Coronary artery disease with single coronary artery.

The authors have reviewed the literature in search of the coexistence of single coronary artery with significant coronary artery disease. Two cases of single right coronary artery are described. In both, the anomalies were unsuspected and diagnosed roentgenographically in life. Both patients had angina pectoris, positive graded-exercise stress tests, and hemodynamically significant obstruction or occlusion to the coronary arteries. In neither case was the stenosis proximal or amenable to bypass surgery.


[Mechanics of breathing and contractility of myocardium of right ventricle in chronic bronchial obstruction (author's transl)].

The Reaction of the right ventricle on pulmonary hypertension in chronic bronchial obstruction is to be described. Limitation of myocardial contraction-capacity may be measured by - the index of contractility, - the tension-time-index of the right ventricle and - the tendency of systolic stain-pressure to reach diastolic pulmonary arterial pressure in time of maximal pressure-elevation-velocity.


[Hemodynamic analysis of pulmonary circulation by microcatheter technique in healthy persons and in patients with pulmonary silicosis (author's transl)].

A comparison of hemodynamic analysis of pulmonary circulation in 18 healthy men (PM less than 20 Torr) and 19 patients with pulmonary silicosis (PM larger than or equal to 20 Torr) at rest and under work load gave following results: In most healthy persons pulmonary pressure rose under load while resistance of pulmonary circulation decreased significantly. In patients with silicosis pulmonary pressure being elevated at rest reached pathological values under load while resistance of circulation decreased less. There was no difference in cardiac time-volume between both groups. The authors found a linear correlation between cardiac time-volume and oxygen uptake related to body surface. They derived a formula of approximating cardiac time-volume by oxygen uptake and body surface.


[Analysis of pulmonary mechanics in patients with silicosis (author's transl)].

Parameters of pulmonary mechanics were measured at rest and during physical effort in patients with silicosis and normal subjects. Between normal subjects and patients with silicosis of stage I a significant difference could not be found. However, a decrease of dynamic compliance and an increase of elastic work of breathing were found in patients with silicosis III during exercise. The PT/VT-quotient is already high at rest. These results are not in agreement with the subjective symptom "dyspnea". The feeling of dyspnea appears when the PT/VT-quotient is enhanced signifcantly during exercise in comparison with the value at rest. Therefore, only the PT/VT-quotient is a suitable parameter indicating dyspnea.


[Bodyplethysmographic analysis in patients with silicosis (author's transl)].

Pulmonary airway resistance was measured in patients with silicosis and in normal subjects using a volume-constant bodyplethysmograph. Values of total resistance RT were compared with spirometric ventilation parameters, oxygen tension during steady-state-exercise and arterial blood pressure. The analysis shows a significant relationship between status of silicosis and the degree of resistance. Resistance values were found enhanced also in comparison with a decrease of vital capacity and FEV1 and with an increase of residual volume and arterial blood pressure.


[Computer analysis of mechanics of breathing by semi-on-line technique (author's transl)].

A program for the analysis of lung mechanics based on esophageal technique and running on mini-computer Cellatron 8205 is described. There are two varieties of analog-digital-conversion of primary flow- and pressure-signals from magnet tape storage to punch tape input channel using transposition of frequency either with sequential or alternating data collection oriented on respiratory half-cycles and unlimited in view of function test time. The program gives a complete status of lung mechanical parameters per respiratory half-cycle and total-cycle, that is pulmonary compliance, elastance, maximal resistance, minimal resistance, peak flow resistance, initial and terminal standard flow resistance, total, static and dynamic work of breathing, power of breathing. Output is provided both in writing and punching results to establish the connection with sequential high-level programs of lung mechanics and statistical data processing.


[Generation and determination of pulmonary distribution disturbances (author's transl)].

Pulmonary distribution disturbances could be generated in patients with bronchial hyperreactivity by inhalation of a Falicain aerosol (Propoxipiperocainhydrochlorid); The inhomogeneities of ventilation and mechanics of breathing were determined by means of several simple and complex methods. Comparison between these methods of analysis of distribution shows that small alterations of inhomogeneity can be indicated also by simple screening tests. The results confirm the significant relationship between ventilation disturbance and pulmonary inhomogeneity. Distribution disturbance enhances both the obstructive and the restrictive component of a ventilation disturbance. These two components cannot be separated exactly by means of the parameters of ventilation and mechanics of breathing because of the influence of inhomogeneity. The generated disturbances of distribution and ventilation became regular after inhalation of an Alupent aerosol.


[Ventilation, gas-exchange and pulmonary arterial pressure during aerosol inhalation of sympathicomimetics (author's transl)].

The effect of inhalation of Novodrin (beta-receptor-stimulus), Phenylephrine (alpha-receptor-stimulus) and of a mixture of both was tested in patients with chronic nonspecific respiratory syndrome. There was no significant difference of pulmonary arterial mean-pressure. Forced expiratory volume and vital capacity rose both after inhalation of Novdrin and after inhalation of the mixture. Nevertheless inhalation of the mixture can not be recommended because of a significant decrease of arterial oxygen-tension.


[Blood gas-analysis and heart catheterisation in newborns with extreme low oxygen content of arterial blood because of congenital heart failure (complete transposition of great vessels) (author's transl)].

Importance of atrial septostomia in newborns with complete transposition of the great heart vessels was to be proved in 75 children, 27 of them with an atrial shunt and 48 without additional shunt. Arterial oxygen-tension while breathing roomair rose from 19 Torr without shunt to 29 Torr after septostomia. Corresponding values while breathing oxygen are 23 Torr before and 40 Torr after septostomia. In 14 children 2-5 years after septostomia control-values of oxygen-tension were 42 Torr in aorta (ventr. dext.), 34 Torr in v. cava, 67 Torr in a. pulm. (ventr. sin.) and 104 Torr in v. pulm. Differences of oxygen-content were 2,97 vol.% between aorta and v. cava, 2.83 vol.% between v. pulm. and a. pulm., 7.46 vol.% between v. pulm. and aorta and 10.34 vol.% between v. pulm. and v. cava.


[The efficacy of spironolacton in cardiopulmonary insufficiency (author's transl)].

In 17 patients with cardiopulmonary insufficiency the authors found a significant positive inotropic heart effect and a moderate improvement of ventilation after one injection of 400 mg Spirolacton. 2. The positive inotropic effect is experimentally confirmed in 8 dwarf pigs. 3. In 13 patients with severe cardiac and cardiopulmonary insufficiency a tendency to normalization of arterial blood gases, of actual bicarbonate and of vital capacity was found. There may be an indirect effect on the respiratory center by alteration of acid-base-status and by diuresis causing diminuation of pulmonary compliance. Spironolacton seems to be a valuable therpeutical completion in cardiac and cardiopulmonary insufficency in its intravenous quick application and its oral time application.


[Alternate-day prednisolone therapy in lung sarcoidosis (author's transl)].

Thirty patients with a biopsy-proven sarcoidosis of the lung (state I = 5, state II = 24, state III = 1 patient(s) were subjected to a primary alternate-day prednisolone therapy. After a treatment of 6 months all signs of sarcoidosis of state I and about two thirds of state II disappeared completely. In one third of the cases of state II (mainly broad focal and extensively infiltrative types of sarcoidosis as well as relapses the inflammatory changes in patients could be suppressed, but moderate fibrous residues remained. One case of progressive sarcoidosis of state III proved to be nearly resistant to therapy. Substantial side effects were not observed. Since the alternate-day prednisolone therapy is highly effective and nearly without any risk it is recommended to all patients with sarcoidosi needing therapy.


[Results of catheter biopsy and catheter aspiration in various lung diseases (author's transl)].

Results of 415 catheter biopsies and catheter aspirations in patients with various lung diseases are reported. Among 263 patients with suspected carcinoma of the lung, in 79% neoplastic cells could be obtained histologically from catheter biopsy specimens. Among 52 patients with suspected pulmonary tuberculosis but without positive sputum, tubercle bacilli were found in 23% by aspiration biopsy. The bacteriological examination of bronchial secretion in various lung diseases showed a prevailing growth by diplococcus pneumoniae, and more sterile conditions in the peripheral bronchial airways of 56 patients. Catheter biopsy proves to be a valuable diagnostic method for the detection of peripheral bronchial carcinomas and the catheter aspiration for the bacteriological examination in specific and non-specific lung diseases.


[Pulmonary changes in a female patient with Pringle's syndrome (author's transl)].

The Pringle's Syndrome (Synon. adenoma sebaceum) is a very variable illness, based on a congenital neuroectodermal genetic defect. The hereditary transmission is dominant and it can be very various. The pulmonary involvement in Pringle's Syndrome is very rare. A case of a 25 year old female patient is demonstrated. She suffered on spontaneous pneumothoraces in both sides and had many typical alterations in other organs. Further examinations revealed disseminated small cystic alterations in the lung. Histologically these changes are based on a congenital defect of bronchioli. The patient's cardiopulmonal efficiency is assessed regarding to its prognosis. Finally the necessity of genetic care for patients with Pringle's Syndrome is pointed out.


[Mediastinoscopy and scar-keloid's in boeck's sarcoid (author's transl)].

The paper represents the results of the mediastinoscopy in 135 cases of Boeck's sarcoid. The frequent formation of keloid's in the scar of the mediastinotomy is emphasized. The histological examinations of the scar keloid's after mediastinoscopy are compared with histological examinations of scars after resections of the thyroid glands. The possible reasons of the differences are discussed.


[Pericardial injuries due to mediastinoscopy (the anatomy of the recussus aorticus pericardii) (author's transl)].

According to results obtained on the topographical studies of the anatomy of the recessus aorticus pericardii the authors stress the possibility of the vulnerability of the pericard due to mediastinoscopy, since its retroaortal fold reaches up to the truncus brachio-cephalicus and its broad-assertion up to the a. pulmonalis.


[The bronchusplasty with lung-resections -- a conservative method of operation in tumor surgery (author's transl)].

Report regarding 32 patients with bronchusplasty in lung resections on account of semimalignant and malignant tumors. Operative indications, -technique, postoperative complications and results up to now are discussed.


[Pulmonary artery pressure in the pathophysiology of lung-resections therapy. Part I: standard values, surgical lung diseases, postoperative death rate (author's transl)].

The early death rate after lung-resections is caused mainly by right heart failure. The level of pulmonary blood pressure plays a decisive role in this respect. In patients with surgical lung diseases the blood pressure is significantly higher in several parts of lung circulation than in healthy persons. The early death rate after operation was found to be increased in patients with a higher level of preoperative pulmonary artery pressure.


[Pulmonary artery pressure in the pathophysiology of lung-resections therapy. Part II: bronchial carcinoma and pulmonary tuberculosis (author's transl)].

Patients with lung resections due to bronchial carcinoma have a much higher early death rate than patients with lung resections because of pulmonary tuberculosis. Functional failure of the cardiorespiratory system and right heart insufficiency are considered to be the main reasons for this difference. Intracardial pressure values were compared between 530 patients with bronchial carcinoma and 200 patients with pulmonary tuberculosis revealing significantly higher pressure values in the right heart and pulmonary artery for patients with bronchial carcinoma. Predisposing factors of the aged people are fundamental in this respect.


[Pulmonary artery pressure in the pathophysiology of lung-resections therapy. Part III: pre- and postoperative investigations (author's transl)].

50 patients were investigated by right heart catheterization to determine the range of blood pressure values in lung circulation after lung resection. A comparison between pre- and postoperative blood pressure values was conducted in 29 patients and a significant increase was found. In some patients the blood pressure values after pulmonary lobectomy rose to 50% and after pneumonectomy to 100% above the preoperative values. Changes of the investigated aterial pressure differences proved to be not statistically significant.


[Relation between manifest bronchial obstruction and bronchial hyperreactivity (author's transl)].

Based on the inquiry of 252 patients an investigation was carried out concerning the frequency of manifest bronchial obstruction in dependence on the bronchial hyperreactivity. Patients with bronchial hyperreactivity showed more frequently with a high significance as well a decrease in the FEV1 as an increase of resistance. Therefore in dependence on the occurrence of a manifest bronchial obstruction also the probability of a simultaneous presence of bronchial hyperreactivity increases. The results are important for understanding the functional dynamics of the bronchopulmonary system, especially the evocation of dyspnea by irritation of the respiratory tract.


[Evaluation of the tussicular reaction in bronchial provocative testing with acetylcholine (author's transl)].

A simple method for registration of the tussicular effect in bronchial challenging is described. The results, obtained in this way, are discussed for their informative value. In bronchial challenging with acetylcholine tussicular reaction in all groups of patients is more frequent than broncho constrictive reaction. Evaluated on clinical defined diagnoses respectively anamnestic date there is a good sensibility of the test (index for sensibility 0.85). Till now the date of specifity are not satisfying. It could be solved only by means of longitudinal studies, if these "false-positive" results have an early diagnostive value with regard to beginning functional disturbances in the airways or if they coincide with diagnostic uselessness of the test.


[Contribution on prevention, diagnosis and treatment of pulmonary embolism (author's transl)].

In the 50 year period between 1917 and 1966, 915 patients, 0.44% of the total surgical patients at the Surgical Clinic of the University of Jena, died from pulmonary embolism. In 20% of the cases autopsy failed to disclose any thrombus. Among 714 fatal cases of postoperative lung embolism, 43% occurred after abdominal surgery, 18% after surgery on the extremities, and 14% followed urogenital operations. Peak incidence of lung embolism fell on the day of operation and on the 6th, 7th, and 13th postoperative day. Patients at risk of embolism can be identified beforehand. The incidence of pre- and postroperative pulmonary embolism can be reduced to a great extent by specific preventive measures carried out prior to, during, and after surgical intervention. Prevention, diagnosis, and present day treatment of pulmonary embolism are discussed.


[Rise in incidence of pulmonary embolism fatalities among surgical patients and disposing factors involved. Analysis for a 50 year period (author's transl)].

During the 50 year period from 1917 to 1966, 210078 patients were treated in the Surgical Clinic of the University of Jena. Autopsies were carried out on 10083 of the patients which had dies in the Clinic. The average incidence rate of lung embolism was 0.44%, the range of values lying between 0.04% (1917) and 1.02% (1965). In periods of famine or distress, lung embolism reached its lowest point, whereas in periods of relative prosperity a high peak was reached. On the whole, the incidence of pulmonary embolism seem to be the increased age of the patients population and the higher frequency of associated heart and circulatory diseases, obesity, and accidents, as well as the extended indications for surgery in the aged.


[Mediastinoscopy in preoperative assessment of operability in patients with bronchial neoplasms (author's transl)].

The results and conclusions of the endoscopic exploration of mediastinum in 352 patients suffering from bronchogenic cancer are analysed. The importance of mediastinoscopy is emphasized especially in the assessment of operability. In the opinion of the authors the cancer is not operable, if metastases are found in the paratracheal and contralateral lymphnodes. Only in young men the extended resection should be done in individual cases if mediastinal lymphnode metastases are detected. Regarding these indications the rate of explorative thoracotomy could be reduced to 10%. The particular importance of preoperative examination of load capacity of the heart and circulatory system is stressed. Finally it is concluded, that an decisive improvement of the common prognosis of the bronchogenic cancer is only possible by an earlier detection and a more rapid introduction of therapy, but not by the extension of the surgical procedures. The enlargement of the surgical procedure should be decided individually. The great possibilities hencefollowing for the mass x-ray examinations are emphasized.


[Complications of mediastinoscopy and their effects on the choice of indication (author's transl)].

Complications of 735 mediastinoscopies are evaluated. In the small number of early complications the bleedings and unjuries of pleura dominate in the described group of patients. At no time a thoracotomy was necessary. The danger of bleeding from an aneurysma of the aorta is pointed out, which is rare but possible early complication. The inoculated metastases do not deteriorate the prognosis of the bronchogenic cancer, if the mediastinoscopy is strictly limited to the paratracheal and tracheobronchial lymphnodes. The observation of a metastasis in the collar cicatrix following three months after mediastinoscopy due to cancer of the oesophagus is described. The low number of observed complications in the opinion of the writers does not justify to limit the range of indications for mediastinoscopy, its diagnostic value is high.


[Acute courses of sarcoidosis which clinically appeared as rheumatic diseases (author's transl)].

After a short review on the manifold relations between rheumatic and pulmonary diseases this aspect is exemplified in detail by acute sarcoidosis. Report on 31 patients with Loefgren-Syndrome, admitted to the rheumatologic-cardiological clinic between 1968 to 1973, nearly all with the suspicion of rheumatic fever. Their symptoms, clinical findings as well as the diagnostic programme carried out is described.


[Clinical picture of a generalized BCG vaccination tuberculosis as an expression of a progressive septic granulomatosis (author's transl)].

Report on a boy, now 3 years old, who presented the typical clinical picture of a BCG generalization during infancy. The BCG agents were verified in the lymph node. Intensive tuberculostatic therapy in combination with the transfer factor failed. The negative NBT test revealed a progressive septic granulomatosis.


[Effectivity of intermittent RMP/EMB treatment in patients with chronic pulmonary tuberculosis (author's transl)].

59 patients with far advanced chronic pulmonary tuberculosis were treated, after a three months daily period of RMP/EMB and a third drug, with RMP 1.2 g and EMB 50 mg/kg twice weekly for the following 9 months and there after with EMB 50 mg/kg twice weekly for another 12 months. Sputumconversion was achieved in all patients within four months. Except for one bacteriological relapse during the 10th month of therapy all patients were TB-negative up to the end of at least four years (4-6 1/2 years) after onset of treatment. In nearly 78% of the patients the treatment was fully accepted and well tolerated during the first year. 8 patients had systemic reactions due to RMP between the 7th and 12th month. Only in 5 patients RMP had to be substituted by another drug. The regimen has proved to be highly effective, well acceptable and tolerable. It could be administered fully supervised.


[Effectivity of intermittent treatment in patients with sputum-positive silico-tuberculosis (author's transl)].

89 patients with sputum-positive silico-tuberculosis got a fully supervised administered antituberculous treatment with intermittent regimens during the years 1969-1974. 65 of the patients had a history of former antituberculous treatment. In only 5 patients the treatment was unsuccessful. Four of the relapses were observed between the 6th and 11th month of treatment. One patient had a relapse 56 months after the onset of chemotherapy. The results indicate that only the quality of the anti-TB treatment is of importance for the course of the tuberculous component in silico-tuberculosis. The results are comparable with those of uncomplicated TB of the lungs.


[Malformations of the lung with abnormal hemodynamics (author's transl)].

The various forms of combinations of bronchopulmonary and pulmonary vascular abnormalities are classified by their special hemodynamic. They are called "pulmonary malformations with abnormal hemodynamics". 11 cases were observed, operated and analysed.


[Compensative dilatation of the vena azygos by abnormalities of the vena cava inferior - a contribution to the differential diagnosis of the tumorsuspected right tracheobronchial angle (author's transl)].

Report on 2 patients, with a mediastinal enlargement at the right tracheobronchial angle revealing an ectasis of the orifice of vena-azygos. It could be shown that the enlargement of the vena azygos ist due to an increase of the flow-volume, caused by an abnormal embryonic drainage of the vena cava inferior into the vena azygos. The diagnostic possibilities for differentiation from vascular and nonvascular space-occupying processes in that region are discussed. An exact diagnosis is possible by angiography.


[Rationalization and standardization in the diagnostic of pleural effusions (author's transl)].

238 pleural effusions found within five years among our patients were investigated according to a prospective fixed scheme, and analysed according to diagnostic groups. In accordance with other authors a predominance of the malignant pleural effusions was evident. Besides the cytohistologic diagnosis proving 84,6% of the pleural effusions of malignant origin, some of the biochemical parameters are of decisive value. In our opinion laboratory examinations should be abandoned which do not contribute effectively to establish the diagnosis. For rationalization a routine programme with five examinations is being proposed: total protein and specific gravity, pH, bacterial examination and cytology.


[Contribution on the chronic fibrinous bronchitis (author's transl)].

The present report deals with an actual case of the rare chronic fibrinous bronchitis. With references to previous publications on this subject the picture of the disease is described on the basis of an actual case. A review of the literature available and the investigation of the actual case have led to parameters of the disease mentioned, which are typical and indicative of this disease. It has been found out that chronic fibrinous bronchitis is diagnosable by clinical means. Problems concerning the therapy, prognosis and etiology are discussed.


[Results of comprehensive respiratory function tests in CNSLD (author's transl)].

34 persons with CNSLD, but fit for work, were examined with the aim to record the degree of disturbance of pulmonary function and the underlying pathophysiological mechanism. The results were compared with 30 healthy subjects. The following function tests were carried out under resting conditions and bicycle ergometer exercises: Analysis of ventilation (FVC% pred., FEV1% FVC, RV% pred., RV% TLC), analysis of lung mechanic (Raw, CL) measurement of diffusion (DL, DM, Vc, DL% pred.) and analysis of lung inhomogeneity (RE/REO, V2/V1, CL6/CL100, deltaFN2/deltaV500, deltaFCO2/deltaV500,IHB). The results were analyzed and evaluated by using the digital computer C 8205. Persons suffering from CNSLD were showing among typical clinical symptoms the following disturbances of lung function: The obstructive ventilation disturbance stands in the foreground in connection with signs of inhomogeneity of lung mechanics and ventilation. While the resistance already shows the airway obstruction objectively under resting conditions, the decreased compliance is measurable at first under exercise. The disturbance of diffusion, which is pointed out, is mainly a latent decreased diffusing capacity of alveolo-capillary membrane. These disturbance of diffusion gets more importance because the inhomogeneity of lung hides the real disturbance of diffusion. The pathophysiological consequence of disturbed partial functions of respiration is the latent hypoxaemia without hypercapnia, therefore the signs of respiratory partial insufficiency.


Intestinal absorption of iron alone and in combination with authentic or natural vitamin C and carotene.

The effect of vitamin C and carotene derived from authentic or natural sources on intestinal iron absorption was studied. Vitamin C caused slight enhancement to iron absorption, while carotene hindered it. The three juices tested, namely orange, parsley and pepper, which were found to be rich in these two vitamins, hindered intestinal iron absorption to different extents. It was recommended that patients suffering from iron deficiency are not supplied with nutrients rich in carotene particulary during iron therapy.


The use of Lupinus termis L. cultivated in Egypt, as a food protein supplement.

1. General analysis of the seeds for protein, fats, carbohydrates, fiber and ash contents were carried out and the results were given in g/100 g dry seeds. Lupinus termis contained a higher percentage of protein (40.36), 290 mg calcium and 6.5 mg iron. 2. All the essential amino acids are present in fair amounts with the exception of sulphur-amino acids and Lysine. 3. Cooking the seeds resulted in a slight decrease of most of the amino acids with the exception of Tryptophan and Lysine, which exhibited a slight increase after cooking. 4. Of the toxic substances present in the seeds is Trypsin inhibitor, which was destroyed by heat treatment, and alkaloids, which were removed by soaking the seeds three days in running tap water. 5. Supplementing the debittered seeds with Lysine and Methionine resulted in an increase in its nutritive value.


[Electrolyte metabolism in obese subjects with various forms of therapy].

In 30 obese subjects three different methods for weight, reduction were applicated over a period of 14 days. One group (n=10) was treated with total starvation, the other group (n=10) with total starvation and 80 mval potassium in addition and the third group (n=10) with a 700 cal. diet. In total starvation the balance of sodium, potassium and phosphate amounted to -9 mval/d, -34,9/d and -8,8 mval/d respectively. Whereas calcium showed a positive balance of 4,4 mval/d. During addition of 80 mval potassium sodium excretion increased whereas potassium excretion was diminished resulting in a potassium balance less negative. During treatment with the 700 calorie diet the highest negative sodium and a high positive potassium balance were observed,


Comparison of xylitol and glucose metabolism in nonhepatic rat tissues.

Capability and extent of xylitol metabolism in vitro was studied in a variety of non-hepatic tissues of rats, using enzymatic and isotopic methods. Only kidney was found to be able to utilize xylitol at a significant rate while in all other organs tested - lung, brain, heart muscle, skeletal muscle and adipose tissue - no uptake of xylitol was detectable using two independent methods. In accordance with these results the incorporation of radioactivity from [U-14C]-xylitol as substrate into the products CO2 and lactate was found to be very small in all organs with the exception of kidney and when compared to that from [U-14C]-glucose it was less than 5%. From these results it is concluded that besides liver only kidney can utilize xylitol to a significant extent while for the other tissues studied xylitol is not a suitable substrate.


[Comparison of time, material and preparation costs as well as nutritive value of conventionally prepared soups and sauces and corresponding "convenience foods"].

In a survey the food and labour costs arising in connection with the preparation in feeding centers - with about a thousand dinners - of conventionally cooked soups and sauces and corresponding convenience food were determined. For soups food costs are lower for convenience food than for conventionally prepared soups. Regarding the sauces, the costs of one of the two preparation manners is not definetely more favourable than the other one. The cost scheme will shift to the disadvantage of convenience food whenever it has to be modified in default of a comparable product, as for instance in the case of béchamel-sauce and horse-radish sauce. Considering the factor time, convenience food will be unambiguously superior to conventionally cooked soups and sauces. The preparation of convenience soups takes only between one fifth and one eighth of the necessary time for the preparation of conventionally, of sauces only between one sixth and one twelfth of the required time. Soups and sauces made out of convenience food have a lower energy content than the conventionally cooked ones.


Nutritive studies on some raw and prepared leguminous seeds commonly used in the Arab Republic of Syria.

1. The proximate analysis of raw Syrian lentils (Lens esculentus), variety red chick pea (Cicer arietinum) variety balady, has been made. The protein content of the two raw seeds were 23 and 22 g% for lentils and chick peas, respectively. Ethereal extract, fiber, ash, calcium, phosphorus and iron content of the two raw seeds have been also assayed. 2. The levels of most of the amino acids were also estimated in the raw and cooked seeds. It was found that tryptophan- and sulphur-containing amino acids were the most limiting ones. Cooking the seeds by the same methods commonly used in Syria resulted in the loss of most of the amino acids, with the exception of lysine and tryptophan which were slightly increased. 3. Trypsin inhibitors and saponins were detected in the raw seeds. Haemagglutinins were present in raw lentils only. Cooking the seeds destroyed the trypsin inhibitors and haemagglutinins and did not affect the saponins. 4. The net protein utilization of whole lentils and chick peas were 38 and 53, respectively. Decortication of lentils or cooking without decortication has no effect on the NPU values. Cooking the decorticated lentil seeds raised its NPU values from 38 to 56. Cooking chick peas resulted in a slight increase in their NPU. Supplementation of the raw and treated seeds with methionine and tryptophan raised its NPU values markedly.


Effect of vitamin C and carotene on the absorption of calcium from the intestine.

The effect of vitamin C or carotene either in the authentic form or naturally occurring as in orange, parsley and pepper juices on calcium absorption was studied. Results obtained revealed that ascorbic acid, orange and pepper juices enhanced intestinal calcium absorption. Carotene and parsley proved to be without effect.


[Lupine, a contribution to the human food supply. 4. Acceptability of Lupinus alba flour].

48 different dishes enriched with lupinus albus flour have been tested by 20 persons. The test duration has been 4 weeks. Meals and products with lupine admixtures have been judged equally with concern to corresponding conventional dishes. Farinaceous products had the best test results. Therefore, it is recommended for Peru to add lupine flour when producing bread, biscuits, sauces, soups, and noodles (maccaronis etc.). The test time had no influence to the test results.


[General problems in the diagnosis of cancer].

Cancer distingishes itself from other chronic diseases in internal medicine by the chance of complete and constant cure in "early" recognition and treatment. The well-timed diagnosis, therefore, is decisive for the fate of the patient. This increases the responsibility of the internist. Early recongnitionof the cancer by well planned medical check-up meets with close boundaries and is nowadays only justified for malignant tumours of the cervix uteri, the mammary gland, the stomach and the lung. The dispensary care of risk groups favours the higher quality of the work of the physician, but is not able to reduce decisively the problem. The dispensary care has important functions in the field of health education and thus also aims at the primary prevention. Quick and relevant diagnostics in complaints is at present and in near future the most important way to the recognition of cancer in the curable stage. Careful general examination of the body and aimed questioning after danger signals independent of the reason of the consultation may improve the situation. Apart from the recognition of the cancer the disribution diagnostics and the judgment of the general resistance to stress are responsible tasks of the internist.


[The paraneoplastic syndrome].

The notion of the paraneoplastic syndrome contains a great number of signs which are not to be explained by the local growth of the tumour. The disturbances may express themselves in form of fever, anorexia and cachexia, or they may also affect selectively determined organs. As a cause for these tumour-associated changes, apart from unspecific and specific metabolic functions of the tumour cell, also the sequelae of immunological reactions between tumour and host organism are made responsible. The metabolic remote action of malignant neoformations proved as clearly manifest above all in the paraneoplastic endocrinopathies. Though most of the paraneoplastic syndromes are not strongly specific for the tumour their knowledge may be significant in the diagnostics and control of the course of neoplasias. This is also the case in emergency situations which can be evoked by such pathological processes. The most important paraneoplastic syndromes and problems of their pathogenesis are explained.


[The importance of endoscopy in oncology].

The importance of the praetherapeutic histological manifestation of tumours is emphasized. In many cases for this purpose an endoscopy with biopsy is necessary. A particular role plays the endoscopy in urology, bronchology and gastroenterology. The endoscopy significantly developed by the introduction of fully flexible glass fibre endoscopes. This particular considers the gastroenterology. Several regions, such as the duodenum, the small intestine and the colon, were thus first accessible to endoscopic biopsy. Indications and possibilities of the individual endoscopic methods are mentioned. As to the question, who individually should perform the endoscopy, the opinion is expressed that every specialist should perform the endoscopy in his field. The performance of all endoscopic methods by one specialist, independent on the speciality, actually gives some technical advantages, which, however, do not compensate the disadvantages concerning a qualified total diagnostics of the diseases. During the last years by the removal of the polyps the endoscopy in an increasing stage also becomes a therapeutic method. At present the technical possibilities of endoscopy came to a certain close. By all means necessary is, however, the further distribution of the endoscopic methods which depends on the availability of adequate endoscopes.


[Nuclear medicine in tumor diagnosis].

After introductory comments on the principle of the tumour scintigraphy and the factors influencing the scintigraphic demonstration the author adopts a definite attitude to the scintigraphy of thyroid gland, brain, lung, liver pancreas, kidney, bone, spleen as well as lymphatic nodes, liquor spaces and adrenal glands from the point of view of tumours diagnostics. For the purpose of a better survey for the first seven organs uniquely the problems are demonstrated according to the principle of examination, method of examination, indication to the tumour diagnostics, preliminary examination and prerequisite to the scintigraphy, the problems of scintigraphy and the functional capacity of other methods.


[Age-corrected analysis of glucose tolerance in blood relations of patients with juvenile onset diabetes mellitus].

Intravenous glucose tolerance test(taking the age dependent variabilities of the glucose assimilation into consideration) was performed in 68 blood relations (30 siblings, 19 parents, 19 children) of 19 patients with juvenile onset diabetes mellitus (JODM). In 29,4% of the first degree relatives (in 20% of the siblings, in 42% of the parents and in 31,6% of the children) an abnormal glucose tolerance was found. Four of the siblings presented with insulin dependent JODM. Glucose intolerance was detected more often (42%) in siblings and parents of patients with later onset (after age 25) JODM than in siblings and parents of JODM-patients with onset before age 25 (20%).


[Longitudinal study on the locomotor function test in patients with rheumatoid arthritis].

With  the help of a four-year observation of the course of rheumatoed arthritis in 100 patients the evidence of the locomotor functional test after Keitel is examined for the longitudinal research. The locomotor functional test proved depending on the actual activity and in a high percentage of patients showed considerable variations from year to year which were not parallel to the clinical and radiological progression. It is not sufficiently evident as the only criterion for the establishment of the progression of the disease. The locomotor functional test is well suited for the  judgement of the success of therapy in short periods and the objectivation of the actual restriction of the function especially for questionings of experts. It is proposed to include the locomotor functional test into the criteria for the establishment of the degree of function.


[Contribution to the clinical picture of Wegener's granulomatosis].

On the basis of 5 casuistics of Wegener's granulomatosis the author deals with the difficulties of the diagnosis and differential diagnosis, whereby above all is referred to the preculiarities of the cases and the malinterpretation of the diagnoses on admission to the hospital.


[Functional study on the sense of smell in patients with chronic liver disease].

In olfacto-odorimetrical examinations of 32 patients with chronic liver diseases (18 female and 14 male patients at the age of 23 to 77 years) 13 patients with a disturbed olfactory function were found. With one exclusion these patients suffered from liver cirrhosis. On the basis of the anamnesis in 10 of these patients a causal connection between disturbance of smelling and liver disease could be assumed. Out of this group with chronic active hepatitis of 10 patients only 1 patient had a disturbed olfactory function. In 8 patients with disturbed olfactory function suffering from liver cirrhosis a comparison of the olfactometrical findings with activity of GOT and GPT in the serum and the serum bilirubin content showed a correlation between possibilitiy of smelling and serum bilirubin level. Possible causes of appearing olfactory disturbances are demonstrated in short.


[The primary gallbladder neoplasm].

From 1960 to 1975 in the Surgical Clinic of the Medical Academy Erfurt altogether 77 patients with a primary malignoma of the gall-bladder were observed. Symptomatology and findings are non-characteristic. 64 times a laparotomy was carried out, whereby in 51 cases the intervention had to be finished as test laparotomy. 13 times a cholecystectomy or a biliodigestive anastomosis was carried out. The average survival time of the patients with test laparotomy was 53 days. A survival time of more than one year could nertainty. Issuing from this the author adopts a definite attitude to carcinogenesis and the importance of lithiasis.


[The reproducibility of the acetylcholine test and the effect of the respiratory flow rate].

The reproducibility of the acetylcholine-test results was controled by means of comparative investigations on 50 patients. The method of investigation render it possible with a high reliability to exclude a bronchial hyperreactivity. However, a single positive diagnose needs an additional control examination with reference to the interpretation of evidence. The different test results are caused by the biological variability of the bronchial hyperreactivity; on the other hand, an influence of variability of the minute output of breathing could be excluded.


[Learning gastroenterologic endoscopy].

1. Knowledge of the gastroenterological endoscopy and biopsy is necessary at all levels of medical education. 2. Knowledge of students: possible methods, diagnostic effectiveness, stress of the patients. Knowledge of the candidates for specialisation: indications, contraindications, possibilities of the method also in reference to the individual case. Persons interested in the subspecialisation gastro-enterology: theory, possibilities and limits, technical performance. Experienced endoscopists: regular refreshment and supplementation of knowledge and skill in highly specialised endoscopic centres. 3. Tested teaching methods are lecture, report, study of atlants and text-books, demonstrations of diapositives in connection with schematic figures, seminars with diapositives, film demonstrations, work at the patient under supervision of the tutor and use of a demonstration device as well as endoscopic demonstration by means of colour television. The centre is, however, the individual examination of the patient. 4. Knowledge of the subspecialist: History of endoscopy, knowledge of instruments, optics and endoscopic perspective, physical fundaments about light and photography, human macro- and microscopic anatomy, care of instruments and desinfection. Indications, contraindications, possibilities and limits of the method, emergency and intensive medicine, writing of the findings.


[The value of aimed biopsy in gastroscopy].

The introduction of the fiberscops with the possibility of the aimed biopsy has considerably improved the diagnostic evidence of gastroscopy, though there exists a whole series of technical problems in the histological ascertainment. Though all regions of the stomach are accessible to the biopsy forceps, the histological findings cannot always be ascertained clearly histologically. Of 105 carcinomata of the stomach and the oesophagus only 84 were verified clearly histologically. Of 101 ulcers appearing benign five proved to be malignant in histological respect. In 14 scars in two cases a carcinoma could be proved. Altogether from 27 polyps appearing benign bioptic material was taken, which in all cases confirmed the primary diagnosis, nevertheless at the operation one polyp proved to be malignant. In 105 cases endoscopically the diagnosis of a carcinoma was made, but in seven cases it was a benign ulcer clearly confirmed by the operation. It is reported on some own experiences concerning the improvement of the result of the aimed biopsy.


[The gastroscopic diagnosis of early stomach carcinoma].

A short report is given on the development of diagnostics of early gastric cancers, whereby it is especially referred to the importance of the Japanese investigations of this phenomenon. The notion of the early carcinoma for gastric carcinomata which have affected only the mucous membrane or only in a slight degree the submucosa is widespread. But it contains a notion of time which is falsely presumed. As we at present do not certainly know, whether the early gastric carcinomata, all over the world known as "early cancer", really could not fail in developing to advanced gastric carcinomata, the name "early" carcinoma is questionable. Concerning this question further investigations are necessary, which should be directed to the definition of a risk group of gastric cancer. Finally is reported on own results in the diagnosis of 12 early gastric cancers.


[The so called early stomach carcinoma and its histological definition].

The histological findings of twenty bioptically diagnosed early cancers of the stomach are described. In the delimitation of the so-called borderline-lesions the intestinal metaplasia in the mucous membrane of the stomach must particularly be taken into consideration. The differentiated ripe form of the intestinal metaplasia is no precancerosis. However, within the process of intestinalisation atypias may appear, which represent possible transitional forms to carcinoma.


[Deep duodenoscopy and endoscopic retrograde cholangiopancreaticography].

A survey is given on indications, results and complications of the deep duodenoscopy and endoscopic retrograde cholangiopancreaticography. The endoscopic retrograde pancreatography is indicated in the chronic forms of pancreatitis, in suspicion to cysts of the pancreas or tumours. Its results have a decisive influence on the indication to surgical procedure and on the planning of the intervention. The endoscopic retrograde cholangiography is of greatest practical significance for the differential diagnosis of the cholestatic icterus: non-obstructed bile ducts exclude an extrahepatic icterus and render a laparotomy useless. Furthermore, the endoscopic retrograde cholangiography is indicated when the demonstration of the duct is intravenously insufficient, when papillary or prepapillary narrowings are present and in the etiologically unclear syndrome of postcholecystectomy. The most dangerous complications of the endoscopic retrograde pancreatography are the acute pancreatitis and the infection of cysts. Cholangitides and septicaemias appear after the endoscopic retrograde cholangiography only in such cases when obstructions of the drainage are present.


[Experiences with coloscopy].

The introduction of fully flexible coloscopes has considerably contributed to the improvement of the diagnostics of the large intestine. According to the hitherto got experiences is to be expected that this method will contribute to the possibility of diagnose malignant and benign colon processes earlier and more exactly. In the paper the methodology of the coloscopy is described and it is referred to its difficulties and complications. The indications and contraindications for the coloscopy are described. It is reported on first results after a one-year experience with coloscopy. The conclusion is that in patients with radiologically and rectoscopically not clarifiable, referring to a severe disease of the colon, symptoms a coloscopy should be carried out.


[Vital microscopic investigation of terminal blood vessels in patients with diabetes mellitus].

It is reported on findings of vital-microscopic investigations at the terminal vascular system of the conjunctiva bulbi and the mucous membrane of the lips carried out on 50 juvenile diabetics and 50 test persons of the same age. By quantitative establishment of the morphological and functional changes of the vessels and the aggregation of the erythrocytes in the different regions of the terminal vascular system we succeeded in delimitating all 50 diabetes as individuum or as collective (x equals 10.7 +/- 1.5) from the test persons (x equals 3.4 +/- 0.9) by means of a point system (p less than 0.001). In 4 figures typical vascular findings are demonstrated. No pathognomonic significance was ascribed to the individual vascular findings. The morphological and functional changes of the vascular wall are regarded as an expression of fundamental reactive possibilities of the vessels of the terminal vascular system after influence of different factors of risk. As criteria of the findings were used: venular sacculations, meander-like forms, convolutions, haemorrhages, aneurysms, reticular structures, varieties of calibres, changed arteriolarvenular relations of the inner diameter of the vessels, constant proof of aggregates of erythrocytes with temporary standstill of the flow in the different parts of the terminal vascular system. The author is of the opinion that with simultanuous establishment of the morphological and functional changes of wall of the vessel and content of the vessel degenerative changes in diabetes mellitus are provable earlier than at the eye-ground by means of ophthalmocoscopy when only morphological findings are established. The reciprocities between the vascular changes and the rheological properties of the blood are described.


[Results of different long term treatments of patients in the early stages of rheumatoid arthritis].

In a clinical 5-year-study on 200 patients with rheumatoid arthritis with the help of the dynamics of radiological changes (radiological progressing), the joint deformation, the reduction of function and the new affection of joints (clinical progressing) as well as the medium position of activity the progressing of the disease and a good, satisfying or missing success of the long-term therapy were estimated. From the characteristics of the individual groups of therapy conclusions for the therapy in the early phase of the rheumatoid arthritis were derived.


[Plethysmographic investigation of the post-thrombotic syndrome].

In 49 patients with a phlebographically ascertained postthrombotic syndrome, who were above all subdivided into morphologically defined degrees of severity, after May and Nissl, a plethysmographic investigation was carried out with the deep positioning test and the venous drainage test. The results were contrasted with a group of 53 patients with a primary varicosis and the measuring results of 102 test persons with healthy veins. A very good correlation between the morphological changes and the haemodynamic findings establishable by means of the phlebembraxis plethysmography could be proved. A clear evidence was possible by means of the venous drainage test, whereas in the deep positioning test a certain demarcation was possible only in stage III of the postthrombotic syndrome.


[Smoking and the change in leukocyte count].

In 20 smokers and non-smokers the effect of one cigarette on the total number of leucocytes, the absolute number of basophilic granulocytes and on the basophil-age-index was investigated. The reduction of the BAI was ascertained in smokers at the 5%-level and in non-smokers at the 1%-level. The number of leucocytes was significantly increased in smokers. The reduction of the total number of leucocytes by smoking was ascertained in smokers at the 1%-level, in non-smokers at the 5%-level. Adaptation mechanisms as well as the importance of the findings for the pathogenesis of arteriosclerosis and smoker bronchitis are discussed.


[Blood circulation disturbances of the upper extremities as a principle symptom of pseudoxanthoma elasticum].

The pseudoxanthoma elasticum is a rare disease of the connective tissue which coincides with typical symptoms of the skin, eyes and vessels. It is reported on a 37-year-old female patient that showed disturbances of the blood circulation in the upper extremities as a main symptom.


[Case report on the problem of individual glycoside requirements].

A report is given on a patient with ischaemic heart disease, whose recompensation in tachyarrhythmia absoluta was for some times possible only by means of unusually high doses of digitoxin (fully effective dose to 5.72 mg, maintenance dose to 0.4 mg). The patient survived a severe decompensation with pulmonary oedema, which appeared under "normal" applications of glycosides, 2 1/2 years under this therapy. Thus it must again be referred to an individual glycoside treatment.


[Molecular mechanisms of the biological effects of UV radiation].

The biological processes taking place in the biosphere are for the largest part bound to the existence of ultraviolet-rays in form of sun rays. Here the furthering effect of the UV-rays on origination, maintenance and further development of life processes is contrasted by the harmful influences of the UV-rays. With the help of the hitherto known facts the primary and consecutive processes which underlie the biological effects of the UV-rays are discussed on molecular level. Furthermore, the possibilities of repairing these lesions caused by UV-rays as well as the biological consequences when repair damages are present are discussed. Finally on the basis of experimental examinations the author deals with the problems of the ultra-violet radiation of the blood.


[The place of adrenal angiography (phlebography and arteriography) in the diagnostic stepwise program in arterial hypertension].

Arteriographical and phlebographical methods are distinctly suited for the diagnostics of the adrenal glands in the stop program of the combat against hypertension. Hypervascular tumours of the adrenal medulla, especially phaeochromocytomata may be established arteriographically relatively certainly. Avascular processes of the adrenal cortex, however, are better to be diagnosed by the selective phlebography of the adrenal glands. The phlebography is also suited for the planimetric determination of the size. The following uncorrected normal values were established: on the left m1 = 10.58 +/- 1.17 cm2, on the right m2 = 6.95 +/- 1.39 cm2. The mean value of normal couples of adrenal glands is M = 18.17 +/- 1.96 cm2. The left adrenal gland is statistically significantly larger than the right one (p greater than 0.001). In 214 patients altogether 44 selective arteriographies and 276 selective phlebographies of the adrenal glands were performed. As angiographical basis examination of all patients was at first performed an abdominal aortography or an angiography of the kidneys. The phlebographical diagnostics was successful on the left in 98.7% and on the right in 90.4% of the cases. 72 patients had pathological processes of the adrenal glands, out of them 20 times a solitary adenoma of the adrenal glands was present. 38 patients had a one- or double-sided hyperplasia, and 4 patients had a phaeochromocytoma. In 10 other cases more infrequent changes were found.


[Screening of collagen diseases in the years 1961-1972 from a selected population sample].

In our article is referred to the recognition of collagenosis in the demarcated whole district with 100,000 inhabitants. The occurrence of these diseases is lower than the occurrence of other rheumatic diseases. Our results as well as the observations of other authors confirm that the lupus erythematodes and the diffuse sclerodermia are not rare diseases even in our circumstances and with their evolution tendency they shorten the lives of the affected persons. The high recognition coefficient with large probability corresponds to the real incidence of these two diseases, which can be achieved only by an observation of many years and repeated controls of the correctness of the diagnosis.


[Experiences with sodium fluoride in the treatment of osteoporosis].

In 10 patients with primary and 13 patients with glucocorticoid osteoporosis a NaF-therapy with an average daily dose of 80 mg was carried out in a period of 1/2 to 4 1/2 years. 22 patients spoke about an improvement of the complaints. Radiologically an osteogenesis could be proved in 19 patients. Dose and duration of the therapy as well as eventual additional treatments, frequency and severity of the side-effects are discussed and the indication for a NaF-medication are elaborated.


[Comparability of jet and ultrasonic aerosols in bronchial reactivity tests].

The use of tests of bronchial reactivity for expert's opinions as well as ability examinations and check-ups in the field of occupational medicine makes great demands on their reproducibility. In the case of different application techniques the comparability of the test results is to be proved. For two aerosol producers used in the GDR test variants reliable for many years were comparatively investigated. Hereby the possibility could be proved on principle to achieve comparable results by variation of the concentration of the acetylcholine solution given. The choice of the test concentration in question is decisively influenced by the aim of the examination and the kind of test persons.


[Primary hyperlipoproteinemia and cardiovascular diseases in relation to age].

The primary hyperlipoproteinaemia is a frequently appearing disease of the second half of life. Out of 188 patients with hyperliporpoteinaemia 19% were at an age of 40-49 years, 33% at an age of 50-59 years and 51% of 60-69 years. The type IV of hyperlipoproteinaemia was the most frequent one (19%), in the second place was type IIa (21%) and in the third place was type IIb (14%). In the 5th decade of life type IV prevailed in males and type IIa in females, in the 6th and 7th decade of life nearly the same percentage for these types was to be found in both sexes. In 60% of the patients with hyperlipoproteinaemia we found a hypertension, in males in 20% coronary insufficiency appeared already in the 4th decade of life, then it rose to 70%, in females these appearances occurred about 10 years later. 9% of the patients fell ill from myocardial infarction. A general arteriosclerosis appeared in 63% of the males and in 89% of the females beginning with the 5th decade of life, then it still increased. Therefore, adequate preventive and curative measures (diet and pharmaca) are necessary in time.


[Unusual joint complications in sickle cell anemia].

It is reported on the casuistics of a 23-year-old Lebanese who since his eighth year suffered from joint swellings and occasional attacks of jaundice. By the proof of false forms of erythrocytes and by the haemoglobin electrophoresis a homozygous sickle cell disease could be ascertained. Peculiarities of the clinical picture were among others changes of the bones of high degree (osteolyses of vertebral bodies, of the head of the right humerus and the heads of the two femurs) was well as of the knee-joints in form of ankyloses.


[Long-term results in electric pacemaker therapy].

It is reported on experiences and results in 317 patients with altogether 690 implantations of pacemakers from 1963 to 1974 and under comparison and with reference to the up to now existing long-term results published in literature state and tendency of the medical and technical development of the electric heart stimulation are discussed. The average age of outpatients was 62.9 years with a peak of age of 46% in the 7th decade of life. 60% were male patients, 40% female ones. With about 50% the constant total atrioventricular block was the most frequent indication. 63% of the familiar types of pacemakers were biotronic apparatuses, 36% of them with fixed frequency. The average duration of the function of all apparatuses was calculated with 20.1 months. Hereby the biotronic types had the longest average function times of 26.7 months (frequency fixed) or 26.3 months (regulated). In 373 reimplantations is shown that 2.17 apparatuses were implanted in each patient. The total number of complications was 21.2% related to the total number of implantations. With 8.9% breaks of the cable were in the first place in myocardial electrodes. Dislocations of transvenous electrodes were observed only in 4.5% of our cases. With 5.8% pressure necroses and infections were the cause of complications stood in the second place concerning frequency. The total lethality was 23.7% with an age peak of 38% in the 8th decade of life. 13.4% of the cases of death belong to an early lethality with a prevailing part of epicardial implantations. In our patients the cumulative survival rate was after 1 year 89.3%, after 5 years 62.3% and after 8 years 47.7%. The 50% survival rate was ca. 7.3 years. In comparison to the population of the same age the average expectance of life is transgressed by about 6 years. The prolongation of the survival time by electrostimulation compared with the conservative treatment of the total atrioventricular block with Adams-Stokes-syndrome is the essential result of the pacemaker therapy.


[Behavior of the plasma renin activity and aldosterone after salt restriction and upright posture in essential hypertension].

In 100 patients with essential hypertension and 50 healthy subjects the relation between plasma renin activity (PRA) and plasma aldosterone level (Ald) was investigated. PRA as well as plasma aldosterone was estimated a) after a diet with normal sodium content (equals 120 mEq per day) provided for 3 days and after an 8 hrs rest ("L" value of PRA and Ald) and b) after sodium restriction (10 mEq per day) for 3 days and 3-4 hrs ambulation ("A" value of PRA and Ald). Concerning the behaviour of "L"- und "A"-PRA all patients were divided into 4 groups: a) patients with normal, b) rigid, c) low and d) high PRA. Despite differentiated values of PRA in patients of all groups a normal increase of the plasma aldosterone level was stated after sodium restriction in the diet and upright position. Even in 18% of healthy subjects with low PRA a normal increase of Ald after sodium restriction and upright position was observed. These results seem to prove that in patients with low and rigid PRA and in 18% of healthy subjects the renin-angiotensin system is not the main or only regulator of aldosterone secretion.


[Physiotherapeutic early mobilization of patients with myocardial infarct].

It is reported on the experiences of the programme of the physiotherapeutic treatment of the patients with myocardial infarction in the phase of hospitalisation, which was used in our clinic in 128 patients since 1972. Under careful control the period of mobilisation could be shortened without larger endangering for the patient and a new temporary step scheme could be given as guiding principle, the use of which, however, always needs the individual adaptation by physician and physiotherapist. The physiological and psycho-social advantages of an early mobilisation are clear.


[The 131I-fibrinogen turnover during activation of blood fibrinolysis].

The influence of stanozolol Stromba and phenformin Dibotin (Winthrop) and complamin (Wulfing) on transformation of 131J-fibrinogen administered intravenously was examined in 39 patients with arteriosclerosis obliterans. The patients were divided into 3 groups; one of the groups included untreated patients. Radioactivity of the plasma and of the urine was determined by means of a scintillation counter. The volume of plasma, plasma fibrinogen (g%, g, g/kg), half time of persistance (T 1/2) and degradation of fibrinogen were determined. The patients who received Dibotin and Stromba simultaneously showed statistically significant decrease of the plasma fibrinogen degradation im comparison to the control group. But in patients who received complamin in spite of significant decrease of the plasma fibrinogen (g%), the fibrinogen degradation was not different from the value obtained in the group.


[Contribution to the continuous indirect blood pressure measurement].

The plethysmanometer described follows the principle of the relaxed wall of the vessel. Here the pressure is adjusted in a finger cuff and by means of a pneumatic regulation is varied in such a way that the light plethysmogram of the adequate finger does not show any more pulsations. Thus the pressure effected on the finger above the cuff corresponds to the pressure in the finger arteries and is to be registered in mm Hg. When the course is measured in the same test person with changing of the arterial pressure (e.g. absolute arrhythmia or compressed-air pressure experiment) the blood pressure of the aorta measured when a heart catheter is diagnostically indicated shows a very close correlation to the unbloodily registered pressure of the finger arteries. On the other hand, greater varieties of the correlation coefficient which can be proved from test person to test person at present do not yet allow a formula obligatory in general, in order to tansfer the value unbloodily measured into the adequate bloody one. Nevertheless, already nowadays great ranges of application are possible for the progressing measuring of the blood pressure.


[Comparative analysis of electrocardiographic findings in diabetics and metabolically healthy persons].

The electrocardiograms of 447 diabetics and of the same number of non-diabetic test persons who were coordinated as biostatic twins, taking into consideration age, sex, and weight, were evaluated according to the Minnesota-code and compared. The cardiac endangering of the diabetics was most clearly expressed in the larger frequency of infarctions and the chronic-ischaemic heart disease which can be proved in all age groups. Diabetic males with short duration of diabetes showed the highest frequency of infarctions. The frequency of coronaropathy which is not increased in most age groups in the long-term diabetics compared with the control persons characterizes them as a positive selection of diabetics with an apparantly primarily low atherogenic potency. Hypertonus and/or adiposity were concomitant with a nearly doubled frequency of the ischaemic heart disease. The breadth of the P-wave as a possible reference to angiopathic changes in the region of the atrium was significantly larger in the diabetics in all age groups than in the control group.


[Clinical ergometry in cardio-pulmonary functional disorders--a comparison of the usual ergometric technics].

It is reported on the results of a comparative examination of 18 patients with two usual ergometric methods (team pathophysiology of respiration and research group diseases of heart and circulation of the GDR). Referred to the intake of oxygen as a measure for the stress of the cardiorespiratory system by means of the ergometric methods recommended by the research group diseases of heart and circulation significantly higher minute volumes of the heart rate were established. Principal differences in the evidence of the two methods did not appear.


[Lethal varicella in infants].

Varicella are regarded as relatively harmless disease. Since the application of antibiotics as complication appear rare mortal courses of generalised varicella above all as a sequel of haemorrhagic-gangrenous forms of course (especially under therapy of corticosteroids), of varicella pneumonia and of encephalitides, while the bacterial superinfection is in second place concerning exitus letalis. Two own observations of varicella infections having a fatal outcome in a 1 1/2-year-old child and a 2-year-old child are reported. In the two cases the efflorescences of the skin were already healing. While one child suddenly died at home (concerning the cells a typical perivenous encephalitis as well as a varicella hepatitis without nuclear inclusion bodies was proved), the older child was admitted to hospital after sudden deterioration and abscess-formation of a chickenpox pustule. Clinically a meningo-encephalitis was established, which after dramatic course led to death still at the day of admission. As to the cells only slight perivenous round cell infiltrates could be proved in severe cerebral oedema, cytolyses and sporadic perivascular haemorrhages and emedullations.


[Immune status in a case of thyroid gland sarcoidosis--selected parameters].

On the basis of a case of sarcoidosis and the thyroid gland selected immunological parameters were examined and they were compared with the findings in pulmonary sarcoidosis. While the examination of the immunoglobulins in the present case did not show any characteristic changes, in the examination of the cellular immunity the hyporeactivity of the peripheral lymphocytes typical for the pulmonary sarcoidosis was found. The inclusion of immunological parameters is an enlargement of the possibilities for the differential diagnostic clarification of granulomatous inflammations of the thyroid gland.


[Isolated ultrafiltration with dialyzer and blood pump in hydropic cardiac insufficiency].

The authors indicate the possibility of an "Isolated Ultrafiltration" in cardiologic patients only with the transportable blood conducting part of the artificial kidney. The loss of oedema fluid by ultrafiltration of the blood is about 500 ml/h using a twin coil dialysator "Keradenta", or, resp., more than 1,200 ml/h using a Hollow Fibre Artificial Kidney "Dow Cordis" Mod. 5 or two HFAKs Mod. 4 in parallel. The method should be practised only in such cardiologic patients, in whom a drug-resistent hyperhydration including hypervolaemia is not a sign of a sure terminal state.


[The cerebrospinal fluid contact processes in the central canal of the spinal cord. A scanning and transmission electron microscopic study of the rabbit].

The surface of the central canal of the rabbit spinal cord was investigated with scanning and transmission-electron microscopy. On the ventral wall of the central canal, a long cranio-caudally oriented area carries a row of bulbs (about 630 per millimeter of length). The bulbs are spinal ventricular processes of cerebrospinal fluid contacting nerve cells. Its cytoplasm contains mitochondria, smooth- and rough-surfaced endoplasmic reticulum and vesicles of various size and contents. The bipolar or multipolar nerve cells are situated below the ependymal cells of the central canal. The perikaryon has the general cytological structure of a neuron. Some nerve fibres are shown to be running in the cranio-caudal direction within the central canal. Axons containing synaptic vesicles (diameter 400 A) form synapses on some of the ventricular processes. Two main types of ventricular processes can be observed, they differ in the size and structure of the end bulb, in the shape of its sterocilia, and in the number of mitochondria. Big globular processes are filled with a great number of mitochondria, whereas stereocilia are lacking. On the contrary, small processes with numerous stereocilia extending radially into the cerebrospinal fluid contain a number of mitochondria. A third type takes the mid position between the two main types. The ventricular processes have no "sensory cilia". On the basis of these morphological differences the possible role of mitochondrial movements in the function of the ventricular processes and the question of the identity of the three types of processes are discussed.


Seasonal variations in the histology of the pituitary gland of Cirrhinus mrigala (Ham.) an Indian freshwater major carp, in relation to gonadal activity.

1. Seasonal variations in the histology of the pituitary gland of Cirrhinus mrigala (Ham.), an Indian freshwater major carp, in relation to gonadal activity has been studied during a one year period commencing, January, 1971. 2. The proximal pars distalis undergoes a great deal of seasonal variation in size, weight and nature of pituicytes. 3. The percentage composition of acidophils and cyanophils in the proximal pars distalis show a reciprocal relationship during the year. The acidophils predominate during the restitution phase of the gonads while the cyanophils preponderate among the different cell types during the breeding season. 4. The chromophobes do not show any significant fluctuation in numerical abundance in relation to gonadal activity. 5. Cyanophils of the proximal pars distalis undergo changes with change in gonadal activity Concentration of glycoproteinaceous material is extremely low during the restitution phase but high during the maturation phase. The cyanophils also undergo hypertrophy and hyperplasia during the spawning period. The latter discharge their contents and become vacuolated during the post spawning period. 6. The number and size of the globules in the cyanophils are related to gonadal activity. 7. Acidophils present in the rostral pars distalis and pars intermedia do not appear to be related to gonadal activity in C. mrigala. 8. The average weight of the gland is directly related to the state of maturation of the gonads, an observation being recorded here for the first time.


Neurohypophysial-adrenal gland responses to water-deprivation in the rose-ringed parakeet.

The aim of the present investigation is to study the relative influence of neuohypophysis, adrenal cortex and adrenal medulla under dehydration stress in the parakeet. Birds subjected to dehydration for 7 days lost body weight. Neurosecretory material (NSM) was partially depleted from the neurohypophysis. Adrenal gland weight was increased followed by a hypertrophy of the cortical tissue. A fall in adrenal cholesterol and ascorbic acid level was marked. Adrenaline and noradrenaline contents of the adrenal medulla were suppressed as was evident from cytochemical and biochemical findings. It is suggested that neurohypophysis, adrenal cortex and adrenal medulla are involved in maintaining water homeostasis in this avian species.


The escape of bile from the intrhepatic biliary tree in acute bile stasis.

The escape of fluorescent dyes from the bile passages during bile stasis and after a retrograde infusion into the common bile duct was examined in rats and mice. After an intravenous dye injection in bile stasis a strong fluorescence is seen in the periportal spaces. During retrograde dye infusion great amounts of dye accumulate in the periportal spaces but, in consequence of focal disruption of liver cell membranes, escapes also into the spaces of Disse, to be consequently transported by the sinusoidal blood.


[Ultrastructure of the vocal muscle and its morphological differences from the myocardium].

A comparative ultrastructural investigation of the M. vocalis in mammals has been carried out. Morphological differences between the vocal muscle and cardiac tissue are reported; a distinct classification of the M. vocalis according to a typisation of skeletal muscle fibers is presented. In all species investigated (man, dog, cat, guinea-pig and rat) the general ultrastructure of the sarcomeres as well as their mitochondrial content and the innervation pattern allow to classify the M. vocalis as to belong to the "fast twitch (white) skeletal muscle fibers. A single innervation was found with large motor endplates containing numerous synaptic infoldings. Structural specializations known to be characteristic for cardiac tissue, e.g. intercalated discs, T-tubules at the level of the Z-band and nuclei in a midst postion of the muscle cell could not be observed. The m. vocalis, therefore, cannot be considered to have histologically any relationship with cardiac tissue. The vocal muscle is described as a special type of skeletal muscle very similar to the extraocular muscles. The electron microscopic findings are discussed with respect to current theories of phonation. The myoleastic theory of phonation can be favoured according to our ultrastructural results.


Correlative cytological and histochemical studies on the avian oogenesis.

A correlative cytological and histochemical study has been made of oogenesis in birds (pigeon, Columbia livia; brown dove, Streptopelia senegalensis; ring dove, S. dacaocto; domestic fowl. Gallus domesticus; and quail, Coturnix coturnix). BALBIANI'S vitelline body consisting of large yolk nucleus, mitochondria, GOLGI bodies and lipid bodies of variable composition is gradually developed in the juxtanuclear cytoplasm of their young oocytes. Histochemical tests indicate that the yolk nucleus consists mainly of RNA, protein and lipoprotein. Mitochondria occur in the form of granules, rods and filaments having a phospholipid-protein composition. The lipid bodies are in the form of granules (composed of phospholipid and triglycerides) and spheres (made up of triglycerides and cholesterol and/or its esters). The organelles consisting of lipoprotein are preserved after classical techniques of cytology whereas the lipid bodies are mostly dissolved. With the growth of oocyte during previtello-genesis the various cell components of BALBIANI'S vitelline body are dispersed in the outer ooplasm where they further multiply and finally most of them are placed in the cortical layer. At the same time, many chromophilic and argentophilic elements of lipoprotein nature are formed in the follicular epithelium, adjacent to plasma membrane of oocyte and in the peripheral ooplasm during previtellogenesis, which gradually accumulate in the central ooplasm where the yolk vesicles first appear. Most of the lipid droplets consisting of triglycerides and cholesterol and/or its esters are depleted from the large previtellogenic oocytes. The possible significance of various ooplasmic structures, which accumulate during previtellogenesis, has been discussed. Corresponding to the development, multiplication and accumulation of various ooplasmic components during previtellogenesis the chromosomes develop the configuration of lampbrush and are the active sites for the synthesis of RNA and protein, which simultaneously accumulate in the ooplasm. The cytological and histochemical characteristics of follicle cells indicate that they are active in the secretion of lipids, glycogen, proteins and RNA which are apparently transported into the growing oocyte. The association of several lipid bodies with some phagocytotic vacuoles adjacent to the plasma membrane of growing previtellogenic oocyte has supported this suggestion. Several follicle cells as such degenerate during previtellogenesis and their products in the form of DNA, RNA, protein and lipoprotein also seem to be absorbed directly or indirectly by the growing oocyte. During early vitellogenesis, the yolk vesicles are formed in the central ooplasm by the activity of ooplasmic structures especially the chromophilic and argentophilic elements. They are ultimately transformed into yolk bodies of variable morphology and chemical composition, which are arrayed in alternating concentric spheres (yellow and white) and consist of proteinlipoprotein, triglycerides, carbohydrates, RNA etc...


Production of experimental atrial septal defects.

Atrial septal defects (ASDs) were successfully created by punch biopsy technique in 67 dogs. The technique is simple, effective and provides an ideal model for the study of ASDs, either for testing closure devices or physiological experiments. The position and size of the defects may be varied according to preference. Of 45 animals subjected to cardiac catheterization, 39 (87 percent) has a patent atrial septal defect.


Surgical treatment of vascular lesions of the spinal cord.

Paravertebral block and resection of upper thoracic sympathetic ganglions were performed on cases in which vascular disturbance of the spinal cord was considered partly responsible. Block was performed in 14 cases and clinical improvement was seen in 10 cases out of them while resection was considered effective in 2 out of 3 cases. The evoked EMG of patients was assumed recovery of a part of synaptic function in the ischemic cord after the block. On the other hand, the skin temperature of the lower extremity did not show considerable change and this supports the view that the restoration of clinical picture was not due to the improvement of the periphral circulation of extremities. From these observations, it would be well presumed that favorable effect of sympathectomy consists partly in the improvement of vascular disturbance of the spinal cord.


[Sports and health, view-point of a sociologist].

The expression "health" covers a wide physical, psychic and social range. The phenomenon "sport", in its cultural form, has evolved historically and is constantly changing. In the today's sport movement, we can see differences in age, sex, and social status related to the type of sport practised, the frequency and the motivation as well as its form of organization. The main inducement for practising sport is by friends. At the end of the article, the author points out that it is problematic to misuse sport for pedagogic aims or aims of preventive medicine, because in such cases, sport runs the risk to lose its initial objective which, originally, had no definite goal other than the experience itself. Moreover, it is irrational to believe that sport alone can cure civilization diseases both in the physical as well as in the psychic and social range.


[Physician and sports].

The main objective of physical activity should be to achieve the best possible level of physical fitness and thereby psychic wellbeing. This important objective in preventive medicine may be obtained by a well balanced leisure sport program. On the other hand, due to its high demands, modern competition sport or elite sport increasingly results in severe organic damages and therefore therapeutic measures are of more importance. The physician has important functions both in prevention and therapy in all aspects of physical activity. Unfortunately, in Switzerland he is ofter insufficiantly prepared to deal with these functions. Most of the requirements for manipulation of performance that the physician is confronted with are questionable and not compatible with the medical ethics.


[Physical activity and coronary heart disease prevention].

Numerous reports indicate that physical inactivity is one of the coronary risk factors; however, proof that exercise has a protective effect is still elusive. Nevertheless, to continue the existing controversy on the prophylactic value of physical activity seems to be inappropriate. On the one hand, a controlled trial is not feasible; on the other hand, physical activity is a physiological function that should be promoted anyway, regardless whether irrefutable evidence of its value in the prevention of coronary heart disease is available. Activity starting in childhood and continuing throughout life is a safe approach. In more general terms, habitual physical activity should be re-introduced into the pattern of life of contemporary society.


[Sociological aspects of sports activities in adolescents].

The purpose of this study was to investigate the epidemiological, psychosocial and sociological aspects influencing the practice of physical activity of young people. Of approximately 1800 17 to 18 years old boys and girls going to an official school in Geneva, 600 were chosen at random. Unskilled workers could not be included into the study. 443 subjects could be contacted and interviewed in spring 1973 through a codified questionnaire. A first evaluation of the answers focused on the influences of sex, social status, type of sport practised, as well as the ideological integration. The results correlated well with current empiric experiences or with most of the hypothesis on which the questionnaire was based.


[Sports activities and motivation].

In a representative study on employees aged 20 to 65 years in Northern Switzerland, several criteria of sports practice and motivation to practise sports were examined. 1260 subjects working in 44 different factories employing more than 56 people were chosen at random and questioned. 36% of the younger men (20 to 42 years old) and 21% of the older ones (43 to 65 years old) were members of a sports club. The first motivation to participate in sports came mostly from friends, but hardly ever from international events. 21% of the subjects were in favour of the way the Olympic Games were conducted, 28% were somewhat critical, 41% were negative, and 10% had no opinion.


[Sports in prevention of postural defects].

Posture results from numerous alternating factors and reflects the attitude of an individual towards a definite situation. If the different conditions, namely the capacity and the willingness of posture, do not correspond to the requirements of the situation the "normal" erect posture will change. The development from abnormal posture into irreversible abnormalities and damages in posture is easy. In order to eliminate these risks one can try to reduce the potential of the situation on the one hand and to improve the capacity of the individual through adequate physical exercise on the other. The practice of daily physical activity at school or during leisure time is the best way to compensate for lack of exercise, to modify prolonged unfavourable situations, and to develop the physical capacity in such a way that dangerous loads can be supported without damage. The versatility of training, in combination with adequate gymnastical exercises and sports help to educate the sense of posture and movement with the effect that erect posture can be adopted and maintained. But only children who feel that erect posture is reflecting their personal image will finally keep the erect posture. Special attention is given to elite training in childhood and adolescence, when the vertebral column is particularly exposed to danger by the intensity of the training and must be protected against deformations by carefully chosen preventive measures.


[State and sports].

By 1874 the State had already started to influence physical activity programs especially of the younger generations in Switzerland. In 1970 the people accepted article 27 of the Constitution regarding physical education and sports. The Federal law that became effective in 1972 now promotes, in a more intensive way, physical education and sports as a means to improve the public health. These measures especially affect public sport (physical education at school, the "Youth and Sports" organization, the construction of sports facilities) whereas promotion of elite sports is entirely the responsibility of the independent sports association. Today, this promotion costs the Swiss government roughly 40 millions of Swiss francs, or 0.3% of the whole budget.


[Medical fitness for sports, with particular reference to cardiovascular conditions].

Whether a person is medically fit to engage in sports depends not only on his or her present state of health but also on his or her previous medical history, age, personality, and of course, the nature of the particular sport in question. Anyone that feels fit, is physically in good condition, abstains from tobacco, alcohol and other intoxicant stimulants, and passes a thorough medical examination is healthy and fully capable of taking part in any sport whatever. Participation in any form of sport, on the other hand, is absolutely contra-indicated for persons suffering from severe or malignant hypertension, inflammatory or bacterial heart disease, severe angina pectoris - especially with an attendant risk of myocardial infarction - or haemodynamically significant arrhythmias that manifest themselves during, or are aggravated by, physical exertion. Physical activity is generally deleterious in patients with advanced pulmonary disease and chronic cor pulmonale, severe decompensated heart failure or severe renal insufficiency. Severe intercurrent infections also constitute an absolute contra-indication for sport. Between these two extremes of absolute fitness and absolute unfitness there are many intermediate states, e.g. diseases like essential hypertension (WHO Stages I and II), coronary disease and peripheral arterial circulatory disorders, in which patients can derive considerable benefit from properly chosen and carefully graded sporting activity.


[Exercise test in coronary insufficiency diagnosis].

If the anamnesis is not conclusive for a definite diagnosis of angina pectoris or if a complementary test is adviseable the ECG, which is hardly ever significant at rest, can become very significant under the influence of physical activity. The easiest methodology is a bicycle ergometer or a treadmill performance test which can be performed under ideal safety conditions and which gives the best possible information. Compared to the coronarography results in 319 patients, the performance test at either maximum heart rate or up to the appearance of the typical electrocardiographic alterations was positive in 75.5% of the cases. It is less instructive if the test is not systematically exhaustive. Its validity also varies depending on the number of coronary arteries affected by stenosis, on the type of the angina pectoris, and the aspect of the ECG at rest. If the test is performed up to the maximum heart rate, its sensitivity is superior to the ones using lsoprenaline or right atrial pacing as a means for influencing the ventricular function.


[Sports accidents: 1963-1973 statistics].

Every year, the Swiss Accident Insurance Administration is paying a considerable amount of money for sports accidents. From 1963 to 1973 the number of these accidents has increased more markedly than other types of accidents. Different tendencies can be observed in the different types of sports: skiing accidents have, after a long period of retrogression until 1973, shown a noticeable augmentation again. Football accidents and accidents in other types of sports have on the other hand increased year by year. Mountaineering and aquatic sports often result in fatal accidents. The numerous preventive measures in skiing accidents have obviously been successful. Not only the fractures have decreased, but also the average number of days where sickness benefit was paid. Next to the traffic accidents, the skiing accidents are the most expensive ones. The nature of the healing cost in sports accidents has changed during the period from 1967 to 1972, depending on the different types of sports. In particular, hospital costs have changed considerably. The number of medical consultations per accident has decreased. Payment of sickness benefit has followed the development of the salaries on the one hand and the modifications of the number of lost days on the other. Finally, the costs of the annuities show more or less the same tendency as the ones for sickness benefit. A very gross estimation on the economical losses through sports accidents in Switzerland makes us believe that the direct and indirect costs actually amount to more than one thousand millions of Swiss Francs per year.


[Elite sports - benefit or damage].

Out of 378 elite athletes investigated in the year 1956, 28 track and field athletes, 14 footballers, 9 cyclists and 18 icehockey-players, who were complaining about serious injuries at the occasion of a sociological investigation, underwent a medical follow-up examination, 30 percent of the examined athletes stated that they suffered from permanent pain as a result of their former career in elite sports. On the other hand, they had a positive attitude about their previous physical activity and would not have missed it at all. Most of the injuries concerned joints (61) or bones (18) whereas other localisations were rather unusual. X-ray examination revealed a considerable number of orthrosis which most of the time, in spite of its sometimes rather grotesque appearance, did not cause the expectes subjective complaints.


[Health risks of various sports].

Sport accidents have become a major problem. When investigating the risks corresponding to different sport activities, we must consider incidence, possible causes and different kinds of sport injuries too. The risks of sport injuries are not inherent to a given sport, but are more likely provoked by the athlete himself and his behaviour.


[Blood coagulation in newborns (author's transl)].

This article gives a survey of the physiology of blood coagulation in newborn infants, subdivided into the particularities of the plasmic coagulation system and the fibronolysis. Etiology, diagnosis and therapy of the consumption coagulopathy as well as the coagulopathy of production are dealed with.


[Bioptical diagnostics of hirschsprung disease by the membrane technique for the histochemical demonstration of cholinesterases (author's transl)].

50 biopsies of the rectum and 8 of the large intestine from male and female children aged 4 months to 7 years, obtained by resection were investigated. The absence of ganglion cells in the intrinsic nerve plexuses is in agreement with the increased cholinesterases reaction. The presence of muscularis mucosae is necessary in the biopsy for the evaluation of the cholinesterase reaction. The instrument used for the excision must fulfill those demands.


[Conservative treatment of infantile supracondylar fractures of the humerus (author's transl)].

58 infantile supracondylar fractures were treated conservatively. Due to accompanying lesions in 2 cases osteosynthesis was performed by using crossed extension wires. According to Morger's evaluation scheme conservative treatment yielded good results in 49 cases, satisfying results in 4 cases and sufficient ones in 5 cases.


[Diagnosis and treatment of a rare intrapulmonary vascular anomaly in a child (author's transl)].

In the present case an artery originating from the abdominal aorta and running through the diaphragma into the inferior lobe of the left lung was identified by retrograde aortography. It ended in a vascular coil which was drained by regular pulmonary veins. By transthoracal resection of pulmonary parenchyma and malformation was removed without complications. Such anomalies represent absolute but not urgent indications for surgery. Without treatment, the shunt volume will cause additional straining for the heart. Furthermore, pulmonary complications and thromboembolic processes may arise.


[Invalidation of a girl after 7 years of succesfull malingering of a wound (author's transl)].

Provocation of wounds by malingering is one of the most typical artefacts in surgery. In this paper the succesful maintaining of a wound in a girl for over 7 years is demonstrated. In this time the girl underwent 25 surgical operations and was invalidated at the age of 18 years. In patients with non-healing wounds, which cannot be explained by the rules of general pathology, doctors are well advised to think of the possibilities of malingering at an early time.


[Comparative colposcopic, cytological and histological studies of the uterine cervix during pregnancy].

The suspected findings, of colposcopic and cytologic cervix uteri in the pregravidity, was reported. Among 5852 patients, who primarily were directed in the clinic for interruption, 63 of them were examined because of their suspected colposcopic results and 3 cases of them were examined because of their suspected cytologic results, at the same time a detailed histological clarifications of their portio during the interruption were made. About 30,8% of the cases were in preinvasive or invasive stages, which were histologically clarified and precarcinogenic treatment of the patients was carried out. On the evidence of the results, we recommend, that by all suspected colposcopic cases -- taken into consideration of the cytologic results -- an early histologic clarification be made.


[Ultrastructural studies on the permeability of the amnion-epithelium for peroxidase and ferritin. Contribution on paraplacental metabolism].

By means tracer substances (horseradish peroxidase, ferritin) the permeability of human amnion and umbilical cord (2. to 6. lunar month) has been investigated ultrastructurally. The structure of intercellular cleft permits a passiv transfer of the water and electrolytes in both ways. The findings indicated, that the passage of proteins with a molecular weight of peroxidase predominantly takes place through the intercellular clefts less by means of pinocytosis. Ferritin particles can not penetrate. The epithelium of umbilical cord seems to play no special role in protein and water transport. The results were discussed.


[Total estrogen level in umbilical cord blood during physiological labor].

The levels of total oestrogens in umbilical vein and artery and in maternal peripheral blood were investigated in 24 normal labours. The levels in the umbilical artery were significantly lower than in the vein. This difference was connected with the level of oestrogens in umbilical vein, but not with the foetal weight. No correlation between the oestrogens levels in the umbilical and maternal blood was found.


[The problem of rifampicin therapy in pregnancy].

Report on a 24 years old first pregnant woman with chronic pyelonephritis, treated for 1 1/2 years, also during pregnancy, with high doses of rifampicin (1200 mgs/day). After normal delivery in the 42 th. week of pregnancy there were bleedings both in mother and newborn with demonstrable temporary disturbances in liver-function and coagulation system. Especially the coagulation factors produced in the liver were concerned. The complications after rifampicin carried out the conclusion that rifampicin should be given in pregnancy only with exact indication.


[Clinical and x-ray studies on the relationship between interruption of pregnancy and premature labor].

On the basis of the number of premature babies of 1975 the possible interdependence is checked between interruptio of pregnancy and subsequent premature birth and is compared with the dates obtained in 1974. Besides the hysterograms of women with premature birth whose anamnesis indicates an interruptio of pregnancy, are examined with regard to lesions of the cervix demonstrable in roentgenograms. As in the years of 1974 and 1975 the number of premature birth has been approximatively constant we conclude, basing ourselves on the investigations of roentgenograms, that no causal relation may be established between interruptio of pregnancy and premature birth in our material.


[Influence of labor induction using Prostin F2alpha on the cardiovascular system of the fetus].

Conform to its reaction, prostin F2alpha is a useful medicament above all in order to initiate risky deliveries having a state of unripe cervix. We have estimated the labor pains and the fetal state, which did not give proofs for any negative influence by prostin F2alpha in 60 initiations of labor. An intensive supervision system is absolutely necessary.