[Blood coagulation tests in children with cyanotic heart defects]. In 57 children with congenital cyanotic heart disease coagulation analyses were performed before operation. The patients with low haematocrit only sometimes exhibited defects of low degree. In patients with haematocrit values of more than 60% were increasingly found complex coagulation disturbances. Many correlations could be proved between the coagulation parameters. Thrombocytopenia, plasmatic defects and hyperfibrinolysis were parallel. The cause of the changes is to be seen in chronic disseminated intravasal coagulation processes. The results of investigations presented confirm the necessity of preoperative coagulation analyses especially in patients with high haematocrit values. Larger disturbances of coagulation may influence the decision between a palliative intervention or immediate causal operation.


[Australia antigen and porphyria cutanea tarda]. In 40 patients suffering from porphyria cutanea tarda the sera were examined for the existence of HBAg and HBAb. Hepatitis was known in the history of 6 patients, in 3 of 23 bioptically examined livers a chronic aggressive hepatitis could be proved. When the transmigration electrophoresis after Pesendorfer and coworkers was used, in no case HBAg and HBAb could be proved.


[Electromyographic diagnosis of tetany]. Whilst the classical picture of tetany is easily to be diagnosed, diagnostic problems may arouse if vegetative, visceral or vascular symptoms predominate. The well-known clinical signs of provocation (Chvostek, Trousseau, Bonsdorff) frequently do not allow any diagnostic ascertainment. With the help of the classical electrodiagnostics after Erb (in the positive case the provocation of the cathodal opening contraction with an intensity of current below 5 mA is possible) or the electromyography we, as a rule, succeed in proving the diagnosis. In the EMG characteristic repetetive potentials in derivation from a small hand muscle are found, either spontaneous or after provocation by means of ischaemia and hyperventilation. The electromyographic examination is regarded as the most sensitive method in the diagnostic spectre at disposal and should be used for proving or excluding a tetany in unclear stenocardias, vasomotor circulatory disturbances, in spastic disturbances in the gastrointestinal tract, in unclear headache as well as in tetanic cataract and after operations of the thyroid gland.


[Clinical aspects of osteomyelofibrosis and osteomyelosclerosis]. The clinical and radiological parameters, the laboratory findings as well as the results of the nuclear-medical examination established in 78 patients with an osteomyelofibrosis or osteomyelosclerosis are compared with the data existing in literature and the problems of diagnostics and therapy of these diseases are derived from this.


[Etiopathogenesis of diabetes mellitus today (continuation)]. In form of a survey report the author enters the modern knowledge and opinions concerning the etiopathogenesis of diabetes. Endogenic (hereditary) and exogenic (above all hyperalimentation and malnutrition, deficient muscular conditioning) factors act together. To the functional capacity and functional reserve of the B-cell a central importance is ascribed. The author particularly deals with the possibility of a bihormonal disturbance and with the metabolic syndrome as well as a differentiation into the two most important types of diabetes is performed. As to several problems the results of the Karlsburg team are cited.


[Diarrhea in tropical diseases and helminthiasis]. The human parasitoses, in which a diarrhoea can appear or is the obligatory symptom, occurring  in warm countries are discussed in a survey.


[Human infestation with liver flukes].

[Human infestation with liver flukes]. Casuistic reports supplement parasitological and epidemiological references to the affection of man with Fasciola hepatica, Clonorchis sinensis and Opisthorchis felineus. Due to the increase of the tourist traffic must be reckoned with a more frequent appearance of these parasitoses little known in Middle Europe.


[Diagnosis of the early stages of diabetes and prevention of diabetes manifestations]. According to our experiences the value of the GIT in the diagnostics of the pre-stages of diabetes on account of the recognizability of the two phases of secretion of insulin and the good reproducibility is above the value of the oGTT and iGTT. In consequence of the large methodical expenditure it is left to the highly specialized stationary diagnostics. The development of the carbohydrate intolerance is concomitant with a significant reduction of the glucose-induced insulin secretion in the early phase. In contrast to this, in about 70 per cent the second phase of secretion corresponds to the normal when the pathological carbohydrate tolerance appears and is significantly reduced to 60 per cent only at the time of the manifestation of diabetes. The reduction of weight as well as buformin are suitable therapeutics of the manifestation prophylaxis. In these cases in the adipose asymptomatic diabetes should primarily always be striven for a normalisation of the body-weight, whereas for test persons with normal weight the indication for the buformin-therapy is given.


[Disaccharidases of the small intestine mucosa in infants and children. "Normal values", log normal distribution and age dependence]. In 63 infants and children with a histological normal mucosa of the duodenum, without an isolated defect of enzyme and with a normal increase of xylose and glucose in serum after a combined xylose-lactose loading test the activities of disaccharidases were log normal distributed. The asymmetric distributions were transformed into symmetric ones and the geometric mean (x) as well as the range (+/- 2 s) of maltase, saccharase, isomaltase, lactase and trehalase were calculated. Only the activity of lactase shows a significant dependency on age. In the first year of age the lower limit (x -- 2 s) of this enzyme is much higher than later.


[Studies on the cytotoxicity of lymphocytes in ulcerative colitis]. Cytotoxic action was examined with 51 Cr labelled fetal human colon epithelial cell cultures -- using lymphocytes of healthy test persons and of patients suffering from ulcerous colitis and colon carcinoma. There was no significant difference as to the cytotoxic action of the lymphocytes between the three above-mentioned groups; these results are in contrast to those obtained by previous research. This fact is considered to be due to the different methods applied. In the cases with ulcerous colitis E. coli or E. coli with CEA together formed the antigen against which complex immuno-processes are generated.


[Effect of an anabolic steroid (methenolone enanthate) on the intra- and extravasal albumin pool in liver cirrhosis]. 15 patients with a histologically and/or peritoneoscopically proven cirrhosis of the liver were treated for four weeks with 200 mg metenolonenanthate (Depot-Primobolan) per week. Before and after the treatment the intravascular and extravascular pool and daily turnover of albumin were measured with 125J-albumin. All patients had a well "compensated" cirrhosis. The only significant difference between the values of the cirrhotic patients and those of a control group of patients was a reduction of the albumin turn-over. The anabolic steroid enlarged the turn-over, the effect was the more pronounced the more pronounced the more the turn over was diminished before the treatment.


[Rheologic studies in chronic agressive hepatitis]. The chronic aggressive hepatitis, type II b, is attended by an elevation of the plasma and blood viscosity values, which corresponds to the degree of the mesenchymal and parenchymatous inflammation. This elevation is mainly due to a pathological increase of those immunglobuline fractions which are effective on the viscosity. During the application of a fluocortolon monotherapy, there could be noticed a regression as well as a normalisation of the primarily pathological laboratory parameters, being typical for an aggressive hepatitis. These changes were correlated to a decrease of the blood and plasma viscosity. The improved blood flow property is considered to be caused by the decrease of the IgG-fraction. The significance of an improved blood flow property will be discussed in correlation to the effect of the microcirculation, resulting in a better nutrition of the cell with the necessary nutritive substances, as well as on the regression of the inflammatory parameters hereby provoked. In addition to the possible benefits of the introduced cortison therapy will be considered in this context.


[Osteopathies and calcium absorption in chronic liver diseases]. Enteral calcium absorption was determined in 18 patients with non-obstructive liver disease (16 with liver cirrhosis, 2 with chronic hepatitis). There was no significant difference in comparison with healthy persons. Osteoporosis in patients with chronic liver disease probably is not due to impaired calcium absorption but to other complications of liver disease as immobility, muscle atrophy, chronic pancreatitis, alcoholism and malnutrition. Osteomalacia on the other hand, is a complication of long standing obstructive liver disease. In these cases vitamin D treatment is indicated.


[The value of gastrocytograms in gastroenterologic practice]. Gastroenterological diagnostics practised in out-patient departments requires a good correlation between costs and rate of success; for this reason the swab probe technique was used for examining the morphology of the stomach. Evaluating the gastrocytogram will have to suffice as a practical method until the day when gastroscopy, cytological tests or biopsies can be done on a large scale in out-patient departments. Since -- despite constant probing for tumors -- only a minority of the patients reveal any lesions of a suspect nature in the X-ray, the majority of cases involves gastritis. The gastrocytogram may replace some of the X-rays and secretion analyses; however, it does not constitute an alternative to purposive gastroscopy and biopsy. Eosinophiles and micro-adenomatous cell associations were found to occur in some cases of atrophic gastritis as a special cytological characteristic.


[Benign tumors as the cause of extrahepatic occlusion syndrome. Report on a neuroma of the bile ducts]. This is a report of a 29-year-old patient with an extrahepatic occlusion syndrome caused by a neuroma in the common hepatic duct. The diagnosis of an extrahepatic tumor of the bile duct, confirmed by surgery and successfully treated, was made by an endoscopic retrograde cholangiography. Histological examination revealed the rare finding of a neuroma.


[Influence of efferent biliary ducts on the composition of bile acids. Studies on subjects with cholesterol gall stones and a stone-free control group]. Cadaveric livers and their gall bladders were used in order to determine the bile acids following separation by thin layer chromatography; spectrophotofluorimetry was employed. In the hepatic tissue of the lithiasis patients the bile acid concentrations and the ratio of the trihydroxycholanic acid (cholic acid) to the dihydroxycholanic acids (desoxycholic acid and chenodesoxycholic acid) are lower than in the control group. In the B-bile only cholic acid and the quotient cholic acid to chenodesoxycholic acid reveal any significant differences. Also, there exists an established positive correlation between the bile acid concentration in the hepatic tissue and in the B-bile of the alcoholic test persons but not in the cholelithiasis patients. From this we may infer that the concomitant inflammation of the gall bladder has an influence on the composition of the bile acids.


[Determination of aryl esterase activity in the human serum using 4-nitrophenyl acetate]. A new determination of esterases and arylesterases (E. C. 3.1.1.2.) with 4-nitrophenylacetate is described. The results are compared with those of the method described by Pilz using phenylacetate. 4-nitrophenylacetate instead of phenylacetate allows a kinetic reaction. The precision of the determination is good, the method easy to handle. Normal values: 1100--2600 U/1 (total esterases), 700--2100 U/1 (arylesterases) at +25 degrees C.


[Contribution on the physiological heart growth. (Experimental autoradiographic studies in mice)]. After injections of 3H thymidine or 3H proline, the physiological hearth growth in mice of the CBA strain belonging to various age groups was studied by means of autoradiography. The most important results are the following: The duration of the postnatal growth period is determined by the degree of maturity of the heart at the time of birth. It varies from species to species. 2. In the perinatal developmental phase the percentage of the 3H thymidine-labelled connective-tissue nuclei is higher than that of the muscle nuclei. In this period the connective supporting tissue is considerably strengthened. 3. During the postnatal developmental phase the DNA synthesis in the muscle nuclei aids the preparation of mitoses. After the postnatal duplication of cells the mitotic genes are repressed. The further growth is effected by the increase in weight of the individual fibres. 4. The process of growth is substantially determined by the intracardiac or intramyocardiac pressure and thus by the extension of the muscle fibre. Prior to birth the percentage of the labelled nuclei of muscle cells and connective tissue cells in the right ventricle was higher than in the left ventricular wall. In the postnatal period we observed a shift in the percentage of the labelled cells towards the left ventricular wall. The basis and the median section of the ventricular wall. The basis and the median section of the ventricular wall contain a higher percentage of labelled cells than does the apex cordis. During the first two weeks of live most of the DNA synthesising nuclei of muscle and connective tissue cells are localized in the two inner muscle shells. Later in life no clear distinctions can be demonstrated between the individual ventricular layers.


Some observations on the intercalated disc of a rat cardiac muscle. During the experimental investigations special attention was paid to the orthomorphology of the ultrastructure of cardiac muscle intercalated disc in a rat. The contact junction between the cellular membranes of adjacent cells and intercellular spaces are typical for the cardiac muscle intercalated disc. Attention was paid to the three zone system of the junctions, namely: 1. nexus (zonula occludens), 2. fascia adherens (zonula adherens) and 3. macula adherens (similar to the desmosome). Apart from this the cell membranes adjacent to the cells may form digital indentations. A single injection of adrenaline in a dose of 2.4 mg/kg causes sinuate widenings of the intercellular space, but only in the zone of the fascia adherens. The structure of the nexuses and maculae adherentes is unchanged during this time.


[Histological and histochemical studies of the mammary gland innervation in cattle (Bost taurus L.)]. With histological and histochemical methods the innervation of the mammary gland of the cow was studies. The skin of the udder has a weak innervation in contrast to the test. In the district of the basement of the gland body nerve stems enter in the teat. In the skin of the teat only isolated free nerve terminals are found. Intraepithelial nerve terminals are missed. In the middle layer of the teat round the blood vessels bundles of nerve fibers and many organs of nerve terminals were shown. The organs of nerve terminals are typical of the teat and present mechanical receptors. It is discussed the functional significance of the afferent and efferent innervation of the mammary gland of the cow.


[Columnar organization of pyramidal cells of the visual cortex in the albino rat]. 1. The arrangement of the pyramidal cells of the visual cortex has been investigated by light and electron microscopy in 36 albino rats. 2. It was shown, that the apical dendrites form bundles. The number of dendrites per bundle is about 5 in the lower lamina Vb and 7.5 in the upper lamina Va, the diameter of bundles is about 25.7 mum. The average distance between the centers of bundles is 76,4 mum, and between the peripheries 53.1 mum. 3. The results are compared with physiological and morphological findings. It was shown, that there is an agreement of diameter of bundles und their lateral branching dendrites with diameters of columns of cells and of terminal branchings of specific afferents. 4. The morphological results are graphically reconstructed.


[The ventricular surface of the area postrema and the adjacent area subpostrema in the rabbit brain]. The ependymal surface of the area postrema (rabitt) was examined by scanning and transmission electron microscopy. The flattened ependymal cells show few microvilli. Towards the central canal, the ependymal cells change gradually to a columnar shape; the number of microvilli increases concomitantly. The area postrema ependymal cell surface mostly bears a single cilia. In contrast, a region immediately adjacent to the area postrema, which has been named area subpostrema (Gwyn and Wolstencroft 1968), shows cilia arranged in bunches. These cilia are regularly covered with colloid -- like droplets. A period-acid-bisulfit-aldehydthionine method (Specht 1970) permits to identify these droplets with glyproteids.it has been suggested that the droplets might derive from the area subpostrema ependymal cells. Above the ependymal surface of the area postrema, a great number of fine unmyelinated neuronal processes and thicker processes are observed. Some of them show bulb-like endings. These terminals contain small vesicles, dense cored vesicles (400...800 A), and mitochondria which are mostly characterized by a single central prismatic tubule. The plasmalemma of some bulbs is in a synaptic contact with the apical plasmalemma of the ependyma, while other bulbs see to end freely in the ventricle. Some neuronal processes penetrate between ependymal cells of the area postrema into the ventricular lumen.


[Electron microscopic identification of spoon-like contacts in the oculomotor nerve of the trout]. In the nc. n. oculomotorii of the trout exist different types of axonal terminals of second order vestibular neurons. In semithin sections there are observed seldom very large end-knobs (calyciferous endings). Electron microscopic pictures of the same terminal show typical spoon-like endings. A random sample like analysis of the mitochondrial density refers to functional differences between the different types of endings. A intramitochondrial cristaline inclusion in the axoplasma of a neuron is shown.


On the origin, development and probable functions of taste bud in the lip and bucco-pharyngeal epithelia of an Indian freshwater major carp, Cirrhinus mrigala (Hamilton) in relation to food and feeding habits. 1. Various developmental stages of taste bud have been observed in the fry, fingerling and adult of Cirrhinus mrigala (Hamilton). 2. The fries are zooplankton-feeders (carnivorous) and sight-feeders. Therefore, functional taste buds are absent in the lip and bucco-pharyngeal epithelia. Only formative stages of taste bud are present. Some epithelial cells aggregate together to form this structure which has no function in gustation. Moreover, the fires have low R. L. G. valle (0.71;..1.20) due to the carnivorous diet. 3. In the fingerling, the stages of elongation, differentiation and maturation of taste bund develop from the formative stage present in the fries in order to adjust to changed food and feeding habit. The value of R. L. G; (1.21...3.10) also increases. 4. Fully formed taste buds along with the stage of differentiation are found in the adult stage. The adult fish becomes herbivorous and bottom-feeder. Consequently, the value of R.L.G. 3.11...12) becomes highest in this stage.


[Fine structural study of keratinization of the filiform papillae in the tongue in humans]. The fine structure of the keratinization of the papilla filiformis of the human tongue was described for the first time; Two biopsies of normal tongue tissue were fixed in 2,5% phosphate-buffered glutaraldehyde, postfixed in 1% osmiumtetroxyde, embedded in Durcopan und contrasted ultrathin sections were examined by electron microscopes JEM 7A and 100B. The findings show a highly configurated epithel-connective tissue border with basal lamina and irregular hemidesmosomes. The epithelial structure of the interpapillary area is identical with the fine structure of the human buccal mucosa, which was classified as non-keratinized or incompletely keratinized. Accordingly, a stratum granulosum is missing. After loss of nucleus and organelles, surface cells become flattened, parallel to the surface of the tongue and have a fine fibrillar cytoplasm. The papilla filiformis is formed by cell growth along the secondary connective tissue papillae and consequently tube-like epithelial structures appear. In the papillary area basal and stratum spinosum cells show epidermal structural features. A difference from epidermal and other oral epithelial cells becomes apparent for the first time in the stratum granulosum by the appearance of a great number of round, small, electron-dense KHG, surrounded by ribosomes. The KHG are not associated with tonofilaments. In the area of the walls of the tubes 1...3 mum large, electron-dense structures are formed by fusion of several KHG. With further differentiation these large KHG disintegrate into bulky or granular masses, filling the cell cytoplasm and thus mask the tonofilaments. The cells at the borders of the tubes show a great structural variability. After the disintegration of nucleus and organelles, the cytoplasm is formed by randomly oriented filaments of different packing or by fiber-bundles. Yet the interfibrilla embedding substance, typical of orthokeratinization is mostly lackingmin some cells of the tubeborders, masses of disintegrated KHG substance are masking the fibrillar cell cytoplasm. In other areas, where the KHG do not increase by fusion, intense fibrillar packing and abrupt keratinization becomes apparent. At the rim of the tube fully keratinized epithelial threads are regularly found. These are lacking at the bottom of the tubes. All surface areas show a strong tendency towards desquamation. Thus a more or less wide surface plaque is formed on the tongue, consisting of desquamated and disintegrated surface cells and of bacterial. Groups of little differentiated basal cells, which can be considered as the initial material for an accelerated regeneration, can be evaluated as a truly remarkable finding. This accelerated regeneration might be due to an increased wear of the inclompletely keratinized cells of the bulk of the papilla filiformis of the human tongue. Based on the findings of this study, an attempt was made, to explain the pathological reactions of human tongue epithelium in various systemic diseases.


[The postnatal development of capillaries in the triceps muscle of arm of the white rat. Light and electron microscopic studies]. This paper continues former ultrastructural investigations about fetal development of capillaries in the muscle anlage of the fore limb of white rats. Present investigations deal with postnatal ultrastructural changes of the capillaries of the triceps muscle of rats from the 4th up to the 23rd day p.p. Counting of the capillaries with light and electron microscope reveal a linear increase of the capillary to fiber ratio in this period proportional to the growth of the muscle. Related to a defined area however the number of capillaries remains constantly. Ultrastructural changes of capillaries consist in further flattening of the endothelial profiles, decrease in number or organelles (mitochondria and endoplasmic reticulum), while the number of pinocytotic vesicles remains highmthe endothelial joints become less interdigitated, the basement membrane shows an increase in density leading to a temporary decrease in thickness. Since the 9th postnatal day all of the capillaries including buds closely border upon the muscle fibres. The distance between endothelium and myofiber diminishes up to 0,1 mum.


[Light and electron microscopic studies of slowly adapting abdominal stretch receptors of the American river crayfish Orconectes limosus (RAF)]. The slowly adapting abdominal stretch receptors of Orconectes limosus (RAF) have been investigated morphologically; 1. Despite their variety of size and shape all slowly adapting receptor neurons show common characteristic features which in addition distinguish them clearly from the fast adapting receptor neuron type SN2. The slightly globular cells have always several dendrites (often 4-6). They originate apical or lateral to the neuron, are oriented mainly longitudinal to the muscle fibres and are brodly ramified. The fine dendrites form a 3-dimensional fibrilar network. 2. The structure and distribution of the connective tissue in the "intertendon" of the muscle receptor organ correspond to the dendrite ramification; In this area, some muscle fibres end direktly at tendon-like connective tissue structures, but a number of different fibres run uninerruptedly through the whole muscular fascicle. 3. The perikaryon of every sensory neuron shows 2 "cytoplasm types" which are clearly distinguishable one against the other. A characteristic feature of the granular-lamellar neuroplasm that closely surrounds the nucleus are many flat vesicles of the granular endoplasmatic reticulum, accumulations of free ribosomes, numerous mitochondria and Golgi fields. The fibril-rich neuroplasm on the contrary contains only few mitochondria, but very many neurofilaments, here and there also neurotubuli. It projects directly into the dendrites and neuritek. Cell bodies, axon and dendrites are surrounded alternatingly by sheath cells and connective tissue of collagenous nature. The innermost layer of the coat cells borders directly on the neuron membrane. Finer dendrites are enclosed by nothing more but a thin layer of sheath cell plasm and intercellular substance. The dendrite terminals are either stored directly in connective tissue ground substance or border immediately on the sarcoplasm. 5. The axo-dendritic or axo-somatic synapses, respectively, contain numerous ellipsoidal (250-350 X 400-500 A), but also many spherical, vesicles. Some vesicles have a slightly larger diameter (700-900 A) and contain an electron-dense core. The synaptic gap measures 150 to 200 A. The neuromuscular (supposedly excitatory) synapses are filled much lighter with vesicles as compared with those just mentioned, which show a relatively unique form and size (nearly all spherical, phi 400-500 A). There are less vesicles with an electron-dense centre. On the average, the synaptic gap is broader (200-250 A) and the contact zone is larger. Apart from these, terminals could be observed in the dendritic ramification area, too, resembling the axo-dendritic and axo-somatic ones, respectively. 6. Finer dendrite branches contain vesicles differing slightly from those mentioned above as far as shape and size are concerned. Their diameters vary between 500 and 1 000 A. "Dense bodies" could be observed sporadically in these vesicles.


[Histological and histochemical studies of the kidney of stickleback Gasterosteus aculeatus L. I. Morphological changes of the kidney epithelial cells during the spawning period]. 1; The tubule of kidney of Gasterosteus aculeatus L. consists of four histologically different regions: Proximal tubule I and III, connection segment and collecting tubule. 2. All of tubule segments inclusively the urinary duct out of the proximal tubule I are showing synthesis of secretion. 3. There are producing two various secretion in two distinct species of cells. From the cells of proximal tubule II are secreted and extruded a granular secretion and from the cells of abducted urinary ducts (connection segment, collecting duct and urinary duct) a hyalo-mucous secretion. 4. During the breeding season the morphological variationes were divided into three stadiums, the stadium of differentiation, of producing of secretion and of reproduction. In second stadium were differenced three phases, in particular characterizing by rhythmical variationes of nucleus structure and synthesis of secretion as extrustion. 5. There are discussing the parallels to synthesis of secretion in glandular cells.


Studies of the fossil dinosaur bone in the scanning electron microscope. A fossil dinosaur bone, 80 million years old, was subjected to investigation in the scanning microscope. The bone surfaces to be examined were prepared with appropritely modified methods used in the technique of replication in transmission electron microscopy. In the scanning microscope pictures of vascular canals were obtained. The walls of these canals were shown to be formed of collagen fibrils. Moreover, it was demonstrated that the internal surface of the canal wall is made up of bundles of collagen fibrils which run obliquely, corkscrewwise, and in the form of plexus to the long axis of tke canal; Besides, osteocytes of the dinosaur bone were isolated and pictures of their spatial structure together with characteristic points of departure of processes from the cell body were obtained.


Three successive ruptured tubal pregnancies. A case of three successive ruptured tubal pregnancies in the same patient is described. This is a rare occurrence. A review of the literature on the conservative approach in the surgical management of tubal pregnancy, is given.


Classification and treatment of loss of conductive hearing. During the last decade numerous advances have been made in otolaryngology. The decade has also seen a number of modifications in diagnosis and therapeutic techniques. The most important advances were in the fields of otology and audiology. Therapeutically the treatment of deafness has seen the greatest advances. Conductive hearing loss occurs when sound cannot reach the cochlea. The blockage may be due to abnormality in the canal, the eardrum or the osicles, including the footplate of the stapes. Lesions central to the footplate produce perceptive hearing loss.


Modification to the conventional wheel for measuring the range of movements of the shoulder joint. A simple modification to the conventional shoulder wheel is suggested. This would enable both the therapist and the patient to make an objective assessment of the range of movement taking place in a painful and stiff shoulder joint. The most common factors in producing an error in the evaluation of range of movement are trunk movement and shoulder elevation. This modification would help to avoid them. It is cheap and easy to manufacture.


Hydronephrosis in a series of 3,400 post-mortem examinations in Zambia, with special reference to Bilharharzia. An analysis of forty-two cases of hydronephrosis occurring in a series of 3,400 post mortem examinations (1.2%) shows that bilharzia could not be regarded as a cause of death in any of them. This is evident in thirty of the cases, since bilharzial lesions were not present in these. In the other twelve cases in which bilharzial lesions were present major obstructive diseases (carcinoma of bladder, prostatic obstruction) sufficiently accounted for the hydronephrosis in six cases. This leaves six cases, none of them severe, in which bilharziasis might have played a part, though other causes such as congenital ureteric constrictions cannot be excluded: This type of lesion was present to the same extent in the non-bilharzial as in the bilharzial group of hydronephrosis. It may be concluded that in Zambia at any rate bilharzia does not seriously contribute to advanced hydronephrosis, but may be responsible for some mild, symptomless forms of the disease.


[Proteins in honey. I. Separation and concentration of proteins in honey (author's transl)]. Several methods for the separation and concentration of high-molecular constituents of honey were tested. Among these, ultrafiltration in stirred cells was the method of choice. The separation and enrichment of high-molecular constituents of honey is described.


Experience with anal stretch in treatment of piles. Fifty patients in two groups of twenty-five were treated with anal stretch and standard haemorrhoidectomy operation. Thy were followed up for six months. Anal stretch patients had less pain and post operative stay in hospital was minimal (3 days). They also returned to work much earlier. No complications occured in either group. It is felt that the anal stretch method is the preferable of the two.


The effect of inorganic salts and some biologically important compounds on the incorporation of 1-14C acetate into aflatoxins by resting mycelia of Aspergillus parasiticus. Zn++, Mg++, and Mn++ ions at certain concentrations, stimulated the incorporation of [1-14C] acetate-into aflatoxins by resting mycelia of Aspergillus parasiticus suspended in tris-HCl buffer of pH 7.2. Ba++ gave consistant stimulation over a wide range of concentrations. Ethanol markedly inhibited the incorporation. Of the tricarboxylic acid cycle intermediates, citric acid gave the maximum stimulation.


[Analysis of a synthetic onion aroma (author's transl)]. A complex mixture of compounds possessing an intensive aroma of onions is obtained, when propionaldehyde, propionaldehyde and acetaldehyde are treated with hydrogen sulfide and ammonia. Dihydrodithiazines, diethyltrithiolane, diethyl-methyl-1,3-dithiine and in small quantities diethyltetrathiane, dimethylthiophene, dipropyldisulfide, dipropenylsulfide, alkylpyridines, and the condensation products of aldehydes can be proved by the GC-MS-technic. The compositions of the synthetic onion aroma corresponds slightly with the composition of the natural onion aroma.


Thyroid parameters in iodine deficiency. Thyroid Plasma Clearance and Free Thyroxine Index were compared in 20 Zambians with iodine deficiency with 12 Zambians and 10 expatriates without iodine deficiency. Mean clearance was similar in the non-deficient groups (19 and 22 ml/min.) but much higher (123 ml/min.) in the deficient group. Mean Free Thyroxine Index was similar in the non-deficient groups (11.2 and 10.3) but significantly lower (8.2) in the deficient group. A relationship between iodine deficiency and low income was seen. No racial difference was apparent.


Secondary lesions of the nervous system in some infectious and toxic--allergic conditions in Zambia. A number of toxic or toxic-allergic manifestations were discovered on careful examination of patients admitted in Chipata General Hospital with infective or febrile illnesses. A total of 111 patients were found to present with various forms of radiculities which resolved on treatment of the primary condition.


Effectiveness of shortwave diathermy and ultrasound in the treatment of osteo-arthritis of the knee joint. Treatment of 100 consecutive knee joints affected with osteoarthritis with shortwave diathermy and ultrasound showed that the latter was somewhat the more effective of the two methods.


Effect of oral therapy for treatment and prophylaxis of anaemia of pregnancy in an urban Zambian population. The effect of iron and folic acid tablets supplied antenatally was studied in 77 urban Zambian patients with haemoglobin levels of 70% (10.2 grams) or over at first visit. No significant difference was found between treated and untreated groups. A haemoglobin level of 80% (10.2 grams) or over at first visit was found to be no guide to the likelihood of anaemia at term. The practice of providing treatment for these patients on the basis of the haemoglobin level at first visit is of doubtful value.


[GLC-mass-spectrometrical investigation of volatile constituents of wine. IV. Identification of secondary amides in wines (author's transl)w]. Aroma extracts obtained by liquid-liquid extraction of wines from various sorts have been fractioned employing column-chromatography and using silicagel as adsorbent. In the polar methanol-elutions the following secondary amindes have been gaschromatographically separated and identified by means of a mass-spectrometer: N-ethyl-acetamide, N-isobutyl-acetamide, N-(2-methylbutyl)-acetamide, N-(3-methylbutyl)-acetamide, N-(3-[methylthio]-propyl)-acetamide, and N-(2-phenylethyl)-acetamide. Moreover the sulphur containing compound has been identified by means of an attached flame photometric detector. The different possibilities of the formation of the secondary amides during the fermentation process are discussed.


[Proteins in honey. II. Gel-chromatography, enzymatic acitivity and origin of honey-proteins (author's transl)]. The honey proteins were separated into five distinct peaks by freezing and thawing and subsequent chromatography on Sephadex G-200. The enzymatic activities were always located in the same peaks and clearly separated. The elution curves of the individual honeys were very similar. No significant differences were observed neither among floral honeys not between floral and honeydew honeys. The determination of the elution coefficients, however, showed that three of the five peaks originate in the bee the other two in the plant.


[Simultaneous, gas-chromatographic determination of ethyleneoxide, ethylenechlorohydrine and ethyleneglycol in grain (author's transl)]. The not comminuted grain (10 g) is extracted for 24 hrs (25 degrees C) with 5 ml methanol (shaking machine), then the fluid phase is separated by centrifugal filtration and directly injected into the GC (10 mu). The GC starting temperature (60 degrees C) is adjusted by cooling the oven with Co2. Yield: EO 73% (concentr. range 25 ppm); ECH 93% (concentr. r. 50 ppm); EG 99% (conc. r. 50 ppm). Standard deviation: EO s = +/- 1,70 ppm (N = 24, conc. r. 10 ppm), ECH s = +/- 1,15 ppm (N = 24, conc. r. 20--30 ppm), EG s = +/- 0,62 ppm, (conc. r. 15--30 ppm, N = 24).


[On the nonexistence of propionic acid in various kinds of breeds (author's transl)]. Analyses of 45 samples of sour dough and various kinds of bread have shown that no appreciable amounts of propionic acid are formed during sour dough fermentation. Bread has no natural propionic acid content.


[On the phenolic acids of vegetables. II. Hydroxycinnamic acids and hydroxybenzoic acids of fruit and seed vegetables (author's transl)]. Fruits of solanaceae (tomatoes, eggplant, and sweet peppers) almost exclusively contain hydroxycinnamic acid derivatives with caffeic acid dominating. Fruits of cucurbitaceae (cucumbers, melons, pumpkins, and zucchini) are extraordinary, because they show very low concentrations of phenolic acids (up to 10 mg/kg) accumulated in the peels. Peas and broad beans have relatively small contents of phenolic acids too. Their husks show like beans considerable concentrations of hydroxycinnamic acid derivatives with dominating p-coumaric acid. In the group of hydroxybenzoic acids derivatives of salicylic, gentisic and vanillic acid could be determined frequently, but mostly as traces.


[On the phenolic acids of vegetables. IV. Hydroxycinnamic acids and hydroxybenzoic acids of vegetables and potatoes (author's transl)]. Lettuce, endive and chicory exclusively, cornsalad and sweet fennel almost exclusively contain caffeic acid derivatives beside traces of ferulic acid. Parsley exclusively and spinach almost exclusively show p-coumaric acid derivatives. Compared to root, fruit and seed vegetables the contents of phenolic acids in green leaves are considerably high. Rhubarb is the only vegetable, which contains gallic acid (chief phenolic acid) beside hydroxycinnamic, protocatechuic and vanillic acid derivatives. Furthermore hydroxybenzoic acid derivatives (salicylic, gentisic and vanillic acid) occur in cornsalad, sweet fennel, parsley and spinach in small concentrations; cornsalad shows p-hydroxybenzoic acid (ca. 20 mg/kg). Onions (Allium cepa) contain almost only protocatechuic acid beside small amounts of p-hydroxybenzoic and vanillic acid. In the outer dry coloured skins protocatechuic acid reaches concentrations up to 2% of plant material; the internal pulpy tissues show lower concentrations (ca. 20 mg/kg). On the contrary to the bulbs the green leaves of onions like chive and leek contain almost exclusively compounds of ferulic and p-coumaric acid. Garlic even shows a different phenolic acid pattern of skins and internal tissues. The caffeic acid derivatives of potatoes are mainly localized to a 1--2 mm thick outer layer. The different localization of phenolic acids in the different parts of vegetable plants is discussed.


[On the phenolic acids of vegetables. III. Hydroxycinnamic acids and hydroxybenzoic acids of root vegetables (author's transl)]. In carrots, celeriac, scorzoneras, and horse radish caffeic acid, in small radishes p-coumaric acid, in beets ferulic acid and in radishes probably ferulic acid is dominating after hydrolysis. The contents of phenolic acids in the roots are much smaller than in the corresponding leaves. Carrots, small radishes, horse radish and partially scorzoneras show higher concentrations of phenolic acids in outer tissue layers. In contrary to hydroxycinnamic acid derivatives the contents of hydroxybenzoic acid derivatives (p-hydroxybenzoic, vanillic, salicylic and gentisic acid) mostly were small. Partially hydroxycoumarins (aesculetin and scopoletin) identified.


[Flavonols and flavones of vegetables. V. Flavonols and flavones of root vegetables (author's transl)]. Root vegetables contain flavon(ol) glycosides in tracers up to small amounts, while the level of their leaves are in part considerable (to more than 1 g/kg, calculated as aglycon). Radish, rutabagas, scorzoneras, and beets contain less than 1 mg/kg kaempferol and/or quercetin; carrots less than 1 mg/kg apigenin and luteolin; celery roots ca. 75 mg apigenin/kg and 14 mg luteolin/kg; horseradish about 20 mg kaempferol/kg and small radish 1-10 mg kaempferol/kg, whereby all these flavones and flavonols occur as glycosides in the vegetables. In leaves of small radish, variety "Eiszapfen", we found besides isoquercitrin (quercetin-3-glucoside) a quercetin-3-0-diglycoside and a kaempferol-0-diglycoside, both with the sugars rhamnose and arabinose, by tlc.


[Investigations of fat-quality of maize with special consideration of linoleic acid contents (author's transl)]. In the past years the cultivation of maize in the Federal Republic of Germany has been intensified, and with the processing of localy bred maize a production of maize germ oil from German varieties could be expected. In order to maintain certain essential points about the amplitude of variations in the specimen of fatty acids in the localy bred maize, a greater number of maize samples from cultural practice trials (varieties, locations and fertilizer) were taken for the year 1971 and 1972 and their fatty acid composition was analysed. The following results were obtained: 1. Comparared to maize of foreign origin, processed in the Federal Republic of Germany, in most cases the localy bred, has higher contents of linoleic acid and lower contents of oleic acid. Thus the linoleic acid contents of the Germany maize varies between 54.3 and 68.8% while the foreign maize varies between 39.5 and 58.7%. 2. Great differences in quality exist between the local genotypes (varieties). Also clear, but not so great differences are induced by ecological factors, as locations, weather and nutrient supply. The differences of local environment in the linoleic acid content in case of variety "Inrakorn" varies between 60.8 and 64.5%.


[Investigation on fat-quality of embryo, endosperm and crush fractions of maize kernel (author's transl)]. Investigations were conducted on the composition of fatty acids in the fat of the embryo, the endosperm and several crush fractions of the maize kernel. The following results were obtained: 1. The embryo fat contained relatively lower contents of palmitin-, stearin- and linolenic acid, on the other hand higher contents of oleic- and linoleic acid in comparism to endosperm fat. 2. This result was identical to each one of the seven varieties examined. 3. The examined varieties presented clear differences both in the absolute contents of single fatty acids in the embryo and in the endosperm, as well as in the relationship between the components in the germ and in the endosperm. 4. The differences observed between the germ- and the endosperm fat in the crush fractions in some cases were clearly visible, while in other cases were not traceable.


Formation of malonaldehyde in frozen baltic herring and its influence on the changes in proteins. The relationship between the malonaldehyde formed as oxidation product of lipids, and changes of proteins in frozen Baltic herring (Clupea harengus var. membranus) was studied. Changes occurred in the muscle proteins due to freezing, so that water-binding capacity, solubility, and the amount of free epsilon-amino groups in these proteins decreased. A close relationship was found between the amount of malonaldehyde and changes of proteins in the different phases of storage. The reaction of malonaldehyde with the free amino groups of the proteins may be one of the factors on which the changes of proteins during frozen storage are based.


Nonenzymic browning. XIV. Reaction of phospholipids with 1,4-benzoquinone. Phosphatidylethanolamine reacts with 1,4-benzoquinone with the formation of a red unstable intermediary product consisting of one phosphatidylethanolamine residue and one 1,4-benzoquinone residue. The secondary reaction products are purple, violet, and reddish brown. Consequently, the absorption maximum shifts from 430 nm to 490 nm during the reaction. Finally, brown macromolecular end-products are formed. Phospholipids derived from choline, such as phosphatidylcholine, lysophosphatidylcholine, sphingomyelin, contribute only a little to the browning reactions, in comparison with phospholipids containing a primary amino-group (phosphatidylethanolamine, lysophosphatidylethanolamine, phosphatidylserine). The browning of a natural mixture of egg phospholipids depends on the content of derivatives containing a primary amino-group.


[Studies on tea. I. Contents of mercury, lead, and cadmium in tea leaves and tea decoctions (author's transl)]. In a survey on 25 teas from different countries for toxic trace elements the concentration of lead was found to be up to 3.08 ppm. of Cadmium up to 0.012 ppm, and of Mercury up to 3.0 ppm, respectively. The actual concentration in the tea decoction is much lower as in the tea leaves, for lead up to 0.02 ppm and for Cadmium below the sensitivity of the method. It was recommended to set the tolerable values for these elements in the tea leaf higher as recommended for the direct consumed foodstuffs or to consider the final concentration in the tea decoction only.


[On the occurrence of derivatives of hydroxycinnamic acids, hydroxybenzoic acids, and hydroxycoumarins in citrus fruits (author's transl)]. Oranges, grapefruits and lemons contained p-coumaric acid, caffeic acid, ferulic acid, and sinapic acid in bound form in concentrations of 10-100 mg/kg, whereby p-coumaric acid is localized chiefly in the peel. Hydroxybenzoic acids, chiefly salicylic acid and gentisic acid, and hydroxycoumarins were only found in traces.


[Cytology and histochemistry of synovial cells in various forms of arthritis]. Synovial effusions from various kinds of arthritis have been examined both morphologically and histochemically. These two methods give complementary evidence, and show (i) that there are two fundamentally different types of cell present in rheumatoid arthritis (ii) that the synovial fluid from septic arthritis can clearly be separated from that of all other forms of arthritis and (iii) that intracellular crystals can be demonstrated in gout. Laboratory methods also give information on the polysaccharide and fat content of synovial fluid, in particular on the lipid material in the cell free supernatant. Large mononuclears in the fluid are probably generated in the local tissue and reflect minimal differentiation from a basic cell type.


[Pulmonary function and rheumatoid arthritis]. Pulmonary ventilation was studied on 100 rheumatoid arthritics from a medical outpatient clinic, using wholebody plethysmography, spirography, and pneumometry. Findings were normal in 2/3 of the patients; reduced lung capacity was found in only 3-6%. Thus it is doubtful that significant restriction of ventilation is present in chronic polyarthritis. Nevertheless, 1/4 of all rheumatoid arthritis patients have bronchial obstruction with resulting pulmonary emphysema. Whether or not the incidence of respiratory passage obstruction is directly associated with the underlying rheumatoid disease must await further study.


Desoxyribonuclease activity in the serum and spleen of rats with mycoplasma induced arthritis. The endodesoxyribonuclease and exodesoxyribonuclease activities were measured in the spleen cytoplasma fraction and serum of rats with mycoplasma induced arthritis and adjuvant arthritis. A higher exonuclease activity was found in the spleen cytoplasma of adjuvant arthritis rats. During the regression of mycoplasma arthritis an increased activity of exonuclease was detected in the serum, but in the acute stage of inflammation the exonuclease activity was similar to the control values. A higher endonuclease activity was found in the spleen cytoplasma fraction of rats with mycoplasma arthritis. The possible origin of the endonuclease and its role in arthritis are discussed.


[Diagnostic-therapeutic problems on heart involvement in chronic polyarthritis]. 200 in-patients with rheumatoid arthritis (RA) were examined with regard to the diagnostic criteria for early recognition of rheumatoid heart involvement. 75 patients showed some evidence (37.5%). The criteria are: subjectively, reduced general state, feeling of oppression, disproportional tachycardia and dyspnea: objectively, changes in the electrocardiogram (tachycardia, T-inversions sometimes resembling to infarct pictures, disturbances of repolarization, extrasystoles and AV blocks). The severity of the change may alter rapidly. Severe myocarditides may manifest as heart failure and dilatation of rapid onset. For prognostic and therapeutic reasons the recognition of a heart involvement, despite these often minimal appearances, is important. It is remarkable that there was no correlation between the activity of rheumatoid process, the titre of rheumatoid factor, and the degree of heart involvement. Age and age of onset, duration of disease and sex also showed no correlation with rheumatoid heart involvement.


[A different interpretation of the Oedipus complex]. Is mans fate irrevocable predetermined or have we a certain amout of free will? We assume, that although restricted by his own developed character, and given circumstances, man has a choice and is capable to influence his destiny. According to Freud our actions and behaviour are often unconsciously motivated and frequently incomprehensible  for ourselves. They are then independent of our "will" and capacity of decision--making. Freud observes rightly the ambivalence of seelings between father and son, mother and daughter and regards this as the essential factor for the character-formation of the developing child. However his interpretation that these feelings are always based on libidinous wishes and jealousy seems to the author too farfetched and not fully proved in all cases. In the author's opinion the basic problem of life must be an insolvable one and that is the problem of death. Seen from the father's point of view, the son, on one hand represents the only solution for continuation of his life, the only possibility of victory over death, on the other hand however, he will substitute him one day, make him superfluous and eventually take his place. A similar process takes place between mother and daughter who on one hand would like to enjoy the beauty and success of her daughter (whom she regards as her biological continuation)--by whom however she feels as well pushed aside and made older on the other hand. The Problem, how to vanquish death and the wish for continuation of our existance, the resistance against extinction and replacement by someone else, is of fundamental and inescapable importance. If we understand this, we will find a more profound explicaiton of ambivalent feelings between parents and children. The aim of human development should be, to find the right way, how to satisfy our justified urges in accepting the limits of our capacities and possibilities within the framework of reality.--In doing so, our creative capabilities and our desires for change and progress should not be inhibited. The acceptance of our Self, of the reality of life and of our limitations includes however also the acceptance of death. This inside therefore will have its positive effect also on the development of the ambivalent feelings between parents and children, which we could handle better, if we know and understand their meaning.


[Chronic psychogenic urinary retention]. Complete and persistent urinary retention of psychogenic origin, a syndrome standing between conversion reactions and the group of psychophysiological visceral disorders, remained an object of contradictory dispute in regard to its frequency and pathogenesis. Curiously enough, compared with other functional symptomatology, somehow this disturbance has been neglected in literature until now. Urologists, surgeons, and internists have more difficulties than psychiatrists to find out that distinct emotional conflicts and especially unsatisfactory sexual adjustment might have contributed to the development of recurrent or chronic urinary retention which they vainly tried to explain by organic findings. Of course the fact that extensive medical evaluations or even surgical procedures revealed no abnormality except the stout urinary bladder never is suifficient to qualify for "hysterical disease". Every diagnosis has to be established on positive grounds. Hypothetic explanations of mysterious syndromes by supposing more "microscopic" and thus undetected morphological deficiencies and changes as the crucial cause of a disease never should become the protective trick by which a physician avoids confrontation with his patients' psychological problems.


[Phobia or fear in rural communities].

[Phobia or fear in rural communities]. In the following paper an attempt is made to demonstrate by means of phobia that neurotic subjective experience can only be understood in its social environment. Patients with phobic symptoms far more frequently come from rural communities and small towns, i.e. from towns which have a ruraltype structure. To support this thesis, empirical-statistical results based on surveys at the Medicopsychological Advice Centre for Students at the University of Göttingen are cited. Further, it is shown that a meaningful integration of this statistical data with psychodynamic and sociological findings is possible. The resulting explanatory model illustrates the attempt to make as comprehensive a statement as possible about the structure of the phobia and its cohesion to social mechanisms. The phobia is not only interpreted as an intrapsychic occurence, but at the same time the boundaries to the respective social conditions are also demonstrated and reference is made to the parallelism of social-historical development and corresponding psychic structure.


[Neuroradiologic diagnosis of basal tumors of the middle cranial foram]. Analysis of the neuroradiological diagnostics of 6 patients with hemi-basis syndrome. The significance of the different neuroradiological methods of examination are worked out, as well as their intended application, which is dependent on the clinical findings. Conclusions are drawn on the rapid and rational diagnostics.


Intracranial pressure in hydrocephalus after subarachnoid haemorrhage. 10 patients with hydrocephalus after subarachnoid haemorrhage underwent a continuous ventricular fluid pressure recording for at least 22 hours, 21-67 days after the first subarachnoid haemorrhage. 3 patients had normal pressures; 4 patients had pressures somewhat above normal, between 10 and 20 mmHg; three patients had rather a high pressure, with a mean above 20 mmHg and peaks to 45 mmHg. 5 patients had a shunt operation, which seemed to improve the patient's condition in 3 instances; a sixth patient improved during ventricular drainage, but suffered a fatal haemorrhage before a shunt could be inserted. Of those 3 patients who improved after a shunt, 2 had a ventricular fluid pressure somewhat above normal (see Fig. 2) and one a high pressure. Of the 2 patients that did not improve in spite of a well-functioning shunt, one had a pressure somewhat above normal (Fig. I) and one high pressure (Fig. 3). 4 patients did not have a shunt operation; in 3 of these the pressure appeared to be within normal limits, and one patient, though the pressure was somewhat above normal, was in such a good conditon that no operation was thought necessary. One of the patients with normal pressure has spent 12 months in a mental hospital; the others recovered reasonably well, though only one has returned to work. From this small series it seems that a pressure recording cannot predict how the patient is going to become with a shunt; but the recording may help to sortout those with normal pressure, who are not likely to require a shunt, particularly as many complications are on record for shunts. In 2 instances, an aneurysmo re-bled after a high ventricular fluid pressure had been reduced, 40 and 38 days after the first subarachnoid haemorrhage; the risks inherent in changing the pressure conditions within the skull should be remembered.


[The origin of intrasellar space-occupying cysts]. One case is documented to verify that cystic hypophyseal tumours do not only stem from adenomas, craniopharyngeomas or as primary craniopharyngeal cysts from epithelial structures of the hypophyseal duct but may also originate from Rathke's cysts or Rathke's cavity.


[Extracranial metastasis of meningeal tumors. Malignant meningioma with regional lymph node metastasis]. Metastases of a meningioma occurred in a 45-year-old man 4 years after removal of a falx meningioma and 1 year after removal of a malignant relapse. They were situated in the cervical, nuchal, and supra-clavicular lymph nodes. The review of 63 cases of metastasising meningial tumours from the literature, shows that lymph nodes are the most frequent site of metastases after lung and liver. The spreading of the tumour into the regional lymph nodes requires a penetration of the primary tumour into the galea, where the tumour cells may reach the lymphatic system. According to the literature, lymph node metastases are caused by benign as often as by malignant meningiomas, the majority being cases who underwent operation. Discussed, are the different theories as to why intracranial tumours only rarely show extracranial metastases.


[Frequency of metastases to the central nervous system of pleuramesotheliomas and lung carcinomas]. Pleural mesotheliomas and bronchial carcinomas differ from each other regarding the incidence of their metastases in the central nervous system. With bronchial carcinomas in the present autopsy material, this amounted to 18%, whereas with pleural mesotheliomas, metastases were found in only 2,4% of the cases in the C.N.S.


[Rupture of the internal carotid artery following blunt cranio-cerebral trauma]. Report on an 18-year-old patient who died 6 hours after a blunt cerebro-cranial trauma due to a hemorrhage from the intracranial extradural part of the internal carotid artery. Autopsy revealed multiple fractures of the cranial basis, hemorrhages due to brain contusion and hemorrhages of the pons as well as a rupture of the wall of the right internal carotid artery within the fractured carotid canal.


Autoperfused multi-organ preparations. II. Microcirculation in the autoperfused organs. The microcirculation of 46 autoperfused heart-lung-liver-duodenum-pancreas-kidney preparations has been studied and the acid-base conditions were determined. The stability of the autoperfused organ preparation was not ensured by the "multi-organ" arrangement, moreover the combination had a detrimental effect, with reduced tissue perfusion leading to hypoxia and acidosis. This general vasomotor breakdown represented a therapeutic drug resistance, so that the organ preparation failed to solve the problem of temporary organ preservation.


[Indication for surgery in the treatment of obliterative vascular diseases of the lower limb in patients with pulmonary tuberculosis]. The guiding principles in assessing the indication for surgery in the case of an occlusive angiopathy in patients with pulmonary tuberculosis are illustrated by 69 cases. The authors take a definite stand with respect to the therapy to be chosen and recommend a scheme of indications taking into account the complaints due to the angiopathy and impaired respiratory function which might serve as guidance in the indication for surgery.


Effect of surgery on carbohydrate metabolism. The effect of surgery on carbohydrate metabolism has been studied in 20 patients. The blood sugar and serum immunoreactive insulin (IRI) levels were determined during various operations. The blood sugar level rose progressively with the duration of the intervention. A difference was detected in the changes of the blood sugar and serum-IRI levels during extra- and intraperitoneal operations. In the first case the rise in blood sugar and serum IRI was slighter and showed no close correlation with time. During intraperitoneal operations, no corresponding insulin response accompanied the increased blood sugar level.


[Operability of mediastinal tumors].

[Operability of mediastinal tumors]. The problem of the operability of mediastinal tumours is discussed on the basis of observations made in 500 cases. The importance of angiography in the assessment of operability is stressed. Benign tumours are operable, provided the operation involves no greater risk than the basic disease itself. Exploration of tumours with uncertain preoperative diagnosis is justified if there is no counter-indication. Excision of the tumour should be performed if there is no sign definitely pointing to inoperability, i.e. if the histological type of the tumour does not exclude the success of surgery.


Mechanism of the development of collatelar circulation III. 133Xe clearance tests in animal experiments. A model of the obstruction of the main artery of the lower extremity was produced in animal experiments. The obstruction was combined on the right side with the constriction of the outflow path, while in this respect the left side served as control. Circulation in the two extremities in the early and late stage was compared by means of the 133Xe clearance technique. In the early stage due to poorer collateral circulation flow on the right side was worse than on the left side. In the late stage the difference was not conspicuous.


[Effect of urinary transport function on the development of kidney calculi]. The formation of renal calculus is, according to the currently accepted view, a polyetiological process whose most important components are the composition of the urine and urinary stasis. The second of these factors is discussed. The importance of anatomical lesions is indicated by the finding of a hindrance of flow in 66 of the 100 patients operated for renal calculus. The stasis may, however, have some functional cause, too. X-rays revealed two types of hypomotility: a temporary, or in certain parts constant, lack of contractions and sluggish contractions of normal frequency. Temporary lack or sluggishness of contraction promotes calculus formation because the physiological pyelo-calicous reflux which occurs in three quarters of the intact cases is lacking. These refluxes counteract sedimentation and together with the orthostatic emptying are the most effective factors preventing the retention of calculus nuclei.


[Methicillin levels in the human serum, pericardial effusion and myocardium]. The antibiotic level in the serum, pericardial fluid and myocardium of 11 patients prepared for heart surgery was tested by means of the agar-diffusion method after the intramuscular administration of 1 g of methicillin. The mean level after 1 to 3 hours was 14.7 mcg/ml in serum, 1.7 mcg/ml in the pericardial fluid and 8.2 mcg/g in the myocardium. In the case of drug sensitivity, the myocardial methicillin concentration is sufficient for the treatment of Gram-positive infections. If the infection is localized in the pericardium, higher doses, local applications, drug combination or complex therapy might be called for.


[Septic shock. Clinical review of 72 cases (author's transl)]. The authors present a series of 72 observations of septic shock. The overall hospital mortality is 51%. Aggravating factors with worst prognosis are a cirrhosis (90% mortality) and wrong antibiotics before shock occurred (88% mortality). Some therapeutic acts (cannulae, venous catheter, urinary catheter, immuno-depressing treatment) increase penetration of gram positive germs of hostipal origin. The germs account for 30% of cases, the most frequent being staphylococcus. Among gram-negative organisms, one finds colibacilli, pseudomonas and last klebsiella. Usual entrance site was respiratory (33%). On clinical grounds we found equal frequency of "warm" shock with vasodilatation (mortality 30%) and "cold" shock (mortality 67%). A certain degree of renal failure sometimes necessitating dialysis is the rule. Intravascular disseminated coagulation occurred 3 times out of 46; 13 had hemorrhage. Finally acid-base disorders were usually of the metabolic acidosis type with respiratory alkalosis. Treatment consists in restauring volemia with abundant perfusions under control of central venous and arterial pressures and diuresis. Antibiotherapy, bactericidal and with wide spectre or specific for the suspected germ, must be immediately started. Importance of surgical debridement when required is evidenced by the low mortality of those cases (2 deaths out of 12). We use steroids systematically at high dosage, intravenous. Vasoactive or tonicardiac drugs are used selectively. Their efficiency and that of steroids are not prooved. Finally a review of the literature concerning the physiopathology and treatment of septic shock and its complications is presented.


[Toxi-infectious shock pneumopathy. A morphological study (author's transl)]. The lungs of 68 septicaemic patients have been systematically studied and compared. The observed lesions include a whole range if alterations usually described in routine sampling of lungs in cases of deaths from diverse diseases. One lesion however appears more frequent and intense: infection of the pulmonary oedema. Inflammatory reactions are associated to acute arteritis at different stages of evolution which, in these patients, was more frequent in cases of shock.


[Digestive complications in patients with severe burns (author's transl)]. This is a report on 18 patients suffering digestive complications, among 593 burned patients treated during seven years. This clinical analysis mainly stresses the poorly understood intestinal ileus that occurs in such patients. The work includes an appraisal and synthesis of some data from the literature.


[Congenital aortic arch anomalies and vascular rings (author's transl)]. The anomalies of the aortic arch are consequences of malformations in the first twelve weeks of the intrauterine life. Embryologically it is possible to explain and classify all of them. Most remain asymptomatic and do not need treatment. About one third of all anomalies are causing tracheo-esophageal compression with consequent complaints. In most cases the symptomatology starts in the first days of life. Some of them can be temporarily treated conservatively. The prognosis of patients, who need surgery is good, even in small infants. Surgery consists mainly in section of the atretic or hypoplastic part of the double aortic arch, section of the aberrant subclavian artery, section of the Botal ligament or duct and liberation of the trachea and esophagus. A normal configuration of trachea and esophagus is reached after several months or even more than a year. There are no reports on reoperations for secondary strictures. In the University Hospital of Nijmegen and Leiden we operated on 17 patients. There were 8 patients of group I A --- Edwards classification -- double aortic arch with both aortic arches open and left Botal duct or ligament; 4 patients of group I B, double aortic arch with one atretic aortic arch with a left Botal ligament; 3 patients of group II B, with a left aortic arch and aberrant right subclavian artery and a left Botal ligament; 2 patients of group III B with a right aortic arch and an aberrant left subclavian artery and a left Botal duct or ligament. Of our 17 patients one died during the operation because of a haemorrhage and overtransfusion; an other one died three weeks postoperatively from an endotracheal bleeding. All the other patients are without complaints and remained so.


[Importance of arteriography in the diagnosis of splenic trauma (author's transl)]. Among 26 cases of suspected hemorrhage the authors report 8 cases of splenic trauma. They note perfect agreement between the importance of the radiological lesions and the seriousness of the clinical signs. Given the harmlessness of the investigation and the frequency of the visceral lesions it disclose, the authors recommend arteriography in difficult cases with subacute or chronic evolution.


[Post-traumatic bronchial stenosis (author's transl)]. The authors have performed plastic reconstruction of a bronchus in a 16 years old patient, 6 1/2 weeks after rupture of the right stem bronchus. This had occurred during a blunt trauma to the thorax. In the acute phase the patient appeared completely cured by suction of the pneumothorax. Later occlusion of the bronchus with total atelectasis appeared. Respiratory function tests, blood gas analyses and pulmonary scintigrams were performed before and 12 weeks after the operation. The authors discuss the data from the literature pertaining to traumatic rupture of the bronchus in its acute phase and during progressive stenosis, for which surgery is warranted. Repair of the stenotic bronchus will make the lungs capable of assuming satisfactory hematosis.


[The meaning of hepatic artery ligation in surgery (author's transl)]. On the occasion of a traumatic rupture of the hepatic artery in a 10 year old boy, successfully treated by ligation of the left branch, the meaning of arterial suppression to the liver was studied. Follow-up of 58 cases reported in the literature are reviewed; so is the role of collateral arterial circulation and of portal circulation as compensatory mechanism. A number of provisions tending towards optimal oxygenization of the patient and towards upholding of portal circulation are proposed as treatments against surgical interruption of the hepatic artery.


Studies on gluconeogenesis and stimulation of glycogen and protein synthesis in isolated hepatocytes in alloxan diabetic, normal fed and fasted animals. Hepatocytes were isolated by collagenase in vitro perfusion technique. Net glucose production in isolated hepatocytes obtained from fed, fasted and alloxan diabetic rats was studied. Net glucose production from alanine, pyruvate and fructose was increased by 2-5 fold in isolated hepatocytes obtained from fasted and alloxan diabetic rats. Similar increases in the incorporation of 14C-bicarbonate into glucose was also observed. Net glucose production in isolated hepatocytes was also compared to other in vitro preparations. Net glucose production was much higher (2-5 fold) in isolated hepatocytes than that reported previously for liver slices or perfused liver. Studies on glycogen and protein synthesis show a 2 fold stimulation in the incorporation of 1-14C-glucoase into glycogen and U-14C-leucine into protein by the addition of 100 muU of insulin to isolated hepatocytes.


The effect of somatostatin on plasma insulin and growth hormone levels in basal conditions and after glucagon in normal and acromegalic subjects. The effect of low-dose somatostatin (2.5 mug/min i.v.) on blood sugar, insulin and GH levels (basal and after i.v. 1 mg glucagon) was studied in 7 normal and 10 acromegalic subjects. No changes in basal values were noted in normal subjects, whereas the insulin response to glucagon was partly inhibited and the glucose response enhanced. Basal blood glucose was likewise unaltered in the acromegalics. There was, however, a significant, though unrelated, fall in both insulin and GH. The insulin response to  glucagon was inhibited to a greater degree than in normal subjects. It is clear, therefore, that somatostatin can inhibit the insulin response to glucagon, as well as that to the other stimuli for which data are given in the literature. Acromegalic subjects appear to be more sensitive to inhibition of insulin secretion by somatostatin, though no relation between this and the drug's parallel inhibition of GH secretion can be shown.


Comparison between cytochemical changes, concentration of PAS-positive substances in peripheral blood lymphocytes and changes of blood glucose values during the oral glucose tolerance test. The purpose of the study was to analyse the correlation between the blood glucose values and the quantity of PAS-positive substances in lymphocytes observed in different groups of subjects during oral glucose loading. In 300 subjects--100 persons with a normal OGTT, 100 pregnant women (with normal, borderline and diabetic OGTT), 50 diabetic patients, 20 borderline cases of diabetes, and 30 persons with a 'lag form' OGIT--the PAS-index was measured at each point of the OGTT. The values of the PAS-index curve followed  the values of the blood glucose level, and the results obtained in different groups of persons were compared. It has been shown that an increased value of the PAS-index is an early sign of disturbed carbohydrate metabolism and that differences between borderline and manifest diabetics, as well as between these groups and normal control persons, are significant.


On some theoretical studies on gene differentiation in natural populations. Different mathematical approaches to study the extent of genetic variation of natural populations are reviewed. The modern understanding of the gene structure permits new interpretations of existing concepts like fixation or inbreeding. A more recent measure of genic divergence, which at molecular level is designed to measure net codon differences is also seen to be related with gene diversity in a substructed population. It is argued that such variations are produced and preserved possibly by simultaneous action of migration, mutation, selection, and random genetic drift. At the present moment it is very difficult to isolate out the effect of each factor because of varying degrees of variation at the different gene sites and between different sets of populations.


A high incidence of positive provocation of plasma pancreatic enzymes in the poorly controlled diabetic subjects. Abnormal responses of plasma lipase, trypsin, and amylase to pancreozymin and secretin in poorly controlled diabetics were found in 42%, 41% and 30% while these responses in well controlled diabetics were 25%, 9% and 9% respectively. Positive provocation of at least one of these enzymes was observed in 67% of poorly controlled diabetics and was significantly more frequent than that (18%) in well controlled diabetics (p less than 0.01). An elevation of fasting lipase and amylase activities was also noted in 26% and 37% in the former in contrast to 0% and 18% in the latter. In the same 6 subjects the degree of abnormal plasma enzyme response was greater in the poorly controlled diabetic state than in the well controlled diabetic state. When insulin effect on plasma lipase response was tested in experimentally diabetic rats, insulin administration for 3 to 5 days normalized the abnormal provocation of lipase observed in chronically diabetic rats. These findings indicate that pancreatic enzymes tend to leak to the systemic circulation in insulin deficiency.


Lower frequency of diabetes among hospitalized Negro than white children: theoretical implications. A review of the case histories of 471 diabetic children admitted to a children's hospital during the decade 1960 to 1970 showed that the proportion of diabetics among hospitalized Negro children was significantly lower than that among white children (3.8 Negro vs. 10.7 white per 1000 admissions same ethnic group, P less than 0.005). However, the proportion of mild diabetes, characterized by absence of ketosis and no insulin requirement, was higher among Negro (18%) than among white diabetic children (0.5%). These differences could not be explained by differences in environmental factors considered. It is suggested that genetic factors may account for a substantial part of this Negro-white difference.


Glucagon, insulin and growth hormone response in obese women. Plasma concentrations of insulin, growth hormone and glucagon were measured during an arginine test in obese women with normal (ON) or abnormal (OD) OGTT and in normal control subjects (N). Plasma insulin levels were higher than normal in both obese groups, while plasma growth hormone and glucagon levels were markedly reduced.


Studies on the geographical distribution of Australia antigen. The world distribution of the Australia antigen, the agent responsible for hepatitis in man, is reviewed on the basis of the available literature, with the addition of a personal research on a sample of German donors.


Carotenemic, skin colour and diabetes mellitus. Carotenemia with its yellowish-red tint is found in diabetes. The frequency of this phenomenon is unknown and the relationship between skin colour and blood carotenoid level is controversial. Frequently the suspicion of diabetes arising from inspection of the skin colour is in fact confirmed by the usual laboratory tests. We decided to examine skin colour, blood carotenoids, cholesterol and total blood lipid levels in 51 overt diabetics, 42 latent diabetics and 25 healthy subjects as well as 14 patients who had recently suffered an acute myocardial infarction. The healthy subjects showed blood carotenoid levels slightly higher than the patients. As is known, in cases of increased intake of carotenoid-rich fruit and vegetables the yellowish-red skin colour is marked. Diabetic patients however show this phenomenon even though they may not follow such a diet. This finding, although diagnostically useful, does not usually parallel a high carotenoid blood level. From this point of view overt and latent diabetes are similar.


Some epidemiological and genetic aspects of congenital heart diseases. This paper presents a general view on congenital malformations and a summary of some anatomic, clinical, epidemiological and genetic aspects of congenital heart diseases. Some "recommendations" for research are also briefly mentioned.


Earlobe attachment, hand clasping and arm folding among Tamil Brahmans in relation to cultural and ethnic affiliations. The traits, earlobe attachment, hand clasping and arm folding, are found to show a high degree of homogeneity in the Tamil Brahmans. The latter appear to be closest to the Bengali Brahmans, with respect to all three traits, and differ significantly from other Brahman populations, with respect to earlobe.


Frequency of left-handedness among the Andhra Pradesh people. The percentages of left-handed people among the males and females of Andhra Pradesh tribals in India were found to be 15.49 and 7.79, and in Hindus 6.9 and 4.65. The difference between the sexes among tribals is significant. The tribal people studied were Koya Doras, Sugalis (or Lambadis), and Konda Reddis. It is suggested that similar quantitative studies of left-handedness should be made in other tribal and aboriginal populations before they are culturally comditioned to right-handedness.


Middle phalangeal hair in some South Indian populations. The study of middle phalangeal hair on a sample of some 5000 nonrelated subjects of both sexes and different age groups, representing 11 South Indian populations, has shown very limited sex and age variability. The frequencies fall within the general range of Indian population groups. Most of the groups tested show genetic homogeneity.


The a-b ridge count in the Gujar Pasis and Kureel Chamars of India. The palmar a-b ridge count has been examined in the Gujar Pasis and Kureel Chamars and compared to other Indian populations.


Phenylthiocarbamide taste threshold distribution among the Rastogis of India. The PTC taste threshold distribution has been examined among the Rastogis and compared to those of other Indian caste groups of Uttar Pradesh.


[Dermatoglyphics in Noonan's syndrome (author's transl)]. Dermatoglyphics in Noonan's Syndrome A dermatoglyphic analysis has been carried out in 7 boys and 5 girls affected by Noonan's syndrome. No deviation from the general population values was found with respect to individual quantitative value, A line termination, absence of C line, a-b ridge count, hypothenar patterns, and presence of p proximal triradius on soles. Whorls were however increased on fingertips and the axial triradius t, as in Turner's syndrome, was in 21% of the cases in position t' or t".


Familial 21/22 translocation.

Familial 21/22 translocation. A family is described with 21/22 translocation, where chromosome segregation appeared to follow theoretical expectations, rather than empirical risk figures, in male and female carriers alike. The usefulness of prenatal genetic studies in genetic counseling is also demonstrated.


[The drug spectrum in rheumatoid arthritis therapy]. The possibilities of medicamental antirheumatic treatment, are reviewed. Drugs are divided in nonsteroidal antirheumatic drugs, corticoids and combined drugs, so called basic treatment, and locally administered drugs. Mechanisms of action, indication, and effects of those groups are discussed and literature is briefly reviewed.


[Side effects of gold therapy].

[Side effects of gold therapy]. 461 courses of chrysotherapy, mechanisms of action, effects, side effects and treatment of the latter are reported. With regard to changes of skin and mucous membranes, of peripheral blood count, urine, and liver enzymes the necessity of periodic controls is stressed. Before gold injection uncommon sensations as e.g. itching or "metallic taste" should be ruled out.


[Complications in chrysotherapy in 268 patients]. Side effects of chrysotherapy in 268 patients with rheumatoid arthritis, are reported. The incidence of side effects of all drugs used (Sodiumaurothiosulfate, Aurothiopolypeptide, Sodiumaurothiomalate) was approximately equal. The most common side effects were eosinophilia, exanthema, itching, albuminemia and leukopenia.


[The effect of D-penicillamine on the course of chronic polyarthritis]. The report deals with 8 years of clinical experience with long-term application of D-penicillamine in rheumatoid arthritis. The mode of action of D-penicillamine is discussed. It seems most probable that the influence of D-penicillamine implies an inhibition of the immunreaction.


[Non-steroidal antirheumatic therapy and the liver]. In 161 patients with rheumatoid arthritis a raised activity of alkaline serum phosphatase was found in 37.3% and identified as hepatic phosphatase by means of heat inactivation, and partly by determination of isoenzymes using the Polyacrylamidgel-electrophoresis. This relatively frequent finding may be explained as toxic hepatic damage due to antirheumatic therapy, and a drug-induced cholestasis. This is caused by several non steroidal antirheumatic drugs, especially upon longer administration, or in higher dosage or both, may be acting as potential hepatotoxic. Therefore, the control of alkaline serum phosphatase and gamma-GT before and during the antirheumatic treatment is recommended.


[Induction of chromosome aberrations by antirheumatic therapy]. 1. The comparison between mean structural chromosomal aberration rates after immunosuppressive therapy and the rate of induction of malignant tumours after application of the same cytostatic substances to animals revealed a far-reaching parallelism: Highest mean aberration rates after therapy with procarbazine (Natulan) and cyclophosphamide (Endoxan) - fewer aberrations after mannitol mustard (Degranol) and no definite induction of chromosomal aberrations after azathioprine (Imurel) (8). 2. The possibility of the induction of chromosomal aberrations in lymphocytes of the peripheral blood after injection of gold 198 into the knee-joint, could be confirmed (9). 3. The mean chromosomal aberration rates before and after infusiontherapy with phenylbutazone (Butazolidin; 300 mg + 600 mg/die during 9 days) showed no significant difference (10).


[Differential indications in rheumatism therapy on the basis of well-known drug side effects]. Special effects and side effects of antirheumatic basic treatment and symptomatic drugs, lead to distinct indications in the management of rheumatic diseases. Chloroquine should mainly be administered in "lupoid" rheumatoid arthritis (R.A.), in systemic lupus erythematosus, and in less active initial stages of R.A., whereas gold and D-penicillamine should be used in more active early stages of R.A. In psoriatic arthritis there is no contraindication for gold D-penicillamine, however, is less effective. Immunosuppressive agents may be used in special cases of R.A. and connective tissude diseases. However, strict controls and special care are necessary. Additive organ disorders may lead to individual contra-indications for basic treatment. All these drugs are not harmless and need careful control. In "lupoid" R.A. corticoids are superior to nonsteroidal antirheumatic drugs. The association of the conversion of R.A. into necrotizing vasculitis has been suggested. There is, however, no proof for this assertion. The new nonsteroidal antirheumatic drugs are assumed to have less side effects, but their real position may be evaluated only after much longer periods of administration. Rare, but severe side effects, especially due to the hematopoetic system, are problbly caused by an incompatibility of the patient. One must not forget the advantages for millions of rheumatic patients. Also, in an age of an exaggerated desire for security, special consideration must be given to these advantages, so that the development of new antirheumatic drugs is not suppressed.


Anesthesia for congenital aortastenosis correction. This case report analyses the anesthetic technique and early postoperative treatment of a five months old baby with congenital aortic stenosis. Administration of cardiotonics and diuretics was necessary before surgery because of severe heart failure. The patient was anesthetized with halothane in pure oxygen and ventilated by means of an Engström ventilator. Surgical treatment consisted of valvulotomy under extracorporeal circulation and normothermia. Recovery was uneventful.


Myocardial contractility during peridural anesthesia. Cardiac contractility was studied in 4 groups of patients using, as parameter, the I/(PEP)2 index proposed by Reitan. 15 patients received 10 mg diazepam i.v. as sedation. The patients in group I were given lumbar peridural anesthesia with 20 ml prilocaine 2%. There was no significant change in the index. The patients in group II were given lumbar peridural anesthesia with 20 ml prilocaine and adrenalin 1/200,000. For 20 to 30 minutes there was a marked rise in the index. The patients in group III received the same lumbar peridural anesthesia as group II, but with a subsequent subcutaneous injection of 50 mg ephedrine HCl. At first the index rose rapidly; this rise was followed by a more rapid return to the initial value. Finally, the patients in group IV, who were under stabilized NLA narcosis, received 2 mg/kg prilocaine intravenously. There was no change in the index before and after the injection.


Comparison between fentanyl and morphine for use in analgesic anesthesia during open heart surgery. One hundred unselected adult cardiac patients operated on with extracorporeal circulation (ECC) underwent analgesic anesthesia. In half of the cases, the analgesic used was morphine and for the others fentanyl. Anesthesia was completed with flunitrazepam, pancuronium, nitrous oxyde and a neuroleptic if necessary. Operative, postoperative and recuperation periods were very satisfactory and very the same in both series. Due to its small administrated dosage (average 1.22 mg/kg) the secondary effects of morphine remained discrete. Although its long action suits well the concerned type of surgery there seems to be no reason to prefer it to fentanyl.


An advanced emergency care delivery system. In order to provide for immediate expert emergency care at the site of an accident or sudden illness and during the transport to the emergency department, different options have been taken in East and West. In Leuven, Belgium an intermediate solution to the problem ha  been chosen, firstly be developing a concise, fully portable set of medical equipment, and secondly by forming a "mobile emergency group" within the emergency department, consisting of nurses (male and female) with experience in critical care and selected through a specially conceived training program. This "mobile emergency group" is capable of administering advanced emergency care at the order of a physician present at the scene, or giving orders by radio. The "mobile emergency group" provides emergency care in the ambulances and in the hospital.


A difficult intubation.

A difficult intubation. This paper describes a case of a difficult intubation in a neonate with the Pierre-Robin syndrome. Direct laryngoscopy was impracticable due to the atypical anatomy of the oropharyngeal cavity. The importance of adequate pre-anesthetic examination is stressed. Deep anesthesia during spontaneous respiration can facilitate endotracheal intubation in such cases.


Purification of nuclear ribonucleoprotein complexes containing poly(adenylic acid). Nuclear 14 S ribonucleoprotein particles containing poly(adenylic acid) were isolated from Ehrlich ascites carcinoma cells and purified by a two step method. The nuclear extract obtained at an ionic strength of 0.1 was treated by pancreatic and T1 ribonucleases and sedimented in a 15-30% sucrose gradient. The 14 S peak containing 50-60% poly(adenylic acid) was chromatographed on a poly(dT)-Sepharose column. The particles thus obtained were of high purity: they had an adenosine content of 90% and a protein moiety characteristic of the 14 S nuclear particles i.e. polypeptides with molecular weight of 51 000, 61 000 and 69 000 daltons.


Examination with x-ray diffraction of cartilaginous tissues of rats of different ages with and without vitamin D treatment. X-ray diffraction examinations were performed on different cartilages (epiphysis, joint, rib, nose-cartilage and discus intervertebralis) of 10 young and 10 old rats. Half of the animals served as untreated control, the other half was treated daily with 40,000 U of vitamin D3 through a gastric tube for 14 days. The examinations were performed partly with a Philips diffractometer and partly in a Guinier chamber, in order to determine the quantitative and qualitative crystallite size. The results obtained are as follows: 1. Cartilage crystallites, except those of the epiphysis, are more rough-grained in the old than in the young animals. 2. A difference was found between cartilages of the same age but of different types. In epiphysial cartilage thin crystals of medium length are formed while thick ones can be seen in discus intervertebralis, joint and rib cartilage. 3. According to the data obtained with the method of X-ray diffraction the crystals in epiphysial cartilage and discus intervertebralis will be lengthened upon the effect of vitamin D, while those in the rib and nose-cartilage shortened and bulkier. It can be imagined that cartilage and bone cells as well as basal substance have an influence on the morphological picture of calcium phosphate. Thus different forms of crystal are formed in cartilages of different functional activity.


Comparison of the immediate effects of etomidate, propanidid and thiopentone on haemodynamics, coronary bloodflow and myocardial oxygen consumption. Since cardiovascular depression at induction is among the most common complications of anesthesia this comparative study was undertaken. Unpremedicated dogs (n = 16) were induced with 3 mg/kg piritramide i.v. and normoventilated (N2O/O2 = 2/1). In 8 animals 0.8 and 1.6 mg/kg Etomidate and 5.0 and 10.0 mg/kg thiopentone and in 8 further dogs 5.0 and 10.0 mg/kg Propanidid were tested. Equipotent doses of Thiopentone and Propanidid caused a marked myocardial depression, which was seen in a decrease in stroke volume and max dp/dt and in an increase of leftventricular end-diastolic pressure and pulmonary arterial pressure. The increased myocardial O2- cosumption mainly due to the rise in heart rate was covered after Thiopentone by an increase of coronary bloodflow (measured with a pitot-catheter) and an increase of arterio-coronaryvenous difference in oxygen. As the latter decreased after Propanidid, it appeared that Propanidid has coronary dilatory properties. The results demonstrated the uneconomic work of the heart under the influence of Thiopentone and Propanidid. In contrast to this the cardiovascular system after Etomidate remained nearly unaffected. The data of this study suggest the use of Etomidate rather than Thiopentone and Propanidid in cases of shock syndrome, heart and/or coronary insufficiency.


Intravenous perfusion of adrenalin during enflurane (ethrane) anesthesia. The effects of an IV perfusion of adrenaline were studied in three groups of patients. The first two groups were anesthestised with enflurane (Ethrane) and the perfusion of adrenaline was started either after stabilisation of cardiovascular parameters, or induction of anesthesia. The third group was anesthetised with halothane, and the perfusion of adrenaline was started after stabilisation of cardiovascular parameters. No significant statistical difference exists between the results obtained in the three groups, and particularly not concerning the incidence of arrythmias.


[Audiological observations of a patient with auditory agnosia]. A case is reported in which a patient was become unable to identify all kinds of auditory material, including speech, despite only subnormal audiometric thresholds (i.e. "auditory agnosia"). The following audiological disorders were shown: some fragility in the perception of brief sound stimuli, difficulties to apprehending prolonged series of stimuli (rhythms), defective sound localization, an increase in the homolateral and in the contralateral effects of masking sounds. On the other hand, differential thresholds for frequency and for intensity, as well as fusion thresholds, were little affected, or unaffected. A complete dissociation appeared between the auditory evoked potentials and the audiometric thresholds; a year after the first examination, and the following years, the auditory potentials were largely reduced, or even have elapsed for one ear, while the audiometric thresholds seem to remain nearly the same.


Rupture of the round window membrane.

Rupture of the round window membrane. Considerable interest has been displayed in sudden sensori-neural deafness in recent years, and especially since Blair Simmons postulated that this could be caused by mechanical disruption of the membranes in the inner ear. The literature concerning such reports is reviewed briefly and two cases of rupture of the round window membrane resulting from inner ear barotrauma are reported in detail. Both these cases were experienced divers who had had little difficulty in auto-inflation whilst diving. The first case had progressive sensori-neural deafness with mild vertigo, and tympanotomy revealed rupture of the round window membrane in both ears. These ruptures were repaired with plugs of fat, following which his hearing was restored. The second case developed marked vertigo following a dive and was thought to be suffering from decompression sickness. When the appropriate treatment did not help him, tympanotomy was performed and a rupture of the round membrane was found. This was plugged with fat with a most satisfactory result. Both of these cases had difficulty with autoinflation, and had been aware of such difficulties for some time. Nasal problems were responsible for this, and it is strongly recommended that all divers should have normal nasal function and that they should be educated in the technique of autoinflation, and, in particular, in the importance of avoiding forceful autoinflation at all times. A third case of rupture of the round membrane following an injury to the head is also reported.


Tympanoplasty of the radical operated middle ear. A type of tympanoplasty is described to restore hearig at patients who had a radical mastoidectomy. The technique of middle ear reconstruction was first studied at the testanimal. It was found that a certain resonance frequency could be of use to get an extra hearing gain. Furtheron amplitude and fase-difference between the round and oval window are explored. The results of 16 patients 5 years after operation are discussed.


Application of tympanometry and acoustic reflex measurements. The probe tone of an impedance bridge has a direct effect on the results of tympanometry. The frequency of the probe tone should be close to the resonant frequency of the middle ear. Of three electroacoustic bridges using three different probe tones 800, 625 and 220 Hz, the one using 800 Hz provided the most identifiable tympanographic pattern in cases with ossicular discontinuity. Five different types of tympanograms could be identified when an 800 Hz tone is used. Important clinical information can be obtained by combining the type of tympanogram with the results of stapedius reflex measurements.


Clinical trials of betahistine hydrochloride in the treatment of Ménière's disease. Thirty Ménière patients were treated with betahistine hydrochlorid for an average period of 17 months. The majority of them had been resistent to every previous treatment. The results of this new treatment were very gratifying with respect to the attacks of vertigo and the accompanying neuro-vegetative symptoms. The tinnitus aurium proved to be resistent, whereas the auditory acuity was significantly improved in 7 patients. Early treatment with this product at the first signs of Ménière's disease is very likely to hold up the progressive degradation of auditory acuity, during the further spontaneous evolution of the disease.