[Possibility of early operations in severe traumatic shock under the protection of assisted circulation].

The results of treatment in 28 patients with extremely severe multiple injuries are analysed: 21 of them had open, comminuted, crushed fractures or tearing of 44 extremities. After a failure of antishock measures an assist extracorporeal circulation with oxygenation was instituted, and surgery was performed. In 128 experiments on dogs a explosive bullet wound was inflicted on the knee joint: a comminuted intraarticular fracture of 2-3 bones was produced, followed by 25-30% bloodletting and additional trauma of the damage site. In 23 control experiments without using the heart-lung machine but with routine antishock measures 83% of animals died after the amputation and 17%--survived. A conclusion is made on the rationale and efficacy of an assist extracorporeal circulation in severe traumatic shock, that would make is possible to perform an early operation and to eliminate "the trigger mechanism" of shock.


[Change in serotonin content in burns].

Serotonin in blood, in burnt skin and burn blister fluid was studied fluorimetrically in 90 patients during different periods of burn disease. Burn disease was found to be accompanied with a considerable reduction of serotonin level in patients' blood, its increased content in burnt skin and its appearance in the blisters fluid. There is a direct correlation between the burn gravity and the rate of serotonin level reduction in blood. The data obtained allow a suggestion that a decreased serotonin content in blood is related with its accumulation in burnt skin and appearance in the blister fluid.


[Damping method of traction].

Damping of the system of skeletal extension with steel coil springs, ball bearing blocks and capron fishing-line was shown by the authors to be a necessity, since the routinely used "rigid" systems proved to be less effective. The authors have elaborated a new method of elimination of angular deviations of fragments and dislocations in width.


[Postural crush syndrome].

The clinic of such injuries is characterized by marked local manifestations (solid progressive edema of the injured limb leading frequently to decompensated ischemia) and a high incidence of acute renal insufficiency. Hemostatic disorders are manifested in hyperkalemia, hyponatremia, hypocalcemia, cell-extracell transfer of electrolytes, metabolic disorders in the myocardium, as evidenced by EEG findings. It is the authors' opinion that therapeutic measures should be aimed at liquidation of the progressive edema (hypothermia, fasciotomy), prevention of acute renal insufficiency and correction of metabolic disorders.


[Diagnosis and treatment of post-traumatic chronic venous insufficiency of the lower limbs].

The authors report 87 observations on posttraumatic chronic lymphovenous insufficiency of the lower extremities. Basic methods of examination of such patients; rheovasography, polarography, thermography, veno- and lymphography are described. Grounds are given for the complex treatment of chronic lymphovenous insufficiency after A.V. Vishnevsky and A.A. Vishnevsky technic and the procedure of fibrolysis with supra- and subfascial ligation of communicating veins.


Oestrogen receptors in feline mammary carcinomas.

Twenty primary or metastatic felline mammary tumours were assayed for the presence of oestrogen receptors by the dextran-coated charcoal method. In only two of the tumours was the presence of specific oestrogen binding protein demonstrable. The high negative rate in comparison with human and canine mammary tumours assayed under similar conditions seemed to be a peculiar feature of the feline tumours and suggested a lack of oestrogen dependency. The possibility remains that other hormones may be concerned with the growth of feline mammary tumours and further work is in progress.


Non-surgical correction of a uterine torsion in the mare.

A case of uterine torsion is described and its correction under general anaesthesia by a method described by Schaffer for the cow. The degree of torsion was 180 degrees and in a clockwise direction. After correction the foal was found to be alive and in anterior presentation and ventral position; it was born normally 84 days later.


Diagnosis of swine dysentery: spirochaetes which may be confused with Treponema hyodysenteriae.

Spirochaetes, designated PWS, microscopically resembling Treponema hyodysenteriae, were isolated from the colon contents of pigs with post-weaning scours from three herds, which on clinical and epidemiological grounds were thought to be free from swine dysentery. One of the isolates was fed to pigs experimentally but no evidence of disease was noted. Their cultural characteristics differed from those of T hyodysenteriae but they were similar to those of a non-pathogenic spirachaete (4/71) which had been isolated previously from the laboratory's dysentery-free herd. Smears prepared from cultures of the PWS spirochaete, 4/71 and two virulent and one avirulent strain of T hyodysenteriae were all positive to a fluorescent antibody test which was in use as an aid to the diagnosis of swine dysentery in the United Kingdom.


Bacteria associated with beak necrosis in broiler breeder hens.

Beak necrosis occurred in 48 per cent of female broiler breeders used fro nutritional studies but none was found in male broiler breeders or in either sex of single comb white Leghorns. About 10 per cent mortality, probably largely due to beak necroses, occurred in the affected flock. Based on electron microscopic photographs of affected beak tissue, we suggest that in our study the breakdown of beaks was associated with the presence of a single morphological type of Gram-positive bacterium.


[Sperm-autophagocytosis in rams affectes with Brucella ovis].

Studied was micrographically the semen of rams affected with infectious epididymitis admixed with leukocytes and Brucella ovis organisms. The animals were CFT-positive for brucellosis. It was found that in addition to the abundantly phagocytized Brucellae in the cytoplasm of the polymorphonuclear leukocytes there were fairly often surrounding sporadic spermatozoa or groups of them whose flagellae and heads have penetrated into the respective leukocyte. To elucidate this phenomenon ultrasections were studied of leukocytes isolated from the semen of these animals using electron microscope. Autophagocytosis of the spermatozoa was observed, manifested to a varying degree. In some of the cases the spermatozoa showed no changes, while in other cases there was lysis predominantly of the plasmalemma; still in third cases both the leukocytes and the phagocytized elements (spermatozoa and Brucella organisms) were completely destroyed. It is believed on the basis of ultrastructural data that phagocytosis takes place actively through engaging the pseudopodia of the leukocytes in the epididmis where the spermatozoa are in the status of anabiosis. On the other hand, proceeding from the state in which there are phagocytized heads vs. fully retained normal structure the concept is set forth that probably spermatozoa gain access to the leukocytes by means of active penetration. The authors refer to this immunologic phenomenon in the biology of breeding, first observed by them, as autophagocytosis of spermatozoa.


[X-ray picture of the limb osteo-articular apparatus of calves of the Sofia brown breed of cattle].

X-ray investigations were carried out on 10 three-month-old and 10 six-month-old calves (each group consisting of 5 male and 5 female animals) of the Sofia Brown cattle breed in order to obtain and study the normal roentgenologic picture of the bone-and-joint apparatus of the limbs. It was established that in this breed's calves the contours of the bones are clearly delineated and assume an angular configuration after the age of three months, which later on becomes more pronouncedly expressed. At the insertion points of the tendo-ligamentous apparatus there appear in the distal parts of the bones, in a volar and plantar aspect an uneveness, which is likewise more strongly manifested with the advance in age. The structural picture of substantia spongiosa in the metaepiphyseal, heel, shoulder, and elbow processes assume the so-called moderate spottiness, and in some parts in the case of six-month-old calves there is rough spottiness. The medullary canal becomes more clearly visible in six-month-old calves that it is in the three-month-old ones. The relief of the metaepiphyseal portions roughens in the older calves, is uneven and becomes more compact. With the advance in age the deeper layer in the joint cartilage is replaced by the growing subchondral bone lamina, this leads to the thinning of the cartilage and the diminishing of the roetgenologically visible joint fissure. Such phenomenon is observed in all joints up to the age of six months, and fluctuates in size within the range of 1,5 to 3 mm. The only exception is the knee joint where, owing to the menisci the joint fisure is wider (about 5 mm). The joint fissures in six-month-old calves, in contrast to the three-month-old ones, are with better manifested contours.


[Effect of several factors on the estrogen activity of lucerne].

Investigations were carried out on the estrogen activity of lucerne from various mowings harvested in years of different climate, studying the effect of age and yield of the crop. The observations were made during three successive years on local populations of lucerne grown under nonirrigation conditions. The estrogen activity was determined ny Bikov's biologic method, and the presence of cumestrol and genestein was established through chromatography. It was found that the estrogen activity of lucerne was to a large extent dependent on the intensity of growth. Young plants giving higher yield of green mass and dry matter manifested higher estrogen activity. Highest was the activity of lucerne from the first mowing, gradually decreasing in each of the following mowings. Variations were likewise established in the content of genestein and cumestrol in dependence on the mowing itself and the yield. All samples demonstrated that genestein was present in the first and fourth mowing, while the content of cumestrol varied within a wide range showing no markedly expressed correlations. The activity of the local lucerne populations during the first years of using the crop and the first mowings of green mass was shown to bring about disturbances in the reproduction process of ruminant animals provided lucerne is offered for a long time in greater amounts.


[Effect of betaine hydrochloride on broiler chickens when used alone or in combination with vitamin B12].

The studies were carried out with 2287 broilers aged from 3 to 56 days, divided when one-day-old into four equal groups. The first group were fed the common ration and served as controls. The remaining three groups were experimental, the broilers of the second group being offered the basic common ration enriched with 0.2 per cent betaine. The third group were also given the ordinary ration, however, they received in the drinking water some 10 mug vitamin BUI per one kilogram feed each. The fourth group received both betaine and vitamin B12 at the rates indicated. Results showed that betaine hydrochloride offered either alone or in combination with vitamin B12 contributes to increasing the liveweight gain of broilers in the course of the starter period, but its use in doses of 0.2 per cent in the finishing period is not effective.


[Effect of phospholipase c on the lipid composition of the membranes of antigen-stimulated macrophages].

Data are presented on the changes in the conformation of the membrane of antigen-stimulated macrophages as a result of studying the changes in their phospholipid composition. It was found that antigen stimulation increases the amount of phospholipids in the membrane of the macrophagesas well as the susceptibility of these phospholipids of the normal (unstimulated) macrophages. This phenomenon of more easily setting in hydrolysis is discussed.


[Pathomorphology of lung alterations in calves naturally infected with the virus of infectious rhinotracheitis].

In addition to diphtheroid rhinitis, and tracheitis, the infectious rhinotracheitis in calves has also been accompanied by a catarrhal-and-necrotic pneumonia. The mucous membrane of the bronchi, bronchioles, and alveoli in such cases is edematous with occasional necrotic areas. The necroses are focal and areactive. The peribronchial lymphoreticular system shows no signs of proliferation. The necrotic lesions in the bronchi and alveoli are considered as the porte d'entrée of the bacterial infection that aggravates the course of the disease and fairly often leads to death.


[Coliform microflora of commercial Caucasian cheese].

Studied was in the course of several years the extent of coliform bacterial contamination and the peculiarities the bacteria present in ripened cow's and ewe's white brine cheese offered for consumption. It was demonstrated that these kinds of cheese released in the commercial system contain up to 3.1 per cent coliform bacteria. Certain correlation was established between the coliform count in the cheese and the degree of ripening, the consistence, and the aspect of the cross section surface. If hygiene measures were not observed cheese could be contaminated additionally with coliforms during handling in the shops. Coliform microflora was presented mainly by strains characteristic of fresh fecal contamination (E. coli) and urease-positive organisms of the Citrobacter and Enterobacter genera. To guarantee the consumption of qualitative (in terms of hygiene) white brine cheese it is necessary to include into the respective standards the index "coli titer" of a unit value.


[Comparative study of infectious and atypical encephalomyelitis in birds].

Studied were morphologically a total of 234 birds for infectious encephalomyelitis (IE) and atypic encephalomyelitis (AE) of which 70 were experimentally infected with standard reference strains of IE (Calnek 1143-42 birds, and Van Roeckel 28 birds), 32 were infected with a brain suspension of affected with AE birds, and 110 were spontaneously affected with AE. Those of the birds that were infected with the standard strains of IE as well as with the brain suspension exhibited changes in the central nervous system in the form of a non-suppurative encephalomyelitis, and in the viscera--lymphoidcell proliferations. These alterations proved analogous with those observed in birds spontaneously affected with AE. The changes in CNS in the case of IE were localized in the brain and the spinal cord, while the lesions in the case of AE were found chiefly in the brain. In AE there were perivascular lymphoidcell were groupings along the peripheral nerves. It was concluded that the histologic changes established may well serve to differentiate IE from AE in Marek's disease, the transitional paralysis, the Newcastle disease, and the alimentary encephalomalacia.


[Swine infected with atypical mycobacteria].

Pigs spontaneously affected with tuberculosis responded with well expressed signs to avian tuberculin, and weakly to bovine tuberculin. Mycobacterium avium cultures of serotype--2 were isolated from 76.9% of them, and  M. avium cultures of serotype -1-from 23.1% of them. The lymph nodes were enlarged, with granulated cross-section area of presenting multiple necroses, some of the latter being in a process of calcification, and some fully capsulated. Histologic changes were also observed characterized by peritrabecular oedemas, decrease in the lymph elements and proliferation consisting of reticular and epitheloid cells. Although rarely there were also tubercules with giant cells of Langerhans type. Pigs given orally Mycobacterium battey (intracellulare), M. fortuitum, M. aquae, M. vaccae, and M. smegmatis responded with an allergic reaction on the 30th day following infection. The skin reactions were better manifested with the use of avian tuberculin. The blood serum of such pigs contained CFT-positive antibodies that were specific for the Mycobacterium genus. The histopathologic changes in the lymph nodes were of proliferative and infiltrative character. Tubercules of giant cells and necroses with calcification were not established.


[Human erythrocyte lipid peroxidation in different pathologic states].

Various capacity to reactions of peroxidative oxidation was found in lipids from erythrocytes of patients with impairments of inflammatory and tumoral nature. The most reactive were lipids from erythrocytes of patients with inflammation; lower capacity of lipids to peroxidative oixidation was observed in the blood cells of patients with tumors. The intensity of reactions of lipid peroxidation had a reverse correlation with the stability of erythrocyte membranes in isotonic buffer pH 3.0.


[Noradrenaline concentration and monoamine oxidase activity in regions of the brain and the livers of hyperoxic rats].

Content of noradrenaline and the activity of mitochondrial monoamineoxidase (MAO) were studied in cerebral cortex, hypothalamus, mesencephalon, medulla oblongata and liver tissue after the oxygen treatment under pressure (4 atm) within 1 hr. Content of noradrenaline was decreased in all the brain and liver tissues studied. The most distinct decrease was found in hypothalamus and the less marked one -- in liver tissue. The MAO activity was increased slightly in hypothalamus; it was unaltered in cerebral cortex (as compared with control), decreased distinctly in mesencephalon and inhibited by 100% in medulla oblongata. In the general brain preparation the MAO activity was considerably decreased. The decrease of the enzyme was less pronounced in liver tissue as compared with brain.


[Relationship between the structural state of chromatin and the biosynthesis of rapidly labeling nuclear RNA in the thymuses of rats subjected to total x-irradiation].

Accumulation of polydeoxyribonucleotides (PDN) was studied in thymus of rats, subjected to total body X-ray irradiation at doses 400 and 800 rad. The content of PDN correlated with the time of treatment; its low-polymer components prevailed after irradiation with 800 rad. Protein/DNA ratio was decreased in DNP within 30 min after the irradiation and it returned to the initial level within 4 hrs. Capacity of DNP to make a complex with actinomycin D was inhibited within 30 min; however it exceeded the control level within 4 hrs after irradiation. Biosynthesis of nuclear RNA, estimated by incorporation of 14C-uridine, was distinctly decreased within the whole experimental period.


[Chemical composition of casein glycomacropeptide components].

Alteration in pH and addition of urea (final concentration 3 M) did not affect the electrophoretic and chromatographic separation of glycomacropeptide. At the same time, urea (5 M) distinctly increased an amount of beta-component in separation by free electrophoresis. Sedimentation constant SO2OW and molecular weight of glycomacropeptide were equal to 1.35 S and 13000, respectively. Both fractions of glycomacropeptide had similar amino acid composition and contained phosphorus (0.4%). The variations were observed in the carbohydrate components of the molecules. The heavy component contained 5-fold higher concentration of sialic acids (9.7-9.6%), 2-fold higher concentration of galactose (13%) and acetyl galactosamine (5.0-4.0%) as compared with the beta-component (3.1-0.9%, 7.5% and 2.5%, respectively). These alterations in carbohydrate component of glycomacropeptide were suggested to affect the polymeric conformation of the molecule.


[Effect of kynurenine and its metabolites on the concentration of 11-hydroxycorticosteroids in rat plasma].

Injections of kynurenine (10 and 25 mg/kg, i.p.) and nicotinic acid (50 mg/kg i.p.) produced a marked increase in concentration of 11-hydroxycorticosteroids (11-HCS) in rat blood plasma. Effect of nicotinic acid was not prevented by dexamethazone (0.6 mg/kg). Subtreshold dose of nicotinic acid (10 mg/kg) enhanced a rise in 11-HCS produced by swimming stress. 3-hydroxykynurenine, 3-hydroxyanthranilic, antranilic picolinic and quinolinic acids (10-50 mg/kg) did not change the concentration of 11-HCS. It is suggested that some of the biochemical and pharmacological effects of injected kynurenine can be mediated through the rise of 11-HCS in blood.


[Native and artificial sub-forms of cytoplasmic aspartate transaminase from swine heart].

Multiple forms of aspartate transaminase from cytosol of pig heart (alpha, beta and psi) were incubated in 0.05 M acetate buffer, pH 5.0 at 4 degrees within 5 and 8 months. Gradual accumulation of denaturated forms was observed on incubation of alpha- and beta-forms; these forms possessed higher mobility in polyacrylamide gel disc electrophoresis and decreased enzymatic activity as compared with the native forms. Multiple forms, produced during ageing of alpha-form, were separated by chromatography on CM-cellulose. Chromatographic resolution of the forms, their activity and spectral properties suggest that they are not identical with the native isoenzymes found in the cell.


[Tissue metabolism of thyroid hormones in cirrhosis of the liver].

Content and ratio of products of iodothyronine tissue metabolism was studied in liver tissue of rats in normal state and in hepatocirrhosis after administration of 125I-thyroxin. The distinct decrease was observed in accumulation, deiodination and conjugation of thyroxin; the hormone was also converted into triiodothyronine in cirrhotically altered liver tissue. The importance of liver tissue in maintenance of hormonal homeostasis and biological activation of thyroid hormones is discussed.


[Regulation of peroxidation of mitochondrial membrane lipids initiated by Fe2+ ions by antoxidants of the 1,4-dihydropyridine series in experiments in vitro].

Effect of antioxidants on the rate of free radical peroxidation was studied in mitochondria in presence of Fe2+. For this purpose derivatives of 1,4-dihydroxypyridine, their heteroaromatic analogues, NAD-H+ and butyl hydroxytoluene (35 substances) were tested in the system by chemoluminescence. Several 1,4-dihydroxypyridine derivatives were found to be effective reagents in the system and could be compared by the activity with the recognized synthetic antioxidant butyl hydroxytoluene.


[Effect of fat loading on the development of silicosis].

Rats were administered with quartz dust intratracheally or subjected to chronic inhalation of the dust. Peroral overloading of rats with fat was shown to increase an accumulation of all lipid fractions in lungs and intensified silicotic fibrinogenesis. Similar alterations in lipid metabolism of lungs were observed in control animals maintained without the dust treatment at the same fatty diet; but these patterns were less distinct and were not accompanied by an increased collagene formation. Alterations in content of lipids in liver tissue and in blood did not depend on the dusting of lungs under fatty loading. Within the later period of inhalational dusting the increased accumulation of quartz was observed in lung tissue of rats maintained at fatty diet. The data obtained suggest that the recommended by some investigators increase in content of fats in miner's diet is not justified.


[Cell immunity indices in carcinoma of the gastrointestinal tract].

A group of 137 patients with carcinoma and benign diseases of the gastrointestinal tract was tested for a specific immunity to tumor, mucosa antigens and PHA. A response of peripheral blood lymphocytes to PHA was suppressed in patients with cancer. An assay of the specific reactivity against tumor antigens was done either by a lymphoblastic transformation or by the leucocytes migration inhibition agarose technic. More than one third of cancer patients showed positive ractions to tumor extracts in autologous as well as allogeneic systems. No differences were noted between the effect of the mucosa or tumor extract in a group of benign diseases by migration inhibition technic, but there were 11 of 23 patients who showed a blasttransformation reaction to tumor antigen. The autologous mucosa extract had no effect on lymphocytes of cancer patients, but it was found to inhibit the leucocytes migration. The action of tumor extracts was comparable in autologous and allogeneic systems. The presence of common or cross-reactive tumor antigens in gastrointestinal cancer is assumed. Some possible reasons of the changes are discussed.


[State of blood basophilic granulocytes in the estimation of sensitization of patients with stomach neoplasm].

One of the methods reflecting the state of antitumor cell immunity is skin allergic reaction of delayed hypersensitivity to injection of antitumor antigen, which together with other indices is believed to be of certain importance in estimating the immune response of the cancer patient organism. The authors compared quantitative and morphological changes in blood basophilic granulocytes and the data of skin allergic reaction. The results of studies conducted indicated that changes in the quantity and degranulation of basophilic leucocytes may be used along with skin allergic response of delayed hypersensitivity as one of the criteria for estimation of the degree of sensibilization of the organism of gastric cancer patients.


[Pseudouridine and uric acid excretion in patients with viral hepatitis].

Daily excretion of pseudouridine and uric acid with urine was studied in healthy persons and in patients with viral hepatitis during various periods of the disease. Excretion of pseudouridine was increased 2.5-fold and of uric acid--2-fold within the acute period of the disease. The degree of impairment in nucleic acids metabolism could be estimated by measuring of excretion of pseudouridine and uric acid and by calculation of their ratio during various periods of the disease.


[Tryptophan metabolism in vitiligo].

An activity of tryptophan pyrrolase was not observed in skin of healthy persons and of patients with vitiligo. Content of serotonin was similar in skin of normal persons and in skin of patients with normal pigmentation and in depigmented area. But content of serotonin in blood and excretion of anthranilic acid were decreased in the patients as compared with healthy persons. Excretion of kynurenine, 3-hydroxykynurenine, 3-hydroxyanthranilic acid, kynureninic, xanthurenic and 5-hydroxyindolyl acetic acids was increased in patients and this increase was more distinct after loading with 1-tryptophan. The data obtained suggest that kynurenine and serotonin pathways of tryptophan metabolism were intensified in vitiligo.


[Antigen, containing tryptophan metabolite, 3-oxyanthranilic acid, in blood serum of patients with stomach neoplasms].

The results of studies of the antigen containing 3-oxyanthranilic acid (3-OAA-antigen), as one of determinantal groups, in blood serum of patients with tumor and pretumor lesions of the stomach indicated that the former is present in the majority of patients with cancer proved histologically and also in some patients with pretumor diseases of the stomach. 3-OAA-antigen is found to be absent in health donors blood serum. The importance of the data obtained for establishing an early diagnosis of gastric cancer is discussed.


[In vitro metabolism of ubiquinone and ubichromenol in the livers of rats with avitaminosis E during individual and combined addition of alpha-tocopherol and phenylalanine].

A maximal incorporation of 2-14C-acetate into ubiquinone and ubichromenol was found within 3 hrs if liver tissue homogenate of E-avitaminous rats was incubated for 4 hrs. Phenylalanine, added to the mixture, stimulated the biosynthesis of ubiquinone and ubichromenol in the liver tissue preparations. alpha-Tocopherol caused an increase in biosynthesis of ubiquinone and a decrease in the rate of ubichromenol biosynthesis within 1 hr and 3 hrs of incubation in vitro. The combined addition of phenylalanine and alpha-tocopherol, almost without exceptions, increased the effect of alpha-tocopherol on biosynthesis of the substances studied. Interrelationship is discussed between vitamin E and ubiquinone and ubichromenol biosynthesis.


[Radioisotope gastroscintigraphy in diagnosis of tumor and pretumor diseases of the stomach].

The results of isotope gastroscintigraphy, performed in 160 patients with tumor and pretumor diseases of the stomach, are reported. Based on a clinico-morphological estimation of gastroscintigraphic findings, it was found that in 115 (72%) patients the data of scanning coincided with the ultimate diagnosis. In 25 (16%) patients pseudopositive and in 20 (12%)--pseudonegative scannograms were obtained. The greatest number of pseudonegative results was noted in patients with gastric cancer (in 19 of 20), in 10 of them tumor being located in the cardiac portion of the stomach. The precision of diagnosing tumors in other anatomical portion of the stomach was 90%. In patients with pretumor lesions the character of scannographic alterations was dependent on the rate of impairment of gastric mucosa function and structure.


[Current questions in the diagnosis and therapy of lymphogranulomatosis].

A summary of main successes in the field of diagnosis and therapy of lymphogranulomatosis is given. The most informative methods of diagnosis that need further development are estimated. Therapeutic schemes that are to be further pinpointed (radiation, pharmacological and combined) as well as possible prospective trends in studying the pathogenesis (the technic of cultivation, an estimate of the immunological status) are being formulated, due to that the therapeutic policy might be substantially modified.


[State of the kinin system in burn shock and early toxemia].

State of kinin system was studied in blood serum of patients with burns of II, III, IIIb and IV degrees during shock and early toxemia. Content or activity of main components of kinin system (kininogen, kallikreinogen, kallikrein, kininase I (carboxypeptidase N)) were repeatedly estimated at 4-6 hrs intervals; BAEE-esterase and antitryptic activities were also studied within 48-72 hrs after the trauma. At the same period plasminogen and plasmin were estimated in 8 patients. The activation of kinin system in burn shock was demonstrated: content of kininogen was decreased on 30-50% (independently on alteration of total protein in blood serum), the kininase activity was decreased, appearance of free kallikrein was observed and content of kallikreinogen was distinctly lowered already within 10-24 hrs after the trauma. Within 24 hrs after the burn the total decrease of kininogen in circulation accounted for 50-70% of the theoretical content. Fibrinolytic system was also activated during the burn shock. Increase in the antitryptic activity within 30-40 hrs after the trauma, which was previously established, is corroborated; the effect correlated with development of burn intoxication. The data obtained suggest that massive production of free kinins occur apparently within 24-48 hrs after burn.


[Method of determining the intregral activity of catechol-O-methyltransferase in the human body in vivo].

A method is developed for estimation of the catecholamine-O-methyl transferase activity in human organism by excretion with urine of unmetabolized isadrine (N-isopropyl noreadrenaline) after loading. Excretion of isadrine was increased both after administration of apomorphine, which is one of the inhibitors of the enzyme catecholamine-O-methyl transferase, and in cases of liver tissue pathology. It is known that the maximal activity of catecholamine-O-methyl transferase is the highest in liver tissue. Imipramine (an inhibitor of uptake of catecholamine) did not inhibit the activity of cafecholamine-O-methyl transferase as estimated by the present method.


[Prognosis in radiotherapy of patients with local recurrence of cervix neoplasms].

An analysis of the results of treatment in 231 patients with recurrences of cervical cancer is presented in relation to 5-year survival criterion ("dynamic analysis"). An actual 5-year survival rate was 16.0%. The most important factors determining the prognosis include the stage of the primary process, localization of the secondary tumor, terms of the recurrence and the absorbed dose of radiation given to the recurrence. Standardized rates showed a 3-5 fold improvement of the results of treatment in the presence of favourable prognostic factors. In combinations of favourable prognostic factors the 5-year survival rate of patients with recurrent cervical cancer reached 67.0%. The amount of the absorbed local dosage of radiation is of practical value for improvement of the results of treatment. Radiotherapy is the method of choice in treatment of patients with local recurrences of uterine cervix cancer.


[Fractionation of DNA on unmodified cellulose].

Not only separation of native, two-stranded DNA from denatured molecules but more distinct fractionation of single-stranded DNA was demonstrated on unmodified powdery and microgranular cellulose. Denatured DNA, absorbed on cellulose, was eluted from a column as two asymmetric peaks by 0,12 M and 0.05 M NaCl (for I and II peaks, respectively). Absorption and fractionation of denatured DNA and poly-A containing RNA on unmodified cellulose was apparently achieved on the basis of the same principles.


[Cytologic method for determination of histological structure in precancer and cancer of the cervix uteri].

The authors studied comparatively cytologic and histological findings in 164 patients in whom pretumor lesions (82) and cervical cancer (82) were revealed. The precision of cytologic diagnosis of pretumor lesions was 95.1 +/- 4.8%, of cancer--91.4 +/- 6.2%. Of 95 observations in which epithelial atypia, from proliferation to cancer, was detected the degree of cell atypia was correctly determined cytologically in 82.1 +/- 8.1% of observations, the degree of differentiation--in 85.2 +/- 7.2%, both factors--in 68.4 +/- 9.5%. Of 67 observations, in which cervical cancer was correctly diagnosed cytologically, the precision of prognosticating the presence of preinvasive and invasive cancer was 86.5 +/- 8.4%, while the degree of differentiation was diagnosed correctly in 83.5 +/- 9.0%, the histostructure being determined precisely in 71.6 +/- 11%.


[Use of lophenal in patients with malignant ovarian tumors].

The use of lophenal in complex treatment of 27 patients with malignant ovarian tumors has shown that the substance possesses a definite antitumor activity, manifested in gaining the clinical effect in 60.9% of patients with an average duration of remission lasting for 5.3 months. The toxic effect on hemopoiesis as well as the side effect of the substance were liquidated by pharmacological drugs. It is concluded that lophenal should be used along with other chemotherapeutic drugs for treatment of patients with malignant ovarian tumors.


[Effect of N-nitroso-N-methylurea on DNA and RNA synthesis in cells of liver and spleen tumors in leucosis L-1210].

During the development of leucosis a progressively retarded incorporation of 2-C14-thymidine and C14-uridine into DNA and RNA of a separate tumor cell and an active incorporation of 2-C14-thymidine into DNA of hepatic and splenic cells were observed. Repeated injections of NMU (20 mg/Kg X 5) in tumor-bearing animals result in a twice increase of life terms in mice and suppression of total tumor cells growth. The observed therapeutic effect is related with deep inhibition of DNA and RNA synthesis in leucosis L-1210 cells, while DNA synthesis in hepatic and splenic cells is only insignificantly suppressed (compared with the normal level typical for intact animals), but RNA synthesis in these organs is actually not involved.


[Study of the factor of ascites fluid of Erlich tumor].

The factor of nucleic nature was isolated by phenol method from acellular ascitic fluid of Ehrlich tumor. DNA was found to be the main component of the factor concerned as indicated by chemical analysis after its purification with preparative electrophoresis in 2.5% polyacrylamid gel or centrifugation in CsCl gradient. Moreover, the factor can be destroyed in incubation with DNA-s. It is not improbable that this factor consists also of small amounts of RNA.


[Bifunctional derivatives of N-nitroso-alkylurea].

Toxic cumulative and antitumor properties of bifunctional N-nitroso-alkylureas as compared with their monofunctional analogues were stuied. Newly produced compounds render a considerable antitumor effect on a number of experimental tumors. A conclusion may be drawn that despite changes in the chemical structure an active metabolic fragment both of mono- and bifunctional compounds is the same, as also evidenced by the cumulation index. However, inspite of a rather high antitumor activity of bifunctional compounds their chemotherapeutic indices are very low.


[Possibility of tissue accumulation and elimination of 3,4-benzpyrene from the bodies of fish].

One-year and two-year iridescent trout and two-year carp during different periods (from 2 months to 1 year) were given protein-vitamin addition to food containing 3,4-benz-pyrene (BP). The total amount of BP entering the organism of fish for the whole period of the experiment reached 12,6 mg/Kg of fish weight in daily dosage ranging from 0.1 to 4.1 m/Kg. In fish tissues BP was either not detected at all, or the content of the carcinogen in them did not exceed its amount in the control. In summer BP was not excreted in feces, but in winter its excretion made 13% of its daily consumption with food.


[Problems concerning metastasis of malignant tumors].

The data on metastases incidence in new discovered patients with malignant tumors of general localizations are presented. The status of current investigations on the ways and mechanisms of metastases, as the basis for elaborating measures of their prevention, is characterized. The most effective methods of diagnosis and treatment of regional and distant metastases are described. Special attention is given to the necessity of using combined and complex treatment of metastatic forms of malignant tumors. It is shown, that along with the widely used methods, the application of radioisotopic, hormonal and some physicochemical influences, hyperthermia and hyperglycemia in particular, seems to be quite promising for this purpose.


[Surgical treatment of precancerous diseases of the stomach].

In benign solitary polyps of the stomach the author recommends to perform polypectomy. Observations of 26 operated patients during the period from 1 to 10 years revealed neither polyps recurrence nor cancer. According to the author's data malignization of callous gastric ulcers was found in 10-26% by histological assays of the resected specimens. To the end of prophylaxis against cancer the author considers it necessary to widen indications to surgical treatment of gastric ulcers.


[Diagnostic value of determining spermidine in the urine of patients with melanoblastoma of the skin].

To estimate the diagnostic value of determination of one of polyamines (spermidine) in the urine the authors examined 58 patients with skin melanoblastomas of different localization and 10 healthy persons. It was found that in 16 of 25 patients having only primary tumor, in all 9 patients having primary tumor with metastases in regional lymph nodes, and also in 14 of 20 patients, who after previous therapy developed recurrence or metastases in regional lymph nodes, spermidine excretion exceeded its normal level. In three patients, subjected previously to radical treatment and considered as being clinically recovered, normal spermidine level was excreted. The data obtained enabled the authors to use this test as an adjuvant criterion in examination and treatment of such patients.


[Variants in the course of papillary carcinoma of the thyroid gland (clinico-morphologic analysis)].

A clinico-morphological analysis of 157 cases of papillary cancer of the thyroid is made. Depending on the presence and time of appearance of regional metastases three groups of patients are distinguished: I -- regional metastases are the first clinical manifestation of the lesion (87 patients); II -- the lesion starts with the appearance of a node in the gland, regional metastases develop later (50 patients); III -- thyroid tumor without regional metastases (20 patients). The groups sungled out differ reliably in the rate of tumor growth and prognosis. The first group proved to be most favourable with respect to prognosis. A five-year survival in patients of the first group was noted in 92 +/- 3.3%, while 84 +/- 7.4% of patients survived for 10 years and longer. There were no essential differences in the morphological signs in the concerned clinical groups of papillary cancer of the thyroid.


[3-Hydroxyanthranilic acid in the blood of patients with kidney tumors].

Antigen containing the tryptophan metabolite -- 3-oxyanthranilic acid-(3-OAA-antigen) was determined by agarose precipitation method, using specific immune rabbit sera in 85 patients, admitted with the primary diagnosis of renal tumor. Among 85 patients 3-OAA-antigen was found in blood sera in 62 patients. Among 23 patients in whom 3-OAA-antigen was not revealed in 20 -- the diagnosis of renal tumor failed to be supported. The authors conclude, that it is possible to use the reaction of 3-OAA-antigen detection for establishing the diagnosis of tumors of the kidneys.


[Means of dissecting the tentorilm cerebelli following cranio-cerebral trauma].

Circulatory disorders in the brain stem due to temporal herniation are among the leading causes of death of patients with craniocerebral injuries. The dissection of the cerebellar tentorium following the removal of a space occupying formation aimed at decompressing the brain stem is a rather traumatizing procedure. A less traumatizing method of tentorial dissection was developed using a specially designed instrument. Fifteen operations were conducted in 14 patients.


[Two-dimensional echoencephalography in focal brain pathology].

Two-dimentional echoencephalographic examinations were conducted in 35 patients with focal lesions of the brain of different etiology. Normal tomoechoencephalogramme and ultrasonic semiotics of transverse sections of the brain in different pathology is described with reference to its nature and interrelationships with the meninges and brain matter (tumours, abscesses, emningeal and intracerebral haematomas, hydroma, brain confusion, intracranial foreign bodies). The authors believe that two-dimentional echoencephalography is a promising method of diagnosis, free of contraindications, combinding safety and promptness of the examination. direct visualization of focal pathology of the brain through an intact skull.


[State of the sympathetic orbito-pupillary innervation in facial pain syndromes].

In 55 patients with trigeminal pain syndromes of different genesis a study of the state of the orbit-pupillar innervation was undertaken judging by the response to sympathomimetic drugs (adrenalin and cocaine solutions) administered into the conjunctival sack. The obtained data were evaluated by way of pupillography. The disorders in sympathetic orbit-pupillary innervation were found to be independent of a prevailing lesion of any of the three peripheral branches of the trigeminal nerve. Trigeminal neuralgias develop without any disorders in the sympathetic orbit-pupillary innervation. In the presence of a neuritic component in trigeminal pains the disorders in the sympathetic orbit-pupillary innervation are noted invariably. In anaesthesia dolorosa of the face an important place in the genesis of the pain syndrome belongs to the cranial portion of the sympathetic nervous system.


[Clinico-electrophysiologic studies of the spastic syndrome and its neurosurgical treatment in patients with spinal cord lesions].

The authors analyse the results of surgical treatment of spastics in 15 patients with spinal cord lesions. The results of a dynamic, neurological and electrophysiological examinations permit to draw several conclusions on the mechanisms of spasticity and its elimination by surgery. A restoration of reflex activity in the absence of the spastic syndrome is considered by the authors as a favourable result of the operation.


[Comparative study of intracerebral and cerebrospinal fluid pressure in neurosurgical clinical practice].

Comparative measurements of cerebrospinal fluid pressure(CSPF), total local intrabrain pressure (IBP) and interstitial fluid pressure(ISFP) have been made in 32 neurosurgical patients in the postoperative period. The obtained data prove that IBP is almost twice higher than ISFP and 1.5 times higher than CSFP. The data of this study show that no direct hydrostatic relation exists between the cerebrospinal fluid and the interstitial fluid. The reasons of "negative" values of ISFP are also discussed. The intracranial pressure is to be considred as a combination of selective mechanical pressures of the main intracranial components. Therefore a more precise term "intracranial pressures" is suggested.


[X-ray diagnosis of cranio-vertebral anomalies].

On the basis of an analysis of the radiological data of 66 patients with craniovertebral anomalies the following forms of them were distinguished: 1) basilar impression; 2) assimilation of the atlas; 3) coarctation of the atlanto-occipital segment; 4) anomaly of the C1-dens. The main radiological signs revealed in the patients with different forms of craniovertebral anomalies with the aid of craniometric techniques and linear and angular indices are presented. The importance of tomography and myelography in the diagnosis of medullar compression and of its concomitant anomalies is emphasized, pneumomyelography being preferred against positive myelography. A combined evaluation of the neurological and radiological data permits to determine the indications for surgery of congenital craniovertebral pathology.


[Subclinical forms of spinal disorders in discogenic lumbar radiculitis].

In patients with discogenic lumbar radiculitis with a unilateral affection of L5 or S1 root motor and central responses of the medial group of plantar muscles were recorded. In S1 root pathology the central response consisted in 25% of the cases in repeated antidromal discharges, which testified to an increased excitability of the corresponding alpha-motoneurons. In patients with L5-radiculitis a predominance of the reflex component in the response was typical. Since this phenomenon was lacking in combined L5 and S1 root lesions, it was interpreted as a sign of a decreasing function of the segmental inhibitory interneurons.


[Clinico-immunologic periods of spinal cord injuries].

A clinical and immunological periodicity of spinal cord injuries is introduced, comprising 5 periods. The periodicity is based on a study of the indices of a specific and non-specific immunological reactivity of 150 persons with vertebral column traumas accompanied by spinal cord injuries studied after different periods following the trauma and compared with the clinical data and results of similar examinations in the controls. The clinical and immunological periodicity plays an important role in the panning of rational therapy, in the evaluation of bacteriuria and the principles of antibacterial therapy, as well as for the exaluation of the neurodynamics of the injured spinal cord.


[Congenital disorders in the stability of the cranio-vertebral region].

A functional radiographic examination of the craniovertebral zone was conducted in 600 normal adults and in 15 children. Normal peculiarities of the interrelationship of the atlantoaxial articulation found in 542 persons were classified. In 58 of them (9.7%) excessive mobility of the atlantoaxial articulations was found, 50 of them having a subluxation of the Cruveilhier joint with a dynamic narrowing of the vertebral canal. The remaining 8 persons had an excessive mobility of C1 along the axis of the dens of C2 overlapping half of the anterior arch of C1 above the apex of C2-dens. Such chronic disorders in the interrelationship of the craniovertebral zone elements caused no neurological disorders. However, in unfavourable cases, like forced movements of the head, a severe acute pathogenetic neurological situation may occur.


[Clinical picture of multiple intracranial hematomas in the acute period of severe cranio-cerebral trauma].

According to the authors, the clinical course of multiple intracranial haematomas is characterized by a prompt formation of the syndrome of acute brain dislocation with the development of severe pyramidal deficit and involvement of the oculomotor nerve on the side of the larger intracranial haematoma. To detect the multiple haematomas it is recommended to employ, both pre- and post-operatively, a careful echoencephalographic and angiographic control in the patients with a severe brain trauma.


[Two-dimensional echoencephalography through a trepan defect in the skull].

With the aid of a non-adapted equipment echoencephalotomogrammes were obtained that revealed fine details of intracranial structures in normals and in patients with space-occupying lesions, these tomogrammes being comparable to those obtained after anatomic sections of the skull in the same planes. This becomes possible thanks to the absence of the bone as a limiting factor. Interpreting the conducted examinations as a model of intraoperative scanning, and considering the results of experimental craniotomies, a conclusion is made as the importance of such investigations especially in cases of bilateral space-occupying lesions.


[Total removal of acoustic neurinoma].

The analysis is based on the results of a total removal of acoustic neurinomas in 120 patients operated on in 1967-1975. The facial nerve was preserved after surgery in 65 patients (54.2%). In the course of the recent 3 years the employment of microsurgical techniques permitted to preserve the VII nerve in 26 among 35 operated patients (74.3%). Among 103 examined postoperatively 96 retained their full or partial capacity for work (93.2%). Ten patients (8.3%) died after surgery. Within the recent 3 years 35 patients were operated on without a single mortality case.


[Diagnosis and surgical treatment of hourglass shaped tumors of cervical localization].

Among 449 patients with intravertebral tumours, 35 patients (7.8%) had sand-glass shaped tumours, 19 of them being localized in the neck, which comprised 19.6% of the 97 cervical intravertebral tumours, and 45.9% of neurinomas. An analysis of the material permits to conclude that when the symptoms of spinal cord compression are combined with an extension of the intervertebral foramen, the indications for myelography for precising the diagnosis are relative. A one-stage total excision of the tumour is indicated, either via a vertebral approach, or via a bilateral approach by way of laminectomy and from the neck. Whenever the intervention has to be divided into two stages, the intravertebral node should be removed first, and the extra-vertebral one afterwards from the cervical incision, always striving to cut the interval between the two interventions down to 3-4 weeks.


[Glycogen breakdown in the tissue of human cerebral glial tumors].

The activity of gamma-amylase (acid alpha-glucosidase) and phosphorylase in the tissue of human glial tumours and the brain tissue adjacent to the tumour was studied. A sharp (more than three-fold) increase of the activity of gamma-amylase was found in the tissue of glial tumours. In the adjacent tissues of the brain its activity was also elevated (approximately, two-fold). The activity of phosphorylase is practically lacking in human glial tumours, and is only slightly apparent in the brain tissue neighbouring the tumour. Gamma-amylase may be suggested to play an important role in glycogen metabolism of glial tumours in man.


[Prognostic value of the ST elevation of the electrocardiogram in the acute stage of myocardial infarct].

The prognostic value of ST segment elevation on electrocardiograms is studied in 400 patients with acute myocardial infarction, 138 of them deceased. A close correlation was established between the degree of ST segment elevation and mortality rate. The average value of ST elevation in all deceased is 5.22 +/- 0.20 mm, und in all survived the acute stage--3.39 +/- 0.15 mm. Those values are higher in anterior infarction--5.55 +/- 0.23 mm and 3.99 +/- 0.15 mm and lower in posterior infarction 4.45 +/- 0.25 mm and 2.65 +/- 0.10 mm. The ST segment elevation over the average values in the deceased is a poor prognostic sign and an elevation slightly lower than the average values in the recovered is a favourable prognostic sign.


[Epidemiological studies of ischemic heart disease and arterial hypertension among the industrial workers and administrative employees in the "Napreduk" factory in Plovdiv].

Five hundred and ten industry workers and 100 administrative employees from the plant "Napredăk"--Plovdiv were studied consuming the same quantity of calories (from 2500 to 3500). The working processes of the workers are mechanized in 70 per cent. The production is based on the conveyor system. Reduced physical activity is established but intensified psychic strain. Reduced physical activity is also established in the administrative employees and high mental loading. All men and women, aged 25-75 were examined for ischemic heart disease (IHD). IHD was found in 30.59 per cent among the industry workers (31.14 among men and 29.38 among women). IHD in 48 per cent (41.9 among men and 34.37 per cent among the women) was found in the administrative employees. The role of certain risk factors for IHD was studied. Arterial hypertension proved to be one of those risk factors with statistical significance, as well as obesity, hyperlipidemia (over 800 mg%), hypercholesteremia (over 250 mg%). Arterial hypertension was confirmed in 12.3 per cent of industry workers and in 19 per cent the administrative employees. More important and statistically significant factors for it are: obesity, hyperlipidemia, hypercholesteremia and neuropsychic strain.


[Thyrotropic hormone plasma level in thyrotoxicosis].

Immunoreactive TTH plasma concentration was investigated twice a day (at 9 a.m. and 9 p.m.) in 30 patients with thyrotoxicosis, 10 out of them in acute stage and 20 in a state of remission after thymidazol treatment as well as in 17 healthy subjects. The authors established that in the acute state of thyrotoxicosis the latter is reduced to low normal or subnormal values (an average of 2.94 +/- 0.70 ng/ml) and after thyrostatic therapy leading to remission--is about the average norm (4.65 +/- 1.10 ng/ml) and does not differ much from that in healthy subjects (4.75 +/- 0.92 ng/ml). The negative correlation between the TIH levels and thyroid hormones (BOI, total thyroxin), typical for the healthy subjects, is found in the patients with acute thyrotoxicosis. No significant difference was established between the TTH values of the morning and evening hours in any of the groups. The physiological regulatory feedback mechanism in thyrotoxicosis is assumed not to be disturbed.


[Diagnosis of oligosymptomatic forms of chronic glomerulonephritis].

An investigation is carried out, by punch biopsy, on 54 patients with chronic glomerulonephritis, its course being evaluated as oligosymtomatic. From the patients followed up 35 were with morphologic changes corresponding to endoproliferative type, 13--to membranaceous type and 6--to membranaceous-proliferative type. The patients' complex investigation (incld. the investigation of biopsy renal material) was established to allow the disease diagnosis in its initial stage, irrespectively of the lack of manifested clinical and laboratory symptoms. Some typical peculiarities in the clinical course and the differences of the followed up laboratory indices, for separate morphologic types, were established and thus the diagnostic opportunities were increased. The duration of the oligosymptomatic course is also different, the highest being in the endoproliferative type--an aveagre of 10 years and the shortest--in the membranaceous-proliferative type--an average of 3 and 4 months. In the patients studied, in spite of the lack of manifested clinical and laboratory activity, a definite tendency is found towards gradual disease course with restricted renal functional potentialities. Besides on glomerulonephritis morphological type, this tendency depends on some additional factors as intercurrent diseases, keeping of no optimal regimen of life and labour, pragnancy etc. The authors are provided grounds to admit that early complex diagnosis specifying is a necessity in carrying out systematic prophylactic and therapeutic measures, thus improving the disease prognosis.


[Frequency and complications of cholelithiasis].

The authors studied a total of 16557 necropsy reports for 20 years, at the Chair of Pathologic Anatomy, Medical Faculty, Sofia, as regards the incidence and complications of cholelithiasis. In order to determine the effect of the applied modern antibiotic treatment, the material studied covers the decades 1932-1941 and 1963-1972. Cholelithiasis incidence grew about five times during the second period. A change in the incidence of certain complications is also observed--a) there is a considerable decrease in the number of liver abscesses during the antibiotic period (about three times); b) the number of the developed biliary cirrhosis grew (about three times). With age aspect, the peak incidence has shifted with a decade backwards during the second period, life prolongation being the reason for it.


[Treatment of obesity with a high-protein, high-fat, "carbohydrate-free" diet].

Sanatorium treatment for 27 days was carried out for 52 patients with obesity of alimentary metabolism type, consisting of moderate loading and high-protein, high-lipid diet with 2430 to 2840 cal daily, with unusually low carbohydrate contents--10 g for the first week and 38 g--in the fourth. The authors established a favourable total and an average daily body weight loss of the patients, irrespectively of the relatively high caloric intake. No sense of hunger was reported from the majority of the patients. The subjective complaints observed are more frequent and more severe, as compared with the other treatment regimens with reducing but balanced dietetic regimens. The majority of the subjective complaints established could be associated with the objectively confirmed compensated metabolic ketoacidosis. The unfavourable changes in the followed-up laboratory indices are: considerable decrease of blood sugar, massive ketonuria, elevation of serum uric acid and deviations in the acid-base parameters. Serum lipid indices fell under the effect of the treatment and body weight reduction. What impresses is the serum cholesterol reduction in spite of the high exogenic import, the diminution of cholesterol-lecithin index and the marked elevation of free fatty acid in serum, manifestation of incresed lipolysis in the lipid depots. (he diet indicated is not balanced and not physiological. It must be applied casually in obesity treatment. Its application is possible only after a strict assessment of each individual patient with obesity with no accompanying diseases, that do not agree with the partial fasting and cannot be included in intensive motor regimen.


[Therapeutic effect in 3 cases of hepatic coma in viral hepatitis].

The author reports his observation on three cases of coma hepaticum in viral hepatitis treated at the Internal Diseases Ward, Military Hospital, in the town of Asmara, Ethiopia. Parallelly with the usual hepatoprotective drugs and antibiotics, corticosteroids were administered as well as the preparation Reducdyn, containing homocysteine and cysteine-carriers of sulphhydryl groups. Complete restoration to health was achieved in two of the patients after three days in grave coma. The third patient was aroused from the comatose state for six hours but later had a lethal end on the eighth day post coma onset. According to the author, the combination of that preparation with corticosteroids is pathogenetically grounded and enables the administration of the latter in lower and safe doses. The author stresses upon the importance of early therapy in coma hepaticum.


[Study of the interrelationship of glycemia-nonesterified fatty acids in physical activity in diabetics and patients with a normal glucose tolerance test].

Sixty four experiments were carried out in middle aged diabetics with normal and over-normal body weight and in a control group of patients with NGTT with a parallel follow-up of blood sugar and NEFA with an uptake of 50 g glucose per os and the performance of a moderately difficult physical loading (hiking) or complete rest in a bed for 2.5 hours. A better glucose utilization was found after physical loading in both groups of patients as compared with the rest period. Glucose utilization in patients with diabetes mellitus in physical loading is the same independently of the blood sugar initial level, providing grounds to admit that the betacyte formation apparatus is not strained. NEFA decrease by the 60th minute in diabetics, both in physical loading and at rest does not substantially differ from the subject with NGTT. That comes to show that NEFA utilization in that period is almost the same for the two groups. In patients with NGTT at the end of the physicalloading NEFA is sharply elevated over the initial level (lipolysis), while in diabetics, they remained at the level of the 60th minute.


[Apex carotis diagram and benign systolic murmurs].

The apex-carotis diagram is a new mechanocardiographic, non invasive method consisting of integration of the carotidogram and apexcardiogram--synchronously recorded. The value of the amplitude height of these curves at every 0.025 sec are transferred to an orthogonal coordinate system and later the points connected in a chronological order thus obtaining the apex-carotidogram (ACD). ACD have been constructed in 62 healthy subjects and in 26 people with innocent systolic murmur, aged between 14--65 years. Our investigation showed no difference between the control group and the people with innocent murmur. The points of connection, lines, segments, fields and axis of ACD were the same in both groups. The angles alpha, beta, gamma, delta, epsilon measured quantity and calculated showed no statistical difference (p greater than 0.05).


[Vegetative polypoid forms of stomach cancer with a cardial location (1 case)].

A case with vegetating polypoid gastric cancer in the cardio-esophageal zone is described. The cancer remained masked by the accompanying circulatory and septic complications manifested on the first place in the clinical diagnosis due to the lack of previous clinical symptoms of the digestive system. Attention is paid to the vegetating polypoid cancers of the cardio-esophageal zone, being with a vast dissemination, before manifesting a typical clinical symptomatology.


[Bone metabolic disorders after prolonged treatment with antiepileptic agents in a patient with idiopathic hypoparathyroidism].

A case is reported of a patient, aged 20, with idiopathic hypoparathyroidism, manifested with the picture of epilepsy with a long treatment with antiepileptic remedies. Two years after the initiation of the antiepilertic treatment, severe skeleton disturbances occurred with manifested osteoporosis and multiple symmetric zones of bone reconstruction, hypocalcemia, hyperphosphatemia and elevated serum alkaline phosphatase. The disturbances of calcium and phosphorus level in blood are favourably affected by the application of relatively high vitamin D doses. The role of the long-term anticonvulsive treatment in the development of vitamin D resistant rickets and osteomalacia is discussed.


[Value of the lymphocyte transformation test with phytohemagglutinin in rhematoid arthritis].

The aim of the present study was to determine the significance of the lymphocyte transformation test with phyto-hemagglutinin in connection with the degree of inflammatory activity and serological changes. Lymphocyte transformation test with phytohemagglutinin was performed on 46 of the patients with rheumatoid arthritis active stage, diagnosed according to the New York criteria. In patients with low and moderate inflammatory activity the lymphocyte transformation test has values close to those of the controls. In patients with high inflammatory activity either low values or considerably higher were established as compared with the control group. The values of the test were proved, through the statistical analysis, to be heterogenous quantities in seropositive and seronegative patients.


[Serum complement level (C'H5O) during treatment of rheumatoid arthritis patients].

Decreased total complement serum level (C'H50) was established in 72 per cent of the 78 patients examined, associated most likely with the developing processes of antigen-antibody reaction and the severe course of the illness. The applied treatment with different antirheumatic remedies, according to their mechanism of action, determined the respective changes in the complement level. Indomethacinum and chinoline derivatives induce complement values elevation, whereas the corticosteroids, salicylate and pyrazolone preparations lead to the complement values normalization.


[Desopimon in the treatment of obesity].

The authors tested the tolerance and therapeutic effect of desopimon preparation (1-p-chlorophenyl-2-aminopropane hydrochloride) in 44 subjects with obesity--I, II and III degree. They found a manifested appetite-inhibiting effect of the medicament in 41 of the patients and slight in two (the treatment was discontinued in a female, due to urticaria). Side effects, similar to those described with phenformin and phenmethrazin derivatives were not established. Body-weight loss is 12,9 kg per subject for a period of a month and a half, and the analysis of the data revealed that the weight loss was entirely on the account of the fatty tissue reduction. Triglyceride diminution was established in serum whereas free fatty acids were increased. After the confrontation of their own data those of some other researchers, the authors recommend desopimon as a suitable additive means in the treatment of simple nutritive (hyperphagic) obesity.


[Several lipid indices in hypertension].

Forty four patients with arterial hypertension were examined. Thorough clinical examinations were carried out. Total lipids, total cholesterin and triglycerides in serum were determined at the laboratory. The lipid-acid composition of erythrocytes was studied by gas chromatography of the same patients. A control group of 10 healthy subjects were also examined. Hyperlipemia incidence among the patients amounts to 75 per cent. The ratio saturated (monoene and monoene) diene fatty acids was found to be increased in erythrocyte lipids of hypertonics. The deficiency of polyene fatty acids in erythrocytes was discussed to correlate to their deficiency in plasma. A relationship was established between the deficiency of polyene fatty acids in erythrocytes and the hyperlipemia present.


[Social risk factors for rheumatoid arthritis (epidemiologic social-medical study)].

An epidemiological social-medical study was carried out in the section of IX polyclinic--Sofia, aiming at the establishment of the social risk factors effect upon the origination and course of the rheumatoid arthritis (RA), in view of the particularly social importance of the disease invalidity. The model is based on statistical methods for programmed computor processing. Two hundred and forty six subjects were examined, the basic group of 44 being with diagnosed RA according to the international criteria (0.35% from the population) and 2 control groups--patients with infectional alergic arthritis and healthy subjects. The assessment of the RA severity degree was performed according to the numeric method, elaborated for that purpose, based on the following criteria: number of the joints, kind of the joint involvement, functional capacity, patients' personal assessment of the difficulties due to the disease, disease duration, ESR, rheumatoid factor, X-ray changes according to the adopted four degrees. The following social factors were studied: occupation, kind of work, working conditions, financial status, education, home conditions, mode of life, activity in the leisure time. A statistically significant (correlation C with P less than 0,05--0,001) unfavourable effect of the following complex of risk social factors was established: 1. RA risk factors--unfavourable microclimatic working (C=0,24) and home (C=0.30) conditions: 2. Risk factors for RA invalidity--occupations with heavy physical work (C=0,40), wol income (C=0,31) and unfavourable home conditions (C=0,22). The results obtained will serve as a ground for concrete directed rheumatoid arthritis prophylaxis. That outlines the perspectives of similar studies for assessment of the effect of life environmental factors upon human health state.


[Acute renal insufficiency in poisoning with cistol (carbon tetrachloride)].

Three cases of acute intoxication with the preparation "Cistol", containing tetrachloro-methane were described, with the development of acute renal insufficiency, treated with hemodialysis. The attention of the physicians and the society is drawn to the risk of intoxication by that preparation. Early hemodialysis is recommended in case of such intoxications.


[Left anterior hemiblock in a variant form of angina pectoris].

Certain peculiarities of the anterior left hemiblock in a variant of angina pectoris are dynamically followed up. The recorded anterior left hemiblock indicates a certain parallelism and succession and follows the rest of the ECG changes. The deviations of the cardiac axis in the left anterior hemiblock in the variant form of angina pectoris has a certain diagnostic and especially prognostic significance. The character of the hemiblock is determined by the topic position and phyoxia degree. The clinic of the hemiblock is determined by the basic ailment.


[Chronic recurrent pancreatitis with erosive gastritis in a patient with primary hyperparathyroidism].

A female with premary hyperparathyroidism and secondary renal lesions, as well as lesions of the stomach and pancreas is described. The initial illness was manifested by repeated renal crises. Later, gastroenterological complaints appeared--epigastralgia, vomiting, frequent hematemesis with melena. That was the cause for a gastric resection, diffuse erosive gastritis being found. After the operation, the pains and the vomiting of hematin matter repeatedly recidivated. Clinically and at the laboratory, data were formed for a chronic recidivating pancreatitis with the presence of primary hyperparathyroidism. The postoperative treatment of the parathyroid adenoma led to an improvement of the gastroenterological complaints.


[Subacute encephalitis during lactation (author's transl)].

Two cases of encephalitis during lactation are reported. The illness started with psychotic symptoms and some weeks later neurological disturbances appeared. The course of the illness was subacute and both cases the brain scan was abnormal with numerous nodules. A CSF proteinogram showed an acute phase reaction, pointing to an organic lesion of the nervous system, but no impairment of the blood CSF barrier and normal immunoglobulin G levels. The possible aetiological factors, as well as the CSF and brain scan findings are discussed.


[Cerebellar ataxia in three generations with apparently dominant inheritance (author's transl)].

The clinical features and genetic inheritance of cerebellar ataxia, presumably of the Holmer type, are described in a family with four affected members over three generations. Two of these cases were severly affected, whilst the remaining two cases were probably of a relatively mild form. The pitfalls in diagnosis are discussed and the dangers of incorrect diagnosis pointed out.


[Cerebral arachnoid cysts in children with local bulging of the skull (author's transl)].

A series is reported of 9 cases of supratentorial arachnoid cysts in children under the age of 14 years. The predominant clinical and radiological sign is local bulging of the skull, caused by the underlying cyst. The characteristic angiographic findings and anomalies in the phlebogram are discussed. Operative measures (trephination and ventriculo-auricular shunt) aim at restoration of the disturbed cerebrospinal fluid circulation and resection of the wall of the cyst. Selection of patients for operative measures and results of treatment are discussed.


[Treatment of forced weeping (author's transl)].

A derivate of gamma-aminobutyric acid was found to have a favourable therapeutic effect in patients with forced weeping (weeping sickness). All 10 treated cases were shown to have motor neuron lesions resulting from other cerebral changer (cerebrovascular accident, brain atrophy, diffuse vascular changes).


[Motor nerve conduction velocity in uraemic polyneuropathy: correlation with metabolic factors (author's transl)].

The following parameters have been examined in twenty-one patients suffering from chronic renal failure (creatinine level between 4.5 and 18.8 mg/100 ml serum): maximum motor nerve conduction of the peroneal nerve, amplitude of the compound muscle action potential of the extensor digitorum brevis muscle, serum creatiine, total protein, serum globulins, serum albumins, alkali reserve, time of increase of serum creatinine above 4 mg/100 ml up to time of determination of the maximum motor nerve conduction, daily urinary excretion, mean blood pressure, (p less than 0.01) was found between maximum motor nerve conduction, as well as amplitude of the compound muscle action potential, and the serum albumin level only. Decreased levels of serum albumin, is correlated with diminished nerve conduction and a lower amplitude. The relationship between the electrophysiological data and serum albumin levels maybe explained on the basis of progression of a pre-existing polyneuropathy due to additional dietary malnutrition. A different interpretation is the assumption of an inactivation of neurotoxin on binding by albumins. A decrease in the albumin level would, therefore, result in an increased amount of unbound toxic agent. The values of the maximum motor nerve conduction were between 16 m/sec and 51 m/sec (mean value 42.2 m/sec), pointing to a polyneuropathy of primary axonal type rather that to primary demyelinization. The amplitudes of the compound muscle action potentials were not greatly reduced and thus the uraemic polyneuropathy seems to be of mixed type. In uraemic polyneuropathy different aetiological factors have to assumed. According to the prevalent factor a polyneuropathy of predominantly axonal or predominantly demyelinizing type may result.


[Rectal electrical potential difference and plasma aldosterone in hyperaldosteronism and low-, normal- and high-renin hypertension].

Rectal electrical potential difference (P.D.), plasma aldosterone and plasma renin activity were measured in 25 normal subjects, 80 patients with untreated essential hypertension, 4 patients with primary and 9 patients with secondary hyperaldosteronism. In normal subjects the rectal P.D. was 26 +/- 10 mV (+/- S.D.); in patients with hyperaldosteronism it was 51 +/- 7 mV. Plasma aldosterone and rectal P.D. were correlated significantly (r = 0.84, p less than 0.001) in these two groups combined. In 29% of patients with low-renin hypertension, in 9% of patients with normal-renin hypertension and in 3 out of 8 patients with high-renin hypertension, rectal P.D. was found to be elevated in the presence of normal plasma and urinary aldosterone and no correlation was observed between plasma aldosterone and rectal P.D. (r = --0.09, n.s.). In 3 out of 7 patients with low-renin hypertension and high rectal P.D., plasma and urinary aldosterone were consistently suppressed. Since patients with low renin and high rectal P.D. responded favourably to spironolactone therapy it is suggested that mineralocorticoids other than aldosterone may contribute to the pathogenesis of the hypertension in these cases. The aetiology of raised rectal P.D. in normal and high-renin hypertension is not clear, but both catecholamines and angiotensin II may be involved. The measurement of rectal P.D. alone is of limited value as a screening test for primary hyperaldosteronism in hypertensive patients, but combined with renin measurements it is a valuable tool for further investigation of patients with suspected mineralocorticoid excess syndromes, as well as for adjusting therapy with competitive aldosterone antagonists in patients with proven primary or secondary hyperaldosteronism.


[World trends in infant mortality since 1950].

Despite the considerable progress made in recent decades, and perhaps even partly because of the very uneven distribution of this progress, infant mortality is still very high in some regions, whereas in other regions it is tending, if not disappear completely, at least to become numerically negligible even though remaining a matter of social concern. Whereas in tropical Africa almost one child in five dies before its first birthday, in Japan or Scandinavia it is one child in a hundred. Infant mortality rate varies between these two extremes, but there is a substantial gulf between  the "most developed" regions which are all below 30% and the "least developed" regions which fall into three categories: 65-100% (Latin America, Eastern Asia except Japan), around 140% (Northern Africa, South Asia, Melanesia), and about 200% (topical Africa). These inequalities between countries overlap with inequalities between social groupings by urbanization, social/occupational level, education and income, are all variables that are correlated with infant mortality to a greater or lesser degree. The pace of the progress achieved since 1950 seems to be independent of the starting level. Contrary to the development of mortality at other ages, it is not in the countries with high mortality that infant mortality has decreased most. The pace of reduction divides the most developed regions into three distinct groups: very rapid reduction (Japan), rapid reduction (Scandinavia, Western Europe, Southern Europe and Eastern Europe), and slower reduction (British Isles, Northern America and Australia/New Zealand). Thus Japan rapidly caught up with Western Europe and the English-speaking countries and has now reached the same level as Scandinavia. On the other hand, the English-speaking countries have fallen behind the Scandinavian countries and are now at par with Western Europe. The reduction of infant mortality mainly concerned deaths of children over one month of age or even over one week of age and otherwise is due to reduction of infectious diseases. Consequently, in the most developed regions mortality is highly concentrated in the first week of life and is mainly attributable to the "causes of perinatal mortality" and the "congenital" anomalies". In the least developed regions, on the other hand, the infectious or parasitic diseases are still of decisive importance and the risk of death remains very high throughout the first year of life and even beyond. The risk may be even higher during the second year, when weaning takes place abruptly and results in serious difficulties in feeding.


[World health-related indicators].

Many of the statistics given in this report are estimates based on tentative data and on that extent are not reliable in a strict sense. But the picture they present of gross differences in demographic and social characteristics, in vital statistics, and in resources of medical manpower and hospital beds between major areas of the world is real. More than half of the people of the world live in South Asia and East Asia; population density is highest in Western Europe; and highest rates of population growth are in Middle America and Tropical South America. In Europe less than one-third of the population are aged under 20 years, whereas more than half the population are aged under 20 im Middle and Tropical South America and the Carribbean, in Africa and in South Asia. Urbanization is high in Temperate South America, Northern America, Northern and Western Europe, and Oceania. The daily dietary energy supply per person is 50% higher in Northern America, Europe, USSR, and Ocenia than in Africa (excluding Southern Africa, South and East Asia. The Gross National Product in Northern America is 10 times higher than in Tropical South America and 30 to 40 times higher than in Western Middle and Eastern Africa and in Middle South and South East Asia. Crude birth rates are close to three times higher in Africa, Middle America and South Asia than in Europe, North America and USSR. Differences in crude death rates are less--rates in Western, Middle and Eastern Africa are double these of America Europe, USSR and Oceania. The Expectation of Life is over 70 years for Northern America, Europe, USSR and Oceania. It is under 50 years for Western, Middle and Eastern Africa. In all areas the expectation of life at birth has increased--by up to 10 years--in the past quarter century. Infant mortality is less than 20 per 1 000 in Northern and Western Europe and Northern America. It is over 100 in Africa and South Asia. Number of physicians range from 25 per 10 000 population in USSR to less than 1 per 10 000 in Western, Middle and Eastern Africa. There are over 100 hospital beds per 10 000 population in USSR and in Northern and Western Europe, less than 10 per 10 000 in Western Africa, Middle South Asia and South East Asia.


[Epidemiology of venous diseases at old age (author's transl)].

Venous diseases are of interest to gerontology because 1. the morbidity in connection with venous diseases in both men and women increases almost linearly with age 2. more complications, some of them fatal, must be anticipated and 3. a greater percentage of secondary and primary diseases are recorded than in younger people, which must always be included in therapeutic planning.


[On the morphology of venous diseases in ageing (author's transl)].

The author discusses age-connected changes in vein walls and problems of phlebosclerosis, varces and of the post-thrombotic syndrome from the morphological point of view.


[Problems of coagulation analysis in diagnosing inflammatory and thrombotic venous diseases in ageing (author's transl)].

Diagnosing inflammatory and thrombotic venous diseases by analysing coagulation is difficult because the results obtained with this method are not certain. Not all persons concerned use scintigraphy, the ultrasonic methods, infrared photography and phlebography as routine diagnostic methods. The surest way of diagnosing inflammatory and thrombotic venous diseases is still to bear in mind the limitations and the criteria mentioned and to combine the clinical and paraclinical methods into a diagnostic mosaic.


[Obliteration therapy of varicosis (author's transl)].

In introduction is given into the etiology and pathogenesis of varicosis. The causal therapy of varicosis, obliteration therapy, indication and counterindications, advantages and disadvantages of this method, the choice of an optimum obliterating agent and side effects are discussed.


[Surgical treatment of acute deep thrombophlebitis (author's transl)].

Preoperative, operative and post-operative measures used in connection with deep phlebothrombosis by the Angiological Centre of the "Heinrich Braun" Country Hospital, Zwickau, are described. The clinical, phlebographic and phlebodynamometric results following thrombectomy are reviewed.


[Surgical therapy of post-thrombotic conditions (author's transl)].

The author begins with a brief discussion of the terminology of phlebitis and then elucidated the significance of the deep veins and of the secondary varices in connection with the post-thrombotic syndroms. He explains why it is not possible to take therapeutic measures direct at the blocked vein section and goes into bypass operations in the case of isolated pelvic vein and formal vein blockade as a possible method of treatment. He stresses the importance of early treatment.


[Prevention of venous diseases from nutritional-physiological aspect (author's transl)].

Definite correlations between venous diseases and disturbances of nutrition have heretofore been known to exist in the case of overweight only. Obese persons generally show a marked tendency to develop phlebothromboses, whereas it has not so far been possible to accurately define correlations with varicosis. Obstipations due to improper forms of nutrition may be considered to be another noxa causing venous disorders. On the basis of latest results of research discussed in this paper, recommendations are made for proper forms of nutrition for the prevention and therapy of venous diseases.


[Ageing changes in collagen -- in vitro ageing changes in collagen (part III) (author's transl)].

In the present three parts of the survey ageing-changes in collagen physical and chemical qualities are discussed at first. Further a summary on questions of the biosynthesis of collagen, changes of the metabolism in the ageing organism and changes of the ripening collagen in the living organism is given. Following in vitro-ageing-changes of collagen and causes of the changes of the ageing organism are described. A summarizing appreciation of the ageing-changes in the collagen finishes the survey.


[Industrial hygienic complex examinations of places of employment of elderly workers in telecommunication technics].

Authors examinated conditions on 76 places of employment of elderly women by means of a screening methode, an estimated findings in comparison to design standards under consideration of special aspects of aged workers. In regard of work organization, physic strain, demands to sense organs and the exposition of environment factors conditions were acceptable. Imperfections in plase dimensions, lighing and laps organization induced 139 detailled straffs. Directions of the examinated enterprise till now many things improved in conformity with this study.


Functional capability of 68-year-old people in the town of Jyväskylä.

A cross-sectional study on the functional capability of 68-year-old persons was performed in 1973 in the town of Jyväskylä in Central Finland. The mean values of the measured variables for men and women, respectively, were the following: vital capacity 1.7 l/m2 and 1.2 l/m2; threshold of auditory perception (4000 cps) 49.0 dB and 28.4 dB, digit symbol 23.9 and 24.3 digits; digit span 9.5 and 9.7 numbers; simple reaction time 0.27 sec; pred. max VO2 26.6 and 21.6 ml/kg - min. Persons with high physical working capacity or good self-assessed health attained better results compared to persons with low PWC or poor self-assessed health.


[Age dependence of visual acuity after incomplicated cataractoperation (author's transl)].

The results of visual acuity in 1523 cataract-extractions were evaluated; comparing the visual acuity of the 7th to the 9th postoperative days, when the patients left the hospital. 73,1% of the patients had a supplemental disease of the eye or another general disease. 76,6% of the patients had a postoperative visual acuity between 5/4 and 5/15, clearly depending on the age of the patients. General diseases influence scarcely surgery, but the older the patients the more we find a reduced visual acuity that is reduced by generative senile macula disease. On an average they stayed in hospital for 9,4 days.


[Influence of cytosolic fraction on incorporation of aminoacids into microsomal system of rat liver (author's transl)].

1. Incorporation of 14C-leucine into a microsomal system from rat liver is decreased on old animals. 2. The decrease in 14C-leucine incorporation is not attributable to changes of the stability of the incorporation systems. 3. The decreased rate of incorporation from old animals is dependent from the cytosolic fraction.


[The influence of age on healing of wounds in men and animals (author's transl)].

There is reported on experimental results (in people and animals) with regard to the course of the healing of wound. Factors influencing the healing of wound characterized by own results.


[Experiences from a function as consultant of geriatrics in a district schwerin (author's transl)].

Consultant of geriatric, district. There is given an organizational model in complex care of the elderly in the district of Schwerin. The continuous care of the elderly, adequate to their requirements, wishes, problems, and difficulties by complex measures is an important part for the realization of the social-political tasks of the SED and government. Especially in the district of Schwerin there are a lot of initiatives and already good results of effects in principle.  For the further improvement of the medical and social care for the aged is based in a foundation of a special working groups of general practioners in the district of Schwerin which coordinates all activities in this field. In this working group and its activities participate all local geriatrics (Kreisfachberater für Geriatrie) under the chiefment of the district consultant of geriatrics.


[Geriatric care commitee (author's transl)].

The medical and social care of the aged is a substantial task of General Practitioners in the GDR Public Health. Increasing consideration must be given to the individual social situation. According to Public Health directives covering all sectors of geriatric care we built a "geriatric care Commitee" whose members are a G.P., a geriatric welfare worker, the district nurses, a representative of the local plant health organisation and one of the elected munifipal council members. Tasks are described and achieved results are related. Significance of purposely coordination of all sectors participating in care for the aged is stressed.


Carbohydrate metabolism of the lens depending on age.

Interpretation of factor analysis of 18 metabolic parameters of the bovine lens leads to the determination of the following criteria of lens metabolism: Factor 1: Biologic aging of the lens 33.9%; Factor 2: Glycolysis regulation 17.7%; Factor 3: Topography of lens metabolism 8.7%; Factor 4: Regulation of fructose breakdown 7.9%; Factor 5: Substrate depot 6.6%; Factor 6: Kinases 6.3%. These results could partly be experimentally verified. This interpretation of factor analysis has been an attempt to fit biochemical processes to formal statistical parameters. There was no indication that any of the variables under investigation were indendently responsible for the age dependend changes. However, the set-up made evident that rather complex biochemical influences of different intensity bring about the observed aging phenomena. It may be assumed that on or the other of these variables acts as a "triggering mechanism". Age related disturbances in the biochemical balance may be initiated by the glycolysis regulation factor, the importance of which is expressed by its high portion of 17%. Here changes in the ratio of reduced and oxydized coenzymes may act as a "triggering mechanism" (26, 30). Topography of lens metabolism, carbohydrate breakdown via metabolic pathways, the presence of substrate depots, and the internal regulation of the kinases are, according to their portion in factor loading, of about equal importance with respect to aging processes, however, factors 1 and 2, with a 50% portion, must be given precedence in any consideration. Factor 1, interpreted as "biological lens aging", yields about 1/3 of the information on the age influence on lens metabolism. This factor stands independent in being loaded by lens weight, which is the accepted age representative. However, lens weight means protein as well as the process of protein synthesis. It may be assumed that this factor represents a connective link between protein and carbohydrate metabolism, since it is well known that changes in protein belong to the most remarkable age disturbances (31,32), and that the quality of the proteins is dependent on the period of its synthesis (18,33).


[The ageing-factors of several physical functions in man (author's transl)].

The ageing-factor is a measure for the rate of ageing. In the model of vitality the error rate mu corresponds to the ageing-factor. The ageing-factors of several physical functions can be determined from the ascent of decrease of these functions. The standardized ageing-factors of the considered physical functions range from 0,001 to 0,017 year-1 and are smaller than the ageing-factor of the whole organism. The date of the occurrence of pathological manifestations as a result of ageing-conditioned decrease of functions can be estimated by means of the ageing-factors.


[Y-chromatin frequency, age (author's transl)].

Frequency of the fluorescent Y-chromatin bodies in the white blood elements of aged men was found to be significantly lower than that of young men (aged: N=35, mean frequency 68,78%; young: N=47, mean frequency 75,96%). This finding indicates that in the progressed age, the Y-chromosome tends to get lost from the cell, probably as a consequence of generalized functional im pairment of aged cell.


[Thromboses and haemorrhages in geriatrics (author's transl)].

In elderly patients thromboses are especially important because of their frequency and consequences (invalidity) often demanding measures of rehabilitation. In thrombophilia there are prophylactic measures necessary founding upon new perceptions on pathogenesis (vascular wall factors; rheologic and microcirculatory factors and factors of hemostasis: increasing of factor VIII; decreasing of antithrombin III; hypofibrinolysis; increased aggregation of thrombocytes). In prophylaxis you should influence the predisposing factors (hypertension, diabetes, arteriosclerosis, adipositas), use dietetic and hygienic measures and also from the pharmalogical point medicines with complex effect, which not only act on one factor (blood coagulation) like the anticoagulants, but also on other pre-disposing factors; and at the same time activate the fibrinolysis and stop the aggregation of thrombocytes. Thrombolytica should be used in elderly patients with precaution. In hemorrhages in the age especially capillary protecting medicaments should be used to correct the increased fragility of capillaries. Of there is at the some time a arteriosclerosis, hypertension, diabetes mellitus, obesity.


[Diabetes mellitus and femoral fractures in close proximity to the hip joint in multimorbid patients of old age (author's transl)].

From a great number of patients with femoral fractures in close proximity to the hip joint with an average age of 78.3 years, all diabetics were compared to persons with a normal metabolism in terms of concomitant diseases, causes of death, complications, and fracture healing. Although no differences with regard to fracture healing and subsequent functional results in later years could be established in patient put on the correct diet and insulin dose, as compared to the control group, the clinical complication rate and the mortality rate were significantly higher among patients of old age with Diabetes mellitus. To bring about a possible change, operating techniques providing the possibility of an early mobilisation and optimal physiotherapeutical after--care are recommended.


[On the problem of so-called ulcer in the old age (author's transl)].

By our own experiences with 471 stomach resections (gastric ulcers) we have found, that the so-called special situation of ulcer in the old age--from Spang firstly defined--has to be critically discussed. There are three groups of patients: 1. Patients with the so-called old age ulcer. 2. Patients who got their ulcer in early years of life. 3. Patients who are younger than 50 years. We mean there is no existance of a special course of this disease in elderly patients. Only the rate of complications which was most frequently to be found in the first group, differs from the other patients. For the surgeons ulcer operations have the same general problems as to be found in operations due to other reasons by elderly and old patients.


[Combined gastroduodenoscopy and suction biopsy of the small intestine].

We are reporting on a simple method for performing gastro-duodenoscopy and biopsy of the small intestine on one course of examination. The biopsy probe for the small intestine carries a looped thread located behind the biopsy cartridge. This loop is grabbed by the biopsy forceps of the gastroduodenoscope. After both instruments have been inserted simultaneously, the biopsy probe may be pushed through the pylorous visibly and without any effort. This is followed by the gastro-bulbuscopy, if necessary with biopsy, and thereupon followed by the biopsy of the small intestine. To date we have examined 15 patients using this method. The examination was delayed in 2 patients only who had a markedly scarred bulb. We consider this method suitable for routine diagnostics since time is saved for both the examiner and the patient, since a two-fold insertion of instruments may be avoided, since the exposure to radiation is reduced, and since it is possible to obtain complete endoscopic findings with biopsy.


[Therapy of abdominal complaints suspected to be of biliary origin].

In 37 patients suffering from functional disorders of the bile duct, a multicenter collective blind study was carried out with Hyoscine-N-butyl-bromide (HBB) sugar-coated tablets (5 X 20 mg/daily), and compared with a placebo in a randomized sequence. A statistically significant therapeutic effect with HBB was confirmed on the second day of treatment both by patients and physicians. The duration of treatment seems to be an important parameter as far as the action of HBB is concerned. No atropine-like side effects occurred.


[Retroperitoneal lymphangiodysplasia with exudative enteropathy. A case of cystic dilated cisterna chyli and splenic cysts].

In a 16 years old girl we found the syndrome of exsudative enteropathy with intestinal lymphangiectasy which differs from previous reported cases by several malformations of the lymphatic system. Besides changes in the intestinal lymphatics there was a retroperitoneal lymphangiodysplasia, a reduction and hypoplasia of the lymph vessels in the legs and cysts in the spleen. By substitution of albumin followed by a diet with middle chained triglycerids (MCT), serum protein was stablised but a relapse could not be prevented. Surgical treatment was not possible because the changes were too extensive. The value of diagnostic measures for differential diagnosis of the intestinal lymphangiectasy is presented.