains the cases of sigma tumours after passing of the urine into the sigma hitherto reported in the literature of the world. Short discussion of frequency, latency period and diagnostic and therapeutic measures after ureterosigmoidostomy.


[Kidney damage in sterile reflux].

On the basis of the data mentioned and taking into consideration the fact that the whole complex of problems is not yet clarified unequivocally we come to the following conclusions: 1. Up to now there are no proofs for the fact that the most frequent type of reflux, i.e. the simple reflux of the urine from the urinary bladder into the upper urinary passage causes a renal damage. 2. The complicated VUR may certainly cause a urinary stasis kidney. In simultaneous calyco-tubular reflux probably focal shrinkings of the parenchyma may develop.


[The application and effect of analytically oriented, professional continuing education - using Protestant clergymen as an example].

The following analysis reveals a hermeneutic application of psychoanalysis in the social field, as well as showing the results of this practice in the form of information about a profession. The method causes these two aspects to be interwowen. The generally accepted motive for this kind of speculative research (= not purely empirical research) emerges, immediately, when analytically orientated and professionally orientated further education are to be conceptualized; for methods condense out of the work, contents, aims, and actual conditions. The extent of control of counter-transference and defence analysis in various work-contexts is introduced: in the contract of further training (as a concretion of career-identification), in exegesis (as the central professional activity of protestant theologists, especially clergymen), in socio-cultural comprehension of collective professional duties and aims. The conflict-centred analysis of excerpts from the Bible reveals possible solutions ranging from the regressive to the mature. These are reflected in the interpreter's unconscious, preconscious, and conscious mind, and they infiltrate his mediation work and relations with the public. This result is highlighted from a cultural-historical point of view. Finally, there follows a review of the possibilities of application in other professions.


[Animal-experiment studies on the effect of magnesium and vitamin B 6 on calcium-oxalate nephrolithiasis].

By chronic intoxication with ethylene glycol or acute intoxication by Na-glyoxalate in the animal experiment a Ca-oxalatenephrolithiasis could be produced. At this model the influence of magnesium, pyridoxine and phosphate was studied. The combination therapy of magnesium and vitamin B6 can completely prevent the formation of Ca-oxalate-microliths in the kidney. The production of a preparation with 200 mg MgO and 10 mg pyridoxine per tablet for the metaphylaxis of oxalate calculi is recommended.


[Radiation exposure of urologists].

On different positions of the body of urologists working in the field of radiology the rayage was measured by means of LiF-teflon-dosimeters. In unprotected regions of the body the radiation dose is essentially higher than under the protective clothing of lead rubber. The raying of the hands is particularly high. Their additional personal-dosimetric control is recommended.


[Pseudo-correlation between neurotic somatic diseases and social class].

The hypothesis that neurotic bodily complaints are dependent on social class, sex, and age, was tested using a representative sample of size N=1549. It is shown that bodily complaints are dependent on age and sex, but independent of social class. Correlations of -.41 between age and education and of -.22 between education and sex were obtained, suggesting that the correlation found in earlier investigations between social class and neurotic bodily complaints were in fact due to the common dependence on sex. It is shown, however, that psychosomatic conceptions of bodily complaints are dependent on social class. People from higher social classes interpret their complaints significantly more frequently as being due to psychological factors. The consequences for the doctor-patient-relationship, which may be drawn from these results, are discussed.


[Determination of the total length of seminiferous tubules in normally descended testes in children].

The total length of all seminiferous tubules of a testicle can be determined with the help of histomorphometric investigation methods. Two different methods are described and discussed. For this purpose bioptically got specimens of parenchyma of the size of a rice-grain are sufficient. In children the total length of the tubules constantly increases. During the prepuberal phase of life an acceleration of the growth of the length of the seminiferous tubules begins. The results of 89 autoptically got and morphometrically examined testicles of children are reported.


[Andrologic significance of anomalies and diseases of the spermatic duct].

The author deals with the anomalies and diseases of the dpididymis, the spermatic ducts and the adnexal glands which may have an influence on the spermatogram and the fertility, respectively. It is reported on the agenesia of the epididymis, the spermatic duct and the glands of the vesicles. Then in turn the concerning relations of the spermatocele and the inflammation in the genital region, above all in their chronic form are discussed.


[Vasectomy and spermatic antibodies].

Before vasectomy, 4 weeks and 3 months after the intervention the sera of 56 fertile patients were examined for the existence of sperm-agglutinating and sperm-immobilizing antibodies. Before vasectomy no antibodies with a titre of 1 : 16 could be established. 4 weeks after vasectomy in 9 sera sperm-agglutinating and in 4 sera sperm-immobilizing antibodies with a titre of 1 : 32 or more could be proved. There was a clear connection with inflammable changes at the place of the peripheral ligature (sperm granulomas). After 3 months with the exception of 2 sera the antibodies had decreased to a titre of less than 1 : 16 or they had disappeared.


[The role of ERCP in the diagnosis and indication for surgical treatment of diseases in the region of the papilla Vateri (author's transl)].

Duodenoscopy with transpapillar examination of biliary and pancreatic ducts has become an important branch in diagnosing gastroenterologic diseases. This will almost guarantee more exact information especially concerning indications and technique in diseases of the biliary tract and pancreas. Better results of operative treatment might be expected in future.


[Gastrointestinal endoscopy in surgical patients (author's transl)].

Gastrointestinal endoscopy with flexible glass fiber instruments is of increasing importance in surgery. Preoperative endoscopic examinations bring good progress in planning the operative procedure, especially concerning proximal selective vagotomy, pancreas surgery and reoperations on the large intestine. By applying postoperative endosocopic controls mucosal alterations can earlier be detected in the area concerned than by radiological methods; this has to be emphasized especially in view of patients operated upon for cancer. Emergency endoscopy in massive gastrointestinal bleeding is one of the outstanding tasks. Under certain circumstances risky abdominal operations can be avoided by therapeutic endoscopy.


[Reoperation on the bile ducts (author's transl)].

The total of 5560 operations on the gall bladder and bile ducts had been performed from 1951 to 1975, the mortality rate being 1.2% of all operated cases. There were 659 papillosphineterotomies, 82% of these were indicated for choledocholiathiasis associated with papillary changes, the remaining 18% for stenosis of the Vaterian system. 29 patients, i.e. 4.4% died following papillosphincterotomy. The total of 21 patients were reoperated on soon after the first intervention, 17 of them for inflammatory complications with four deaths, 4 for haemorrhage without any death. One of the patients died from a bleeding duodenal ulcer, 3 from postoperative pancreatitis. The last four patients were not reoperated. Later reoperations up to 7 years were performed in 24 cases. The other part of the paper presents an analysis of 35 patients reoperated on for iatrogenic postoperative strictures of the bile ducts mostly due to an injury induced during cholecystectomy or gastric resection.


[Long term results following surgical therapy for chronic pancreatitis (author's transl)].

A report is presented on the results of the follow-up examination of 43 patients who had been previously operated on chronic pancreatitis. Clinical data such as the patients' well being, their ability to work were collected and specific tests for the function of the pancreas such as fat-content in faeces and glucose-tolerance-test were made. It was shown, that the pancreas-resected patients felt better in themselves. Moreover, their clinical picture was superior to that of non-resected patients although they had initially required a longer postoperative rehabilitation phase. Pseudocysts, which had been drained, showed no diminution of the pancreas function, nor any tendency to rest-pancreatitis.


[Coecal complications in distal colonic obstruction (author's transl)].

Construction and function of the colon leads to dysfunction of the coecal region as a result of obstruction of the distal part of the colon. Painful coecal distension, ischaemic inflammatory bowel-wall disturbancy, perforation, or secondary appendicitis are the most frequent complications. Because of these complications, the real origin of the illness is often micjudged. In diagnosing appendicitis in the aged patient, distal colonic stenosis should be considered and, if possible, excluded. 6 cases of coecal complications (6,3%) in 96 patients with distal colonic cancer were observed.


[Radiation in inflammatory diseases of the hand (author's transl)].

Pyogenic infections endanger the function of the hand. X-ray therapy beginning as early as possible has a good effect. From 1960 to 1975 170 inpatients and 250 outpatients were treated in this way. It has to be emphasized that surgical therapy cannot be replaced by X-ray therapy, but early radiation helps to keep disfunction (handruins) low.


[Injuries of the knee joint (author's transl)].

Immediate operative reconstruction of ligament injuries of the knee joint is recommended for the performance age. The optimal operation time is within 24 hours after the accident, it should be done within 72 hours. The important advantage of this early operation in comparison to a non-operative treatment is the possibility of an exact reconstruction of the damaged ligaments and the distinct shortening of the rehabilitation time.


[Conservative or operative treatment of fractures of the head of the tibia (author's transl)].

Whether fractures of the head of the tibia have to be treated conservatively or surgically in an active way depends on the type of the fracture. In cases with small dislocation conservative treatment should be given priority. Only fractures with badly dislocated fragments should be operated on (osteosythesis).


[Fistula carcinoma arising from chronic osteomyelitis (author's transl)].

224 cases of fistula carcinoma arising from chronic osteomyelitis from literature and 6 own observations are reviewed. This malignancy results in about 1,5% cases of chronic osteomyelitis. The mean age of all patients was 55.7 years. The sex relation male to female was 7.4:1. The time from the beginning of the chronic osteomyelitis up to the diagnosis of the fistula carcinoma was 33.6 years. This time is called "Exposition time". The analysis of this time shows that, the older the patient was at the beginning of the chronic osteomyelitis the shorter was the exposition time.


[Morphological change of lipids in the vaginal epithelium after intrauterine fetal death (lipid test)].

The authors studied the lipid content of the vaginal epithelium of gravida in whom intrauterine fetal death had occurred. Fifteen gravida in the 6th to 10th month of gestation were examined and an unusual, inconsistent with the respective gestation term increase in the intra- and extra-cellular lipid content of the vaginal epithelium demonstrated. This is related to a decrease in the amount of estrogen hormones secreted by the placenta. A cytochemical 'lipid test' based on the above findings has been developed by the authors for the diagnosis of intrauterine fetal death during the second half of pregnancy.


[Changes in the age-specific fertility distribution in the GDR (German Democratic Republic) between 1968 and 1973].

The evolution of the agespecific fertility by its dependence of the order of life-births is analysed in this paper. These terms are further calculated on the basis of life-tables. It became evident that the behavior of reproduction of women of the GDR 1968-1973 is well described by the evolution of the structure of birth-order. It is calculated, that about 5% of all women at the age of fourteen participate the reproduction of the population up to the age of forty five. The trend to 1 respectively 2 children a women was increasely carried in the years 1972/1973 so that we have a real loss by life-births.


[Pilot study on interval gradation for the evaluation of conditions related to the desire to bear children].

The purpose of this investigation was to test the method of Comparative Judgement in connection with the question, which conditions are relevant, if a woman want to give birth to a child. 31 pregnant woman, who intend to get interrupted their pregnancies had to decide by pairs about conditions which relate to health, age, parity, education, calling resp. profession, situation of dwelling and income and to personal or confessional questions. On the basis of the Law of Comparative Judgement (Thurstone 1937) we constructed an interval scale about these conditions.


[Complex therapy of functional sterility].

Discussed are 41 pregnancies following a 6-months successful complex therapy of functional sterility. The patients were transmitted to the centers of prenatal care. The complex therapy enabled an increase in the present successful treatment with Clomiphen from 45 to 65 per cent of cases.


[Obstetric problems--with special reference to cesarean sections--at the University Hospital for Women in Oran (Algeria)].

Report of a 2-years-period of obstetrical work in the maternity-hospital of the Univeristy, Oran in Algeria. Caesarean section as the most important obstetrical operation is examined more closely with regard to the indication and the methods of operation. The incidence of uterine rupture and caesarean hysterectomy is reported. Finally common experiences are mentioned.


[Persistence of right umbilical vein--a rare vascular abnormality of the umbilical cord].

We report on a persistent V. umbilicalis dextra as an extrem rare anomaly of the  vessels of the umbilical cord and its embryological base. The compression of this umbilical cord was responsible for the emergence of abnormal QRS-complexes in the fetal electrocardiogram according to typus 2 by Larks. To detect these anomalies of vessels should be investigated on princip every umbilical cord.