Further study of fibrinogen degradation products in bladder cancer detection. A new, rapid immunoassay kit for assaying fibrinogen degradation products (FDP) was studied in 56 patients with cancer of the bladder and in 48 control patients. The specificity of the kit was demonstrated with a small number of false positive results. In bladder cancer patients with low-stage, small superficial tumors, FDP was positive in 32.2 per cent. The combination of urinary cytologic examination with FDP increased the accuracy of the positive results to 80 per cent. The rapid FDP test supplements the urinary cytology in the follow-up and detection of early bladder cancer.


Infectious osteitis pubis.

Infectious osteitis pubis. Osteitis pubis is a well-recognized painful inflammation involving the structures of the anterior half of the pelvic girdle, but its cause remains controversial. Biopsy and culture of the pubic bone in 3 patients with osteitis pubis after implantation of a urinary anti-incontinence device were consistent with pubic osteomyelitis which responded to antibiotic therapy. Infection was also found in almost all previously reported cases of osteitis pubis subjected to similar biopsy and culture. Bone biopsy and culture should be strongly considered before initiating frequently unsuccessful empirical therapy in patients with osteitis pubis.


Effects of prostaglandins on vesicourethral smooth muscle of rabbit. Therapeutic implications. The effects of PGF 2-alpha and PGE2 on the vesicourethral smooth muscle of the rabbit were studied in vitro. PGF2-alpha had potent contractile effects on the bladder body and comparatively less in the bladder base and the proximal urethra. PGE2 contractile effects were two times greater than PGF 2-alpha on the bladder body but minimal or absent on the base and the urethra. The effects of PGF2-alpha and PGE2 seem to be mediated through a prostaglandin receptor as indicated by competitive antagonism of both prostaglandins by N-0164, a synthetic phenyl phosphonate. It also appears that the effects of PGF2-alpha PGE2 may not be mediated through muscarinic, adrenergic, nicotinic, or histaminic receptors or direct smooth-muscle action. The therapeutic implications of PGE2 in the  patients with problems of bladder emptying are discussed.


Vasectomy and lowering surgeon's risk of liability. The increased demand for vasectomy as a method of fertility control has resulted in an increase in professional liability suits against those surgeons performing this procedure. In some instances this litigation appears to arise from vague or casual instructions from the surgeon, but an additional causative factor is a misunderstanding on the part of the patient regarding the operative and postoperative periods and his responsibility for utilizing alternative contraceptive methods. I suggest some means for addressing these problems, and comment on the factors to consider when the surgeon finds himself the defendant in a lawsuit on "failed" vasectomy.


Role of nurse clinician in urologic oncology. The incorporation of single and combination chemotherapy into the therapeutic regimen for some advanced genitourinary tumors has greatly added to the myriad of medical and psychologic problems already present in these patients. Working closely with a urologist, a nurse clinician can be of significant help in the total care of this group of patients. Due to the seriousness and chronicity of the neoplastic process, the emotional and social impact as well as physical factors affect all phases of the patient's life, as well as the lives of family members. The incorporation of traditional nursing values into the medical education of nurse clinicians helps to prepare them to deal with these problems, and their participation serves to make the medical team more complete.


Bilateral angiomyolipomas and renal cell carcinoma in polycystic kidney. A case is presented of a twenty-eight-year-old man in whom renal failure developed at age twenty-four from polycystic kidney disease known to be present since childhood. He also had cutaneous manifestations of the tuberous sclerosis complex. Intrarenal hemorrhage led to bilateral nephrectomy. Microscopic examination disclosed typical polycystic disease and multiple angiomyolipomas in each kidney. In addition several renal cell carcinomas of oncocytic, papillary, and clear cell type were found. Review of the literature disclosed the uncommon coexistence of any two of these lesions and did not uncover any reported case of the simultaneous existence of all three.


Congenital ureteric cyst--rare anomaly.

Congenital ureteric cyst--rare anomaly. A rare example of a congenital cyst of the ureter is described and the embryologic development of the abnormality discussed. The world literature relevant to the case is reviewed.


Emphysematous cystitis presenting with subcutaneous emphysema. A case is reported of subcutaneous emphysema of the neck in association with emphysematous cystitis and uncontrolled diabetes. Problems in its management are discussed. Anatomic pathway for the spread of the gas from the bladder to the subcutaneous tissues of the neck and the back is speculated.


Duplication of male urethra.

Duplication of male urethra. Male urethral duplication is an unusal anomaly with many variants including complete duplication from the bladder to the glans penis as well as incomplete and abortive forms. Two cases are presented of duplication of the male urethra of the epispadiac incomplete type. A chart has been constructed to facilitate categorization of the various forms of urethral duplication in the male.


Pulmonary embolus presenting as initial manifestation of renal cell carcinoma. Pulmonary emboli from renal cell carcinoma may be more common than previously suspected. A case is reported of renal cell carcinoma presenting with a massive pulmonary embolus. Pulmonary embolectomy followed by radical nephrectomy with venocavotomy and tumor thrombectomy was successfully performed.


Malacoplakia of epididymis.

Malacoplakia of epididymis. Malacoplakia localized to the epididymis is described. Ultrastructural study revealed the presence of bacterial bodies in phagolysosomes of malacoplakic macrophages. The possible role of the phagocytosed bacteria in the pathogenesis of malacoplakia is briefly discussed.


Renal angiomyolipoma: ultrastructural study. An angiomyolipoma from a twenty-six-year-old woman was studied by electron microscopy. The tumor was composed of a mixture of mature smooth muscle cells, fat cells, and abnormal blood vessels. MAny of the smooth muscle cells showed excessive intracytoplasmic accumulation of glycogen, while the abnormal blood vessels lacked a normal media.


Solitary primary amyloidosis of urinary bladder. Light and electron microscopic study. A fifty-four-year-old white woman with a history of episodic gross hematuria was diagnosed as having solitary primary amyloidosis of the urinary bladder involving a large segment of the dome and anterior wall. A segmental resection of the bladder was performed with good results. Electron microscopic examination of the lesion revealed evidence to indicate that amyloid in this case was produced by the fibroblasts within the lamina propria of the bladder. The mode of amyloidogenesis is identical to that noted in some of the previously published electron microscopic studies on localized amyloidosis of skin. Solitary primary amyloidosis of the urinary bladder is a rare lesion with only 46 cases having been previously reported in the literature.


Diagnosis and treatment of ectopic renal papilla. Although ectopic renal papilla has been reported only recently, there is indication that it is more common than these few experiences would suggest. Awareness of this entity and its radiographic features should direct the urologist toward a conservative approach confirming the diagnosis by operative nephroscopy, thereby obviating nephrectomy.


Value of computerized tomography in evaluation of kidney. The use of intravenous iodinated contrast material after a preliminary computerized axial tomographic scan of the kidney has been an extremely valuable adjunct in differentiating benign, malignant, and some inflammatory processes. The diagnosis of type of lesion present has been facilitated and allows direction for further diagnosis and therapy.


False positive findings on liver scans in carcinoma of kidney. In most urologic centers, liver scan is a routine investigation for evaluation of carcinoma of the kidney. Herein are described 3 patients with carcinoma of the right kidney, who had abnormal liver scans and did not show any metastases on exploration and open liver biopsy. These false positive findings were found to be due to the extrinsic compression of the liver by the tumor. When interpreting the liver sacn in a patient with renal tumor on the right side, the possibility of this false positive finding due to extrinsic compression to be considered and an abnormal hepatic scan alone should not be a contraindication for possible radical surgery.


Provisional model for propagation of electrical activity in upper urinary tract. A theory on the function of the renal pelvis as a pacemaker for ureteral peristalsis is given. The bioengineering "black box" approach is used to describe peristaltic behavior monitored at the ureter and thr renal pelvis, by both peristaltic pressure and electromyographic methods. The model provides a stimulus to further thought on the nature and significance of electrical activity in the upper urinary tract.


[Surgical treatment of acute pancreatitis]. The authors studied 939 patients with acute pancreatitis; 144 of them were operated upon. Total postoperative mortality was 18%; of them 1.05% mortality was due to a mild form and 51.0% mortality occurred in pancreonecrosis and purulent pancreatitis. In extensive necrosis and abscess formation the drainage of the abdominal cavity and retroperitoneal space is recommended. The authors believe that omentopancreatopexy should be applied in oedematous and hemorrhagic forms of pancreatitis and in focal necrosis, as well.


[Chronic pancreatitis and its treatment in diseases of terminal segment of the common bile duct]. Clinical observations embrace 77 cases of chronic pancreatitis combined with various pathologic changes of the choledochal terminal portion. The surgical correction of these changes was carried out upon 73 cases. The follow-up lasting from 2 to 6 years has shown the manifestation of chronic pancreatitis either disappear or subside dramatically in the most cases following the surgical correction of the pathologic changes in the choledochal terminal portion.


[Transduodenal transpapillar operations in acute cholecystitis complicated by pancreatitis]. The authors consider the urgent surgery for acute cholecystitis complicated with pancreatitis and with marked bile and pancreatic hypertension to be indicated. In their opinion, the best method of eliminating the cause of duct hypertension in the bile and pancreatic duct system is the transduodenal dissection of the papilla followed with papillocholedochoplasty combined in some patients with plasty of the Wirsung's duct. A separate drainage of the common bile duct and main pancreatic duct according to the Doubilet's method was used. Cholecystectomy was carried out upon all the patients. On patient died of progressive pancreonecrosis.


[Diagnosis of "shock lung"].

[Diagnosis of "shock lung"]. The dynamic x-ray changes in the lungs of 57 cases with severe non-thoracic traumas and shock were studied. 18 patients showed a symmetric injury to the lung, increase of the size of the pulmonary roots and dramatic markedness of the vascular picture within the first hours after trauma. The small peripheral vessels dilated and became very visible. Alveolar oedema was found in 39 patients 6 to 12 hours after trauma. In 11 patients alveolar oedema progressed to massive oedema. Two phases were found in the development of alveolar oedema: microfocal and macrofocal ones.


[Coagulative and fibrinolytic properties of blood effused into the pleural cavity after lung surgery]. Coagulative properties of the blood and exudate accumulated in the pleural cavity following lung operations were studied. On the grounds of the studies of plasmin potential and active antiplasmin of the exudate a method of local fibrionolytic therapy of coagulated hemothorax with intrapleural injections of fibrinilysis activators was devised. Fibrinolytic therapy was applied in 106 patients, streptokinase preparations were injected to 28 of them.


[Prevention of adhesions after appendectomy]. The author suggests a modification of the invagination method of appendectomy without ligation of the stump. This method is the most physiologic one; it minimizes the inflammatory process and prevents an undue formation of adhesions. Experimental grounds for the method are described. 204 patients were operated upon. This method has shown better long-term results as compared to typical appendectomy.


[Prevention and treatment of horseshoe-shaped rectal fistulas]. The paper deals with a newly developed effective method of the treatment of horseshoe fistulae, which was successfully applied in 110 patients. This method is distinguished for its low traumatic effect. The closure of the internal opening is carried out by means of the plasty with a wide layer of the mucous membrane displaced laterally.


[Cytomorphological features of epithelial tumors of the rectum]. The discharge and scraping from tumors of the rectum in 166 patients (cancer--103, simple polyp--32, proliferating polyp--17, villous polyp--5, malignant polyp--9) were studied at a time by means of various methods of cytoanalysis of suspension preparations (phase contrast, luminescent, supravital microscopy) and of smears (Pappenheim's staining, staining with hematoxilin-eosin, Papanicolaou method). On the grounds of the obtained data the phase optic, cytoluminescent and cytomorphologic patterns of various histological forms of cancer and polyps are set forth.


[Age-related indicators of the rheorectography in healthy persons]. Using the method of rheography the authors studied the rectal circulation in 77 healthy individuals. The electrodes of different length (30, 70, 100, 130 and 160 mm) designed expressly for the recording of the rheorectography findings were used. On the grounds of the analysis of 369 RRG the authors have drawn the conclusion about reliability and prospects of this electrophysiological study and set forth the normal indices of RRG as related to the age.


[Indications for sclerosing theraph of superficial varicose veins and its possibilities]. 17 years experience with the use of sclerosing preparations for the treatment in varicosis of the superficial veins of various genesis in 1477 patients is set forth. The studies of the long-term results (2 to 15 years) have shown good and fair cosmetic and functional results in 82.6% of cases. Recurrence has been found in 17.4%.


[Basal metabolism and external respiration in thyrotoxicosis]. Basal metabolism indices and data on external respiration function in 352 thyrotoxicosis cases are set forth. The significance of the definition of basal metabolism helping to determine the severity of thyrotoxicosis; they serve as objective criteria in the assessment of the effectiveness of the preoperative management.


[Injuries and wounds of the heart and pericardium in children]. Among 420 cases of wounds and injuries to the heart and the pericardium the authors observed 18 children (4 girls and 14 boys). 11 children died: 7 of them died on the spot, 4 in surgical clinics; 7 children recovered, 4 of them developed complications.


[Complicated mesenteric cysts in children]. Basing on the literature data and own experience with 9 patients the authors have come to the conclusion that mesenteric cysts occurred only in 0.01% of children operated on urgent indications. In 6 children surgical interventions were carried out for the clinical picture analogous to that of acute appendicitis, 3 patients were operated upon for the clinical picture of ileus.


[Remote results of surgical treatment of intestinal trauma in children]. The authors studied long-term results of the surgical treatment of 67 children followed-up for 1 to 22 years. Good results were noted in 32 operated patients operated upon for isolated intestinal injuries mostly within the first hours after trauma and subjected to a complex postoperative management, devised in the clinic. 17 children operated 12 and more hours after trauma who developed various complications showed fair results. 50% of them underwent antiadhesive therapy; full volume infusional therapy was not carried out. Poor results were observed in 18 patients operated mainly for a combined intestinal trauma. These patients were not subjected to a complete complex of therapeutic measures and developed various complications.


[One-stage osteosynthesis of 2 segments in multiple fractures of bones of the limbs]. From the experience with one-stage osteosynthesis of two segments in 71 patients with multiple fractures of the extremities and their sequelae the author considers that up-to-date achievements of anesthesiology favour such interventions. He believes that the patients tolerate well one-stage operation which has some advantages as compared to multi-stage operations: only one exposure to narcosis, psychic trauma and unpleasant sensations of the postoperative period; this type of intervention affords motility of the patients and makes it possible to start the functional treatment early and to prevent development of contractures and hypostatic complications. The period of the treatment shortens, which is of economic and social importance.


[Method of surgical treatment of inveterate traumatic aneurysms of the limbs]. The described method of surgical treatment of traumatic aneurysms of the extremities consists in autovenous plasty of the artery following the dissection of the aneurysmal sac and resection of the injured walls of the vessels: after partial resection of the aneurysmal sac walls their remnants are used for covering the vascular graft. The method was applied on 3 patients. The follow-up from 3 months to 3 years has revealed good results.


[Scope of transfusion therapy in acute pancreatitis]. The paper deals with the tranfusional tactics in acute pancreatitis. Some useful recommendations on the use of various transfusional media in different phases of the disease (stage of shock, intoxication and of septic manifestations) are suggested.


[Hemodynamics in double plasmapheresis in lung cancer]. The effect of double plasmaphoresis upon the central hemodynamics in 37 cases of pulmonary carcinoma was studied. Plasmaphoresis was aimed at the storage of an autologous transfusional medium to compensate the operative blood loss. Taking 400-500 cc of plasma does not cause any hemodynamic changes in patients without heart disease signs. The choice between surgical intervention and repeated plasmaphoresis should be made with regard to the time necessary for normalization of the circulatory parameters following plasmaphoresis.


[Clinico-roentgenological characteristics of renal hemorrhage in hemophilia]. The observation over 20 cases of hemophilia with severe renal bleedings proved the possibility of rendering an effective surgical aid to these patients. Besides, on the grounds of the observations the authors concluded that in all the cases of hematuria and microhematuria constitute indications for x-ray examination of the kidneys and the urinary tract.


Respiratory patterns in anaesthetised dogs during surgery. The respiratory activity of spontaneously breathing dogs undergoing surgery during halothane/nitrous oxide/oxygen or methoxyflurane/nitrous oxide/oxygen anaesthesia was studied using a spirometer system. Respiratory tidal and minute volumes were directly related to body-weight under methoxyflurane but under halothane anaesthesia only the tidal volumes could be correlated with body-weight. Periodic deep breaths were seen in about one-third of the animals anaesthetised with methoxyflurane but were seldom seen in animals under halothane anaesthesia. Physiological dead-space remained constant for each animal during anaesthesia.


Immunoglobulin levels in calves fed colostrum by stomach tube. Three female and three male unsuckled newborn Holstein calves were tube-fed pooled colostrum and fresh colostrum respectively at a mean dose of 81.1 ml per kg birth weight at about six hours of age. The pre-colostral mean total serum immunoglobulin gradually increased from 0.07 mg per ml to 31.73 mg per ml by one day of age. IgG1, IgG2, IgG and IgM gradually increased to maximum concentrations by one day of age. IgA was higher in the 14 hour than in the 24 hour sample due to catabolic loss. The pre-colostral packed cell volume (PCV) of 41.83 per cent significantly (P less than 0.05) decreased to 37.17 per cent 18 hours after intubation. The pre-ruminant rumen of the newborn calf can empty itself efficiently and adequate intestinal absorption of colostral proteins can take place before closure sets in. Normogammaglobulinaemia can be established in almost all normal calves and neonatal morbidity and mortality reduced by force-feeding newborn calves with good quality colostrum immediately after birth.


The Sacrewell project: an on farm demonstration of the potential of egg transfer. A surgical demonstration of the potential use of egg transfer for converting a herd of cattle from one breed to another (Jersey to Friesian) was undertaken on farm. Friesian donors were non-lactating but 50 per cent failed to respond adequately (greater than 3 ovulations) to treatment with PMSG (1500 to 3000 iu). Heifers yielded more ovulations and eggs than cows, but recovery rate was higher from cows (80 per cent cf 60 per cent). Fertilised eggs were recovered from old (13 years) cows, some of which had ceased to breed normally. Pregnancy rate after transfer of these eggs was normal. Purebred Friesian calves out of Jersey recipients were Friesian weight (male, 44.8 kg; female, 37.4 kg) and contrary to experience with crossbreds caused severe dystocia problems. Severity of dystocia was related to birth weight and sex of calf.


Gastrointestinal globidiosis of Yankasa sheep in Nigeria. The first report of globidial gastroenteritis of sheep in Nigeria is presented. Clinical symptoms, gross and histopathological lesions associated with the disease in nine adult rams are described. The importance of differentiating the disease from intestinal coccidiosis in Yankasa sheep is stressed.


Forecasting the incidence of parasitic gastroenteritis in lambs in England and Wales. An empirical method for forecasting the incidence of parasitic gastroenteritis in sheep in England and Wales is described. The level of disease in lambs in late summer depends on the date soil moisture returns to field capacity (the autumn return date) in the previous year together with rainfall from May to July in the current year. The importance of a late autumn return date and winter weather in relation to disease in stock at other times of the year is also discussed.


Forecasting the peak of gastrointestinal nematode infection in lambs. The pattern of sheep nematode infective larvae on pasture shows a marked midsummer peak arising largely from the ewe peri-parturient egg output. Records of larval pattern over a nine-year period were examined in relation to meteorological data, and a correlation was demonstrated between the time of the summer peak and cumulative rainfall. A "wet score" was allocated to 12-hourly rainfall figures, and a "critical index" of 440 units of wetness was shown to be necessary before the larval peak was reached. A "warning index" of 350 to 380 wetness units is suggested which would allow a prediction to be made of the onset of major infection in lambs.


Induction of farrowing with cloprostenol on a commercial pig breeding farm in Yugoslavia. Treatment of pregnant sows with 175 microgram of cloprostenol achieved efficient synchronisation of farrowing; 93% of treated animals commenced farrowing between 20 and 30 hours and 82% between 24 +/- 4 hours after injection. Duration of farrowing and weights of piglets at birth and weaning were not significantly affected by treatment. There was no harmful effect on piglet viability up to weaning and treated sows returned to oestrus within the expected time after weaning. There was a higher incidence of the mastitis-metritis-agalactia syndrome in control sows. The implications of these findings on the management of commercial pig farms is discussed.


Induction of parturition in dairy heifers using prostaglandin F2alpha. Prostaglandin was used to induce parturition in three trials on two farms, involving 55 Friesian heifers. Calf viability, dystocia, percentage retained placenta, induction interval and colostrum absorbtion (in 18 cases) are discussed.


The influence of breed on the susceptibility of sheep and goats to a single experimental infection with Haemonchus contortus. Four breeds of sheep and three breeds of goats, maintained on both high and low planes of nutrition were given a single infection of 350 Haemonchus contortus larvae per kg. Although animals on a low protein diet had much higher faecal egg counts than those on the high protein diet the pattern of relative susceptibility was similar in both cases. It would appear that the nutritional status of the host influences its resistance to H contortus infection. Of the breeds studied the indigenous Red Masai was the most resistant breed of sheep while the exotic Saanen was more resistant than the the two indigenous breeds of goats.


Traumatic duodenitis in a dairy cow.

Traumatic duodenitis in a dairy cow. The history, clinical signs, and clinical pathology in a mature Holstein cow were consistent with a diagnosis of intussusception, but the lesion found during exploratory laparotomy consisted of a penetrating wire in the anterior duodenum.


Techniques of surgical and non-surgical ova collection of superovulated cows. A comparison is made of the results of ova collection from 65 superovulated cows of varying ages using the conventional surgical technique and a non-surgical (transcervical) technique. Two types of apparatus, rigid and flexible, were developed for non-surgical collections. The problems associated with these techniques are discussed and some remedial measures suggested. A mean of 9.8 ova per donor cow were recovered by the surgical method compared to 2.9 and 3.0 ova recovered by the transcervical method using flexible and rigid apparatus respectively. Eight young cows, which had not been previosly subjected to superovulation and embryo collection, yielded an average of 5.6 ova per donor by the non-surgical technique.


[Chemoprophylaxis and therapy of coccidiosis in the rock partridge, Alectoris graeca cypriatis]. A number of coccidiostatica--amprolium (Merek Sharp & Dohme), both for the prevention and treatment, DOT Solubile (By-Gulden) and Esb3 (Ciba Geigy) for treatment--were tested with artificially raised rock partridges on an infected farm. The trials were carried out with a total of 12300 young (12-day-old) birds suffering from spontaneous outbreaks of coccidiosis and 60 such birds with experimental coccidiosis. The comparative study on the results obtained revealed that amprolium produced a good prophylactic effect and a low therapeutic one in cases of clinical coccidioses, used at the rate of 125 mg/kg and offered with the forage mixture. DOT at 30 g/10 1 of water had a pronounced therapeutic effect in the course of 5 days. The preparation Esb3 at the rate of 1 g per one liter of water for 3 days was tested in experimentally induced coccidiosis (E. kofoidi). It produced good therapeutic effects with the highest coccidiosis index ever noted on the second day following infection. It can be applied on occasions of E. kofoidi-induced coccidiosis.


[Experimental poisoning of carp fingerlings (Cyprinus carpio L.) with the herbicidal preparation, lasagrin (alachlor)]. The acute intoxication of K1 carp (Cyprinus carpio L.) with the herbicide preparation lassagrin (alachlor) was studied under experimental conditions in a laboratory. Used were a total of 360 young carps of 10 g each, measuring 9-10 cm. The experiments were carried out in 30-1 glass aquariums that were preliminary filled with water that was adequately heated and deprived of chlorine at pH = 6.9, T0C = 18-20 degrees C, O2 = 10.4 mg/1; hardness = 1.5 German degrees. The preparation was directly placed in the aquariums in eleven concentrations. The following characteristic symptoms of intoxication were established: higher irritability of the nervous system with superactivity, lack of coordination and orientation, depression in later hours, loss of sight, disturbed pigmentation. No morphologic changes were found at necropsy. Determined was the concentration at which 50% of the test material died at the 96th hour of exposure: LC50/TLm/=4.67 mg, the interval of dependability at 95% probability being 4.04-5.30. Both toxicometry data and intoxication symptoms with the use of lassagrin (alachlor, lasso) made it reasonable to believe that the preparation could be referred to poisons having resorptive action so far as carps are concerned.


[Use of gravohormone to increase conception and fertility in cows]. Tested was the gravohormone preparation (produced in USSR and Bulgaria) to shorten the period from calving to impregnation and raise the conception rate and the fertility in cows. The experiments were carried out with a total of 84 cows (34 of the Bulgarian Red breed and 51 of the Bulgarian Brown breed) under productional conditions. The animals of the first group were injected on the 25th-28th day following calving, singly, i/m, using the Soviet made gravohormone at the rate of 10 IU per kg body weight. The cows of the second group were additionally injected with 1500 IU of the preparation (produced in 0ulgaria) on the 3rd and 6th day following insemination. It was found that the single application of 4000 IU of gravohormone between the 25th and the 28th day after calving shortened the time from calving up to the first insemination by 7.29 days, on an average, and the time from calving to impregnation--by 13.57 days, raising the conception rate at first insemination by 13.50%. The additional twofold injection with 1500 IU each time raised the rate of fertility in cows by 23.58% as against the controls.


[Trials in the therapy and prevention of sheep nose bots]. Comparative experiments were carried out on the effectiveness of some antiparasitic agents for the treatment and prophylaxis of estrosis in sheep. An evaluation is made of all methods applied in the modern technologies of sheep raising. It was found that the method of fumigation of airtight premises using negouvon at the rate of 0.6 g/m3 and a 60-min exposure was adequate and effective for group treatment. Negouvon proved to be well tolerated by sheep and had no essential effect on the level of cholinesterase. The use of the preparation ranid is economically justified only with animals having a mixed infection of Fasciola hepatica and O. ovis larvae.


[Type and frequency of malformations in chick embryos]. Studied were histopathologically 7421 chick embryos of eggs at the end of the incubation period, originating from flocks raised under industrial technology. Established were a total of 39 deformities that involved all body parts in 6.28% of the studied embryos. First in number ranked the malformations of the legs and feet (curved legs and feet micromelia, achondroplasia), followed by head deformities (acrania), etc. Most of the affected embryos were single (simple), however, double ones (connected) were also encountered; 64.6% of them had one defect only, 29.9% had two defects, and the remaining 5.2% had three defects and more. Age-associated limits of the affected embryos ranked within the 15-21-day range.


[Colorimetric method for the quantitative determination of arsanilic acid in combined medicated premixes]. A colorimetric method was worked out to determine negligible amounts of arsanilic acid, based on the property of amino groups to form a yellow stained Schiff base in the interaction with an acid solution of p-dimethyl- aminobenzaldehyde. The optic density of the coloured solution in methanol is determined at 450 nm. The presence of the A, D3, C, K3 vitamins, furazolidon, neomycin sulphate, and tylosine phosphate does not interfere with the determination of arsanilic acid.


[Sensitivity of a Rickettsia burneti strain to antibiotics]. Tested were ten of the most frequently used broad-spectrum antibiotics. Each preparation was used in concentrations of 0.001, 0.0005, 0.00025, and 0,00012 mg. The experiment made also use of the 35th passage in chick embryos of a rickettsial strain BP (titer 10--8) isolated from sheep. Results showed that the test strain of R. burneti manifested a good sensitivity to tetracyclin and abricyclin, a moderate one to tetraolena, rondomycin, streptomycin, and chloramphenicol, and a strong one to ampicillin, metacillin, kanamycin, and gentamicin.


[Comprehensive method for the prevention of mastitis in cows]. Trials have been carried out in the course of two years to reduce the cases of clinical and subclinical mastitis and the losses thereof in the industrial raising of cows. As a result of mastitis control measures the outbreaks of the disease were decreased: by 58.8 per cent, and by the end of the second year--by 66.2 per cent (subclinical mastitis) and by 33.0, resp. 28.6 per cent (clinical mastitis). This went along with the increase in the milk yield--by 120 1 per cow in the first year, and 70 1--in the second year.


[Vitality of newly hatched chicks].

[Vitality of newly hatched chicks]. Comprehensive morphologic, hematologic, biochemical, clinical, bacteriological and bacteriostatic investigations were carried out with newly hatched birds with and without visible pathologic deviations. It was found that birds of lower vitality were characterized by lower motor activity; weak response to external stimuli; lacking or weak pecking reflex; small, dull, and deep slightly moving or immobile eyes, with eyelids partially or fully covering the eyes; soft, colorless bill, empty crop, enlarged and stiff abdomen, imcompletely closed navel; the down being short, thin, lacking in brilliancy pigment, and density, wet and dirty; the birds having lower body weight and lower temperature, hemoglobin, erythrocyte, total protein, blood sugar, pseudoeosinophil, and eosine values; higher lymphocyte, basophile, and monocyte values; with enlarged gallbladder containing darkcolored and dense bile; the digestive viscera having lower volume; the gizzard with a dark-colored cuticle; dark intestinal content; enlarged residual yoke persisting for five days and more; inadequate adaptability to stress factors; higher death rate. It is concluded that the lack of vitality or the presence of weakness (Debilitas vitae) is diagnostically important so far as the health status of newly hatched birds is concerned. Debilitas vitae is expressed by atypical pathologic deviations and inadequate adaptability in view of the environmental conditions.


[Ultrastructural changes in the testis and epididymis of rams with infectious epididymitis]. Electron microscope studies were carried out on the ultrastructural changes in the testis and the epidiymis of rams affected with infectious epididymitis, manifesting a pronounced clinical picture. The following conclusions were drawn: 1. The changes in the seminiferous tubules are characterized by a strongly expressed sensitivity of the cells at all levels. Noticeable are disturbances in the normal structure of the nuclear substance of both spermatogonia and spermatocytes, vacuolation of the nucleus and the cytoplasm, disrupture of the nuclear and cell membranes, decapitation of spermatids and spermatozoa with expressed lysis phenomena, and free lipid drops in the lumen. 2. The ultrastructural changes in the epididymis tubules resemble those in the seminiferous tubules: degeneration and desquamation of the ciliated epithelium, occasional disrupture of the basal membrane, and hemorrhages. The cell content of the lumen, beside the presence of pathologic spermatozoa, is admixed with leukocytes and Brucella ovis cells.


[Case of MD-VD in cattle].

[Case of MD-VD in cattle]. An enzootic is described of the classic form of virus diarrhea mucosal disease on a newly organized farm for heifers. The disease ran a sporadic course, mainly with intrauterine infections, while with the calves it was recorded as an enzootic with 100 per cent morbidity rate and 28 per cent mortality rate. The clinical picture was complicated--in some calves the disease started with fever, in other respiratory distrubances were observed, while in a third group diarrhea was prevailing. A detailed description is given of the clinical symptoms and the morphological lesions. A virus was isolated, identified as a virus of the mucosal disease--virus diarrhea. A virus antigen was likewise demonstrated by the gel precipitation test after Wachendorfer and Darbyshire, modified by Haralambiev. Various agents were used for treatment. Better results produced the strain K vaccine against swine fever in combination with semiliquid agar.


[Density gradient and ultrastructure of bovine adenovirus type 1]. Isolated and purified were virions and hexones from the bovine adenovirus type 1. The infectious virions were of equilibrium density of 1.34 g/cm3, and the empty capsids--of 1.305 g/cm3. The virions had a facet length of 43.5 nm, their size being 82.7 nm (distance between opposite poles) to 74.0 nm (diameter of the virion). The fibers of the bovine adenovirus type 1 measured 26.0--28.0 nm. The virus was destroyed by 30 per cent formamide, yielding free hexones of 1.290 g/cm3 of equlibrium density. The hexones were 10.0-12.0 nm high, were thicker at their base, and possessed a central cavity. Beside single hexones groups of 9 hexones each were also found in the soluble components (being of a left and a right type according to the arrangement of the capsomeres in them). It was demonstrated serologically that the hexones possessed 2 antigen determinants which retained their antigenic activity even after the hexones degraded and lost their morphologic type.


[Use of new Bulgarian hydrosol vitamin preparations in veterinary medicine]. Studied were the new Bulgarian hydrosol preparations Hydro-AD3EC, Hydro-AD3EK, and Hydro-EC. Their tolerance was investigated with the use of albino Wistar rats, the resorption and retention (by their liver content) of retinol and d, 1-alfa-tocopherol was investigated in young broiler chickens, the resorption of ascorbic acid was followed up in White English layers, the antihemorrhagic effect of Hydro-AD3EK was studied in rats with experimentally induced hemorrhagic diathesis offering 30 mg ethyl biscoumacetate (pellentan tablets) with the feed. It was found that the oral application of the first three hydrosol preparations to albino rats at the rate of 12.5 cm3/body weight (equal to 10-15 effective doses for birds) did not produce toxic effects. The retinol and d, 1-alfa-tocopherol constituents of AD3EC and AD3EK, given with the drinking water to birds, were well resorbed and were deposited in the liver. Fuller resorption was observed with the use of AD3EC. The ascorbic acid of AD3EC and AD3EK when these were offered per os to adult chickens was resorbed quickly, which was better expressed with AD3EC. AD3EK in oral application to rats produced antihemorrhagic effects. The use of these preparations in a prophylactic scheme with young broilers shortened the fattening period and improved the feed conversion.


[Cyclophosphamide content in the meat and milk after a single application to sheep]. Investigated were two groups of 10 Merino sheep each. The test group were given orally cyclophosphamide, singly, at the rate of 25 mg/kg, while the controls of the second group were not treated but were kept under the same conditions. Both milk and meat of the two groups were investigated by thin layer chromatography and gas chromatography on the 1st, 4th, 9th, 14th, 23rd, and 30th day following the introduction of cyclophosphamide. The results obtained by gas chromatography showed that it was not until the fourth day that there were two metabolites of the compound in milk only. On the 9th day the same were established in the milk and meat samples in a maximum concentration, the excretion from the body of the treated animals starting as early as the 14th day. By the 23rd day there were traces only, and after the 30th they were no longer established. Thin-layer chromatography showed that the two metabolites were found in approximately equal amounts up to the 14th day following treatment, and were fully excreted after the third week. Therefore, the full elimination of cyclophosphamide metabolites from the milk and meat of sheep treated with it at the rate cited takes place in about four weeks.


[State of the stroma in melanoma in patients with different delayed hypersensitivity reaction to neoplasm antigen]. The data are reported on studying the stromal response of 19 melanomas of analogous localization, showing the same type of growth, histological structure, the level of invasion and area of ulceration in patients with positive and negative delayed hypersensitivity reaction to injection of the polysaccharide fraction from melanoma tissue. A high degree of pronouncement of lymphoid-cellular infiltration of tumor stroma correlated with a positive delayed hypersensitivity response, whereas a low degree -- with a negative one.


[Immunologic reactions in patients with soft tissue sarcomas after surgical treatment]. Under examination was the possibility to reveal clinico-immunological features in patients with soft tissue sarcomas prior to and after surgery. Different immune responses were observed in patients with various forms of tumor progression. In case of a favourable course of the process surgery somewhat stimulates the cell immune response and reduces the titre of humoral antibodies. In patients with the tumor progression despite the employed treatment, a gradual fall of high cell immunity indices with a simultaneous increase of the humoral antibodies titre was noted. Wide metastases spread in the terminal phase is manifested by suppression of the immune response.


[Combined chemotherapy of disseminated skin melanoma]. The author's experience with nitrosomethylurea+prospidine treatment in 37 patients having disseminated melanoma is described. The mentioned scheme of the combination therapy is proved to be effective.


[Recurrent thyroid gland neoplasms].

[Recurrent thyroid gland neoplasms]. The data on 106 patients with thyroid cancer recurrence are reported. The recurrences occurred in the zone of surgery in 76.4%, beyond this zone--in 23.6%. During a 3-year period the recurrence occurred in 41.5%, from 3 to 10 years - in 44.4%, after 10 years and longer - in 14.1%. One of the main causes of the recurrence is an inadequate extent of primarily performed surgery. The recurrent tumor was detected by palpation, regional metastases were detected in 47.1%, distant--in 22.6%. A lower differentiation of the recurrent tumor was noted. The combination treatment was employed in 64% of patients. The principal surgical procedures were as follows: total thyroidectomy and subtotal thyroidectomy.


[Morphogenesis of dysplasia and lobular cancer of the breast]. During the recent ten-year period lobular cancer of the mammary gland arrests special interest. It is characterized by a specific clinical course, frequent bilateral involvement of the glands, multicentric and manifest invasive growth without any noticeable signs of destruction of the pre-existing glandular tissue. This cancer is preceded by carcinoma in situ. In the paper, the necessity is substantiated to differentiate this kind of cancer as a special nosological unit, its peculiar structure being described. Besides the classical form of the growth from small homologous cells like chains, also there was found a special form of the growth as alveolar structures consisting of light pagetoid cells. The initial stages of lobular cancer growth are described both against the background of carcinoma in situ and avoiding it from dysplasia. Attention is given to a tendency of this cancer to mucicarminophilia, a frequent association with mucous cancer, the data speaking in favour of its myoepithelial origin are reported. It is emphasized that carcinoma in situ may give rise both to lobular (myoepithelial origin) and other forms of cancer.


[Evaluation of the effectiveness of treatment of operable breast cancer]. An effective treatment of patients with primary operable breast cancer seems to be feasible only in local involvement of the gland. Since a spread process would much worse respond to modern therapeutic measures. Surgery remains to be a dominant procedure. According to the data of the P. A. Herzen Research Institute of Oncology radical Halsted mastectomy at early stages of cancer provides for an effective recovery in more than 90% of patients. In females with spreading of the process, regional metastases a 5-year survival is markedly reduced up to 45.1%.


[Treatment of maxillary cancer].

[Treatment of maxillary cancer]. The experience of the Moscow Research Institute of Oncology named after P. A. Herzen with the treatment of 368 primary patients with malignant tumors of the upper jaw, and the analysis of the literature data allowed a formulation of basic tendencies in therapy of this affection. These include a wide use of the combination therapy with preoperative radiation treatment; an elaboration of some extended variants of surgical interventions; an improvement of radiation technics, use of drug therapy, mainly as regional chemotherapy associated with radiotherapy. Further elaboration of the early diagnostics is also of importance. Patients in whom malignant tumors of the upper jaw were detected should be treated in specialized oncological departments, specially equipped and having well-trained medical staff.


[Differential diagnosis of cancer recurrence and cicatrical stricture of esophageal anastomosis]. A careful analysis was made of the causes, terms of occurrence and course of cancer recurrence in the area of gastrointestinal and gastroesophageal anastomoses after 498 gastrectomies, resections of the cardia and esophagus for cancer. The possibility of the differential diagnosis between the recurrence and cicatricial strictures of esophageal anastomoses is shown. Based on the clinico-roentgenological data etiopathogenetically 3 variants of cicatricial strictures were singled out: a) due to technical errors, inadequate anastomotic sutures and fistulas; b) due to grave anastomositis, and c) due to reflux-esophagitis. Among cancer recurrences at the site of esophageal anastomosis three forms were differentiated, depending on the origin of recurrence and a form of tumor growth: exophitic, endophitic and paraesophageal recurrence. Special attention is given to an early recurrence and the development of it against the background of pre-existing cicatricial stricture of the anastomosis.


[Remote results of combined treatment of operable stomach cancer]. The rationale of using preoperative radiotherapy as an adjunct in the combination therapy of gastric cancer is discussed. 102 patients mostly with the process in stage III (91) were treated. The analysis made enabled the authors to reveal a significant increase of resectability in a group of patients receiving distant gammatherapy. This index was 72.2% versus generally accepted indices 55--65%. The survival in this group of patients with terms of the follow-up from 5 to 8 years made 32.3% versus 20.8% of only a 5-year survival in a group of patients treated surgically.


[Persistent pulmonary hypertension in newborn infants (author's transl)]. Three cases of persistent pulmonary hypertension in newborn infants are reported. One patient developed this syndrome following a normal pregnancy and uneventful delivery, whilst the others had a history of fetal or perinatal distress. Cardiac catheterization showed pulmonary hypertension in two cases in the absence of cardiac or pulmonary disease or metabolic disorders; one of these babies died unexpectedly following initial improvement. The second infant died from massive cardiac failure before cardiac catheterization could be carried out. The surviving infant was reinvestigated at the age of 7 months and showed normal pulmonary pressure and no evidence of cardiac disease. Aetiology, haemodynamics and clinical picture of this syndrome are discussed in relation to the varying clinical features manifested by our patients and the course taken.


[Vaccination status of children in the Vienna area (author's transl)]. The vaccination status was investigated in 1482 patients between the ages of 1 and 14 years admitted to hospital with scarlet fever. Most of the patients were vaccinated against tuberculosis (97.7%), diphtheria, tetanus and whooping-cough (95.3%) and poliomyelitis (94.1%), relatively few against measles (21.1%) and very few indeed against mumps (0.7%) and tick-borne encephalitis (1.9%). The booster vaccination against tetanus and diphtheria had been omitted in more than 40%. Although the beneficial results of vaccination against tuberculosis, diphtheria-pertussis-tetanus and poliomyelitis remained more or less the same, the tendency towards vaccination did not spread as might have been anticipated. On the contrary, the extent of vaccination decreased, especially during the past years. In the same way the tendency towards vaccination against measles showed a sudden slowing down after a period of rapid increase. This implies that vaccination of children does not tend towards perfection. The vaccination rates differ widely between foreign children living in Vienna and natives. Although the foreigners show a similar vaccination distribution pattern as the natives, the numbers of unvaccinated children are much higher.


[The incidence of caries in juvenile diabetics (author's transl)]. The present state of knowledge regarding the aetiology of caries implicates the interrelationship between low-molecular carbohydrates and the bacterial flora as an essential factor in the potential development of caries. Persons with hereditary fructose intolerance and patients with diabetes mellitus are of special interest in studying these interrelations. The DMF/S index was calculated and a regression analysis carried out in 101 diabetic children and juveniles aged 4 to 18. The incidence of dentine caries was significantly lower in children with onset of diabetes preceding the appearance of the second dentition than in children with manifest diabetes of up to 3 years' duration. The DMF/S index was high in individual patients in spite of the prescribed dietary treatment.


[DTIC in the therapy of solid tumours (author's transl)]. From 1975 to 1977 42 patients with advanced solid tumours were treated with imidazole-carboxamide (DTIC). It was applied in 18 cases as monotherapy: in the remaining patients it was administered in combination with other cytostatic agents. Tumour remission was recorded in 4/22 patients with melanoma, 2/2 with Kaposi sarcoma and 2/7 with soft tissue sarcoma. No change in tumour behaviour was recorded in 6/22 melanomas, 2/7 soft tissue sarcomas, 1/7 head and neck tumours and 1/1 thymoma. Side effects of DTIC monotherapy were comparably low. The optimum dosage and frequency of DTIC therapy have not yet been established. Combinations with other cytostatic agents are still being tested.


[Dimethyl-triazeno-imidazole-carboxamide (DTIC) in combination chemotherapy for childhood neuroblastoma (author's transl)]. Eight children with state III or IV neuroblastoma were treated with courses of chemotherapy consisting of nitrogen mustard (6 mg/m2), vincristine (2 X 1.5 mg/m2), doxorubicin (40 mg/m2) and dimethyl-triazeno-imidazolecarboxamide (850 mg/m2) every three weeks. Three children died after a median survival of 8 (+/-5) months. Five children (62%) have now survived for a medium duration of 21 (+/-16) months without clinical evidence of disease. These results are far better than previously-achieved survival rates at our department.


[DTIC--one component of ABVD combination therapy in Hodgkin's disease (author's transl)]. 11 pretreated patients with advanced Hodgkin's disease were treated according to the ABVD schedule. In 6 cases this treatment had to be prematurely terminated due to considerable side effects or due to progression of the disease. The other 6 cases responded favourably, but the improvement was only of short duration.


[Fundamental problems of ageing (author's transl)]. Issuing from the second theorem of thermodynamics a cybernetical schema and a corresponding system of differential equations are proposed, describing dehydration and diminishing metabolism rate of the aging cell. With respect to the organism as a whole, there results the well known vitality formula of Beier, but with an altered expression for F(t).


[Air humidity and their influence on concentration changes of spray fluid in aerosol generators (author's transl)]. With the fine dispersion of aqueous solutions concentration changes in the basic solution are occuring. These changes are basically dependent on the rate of air flow and the saturation deficit which is present between the air at the entry to the aerosol generator and its exit. Above all with compressed gases which are used in production of nozzle aerosols the deficit and with it the concentration change is large. But on ultrasonic generators this effect is to be observed too. Under normal manufacturing conditions a concentration increase in the spray solution occurs. Conditions resulting in a concentration decrease can rarely be expected.


[Reproducibility of bronchial provocative testing in bronchitis (author's transl)]. Bronchial reactivity was examined every 3 month in a follow-up study of 40 subjects mostly showing chronic nonspecific lung disease and all having bronchial hyperreactivity at the beginning of the study. Only 7 of them (17.5%) had constant hyperreactivity for the time of observation. There has been parallelism between test results and complaints in 72% of patients with chronic bronchitis and in 65.2% of the second group (mostly subjects with bronchitis).  Seasons had no strong influence on bronchial reactivity. Bronchial provocative testing has proved as a valuabel method for verification of obstructive complaints. The test results shouldn't be interpreted without regarding clinical data. Using as a screening test a more detailed diagnostic and follow-up are necessary to avoid false and premature consequences. As to expert opinions and decisions on compensation the test results can correctly be interpreted only if reproducibility in the single case has been proved and if they are in agreement with the clinical signs and symptoms of the case.


[Immunoglobulins (IgG, secretory-IgA) and function of parotid gland in children with cystic fibrosis, with bronchial asthma, and with chronic bronchitis (author's transl)]. The immunoglobulins IgG and IgA (Secretory-IgA) were determined in connection with the parameters of secretion in parotid saliva. Children with cystic fibrosis, with bronchial asthma and with chronic bronchitis were compared. No significant differences were found for the groups of cystic fibrosis, of bronchial asthma, and of chronic bronchitis in comparison to a control group in relation to flow rate and protein content in parotid saliva. The comparison of the groups of diseases showed striking differences only with regard to the output of the gland after stimulation. The output of the gland per minute for IgG was decreased for patients with bronchial asthma as well as for patients with cystic fibrosis. No differences were found for the patients with chronic bronchitis and for the control group. Also the output of the gland for secretory-IgA was decreased after stimulation in the groups of disease: bronchial asthma and cystic fibrosis. The concentration of immunoglobulins in serum no correlation with the concentration of immunoglobulins in saliva neither for IgA nor for IgG. A high content of IgG in serum of patients with cystic fibrosis was observed. The mean values of IgA in serum of patients with chronic bronchitis were found to be significantly decreased.


[Intra-and postoperative complications in pulmonary surgery (author's transl)]. The age of the patients, the causative diseases, and the extent of the surgical operation are decisive for the development of intraoperative and postoperative complications in pulmonary surgery. Restrictive and obstructive pulmonary changes of the older-age group involve the danger of postoperative complications. By our experience the critical age for pulmonary surgery is about 50 years.


[Rare thoracic injuries (biomechanics, diagnosis and therapy) (author's transl)]. Thoracic injuries caused by direct or indirect power action involve various injury effects. The extent of injury depends on the force and the direction of the acting power, on the biomechanical properties of the partial structures of the thorax, and on genetically determined variations of form and structure. These correlations are demonstrated by special examples of rare thoracic injuries. The motto for the diagnostic and the choice of the therapeutical procedure is: "Inter vulnerationem thoracis diagnosis incipiat".


[Differential diagnosis of mediastinal  affections (author's transl)]. Differential diagnosis is necessary about chronic affections in the mediastinum. They are classified through appointed criterions in 3 groups. The technical methods of differential diagnosis and the degree of information are described. Operations of mediastinal tumours should be done as early and radically as possible.


[Defence mechanisms of the lung (author's transl)]. A review on defence mechanisms against inhalated germs of infection, dust particles and other noxiousness is given. The role of bronchial secretion, of the aerodynamic filter system, of the respiratory tract and of the surfactants as well of the local humoral and cellular immunity in the defence mechanisms is empharized.


[Angiographic studies on regional contraction behavior of the left ventricle in the acute phase of myocardial infarction]. Quantitative angiocardiographic examinations concerning the regional contraction of the left ventricle in 16 patients with acute myocardial infarction were performed. In comparison to a control group of 6 healthy male patients the determination of the speed of the medium regional shortening (MVRF) of 12 different ventricle segments resulted in typical findings deviating from the normal. On the second day after beginning of the infarction in the area of the myocardium affected by an acute infarction there existed as a rule severe hypokinetic and akinetic disturbances of the contraction (13 times), only in three cases slight paradoxical movements of the ventricular wall (dyskinesias) could be observed. The average speed of shortening of all segments together (MVRF) excellently represents the momentary global function of the ventricle. It comprises in the same way acutely and chronicly disturbed areas as well as also the function of regions of the myocardium which are not disturbed. MV/RF and systolic ejection fraction (SEF) show statistically a highly significant correlation of r = 0,797 (p less than 0.001). On the basis of the findings got considerations are performed concerning a proved differential therapy in the acute stage of the myocardial infarction.


[Hemodynamics and metabolic parameters during use of the antihypertensive agent diazoxide]. The antihypertensive remedy diazoxide (hyperstat) was applied in 11 patients with hypertension of the clinical stages III and IV. The patients were applied a single intravenous injection of 20 ml = 300 mg diazoxide. The behaviour of blood pressure, pulse, blood sugar and cortisol level as well as of the blood supply in rest of the musculature of the extremities was tested and evaluated. Within 1 minute after the injection the systolic blood pressure decreased by 12%, the diastolic by 20%. After an above all show increase of the diastolic blood pressure once more a slight decrease of the systolic blood pressure followed after 90 minutes, which lasted several hours. Also after 24 hours the blood pressure did not reach the original value. The increase of the pulse rate was clinically not relevant. The blood glucose increased in the 5th minute, after 15 minutes it reached its culmination point and, beginning with the 30th minute it showed a decreasing tendency. The initial values were got after 180 minutes. After the 15th minute began a relative short-term decrease of the plasma cortisol, which, however, again increased after 60 minutes. On the other hand the occlusion-plethysmographic investigations of the veins showed an increasing blood flow in rest up to 3 hours after the injection.


[Granulomatous angiitis of the central nervous system]. It is reported on 3 observations of isolated granulomatous angiitis of the central nervous system. The case in question was in two 42-year-old men a granulomatous giant cell arteriitis with exclusive affection of the intracranial arteries. In a 33-year-old woman (case 3) there existed a granulomatous angiitis in generalised cerebrospinal granulomatous epitheloid-cellular inflammation (sarcoidosis) of the central nervous system with participation of bifurcal lymph nodes and of the lung. In all the three reports the diagnosis could be made only by autopsy. Clinic, pathomorphology, and diagnostic difficulties are described.


[Bone fluorosis].

[Bone fluorosis]. It is reported on a 80-year-old man with a pronounced bone fluorosis which was ascertained by X-ray findngs, dissection, and determination of the fluor content of the bones. Since there was no professional flour exposition a so-called neighbourhood fluorosis was to be assumed. It was caused by an already naturally increased fluor content of drinking water, which was essentially increased by the sewage of a fluor plant. In addition to this an increased fluor emission was present, since the patient has lived for more than 30 years in the nearest environment of the plant. By suitable measures the prescribed values of the fluor content of drinking water and of the fluor emission have to be kept.


[The problem of cardiac metastases].

[The problem of cardiac metastases]. Report on metastases of the myocardium of a bronchial carcinoma in a 66-year-old woman. On the basis of an own case as well as of literature the author adopts a definite attitude to frequency, localisation and diagnostics of the secondary tumours of the myocardium.


[Significance of liver biopsy for the diagnosis of occupational liver lesions (histopathological examination)]. Report on the morphological assay of liver biopsies of 29 patients after acute or long-term influence of industrial poisons (pesticides, solvents). There were observed cytotoxic lesions with differently marked non-specific reactive hepatitis, the retrogression of which is demonstrated by repeated biopsies. As a rule a restoration took place after one year. Transitions in chronic liver diseases were not seen. It is referred to the particular importance to perform the first biopsy as much as early after the clinical discovery of such lesions of the liver.


[Significance of the determination of multiple forms of urinary amylases for the diagnosis of exocrine pancreas diseases]. The multiple amylases of the urine were examined in healthy persons and in patients with acute and chronic pancreatitis as well as with parotitis using the polyacryl amide gel disk electrophoresis. A separation into about 7 amylase-containing fractions was achieved which could be coordinated to the pancreatic juice and to saliva. In acute pancreatitis the pancreas amylases increased, in chronic pancreatitis, on the other hand, they decreased. In parotitis the salivary amylases increased. For diagnostic purposes the formation of quotients from certain fractions was useful. The examination of the multiple amylases of the urine according to the method mentioned leads to an improved clinico-chemical diagnostics of diseases of the exocrine pancreas and gives the possibility of their course control.


[Influencing the automatized chelesterol determination using the Liebermann-Burchard technic through selected drugs in vitro]. The ascertained influences of this cholesterol determination in vitro mentioned in the survey literature for therapeutically relevant doses are astonishingly small. In the present paper the following drugs were tested: Dextran, vitamin C, procain, chlorpromazine, methyldopa, phenacetin, fluphenazine. With the exception of methyldopa pure substance was used. In every case twelve-fold determinations with the concentrations 0.02, 0.2 and 2 mmol/l were performed. Though particularly for vitamin C and methyldopa depending on dose, as well as for all other drugs with the exception of dextran increases can be proved, these, however, remain eventually in the normal region of the method. The influence of the determination of cholesterol proposed by the drugs tested under therapeutic conditions is only of insignificant practice relevance. This is a positive evidence for the use of this method in the routine laboratory.


[Value of sonography in the differential diagnosis of icterus]. In early use the sonography may facilitate and accelerate the differential diagnosis of the jaundice. In parenchymal hepatic icterus frequently pathologic changes of the liver may be proved sonographically. The typical findings of dilated and thus sonographically demonstrable intra- and extrahepatic biliary ducts speak for obstructive jaundice. Characteristic constellations of dilated segments of the bile duct allow conclusions to the localisation of the occlusion. Changes which cannot be explained by sonography are a cause for further examinations.


[Diagnostic problems in early gastric cancer]. It is reported on 48 early carcinomas in 47 patients who were diagnosed and treated in the Robert-Rössle-Institute Berlin-Buch between 1965 and 1977. In these cases the authors above all deal with the difficulties in the endoscopic and bioptic diagnostics which prove supreme in comparison to the X-ray diagnostics. In the patients who underwent a follow-up observation of more than 5 years the survival rate corresponds to the results reported by Japanese authors.


[Olfactometric results of the olfactory function in diabetics]. Olfacto-odorimetrical examinations in 110 diabetics resulted in comparison to an examined control group of 110 rhinologically healthy non-diabetics (patients of an ENT-outpatient department) in olfactory disturbances in the sense of a quantitative dysosmia. The percental ratio of the patients with normosmia to patients with dysosmia in the entire group of diabetics was 23.6 : 76.4 in comparison to 58.2 : 41.8 in the non-diabetics. After the chi2-test the result was a significant difference between the two groups. In the diabetics as well as in the control group a decrease of the olfactory function with growing age which was shown in an increase of the olfactory perceptual threshold could be statistically ascertained. Clear connections between olfactory ability on the one hand and sex, number of births in women, smoker habits, blood sugar content and content of urinary sugar, kind of medication, relative metabolic condition, concomitant diseases and duration of diabetes on the other hand could not be established.


[Compulsory health education in invasive diagnostic procedures in cardiology]. The medical and juridicial side of the information duty concerning the basic character of a disease as well as diagnostic and therapeutic interventions are briefly discussed. By means of information paper for cardiological invasive examinations it is possible to deepen and to confirm the references given in the medical information talk. Apart from this the patient confirms by his sign that he was informed about the planned examination and that he agrees with it, which possibly is of importance for expertises.


[The extragradient of agar-gel electrophoresis in hyperlipoproteinemia]. In the present paper we report on the occurrence of an extra band suggesting a possible M-component in a case of hyperlipoproteinaemia with excessive elevation of lipid values. The enhanced apolipoproteins result in a distinct extra band in the alpha2-beta1-interzone of protein electrophoresis. The extra band disappeared after treatment of the hyperlipoproteinaemia.


[Circulating immune complexes and in vivo fixation of immunoglobulin G, A and C3 onto hepatocytes in patients with Crohn's disease (author's transl)]. In vivo fixation of immunoglobulin and C3 onto the hepatocellular membrane of patients with Crohn's disease was studied by immunofluorescence. IgG binding was observed in 93% of patients with disease activity but not in patients without disease activity. C3 binding was present in 21% of patients with active disease. IgA binding was found in approximately one half of all patients with Crohn's disease irrespective of disease activity. The immunoglobulin and C3 binding to hepatocytes was not correlated with histopathological findings. Circulating immune complexes were detected with the Raji cell assay in approximately one half of all patients with Crohn's disease and showed no correlation to disease activity. The following conclusions can be derived from these studies: 1. The in vivo fixed IgG represents immune complexes, which is eliminated by the liver as part of the physiological clearance function. 2. These aggregates bind to hepatocytes predominantly via IgGFc receptors. 3. Hepatocellular bound IgG and C3 show no correlation to histopathological liver alterations. 4. In vivo bound hepatocellular IgG aggregates have different properties than the immune complexes detected by the Raji cell assay.


[Differences in plasma aminograms in hepatic and diabetic coma]. In hepatic coma as well as diabetic coma severe disturbances occur in the amino acid metabolism. The defect lies in completely different levels which result two different plasma aminograms (PAG). In 24 patients with hepatic encephalopathy stage III-IV (7 patients with acute and 17 with chronic liver failure) the PAG were evaluated. The determination of the plasma amino acids (PAA) was carried out on Multichrom B (Beckmann, Munich). In hepatic coma high concentrations of Met, Tyr, Ala, Lys and Arg are found. The deviations of PAA from normal controls show between acute and chronic hepatic failure no qualitative but only quantitative differences. In diabetic coma the three branches chain AA (Val, Leu and Ile) were elevated upon 3--5 times of normal. Near normal concentrations are found for the AA Thr, Ser, Gly, Ala, Met and the aromatic AA (Phe and Tyr). The quotient between the branched chain and aromatic AA lies for hepatic coma at a mean of 1.18 and by diabetic coma at 7.18 (p less than 0.001). In hepatic coma a correlation exists between the level of the AA-quotient improvement and the decrease with a deterioriation of the metabolic encephalopathy. The high level of the AA-quotient in the patients of diabetic "coma" gives therefore a good explanation for the rare unconscious state of these patients.


[Chronic hepatitis as sequela of acute viral hepatitis A and hepatitis non A - non B (author's transl)]. 329 patients with acute ouvert viral hepatitis which occurred in the Hannover area 1975 were classified according to virological data. The proportions of type A and type non A - non B hepatitis were each approximately 20 percent of the total cases (n = 60). Viral hepatitis B was the most frequent type of viral hepatitis (n = 209). 174 individuals of the 329 hepatitis patients were reexamined serologically two years after the onset of the acute disease. 7 out of 105 patients with hepatitis B (6,7%) and 5 out of 40 patients with hepatitis non A - non B (12,5%) revealed a serological pattern compatible with chronic hepatitis. In contrast none of 29 patients with hepatitis A indicated chronic liver disease. The frequency of anti-HAV was also determined in 41 patients with HBsAg positive and HBsAg negative histologically proven chronic hepatitis or liver cirrhosis. All patients were under 35 years of age. An equal proportion of anti-HAV was found in both groups. These results suggest that hepatitis A practically never results in chronic hepatitis, while hepatitis non A - non B can run a chronic course with a frequency similar to that of hepatitis B.


[Aneurysms of the splenic artery--pathogenesis and clinical study (author's transl)]. The pathogenesis and clinical study of the aneurysms of the splenic artery will be represented from the available literature. Retrospective from the literature 144 cases were taken into consideration and a further 6 added on. The problems of the diagnosis will be discussed, the importance of the selective angiography as the only possible means for a definate pre-operative diagnosis emphasized. Different methods of operation will be described, in which the removal of the aneurysm together with a splenectomy represents the method of choice.


[Fetal and placental maturation processes towards the end of pregnancy and their diagnosis (author's transl)]. Prenatal fetal maturation is defined as the sum of all growth and differentiation processes necessary for a mature, eutrophic newborn capable of further independent development. These growth and maturation processes, which can be precisely assessed in animal experiments, are subject to genetic and teratogenic influences, but are mainly determined by the duration of pregnancy and uteroplacental function. With the diagnositc procedures available today, such as somography and fetal electrocardiography, the growth and differentiation processes mainly depending on the duration of pregnancy may be assessed from early gestation until term; in cases with discrepancy between duration and normal maturation, the time of birth may be advanced or postponed, and in cases with insufficient growth analyses of steroid and protein hormones permit conclusions as to disturbed uteroplacental function.


[Epidemiological aspects of idiopathic early birth (author's transl)]. Epidemiological data of 338 preterm deliveries (excluding multiple gestations) were compared with the same number of term deliveries. Both groups were matched for age and parity. In one third of the cases only, possible organic factors could be attented to preterm delivery. In the remaining patients the etiology was unknown e.g. "idiopathic". These results confirm the difficulty to identify the patient at risk for preterm delivery, especially in the nullipara.


[The influence of dolcontral (pethidin) on the fetal electrocardiogram sub partu (author's transl)]. The influence of drugs on the fetus, given during labor to the mother, would often explored. The results, published out of various points of view, are wellknown also from Dolcontral. In this publication should be examined the influence of Dolcontral on the fetal electrocardiogram, and it is to observe, that Dolcontral has no influence on the various measurements, so that the fetal electrocardiogram stayed unchanged.


[Possibilities of ultrasonic diagnosis in fetal abdominal monstrosities (author's transl)]. The diagnostic possibilities of intrauterine ultrasonic assessment of the fetal abdomen by rapid B-scan are described on the basis of two cases (megalocystis/megaloureter syndrome and omphalocele with cloaca formation). Other examination methods of prenatal diagnosis to confirm the findings are also discussed, but their diagnostic significance is even more limited than that of sonography, individual cases excepted. Although early detection of neural tube anomalies is the most important application of ultrasound, pronounced monstrosities of the fetal abdominal region are also definitely recognisable via ultrasonic examination.


Cervical pregnancy and ultra-sound examination. A short outline is given of the literature about cervical pregnancy. The condition is rare. Just under 300 cases have been described. The most frequent symptom is vaginal bleeding without pain after six to eight weeks of amenorrhoea. The diagnosis is difficult and only seldom made preoperatively. Ultra-sound examination seems however to be of value. Only two cases have been diagnosticated this way and we present a third one. Our case is further remarkable in that bleeding was controlled without hysterectomy.


[Severe fetal growth retardation by maternal heroin addiction. A casuistic report (author's transl)]. A case of poor intrauterine fetal growth is reported, observed during the pregnancy of a 16 years old heroin addicted primigravida. Near on term she was delivered of an almost mature male liveborn of only 37 cm and 1300 g. Our results of placental function-tests with reference to otherwise reported effects of maternal heroin addiction are discussed.


Pathological changes in the lymphoreticular tissues of Swiss mice infected with Echinococcus granulosus cysts. Swiss mice infected intraperitoneally with approximately 1,500 protoscolices of Echinococcus granulosus and sacrificed at three and 13 months post infection yielded both viable and degenerated hydatid cysts. The mean cyst weights in the three and 13 months post infected mice were 0.13 and 2.1 g, respectively. Sections of spleens and lymph nodes in the three months post infected mice showed hyperplastic follicles and blastoid cells in thymus dependent areas. At 13 months post infection T cells from paracortex and periarterial areas were replaced by plasma cells and confluent sheets of histiocytes; follicles had retained germinal centres and medullary areas showed intense plasmacytosis and sinus histiocytosis. Failure of mice to control the histogenesis of hydatid cyst with reference to numerical reduction in T cells is discussed.


The efficacy of anthelmintics against third stage larvae of Ancylostoma caninum in Mastomys natalensis. Investigations have been carried out on the multimammate rat (Mastomys natalensis), orally infected with 1000 third stage larvae of Ancylostoma caninum per animal, to evaluate the larvicidal efficacy of anthelmintics in this paratenic host. The oral or subcutaneous administration of 19 anthelmintics and filaricides revealed good activity for levamisole, cambendazole, and mebendazole against 15-day-old Ancylostoma larvae which were located in the muscular tissue. Similarly, good results were obtained with levamisole and cambendazole against the migrating third stage larvae, by treatment two to six days after infection. The benzimidazole derivatives, thiabendazole, oxibendazole, parbendazole, and fenbendazole showed marked activity only at high dosage rates. The anthelmintics methyridine, amoscanate, pyrantel tartrate, morantel tartrate; the microfilaricidal organophosphates dichlorvos, fenthion, and haloxon; as well as the micro- or macrofilaricidal drugs diethylcarbamazine, nitrofurantoin, nifurtimox, suramin sodium, and thiacetarsamide sodium failed to show larvicidal activity even in high dosages. The average larval recovery rate after oral infection with 1000 third stage larvae, in untreated control animals, was 14.85%.


Cerebellar hemorrhage and CT scanning.

Cerebellar hemorrhage and CT scanning. We have reviewed the clinical syndrome of acute cerebellar hemorrhage and have presented five cases of cerebellar hemorrhage of various types in which CT scanning was a significant aid in management. Recognizing the clinical syndrome, establishing the diagnosis rapidly by CT scanning, and avoiding potentially lethal diagnostic procedures, are all of crucial importance in expediting surgical treatment and improving the morbidity and mortality associated with this entity.


Health education research-a UK venture.

Health education research-a UK venture. In recent years health education has striven towards the goal of becoming a research based discipline, and in doing so has borrowed techniques and theoretical frameworks from other, more established sciences. However, a combination of practical constraints and the limitations of borrowed theories have left those involved in health education with much fundamental work on research to be done. The "Better Health" campaign has attempted to deal with many health factors in an integrated way (still a somewhat unusual approach) but to date has adopted a fairly traditional evaluation design. The campaign will be modified in subsequent phases; for example, evening classes for adults are now being piloted and may well form a support network operating in conjunction with mass media work in the future. It is to be hoped that this challenge to evaluation strategies will be taken up and that not only detailed data but fresh thoughts on evaluation will be offered in following papers.


[The significance of topic differences and cadaveric changes of histamine and serotonin levels for the determination of the age of wounds in animal experiments (author's transl)]. Even when the extraction method of Fazekas for the determination of the so-called free histamine and serotonin is used, different dorsal skin areas of laboratory animals show certain differences in the amine content, which reach higher values for histamine than for 5-HT. 1) Related to the animal collective, no differences in the mean values of the 5-HT and histamine content between the right and left side of damaged dorsal skin of guinea pigs resulted, although in single cases remarkable differences (up to 1.26 microgram/g) were found. Descending from nuchal to caudal a decrease of the amine content--less in case of 5-HT, more in case of histamine--is noticed. The observed topical differences possibly depend on the continous moulting of the animals. 2) From these analytical data a method for statistical prediction is derived, which allows to state, when and with which probability a single difference value exceeds the normal variance. Applied to the comparative measurements wounded skin/control skin it is thus made possible to test the validity of the findings obtained in practical cases. 3) Postmortal changes of the amine content of the wounded as well as the normal skin are not detectable for the 5-HT, while in the case of histamine solely the values of the damaged skin first show a decrease (24 h p.m.), followed by an increase (48 h p.m., bacterial neogenesis?).


[Activity alterations of unspecific esterases during wound healing. Investigations by means of electrofocusing (author's transl)]. Electrofocusing of skin-wound extracts on polyacrylamide flat gels is appropriate for zymographic separation of the esterase isoenzymes. In animal experiments and corpse material most fractions indicated non-synchronous, wound-age depending alterations of activity. As early as 15 minutes after incision obvious activity increases of A1-3-isoenzymes could be demonstrated, followed by a transitory decrease and another maximum. Important activities of the A4-isoenzymes became evident not before the 1st (human) resp. 3rd hour (guinea pig) after incision. There are no sufficient correlations between activity alterations and wound age, to allow a fairly exact time interval classification.


Correlations of CT-findings and neuropathological investigations in cranio-cerebral trauma. For direct comparison of computerized tomograms (CT) and autopsy findings after cranio-cerebral trauma 86 brain specimens were sectioned along the horizontal planes of CT-scanning. A high reliability of the new x-ray method was found in about 72% of the investigated cases. The causes of insufficient correspondence in other cases were discussed.


[A simple gas-chromatographic method for the determination of 2,2-diethylallylacetamide in serum and its application in cases of poisoning (author's transl)]. A simple gas-chromatographic method for the determination of 2,2-diethylallylacetamide is described. A saturated solution of ammonium sulfate is added to 1 ml serum and the mixture is extracted by chloroform. The organic phase is evaporated. The residue is dissolved in ethylacetate/acetic acid and injected into gas-chromatograph. The coefficient of variation for the precision in the series is 8,5%, the recovery 76%, the detection limit 3,2 mumol/l. The extract can be used for the determination of other hypnotics, e.g. barbiturates or carbromal. In cases of poisoning the concentration of 2,2-diethylallylacetamide exceeded 700 mumol/l.


[Fatal incident after diagnostic hepatic needle biopsy (author's transl)]. Included among the complications after hepatic puncture are, expecially intraabdominal haemorrhages. This report concerns a 22-year old woman with a delayed haemorrhage, which culminated in death 5 days after a hepatic needle biopsy. The arguments for and against the necessity of this surgical procedure and the legal responsibility are discussed with the pertinent literature references.


[Criminalistic aspects of iatrogenic air embolism (author's transl)]. With reference to 7 cases of iatrogenic air embolism examined by autopsies at the Vienna Institute of Forensic Medicine between 1968 and 1977, the most important causes of such complications are discussed. The wide-spread use of intensive therapeutic methods has led to the tendency that an increasing number of air embolic incidents happens during intravenous infusions. Four cases are reported: two of them occurred by incorrect handling of an automatic infusion pump; two further complications followed insertion or use of central venous catheters. Frequently outward circumstances refer to an air embolism even ante obductionem. In our cases the suspected diagnosis was based on the following signs: air filled venous catheters remaining on the body [3], striking manipulations on infusion apparatus [2], premortal X-ray film [1], typical clinical picture [1]. The analytical-chemical part deals with the infrared and mass spectroscopic investigation of adhesive residues. The traces, which were detected on the housing of an infusion pump, originated from an adhesive tape used to hold down a push button to turn off the warning device. Comparing the spectra of known adhesive tapes it was possible to adjoin the incriminated residues to the adhesive component of 'Normaplast'.


[On a case of a repidly proceeding lethal intoxication due to n-propylajmalium bitartrate (author's transl]. A case of N-Propylajmalinum bitartrate intoxication (Neo-Gilurytmal) is reported in which the death occurred within 20 minutes after the consumption of the drug. The quantitative estimation of the drug after isolation using Extrelut--columns was carried out in stomach spectrometrically, in the blood, bile, liver, kidney, and brain by gaschromatography after trifluoroacetylation. A high Prajmalium-bitartrate concentration was found in the blood (3,85 mg/l), negative results in bile and brain, low levels in liver (0,29 mg/kg wet weight) and kidney (0,06 mg/kg wet weight). Prajmalium-bitartrate was ingested together with beer, and a blood alcohol concentration of 0.061% was determined. Furthermore, a quantity corresponding to six tablets of Neo-Gilurytmal was still found in the stomach. The rapid fatal progress of the intoxication is explained as a strong effect of the drug on the heart due to the alcohol accelerated resorption of the substance.


[Urologic complications in genital prolapse in women]. With the help of a large number of patients of the gynaecological hospital of Berlin University is demonstrated that with increasing genital descent incontinences of urine more infrequently appear, infections and cases of urinary stasis, however, more frequently. The causes of this are shown. In urinary incontinence must always be thought of the fact that apart from the urethral occlusion insufficiency also a pseudostress incontinence, urge-incontinence or overflow incontinence are possible. - infections of the urinary tract demand prophylactic as well as aimed therapeutic consequences. - Functional disturbances of the kidneys and of the upper urinary tract can nowadays be demonstrated early and carefully by means of the isotope nephrography. The indication to chromocytoscopy and urography is thus further restricted in descent and prolapse. Symptoms of renals insufficiency were observed in 15% of the prolapse diseases. Gynaecologists should more frequently consult nephrologists. On the other hand, in renal insufficiency of older women nephrologists should always think of the genital prolapse as a possible cause.


[Surgical treatment of nephroptosis in children]. By a nephroptosis already in childhood an obstruction of the urine flow with reduction of the drainage effect and thus the appearance of a pyelonephritis may develop. Changes at the vascular pedicle are also possible on account of the abnormal mobility of the kidneys so that without treatment from there may result parenchymatous and functional lesions which, as a rule, become manifest only at adult age. On the basis of own experiences which support themselves on the results of 29 children with nephroptosis we recommend the nephropexy in childhood. The operation is an active prophylaxis of the pyelonephritis caused by nephroptosis with its deleterious sequelae.


[Urination disorders following general surgery]. The disturbance of miction after general surgical operations has three causes. They exist individually and combined. The first cause is a relative trauma of anaesthesiological remedies. They have a central site of action in the brain stem and a peripheral one in the parasympathetic and sympathetic ganglian of the urinary bladder. The second cause is an operative trauma of the abdomino-pelvic initial reflex of the miction. The two traumata, the vegetative and the mechanical one, decompensate an imminent neuropathic or obstructive reduction of the urinary bladder. The two traumata are prolonged by abdominal, pulmonary and cerebral insufficiency. The third cause is a direct lesion of the sacral plexus pelvicus. - The postoperative disturbance of miction concerns about 25% of all operated persons. Children are specifically rarely concerned. Operations on the lower half of the body cause the disturbance of miction by far more frequently than operations on the upper half of the body or on extremities. The therapy consists of a rational, liberal and differentiated use of the catheter, further in parasympathomimetic and sympatholytic medication, in the obstructively or neuropathically decompensated cases in transurethral operative correction of the outlet of the urinary bladder.


[In vitro ultrasound pictures of kidney tumors]. In 5 patients with malignant renal tumours apart from in-vivo-sonogrammes ultrasound pictures of the operatively removed perfused preparations of renal tumours were additionally performed. The nephrosonogramme intracorporally showed the typical ultrasound picture of a tumour with coarsely disseminated echostructure in acoustically homogenous normal renal parenchyma. In the extracorporal sonogramme the tumour imposed as relatively echo-poor zone compared with the normal renal parenchyma with strong echos. The loss of the extracorporal turgor is discussed as cause of the reversion of the intensity of the echo pattern. In 3 other tumour-free renal preparations the acoustic reversion phenomenon of the normal renal parenchyma was confirmed in the extra-corporal renal preparation.


[Bilateral testicular neoplasms].

[Bilateral testicular neoplasms]. With 23 years an embryonal teratoma of the testicles and with 29 years a seminoma was treated by semicastration and post-irradiation or applications of cytostatics. In the two cases 10 or 12 years later seminomas of the other side appeared. Problems of the double-side simultaneous and successive affection are discussed, therapeutic consequences derived and the prognosis is entered. Apart from this the clinical and morphological signs of bilateral metastases of the testicles by a bronchial carcinoma are explained and discussed.


[Immunoprophylaxis of rabies (author's transl)]. In the past Hempt-rabies vaccine produced in the GDR proved to be effective and relatively innocent like other brain-tissue-vaccines. Connected with progress in virology and genetics the production of rabies-vaccines changed to cell culturing techniques. The rabies viruses got adapted to embryonated eggs of chicken and duck, and it multiplies now in tissue-cultures like hamster kidney cells, chicken fibroblasts and human diploid cells too. It is possible now to produce a cell culture vaccine of high efficacy and innocuity, such as those done by Selimov and co-workers in the Soviet-Union. Strain Wnukovo-32 is multiplied on primary kidney cells of syrian hamsters. From 1971 to 1976 about 45,000 persons were vaccinated with the new lyophilized vaccine in the USSR. From April 1976 till October 1977 a comparison in the clinical field was performed in the GDR applying either the Soviet cell culture vaccine or the rabies vaccine after Hempt of the GDR. The results of this test including serological control of induced antibodies allow the pharmaceutical registration of the Soviet vaccine and its exclusive use in a shortened application schedule.


[Endoscopic papillotomy (EPT) (author's transl)]. From August 1974 to December 1977 a total of 155 endoscopic papillotomies were performed. Endoscopic papillotomy (EPT) has proven to be an acceptable alternative to surgical reintervention at the biliary tree especially in aged and cholecystectomized patients where obstructive jaundice is caused by a concrement. The rate of all complications (9%) is comparatively low. In our own series 3 patients died after endoscopic papillotomy. EPT may be justified in jaundiced patients without previous cholecystectomy when there is a high risk for laparotomy. Preoperative drainage of massive hyperbilirubinaemia caused by a carcinoma of the papilla of Vater and treatment of the blind sack syndrome in cases of choledochoduodenostomy are further indications of this method. Late complications after EPT are not known until now.


[Bileduct reoperations (author's transl)]. After cholecystectomy reoperations are required in 7%. A reoperation in indicated by pathologic alterations overlooked at the first operation, not working biliodigestive anastomoses and injuries to the common bile duct. 138 reoperations of the bile duct wer performed within 4 years which were aimed at reconstructing the normal bile duct anatomy. Mortality rate 8,7%.


[A balanced synthetic diet (Berlamin) in colonic surgery (author's transl)]. In preparation for surgery of the colon and rectum 50 patients were fed an oral balanced synthetic diet. Additionally, antibiotics were administered. With the exception of 4 patients the bowel was completely free from faeces. During the preoperative period, averaging 5 days, no pathological laboratory findings were observed. On the 5th day of the oral diet feeding there was a total N-retention rate of +2,8 +/- 1,2 N/day.


[Operative policy in colonic obstruction of neoplastic origin (author's transl)]. From 1958 to 1977 a total of 390 patients underwent surgery for colonic obstruction of neoplastic origin. The series includes 218 women and 172 men, average age 64 years. 135 patients (35%) came to death. The incidence of left colon carcinoma considerably exceeds the carcinoma of the right side (73 or 27% accordingly). The  operative methods used are grouped under three headings: primary resection (200 cases = 51%; mortality rate 31%), staged resection (52 cases = 13%, mortality rate 33%), palliative interventions (138 cases = 36%; mortality rate 40%). The results of this study suggest to restrict the range of indications for primary resection in case of deterioration of the general condition and of ileus-peritonitis.


[Intraoperative bacterial contamination and posttraumatic wound infection (author's transl)]. In a consecutive series of 150 fractures treated surgically 16 wound infections were observed. Evaluating the intraoperative wound swabs, type and localisation of the fractures, duration of operation and tourniquet time it was tried retrospectively to find a relationship to these posttraumatic wound infections. The highest rate of infection was found in fractures of the tibia. Open fractures had a higher risk than closed ones. Furthermore, a prolonged duration of operation was related to a rising risk of infection. The intraoperative wound swabs themselves did not allow any conclusion concerning the risk of postoperative infection. Postoperative wound infections appeared nearly as frequent after negative as after positive intraoperative swab. Only the species of bacterias found intraoperatively allowed a conclusion concerning subsequent wound infection so far that after an intraoperative finding of gram-negative bacterias and - surprisingly - apathogenic sporogenic bacterias postoperative wound infections were observed more frequently than after finding other bacterias. In summary, however, the routine intraoperative wound swab does not seem to be suitable as a sreening-test for early recognation of impending postoperative wound infections.


[Animal experiment studies on the question of damage to the fetal kidney by gentamycin]. It is reported about animal experiments of pregnant guinea pig. We found a special affinity of gentamyzin to maternal and fetal kidney-tissue. The application of this aminoglycosid seems therefore problematic in pregnancy.


[Incidence of gestational diabetes as well as changes in insulin secretion during pregnancy. 1. Studies on pregnant women suspected of diabetes using the glucose infusion test (GIT)]. Based on the glucose infusion test, we find with 17.9 per cent of a group of anamnestically tainted pregnant women gestational diabetes, and with 5.7 per cent of this group a carbohydrate tolerance with disturbed boundaries. With probands having a carbohydrate tolerance with disturbed boundaries we find a significantly more frequent IRI-high-response. This coincidence of a carbohydrate tolerance in the border range and of an IRI-high-response might correspond to the early asymptomatic stage of diabetes. In the following stages, there will take place a depression of the early insulin phase with a pathological carbohydrate tolerance of the pregnant women in the sense of a gestational diabetes. With probands exhibiting a disturbed carbohydrate tolerance, a diminished depression of free fatty acids is found. The total lipid content and cholesterol are not essentially changed. With women suffering from gestational diabetes urinary sugar excretion is significantly higher than with probands showing a normal carbohydrate tolerance.