[Factors affecting restoration of work capacity after myocardial infarct]. The effect of some clinical peculiarities of the disease upon the restoration of the patient's capacity for work was studied along with the factors increasing the risk of repeated disablement after resuming the professional functions. The discussion is based on the results obtained in an out-patient study of 285 males who have been employed before their myocardial infarction in administrative-managerial jobs. Three groups of factors characterizing the functional state of the cardiovascular-system in the pre-infraction, acute and post-infarction periods are distinguished. It was demonstrated that the functional state of the heart when the patients resumed their work was characterized by the degree of chronic coronary and cardiac insufficiency, the scope of every-day physical activity, and was one of the essential criteria for the evaluation of the degree of rehabilitation. The first group of factors (essential hypertension, chronic coronary insufficiency preceeding the development of myocardial infarction) and the second group (clinical and anatomical peculiarities of acute myocardial infarction) are of secondary importance in determining the degree of rehabilitation. At the same time, the functional background of the cardiovascular system teinted prior to the infarction and the depth of the infarction, as well as the reduced level of the heart's functional capacity before resuming the professional functions, belong to the factors that increase the risk of secondary disablement in persons who have resumed working after a sustained myocardial infarction.


[Stage-by-stage rehabilitation of patients with myocardial infarct]. Continuous stage-wise rehabilitation was used in 102 patients who survived acute macrofocal myocardial infarction that was of a transmural type in nearly 60% of them. While hospitalized in a clinic, the patients underwent a 5-week physical activization course. Depending on the severity of the lesion the average duration of their hospitalization ranged from 34.2 to 43.1 days. Seventy patients (68.8%) were referred to the local cardiological sanatorium directly from the hospital. Subsequently all these patients were followed-up (up to 2 1/2 years) and treated on an out-patient basis in the cardiological service of the clinic. Among 88 patients who had worked before infarction, 72 persons (81.8%) returned to their professional activities after 4.9 months, on the average, following the development of myocardial infarction. Professional rehabilitation proved more effective in those who had received the sanatorium treatment after hospital, 87.1% of them returning to their jobs, and nearly 1 month sooner than those who had had no sanatorium treatment. Among the main clinical and instrumental methods of control of the state of myocardial infarction cases during the rehabilitation period the test with portioned physical exercises was also used. The examinations were repeated in 80 patients, in 50 of them -- on the 30th--35th day of the disease. The obtained data indicate that the threshold tolerance of the patients increases due to the stage-wise rehabilitation measures.


[Use of small doses of obsidan in physical rehabilitation of patients with myocardial infarct]. A study of 152 patients with transmural or large-focal myocardial infarction was conducted; 82 of them received low doses of Obsidan (40 mg/day) for 14 days during the activization period. The employment of such doses of the drug was found rational for ensuring a more effective activization of the patients who had a persistent pain syndrome, sinus tachycardia, extrasystolic arrhythmias and "ischaemic" changes of ECG in response to definite stages of the kinetic regimen. A decrease of cardiac output noted during the therapy was especially distinct in cases of cardiac aneurysms and corresponded to the alternating conditions of the metabolic processes.


[Early and late physical activation of patients with acute macrofocal myocardial infarct in a central regional hospital]. The favourable effect of early physical activization and the unfavourable effect of delayed activization on the haemodynamics and complications were established in cases of acute large-focal myocardial infarction. The distinct informative capacity of the haemodynamic values determined by means of the commonly available and known physical methods was established. It is recommended to use widely the indices of pulse rate and pulse pressure as the simplest criteria for the beginning of physical activization and for the adequacy of physical exercises in the process of rehabilitation of hospitalized patients with large-focal myocardial infarction.


[Importance of electroimpulse therapy for restoration of work capacity in patients with auricular fibrillation]. Social rehabilitation was studied in 799 patients with atrial fibrillation. Before the sinus rhythm was restored 26% of the patients had been working. Among the working patients the history of atrial fibrillation was usually of a short duration (9.8 +/- 1 months, on the average), and among the nonworking patients it comprised 28.9 +/- 0.6 months. After the reestablishment of the sinus rhythm the precentage of rehabilitation grew to 40. It greatly depended on the nature of the underlying pathology, sex (among the working patients, 51.8% were men and 25.5% -- women), place of habitation (capacity for work was restored in 45.8% of urban patients, and in 32.0% of rural patients). Upon the restoration of the sinus rhythm the capacity for work increased most markedly among the patients previously subjected to surgical correction of mitral stenosis (by 26.3%), and among those with post-myocarditis cardiosclerosis  (by 17.4%). Repeated counterpulsation procedures in cases of atrial fibrillation recurrences provided for a lasting maintenance of the patients' capacity for work. To prolong the rehabilitation results it is rational to recommend such jobs for the patients that would not entail important physical and emotional stress.


[Content of immunoreactive insulin and catecholamines in blood plasma and disorders of carbohydrate metabolism in patients with myocardial infarct]. The blood plasma level of immunoreactive insulin was studied dynamically be means of radioimmunoassay and the blood sugar level by the orthotoluidine technique in 70 patients with large-focal myocardial. In 48 of them the plasma level of catecholamines was determined simultaneously by the fluorimetric technique. The control group of patients was composed of ischaemic heart disease cases without myocardial infarction. Patients with acute myocardial infarction appeared to have hypercatecholaminemia and insufficient insulin excretion: 65.4% of acute myocardial infarction patients having an absolute insulin insufficiency, and 34.6% -- a relative one. The most distinct hypercatecholaminemia and insulin secretion inhibition were observed in those with acute myocardial infarction and congestive heart failure. In patients with an absolute insulin insufficiency the plasma level of noradrenaline was considerably and statistically significantly higher, than in those with a relative insulin insufficiency. In patients with high hypercatecholaminemia the insulin secretion inhibition was noted more often and was more severe. In patients with acute myocardial infarction and an absolute insulin insufficiency complications, such as congestive heart failure and rhythm and conductivity disorders, were more frequent and lasting, than in those with a relative insulin insufficiency. During the acute period of myocardial infarction the disorders in the carbohydrate metabolism were observed in 82.2% of the cases, and were more distinct in those with an absolute insulin insufficiency. By the 20th--22nd postinfarction day the carbohydate metabolism disorders persisted in 35% of the myocardial infarction patients.


[Effectiveness of individual units of aerosol therapy equipment]. Various methods of drug atomization and future prospects for their application in medical practice are considered. On the ground of a research into the influence produced by the administered doses and the density of the aerosol on the therapeutic activity the expediency of employing aerosol generators based upon pneumatic atomization by using the principle of ejecting an additional volume of air, as units yielding a substantial curative effect, is demonstrated. Data which bear proof to economic advantages of the units under review are given.


[Effect of certain methods of sterilization on the quality of dental instruments]. Comparative investigations of the sterilizing action produced on the stomatological instruments by 4 chemical bactericidal agents and hot air tend to give preference to sterilization with a 2% solution of glutamic acid in a combination with a 70% isopropyl alcohol at a 45 minutes long exposure. Such a sterilization does not cause any corrosion of the instruments and reduces to a lesser degree the resistance of the cutting edges than in the case of sterilization with hot air.


[Evaluation of the effectiveness of a technical system in radiological department on an example of the block of closed sources]. The specificity of operations performed by a radiological department in fulfilling this or that functional objectives has made it necessary to create a special method of a complex assessment of the technical system adopted for the use. Such a method enables it to consider the totality of the equipment employed and the personnel attending it as an integrated complexely organized system. By accepting the minimum of expenditures and of the radiation load on the personnel as a principal criterion for the optimal efficiency of the system, without any prejudice to the quality of the medical treatment and care of the patients, it appears possible to appraise the relative effectiveness of any technical system. The assessment of various existing systems designed for carrying out radiological procedures made by making use of this criterion showed the complex system to be the most effective one (the appraisal was made on an example of a closed sources block). A list of protective and technological equipment used in the system is presented.


[Apparatus for cardiosynchronized artificial circulation]. The development of outfits for ancillary circulation is oriented towards improvement and construction of new pneumatic, hydraulic and electromechanical actuating systems--units intended for an optimal disposition of pressure waves moving from the pump to the aorta, etc. An inference is drawn about advantages and perspectives offered by functionally monitored actuating units, as well as about the need for the pulsating stream to pass through the low-power side intended to pre-set the shape of the pressure curve.


[Radiation detectors and the problem of radiation loads in roentgenodiagnosis]. The development of new effective roentgenolumonophors, screens, based thereon, and image intensifiers helps reduce the exposure radiation dose in radiography, fluorscopy and fluorography. The effect produced by the characteristics of diverse elements of the radiation dectector on the increase of sensitivity is considered. Numerical values of some characteristics are cited.


[Method of stabilization of acoustic contact during ultrasonic diagnosis in ophthalmology]. To provide for a stable acoustic contact between the sensor and the surface of the eye it is proposed that the echoophthalmograph "Echo-21" be equipped with a sensor of new design, made in the shape of a capsule containing a 0.5% dicain solution that is moving freely in the vertical direction inside a hollow fluoroplastic cylinder. The capsule, together with the guiding cylinder, is readily fixed on the mounting of an optical glasses set.


[Set of trocars for drainage of the urinary bladder in acute urinary retension]. At present urologists give preference to drawing the urine by puncturing the anterior wall of. the urinary bladder by means of a trochar with introduction of a drain-tube. A set of 3 types of trochar-drain tubes of a similar construction but differing in their diameter are proposed for superpubical drawing of the urine. By using a simple in its arrangement and a little-traumatic trochar-drain tube a single-stage cystotomy can also be effected with the help of Foley, Maleko or Pezzer's catheters. Not a single of 152 patients subjected to superpubical drainage with these instruments suffered any complications.


[Equipment for programmed multi-channel electric stimulation of the motor neuro-muscular structures in man]. It appears possible to apply electric action not only for medical purposes, but also in stimulating the locomotor apparatus of healthy people. To achieve an effective influence on the neuro-muscular structure of the locomotor apparatus in man all-purpose multichannel on the neuro-muscular structure of the locomotor apparatus in man an all-purpose multichannel programmed electric stimulator with an autonomously pre-set program that permits it to form an arbitrary structure of stimulation signals, capable of being reconstructed in the course of the action, is proposed. This makes it possible to more flexibly and accurately take account of a naturally coordinated interaction of the muscles. A simplified portable version of an all-purpose stimulator is discussed.


[Acoustic neuroma. Apropos of a series of 40 cases]. The authors present statistics of 40 acoustic neuromas operated upon by micro-surgical technique in co-operation with oto-neuro-surgery. As regards clinical picture, all persons presenting with unilateral progressive sensoryneural deafness should be subjected to cochlear vestibular and radiologic examination. They advocated essentially two routes:--translabyrinthine approach for the tumours within the internal auditory meatus, --posterior fossa approach for the other tumours. They reported their results and analysed the major advantages of the microsurgical technique which diminish considerably the risk of this surgery, so that the functional result should be of first importance.


[The importance of the histological structure of the superficial temporal artery for the functioning of the arterial extra-intracranian anastomosis]. After extra-intracranial anastomosis one could find a considerable dilatation of the superficial temporal artery in a relatively short period of time. This vessel as well as other arteries of the circulatory system were examined histologically. On the basis of a large amount of autopsy material the atherosclerotic changes of the different vessels were correlated. Thus it turned out that the superficial temporal artery revealed another type of atherosclerotic changes. A type which exhibited hardly any calcification, but shows an increase of elastic fibers which make dilatation of the vessel possible despite of its thickened wall and primarily narrowed lumen.


[Anomia and alexia during a closed craniocerebral injury]. Observation of a traumatic aphasia in a young man. After a coma and a period of mental confusion, language difficulties are limited, during a few weeks, to a severe global deficit in reading and naming. Meanwhile objects and pictures are perfectly recognized and the meaning of some words can be understood correctly. The commentary is made with reference to previous reports of similar case histories. Clinical and neuropsychological data suggest a focal lesion in the left temporal lobe, probably on the 2nd and the 3rd gyri.


[Extracranial angioma with dural participation]. Extracranial congenital arteriovenous malformations are often associated with dural and/or cerebral malformations. One case is presented. The angiography of the common carotid artery revealed no evidence of abnormal vessels into the internal or external carotid territory. The injection of contrast medium into an enlarged epicranial vein showed the extracranial malformation, well opacified; the phlebography revealed also a small dural malformation draining in the superior sagittal sinus. The Authors outline the importance of complete angiographic study in all the cases of extracranial vascular malformations even if the carotid angiography is apparently normal.


[Short term comparative study of effects of n-9 trans-docosenoic (brassidic) acid and n-9, cis-docosenoic (erucic) acid on the cardiac lipids of weanling rats]. Cardiac lipids (triglycerides and phospholipids) of weanling rats fed diets containing 15% by weight of rapeseed oil (RSO), hydrogenated rapeseed oil (HRSO), trierucin (TE) or tribassidin (TB) were analyzed after 3 and 7 days of feeding. The amount of C22:1 was made equal in the 4 diets. Trans-isomers of erucic acid found in HRSO and TB do not cause as high an accumulation of lipids and docosenoic acids in the heart as erucic acid. Digestibility of brassidic acid (46%) is lower than that or erucic acid (83%) but even then, the amount of brassidic acid found in cardiac lipids (calculated per gram of absorbed fatty acid) after 7 days of feeding is 10 times less than that of erucic acid. Brassidic acid, like erucic acid, can be converted into shorter monoenes (C20:1 and C18:1) since transC18:1 has been found in cardiac phospholipids of rats fed trans-docosenoic acid as the only source of trans-acid in the diet.


Increased levels of esterified arachidonic acid in plasma by feeding gamma-linolenic acid. The effects of diets containing 5% of methyl-gamma-linolenate (delta 6,9,12) or 5% of methyl-alpha-linolenate (delta 9,12,15) on the fatty acid composition of lipids in rat plasma were studied. After 10 days the cholesterol esters and total phospholipids in the plasma of rats fed gamma-linolenate contained higher percentages of arachidonic acid than the corresponding lipid classes in the plasma of rats fed the alpha-isomer. A fairly high percentage of gamma-linolenic acid was incorporated into the cholesterol esters of rats fed methyl-gamma-linolenate.


Hepatic triglyceride storage and ketonemia in rats fed high fat diets. Hepatic triglycerides and ketonemia were studied on young rats fed a carbohydrate diet C or fat diets f (22.5% fat) and F (41.5% fat) for 8-15 days. Rats were sacrificed between 9 and 11 a.m. (1) Triglycerides and ketonemia varied proportionally to the diets but triglycerides were strikingly increased with protein deficient fat diets (10% proteic calories). Weight gains were then most reduced but ketonemia remained unchanged. (2) A 24-hour fasting was sufficient to suppress the excess of triglycerides while ketonemia remained still more elevated after 48 h of fasting in rats previously fed the fat diet F as compared to diet C. (3) During the adaptation to the fat diet F, liver triglycerides and plasma non-esterified fatty acids showed an acute rise on day 2 followed by a stabilization to lower levels after 8 days and an increase again with ageing (7 months) while ketonemia was relatively stable. The liver participates in adaptation to a fat diet that induces obesity, by the rapid esterification of the exogenous fatty acids and their output back into the circulation as lipoprotein-triglycerides.


Nutritive value of rapeseed meals and rapeseed protein isolates. Defatted meals of two new varieties of rapeseed, Brassica napus, Erglu and Lesira, and protein isolates prepared therefrom, were fed to chicks that had been depleted of their embryonic protein reserve. First, the animals were fed at a 12% protein level, half of it from rapeseed meal, or a rapeseed protein isolate and, subsequently, at a 20% level, all of it from rapeseed products. Feed consumption, weight gain and protein efficiency ratio revealed better performance of the protein isolates as compared to the corresponding meals. This is attributed to the favorable amino acid patterns of these isolates and the absence of glucosinolates. Erglu meal, too, is eminently suitable as a supplement to chicken feed, whereas Lesira meal, although its amino acid pattern is adequate and similar to that of Erglu meal, showed detrimental effects, probably due to its high glucosinolate content.


Biochemical assessment of thiamin status in patients with neurosis. The thiamin status of 65 patients with neurosis was studied soon after their admission to the psychiatric department; 49 healthy persons were also studied. In comparison with the control group, the patients with neurosis had a twice as low thiamin excretion and a 22% lower erythrocyte transketolase (p less than 0.001), while their blood pyruvate and pyruvate excretions were 31-38% higher (p less than 0.001).


Cellular immunity in malnourished mice.

Cellular immunity in malnourished mice. The effects of malnutrition on the cellular immune response were studied in mice. Cellular immunity, measured by contact sensitivity to 2,4-dinitrochlorobenzene, was found to be impaired in protein energy deficient animals.


Outcome of pregnancy from day 0 to 19 and serum tocopherol levels in mother rats fed on a rapeseed protein concentrate essentially free from glucosinolates. A rapeseed protein concentrate containing only minute amounts of glucosinolates was fed to rats during gestation as the sole source of protein at a 20% dietary protein level. Compared with rats obtaining a casein-based diet at the same level of protein, the mother rats on the rapeseed diet showed much lower weight gains during the last trimester. At day 19 of gestation, rats treated with rapeseed protein showed a reduced number of live fetuses and an increased resorption quotient. The average weight of the fetuses was similar, in some cases even higher, in mother rats given the rapeseed diet vis-à-vis the controls. The animals on the rapeseed diet also showed a highly significant decrease in the serum content of tocopherol, which amounted to between 24 and 41% of the control values.


A model system for direct in vivo measurement of absorbed nutrients in portal venous blood. Applicability to alcohol studies. In order to investigate the in vivo effect of alcohol on intestinal absorption and on other factors which influence the rate of appearance of nutrients into the portal venous system, an experimental system has been developed in which separate cannulas have been implanted in the duodenum and portal vein of the rat. Following recovery from surgical procedures, unanesthetized animals may be administered nutrients directly into the duodenum, with and without alcohol, and the rate of appearance of nutrients in the portal system may be monitored by rapid sampling of the portal blood. Potential applicability of this experimental animal is demonstrated by the kinetics obtained with an amino acid, L-phenylalanine, both in the presence and the absence of alcohol.


Lipid response to female gonadal hormones of female rats fed a high glucose or a high fructose diet. Sexually mature female rats were given, for 11 weeks, diets high in fructose or glucose and at the same time oestrogen and progestogen were administered both singly and together. Analysis of the lipids in the liver, serum and adipose tissue was carried out after ingestion of 14C-fructose or glucose. Oestrogen lowered the liver triglyceride level but raised the serum triglyceride concentration. Progestogen tended to raise both cholesterol and triglyceride levels in liver and serum and it also caused a greater increase in body weight than in control or in the oestrogen animals. An increased specific activity was seen at first in the adipose tissue of the glucose-fed rats receiving the hormones. Overall, there was a tendency for the female gonadal hormones to exaggerate the changes brought about by the high carbohydrate diets.


[Analysis of the formation of tissue antigens of the retina of chicks in embryogenesis]. The following antigens were found in the chick retina: one organospecific, three interorganic antigens of narrow specificity characteristic of only the tissues of the eye and brain, and seven interorganic antigens of broad specificity characteristic of, besides the tissues of the eye and brain, many other organs of the chick. The interorganic antigens of broad specificity manifest themselves the first in the retina during development. The interorganic antigens of narrow specificity and the organospecific antigen arise during the period of retinal histogenesis. One of the antigens of narrow specificity (retina--iris--brain) arises in the brain at the same time as in the retina.


[Metaplastic transformation of the tissue of the eye in tadpoles and adult Xenopus laevis frogs]. The pigment epithelium of the tadpoles and adults X. laevis, as well as of other anurans and cyprinids, is not capable of transformation into the retina without the special influences of agents produced by the retina. When implanting a layer of pigmented epithelium of tadpoles with the Bruch's membrane into the cavity of lensless eye of a tadpole, the transformation of pigment epithelium into retina proceeded in 40% of cases and when implanting the pigment epithelium of adults without the Bruch's membrane, the transformation proceeded in 68% of cases. The lens regeneration from the cornea which proceeds simultaneously under the retina influence exerted no effect upon the metaplasia of pigmented epithelium.


[Some regulatory mechanisms of asexual reproduction in planaria]. The conditions were studied which influenced the reproduction of an asexual race Dugesia tigrina. The decapitation was shown to arrest divisions until the restroration of a new ganglion. The division of intact planarians does not depend on the presence of additional cut head regions and is inhibited in the presence of other intact or decapitated specimens. These data suggest that two antagonistic factors influence the division of planarians: a stimulating factor is related to the activity of the ganglion and is propagated endogenously; an inhibiting factor is localized in the trunk or tail regions. The latter may be secreted outside and influence other specimens.


[Ontogenetic changes in the reaction to the effects of pesticides in sensitive and resistant strains of the spider mite (Tetranychus urticae Koch)]. The susceptibility to pesticide was studied in the resistant and sensitive strains of the red spider mite Tetranychus urticae Koch. at different developmental stages. A phase of the maximum sensitivity to the effect of drugs was determined in the mite ontogenesis which coincides with the stage of the spiracle protrusion. Changes in the range of stage susceptibility were followed with respect to the acquisition of resistance against acaricides. 3 types of the ontogenetic reaction of resistant specimens are described which appear to be related to the differences in the physiological mechanisms of resistance against the drugs of different chemical groups.


[Kinetics of the synthesis of nucleic acids in haploid and diploid loach embryos]. Al kinetic analysis of incorporation of the mixture of 3H-nucleosides in the nucleic acid fractions was carried out to examine the mechanisms of compensation of the genetic material deficiency. Both the haploid and diploid embryos of the loach (Misgurnus fossilis L.) were analyzed. When comparing the DNA and RNA syntheses, the level of phosphorylation (nucleotide pool) in the both genetic variants was under control. The rate of incorporation of the labelled nucleosides in DNA was shown to be higher in haploids at the early developmental stages than in diploids but later it became the same. The increased level of DNA replication in the early haploid embryos was due to the compensatory increase of the cell number in them as compared with the diploid ones. The rate of total RNA synthesis corrected by the differences in the rate of nucleoside phosphorylation varied directly with the degree of ploidy at the blastula stage; at the gastrula stage the value of RNA synthesis per haploid genome was compensated, and at the stage of organogenesis the production of total RNA, as calculated per cell, became in haploids even higher than in diploids. The data obtained suggest the essential changes in the patterns of RNA synthesis control during development.


[Apical growth of the bud in Hydra].

[Apical growth of the bud in Hydra]. The experiments with markers combined with the vital and histological methods have shown that there is a zone of apical accretion in the bud of Hydra attenuatu. During one of the phases of periodic cell movement, the mesoglea breaks through in the center of apex and the endodermal cells insert in the ectoderm.


[Abnormal popliteal arteries].

[Abnormal popliteal arteries]. Arteriopathy restricted to the popliteal artery, except in cases of atheroma, must indicate three of four unusual diagnoses: the trapped popliteal artery and the dessicating haematoma are anatomo-clinical entities that have been identified only relatively recently. The popliteal artery may be trapped by the medial gastrocnomius muscle, round the tendon of which the artery passes (totally or partially). This results in compression of the artery and eventually in thrombosis. Clinically, intermittent claudication is seen that may deteriorate and lead to gangrene of the toes. Arteriography makes it possible to diagnose the condition as the condition as the artery is considerably displaced inwards. Surgical correction is simple: sectioning of the tendon and repositioning of the artery. Dessicating haematoma of the popliteal artery is due essentially to atheroma, associated with medianecrosis. A "egg-timer" stenosis is found by arteriography and this condition also progresses towards thrombosis. Arterial restoration is called for, usually by bridging.


[Thoraco-brachial outlet syndrome].

[Thoraco-brachial outlet syndrome]. Under this name are included all the neurovascular disorders of ftthe upper limb caused by compression of the subclavian vessels and the vessels of the brachial plexus. There are three dangerous anatomical regions where trouble can arise: the now of scalene muscles, the costo-clavicular interspace, and the pulley of the smaller pectoral muscle. The clinical manifestations are fairly variable but often indicate the diagnosis. Certain clinical tests, in particular angiography with the arm in hyperabduction contribute towards confirmation. With minor forms of the syndrome rehabilitation should suffice. In other cases the cause of the sompression can be removed by surgery: sectioning of the anterior scalene, suppresion of a cervical rib, and particularly resection of the first rib, as this plays an important role.


[Indications for aorto and iliofemoral bridges]. As distinct from aneurysmal and embolic lesions, chronic aorto-iliac obliterating lesions often involve a difficult choice of therapy: whether to be optimistic and treat the lesions medically because they are discrete and not dangerous; to amputate because the lesions are too advanced; to carry out careful consservative surgery, hyperaemizing surgery, or alternatively more radical surgery involving deobliteration or bridging. The clinical picture (general condition, social context, clinical stage, unilateral or bilateral lesions) will influence the decision, but the last word depends on the aorto-arteriographic picture and on the result of vasomotor tests. Arterial reconstruction by bridging using a Dacron prosthesis is not advised except in a minority of cases.


[The place of axillofemoral bridges in the treatment of arteriopathies of the lower extremities]. Certain patients who would be candidates for aorto-iliac revascularization surgery because of decubitus pain or gangrene, are not suitable for direct surgery because of general contraindications. Axillo-femoral bridging is thus an excellent and less aggressive revascularization procedure for these patients in order to avoid amputation. The authors carried out this type of bridging 261 times in 5 years in cases of high surgical risk.


[Bridges through the obturator foramen and suprapubic bridges]. Bridging through the obturator foramen and suprapubic cross-bridging are among the types of atypical bridging most frequently used in vascular reconstructive surgery. Suprapubic bridging, as with axillofemoral bridging, makes revascularization possible when there are contra-indications to a transperitoneal approach to the aortic bifurcation. Bridging through the obturator foramen makes it possible to avoid the edge of the scrapa, particularly when there is suppuration. These types of bridging, which are often the only way of avoiding amputation or of taking a grave risk, give results that are quite acceptable if not comparable to those obtained by the standard techniques.


[Principles of surgery of the deep femoral artery in arteritis of the lower extremities]. The role of the deep femoral artery has too often been ignored in the assessment of arteritis of the lower limb. This anatomical distribution, which seems to be restricted to the thig, has left pride of place to the superficial artery as being responsible for intermittent claudication. In fact the deep femoral artery represents an exceptional and privileged route for anastomosis that is capable of replacing almost perfectly an obstructed superficial femoral artery and also in a more limited way femoro-popliteal arteries with extensive obstructions. The authors estimate that the deep femoral artery represents a true physiological bypass for a thrombosed superficial femoral artery on which a lumbar sympathectomy has a particularly remarkable action. It is important, in order to obtain as good a result as possible, that the flow in the deep femoral artery should be good, which presupposes complete freedom of the iliac axis and good permeability of the trunk of the artery, begining at its ostium. Surgery of the deep femoral artery is short or lon angioplastic surgery depending on the type of lesion, usually involving a venous patch. The surgical approach is straightforward. Whe it is used for isolated lesions or as the last stage of aorto-iliac surgery, delicate angioplasty of the deep femoral artery is a perfectly feasible operation which the authors believe should take its place, in association with lumbar sympathectomy, in the restoration of the superficial femoral artery.


[Lumbar sympathectomy].

[Lumbar sympathectomy]. The authors undertook a study of the present indications for lumbar sympathectomy in cases of obliterating arteriopathy of the lower limbs. The principal physiological effects are described in addition to its action on the circulation. Apart from the opening of arteriovenous shunts, the lifting of the precapillary block should be emphasized since this increases the flow and consequently leads to the development of the collateral circulation. A recent experiment over a period of three years involving 457 hospitalized patients is then analysed: out of 371 conservative operations performed, 169 involved restorative arterial surgery and 202 involved only lumbar sympathectomy. Lumbar sympathectomy was combined with the arterial surgery in 150 of the 169 cases quoted above. Lumbar sympathectomy alone is required in stages III and IV when arterial is not possible. At stage II, there is a choice, sympathectomy being preferred to direct surgery. The results are analysed and the best were obtained with patients at stage II.


[Chances of avoiding amputation in an arteritis patient with gangrene]. During the period 1970-1974, restorative surgery was carried out 324 times in patients with gangrene or severe ischaemia caused by arteritis of the lower limbs. In 67 percent of the cases major excision surgery, such as amputation at the thigh or of the whole leg, was avoided and the support was retained. In 61 cases (19 percent) amputation was necessary either immediately or within a few weeks or months. Death occurred in 47 patients (14 percent) either in the operative period or in the 3 following years.


[Possibilities for the use of a wirelsss telemetric technic in electroencephalography]. Telemetry is the transmission of the test data of moving object, with a distinction being made between wireless and wire-connected telemetry. The applicability of this technique is examined on the basis of experience gained, and data gathered from books and articles on the subject. Biotelemetry constitutes a new development in technology and methodology which, if critically applied in meeting the various challenges confronting the specialist, can render useful service in the field of electroencephalography.


[Psychotherapeutic counselling - theory and technique (author's transl)]. The theory of psychotherapeutic counselling is based on the assumption that human behavior is a dialectic process between progression and regression. The goal of progression is autonomy, the constructive and meaningful handling of things and people. The goal of regression is being cared for, the experience of being accepted and protected. Active attempts at learning lead to progressive goals, needs and passive movements lead to regressive goals. Attempts at learning are put under pressure, protection-seeking movements are manipulated and fixed. Insight, confrontation and projects are the means of psychotherapeutic counselling. Insight helps to understand situations and interactions which cause illness and to detect symptomatic forms of behavior. Both the external and the internal conditions of behavior have to be cleared up. Confrontation interpretes the present relationship and provides the learning process with sample experiences. Projects are designs of behavior conceived during counselling, systematically tried out outside the counselling session. The goal of psychotherapeutic counselling is to enable the patient to change critically the situation and the self.


[Psychoanalytic interpretation of sleep-disturbances. Model of a structural-theoretical classification (author's transl)]. In psychoanalytic literature anxiety, guilt-feelings and unconscious hostility are assumed to be the most common causes of spleeplessness. The author attempts to ascribe these emotions to conflicts between the instances of the psychoanalytic personality model as a structure-theoretical classification of sleep-disturbances. Three large groups emerge: Neurotic disturbances of sleep with internalized conflicts (these correspond essentially to what are generally understood to be neurotic sleep-disturbances), neurotic disturbances of sleep with externalized conflicts (these are more common in childhood) and non-neurotic sleep disturbances. Within these groups the relative parts of effectiveness of the instances of the psychoanalytic personality-model - ego, super-ego, id and reality - are discussed.


[A contribution to handling counter-transference in borderline patients (author's transl)]. This paper is based on the concept that, instead of neurotic conflicts as studied and treated by Freud, Earlier ego-disturbances e.g. psychotic and borderline reactions have nowadays become prominent and need a very different technique of treatment. These so called archaic ego-illnesses are due to an unresolved symbiosis complex, a disturbance which arises already in very early childhood before the development of speech. On a sample of a female borderline patient the author tries to show that in such cases active use of countertransference often provides the only technique with which the psychotherapist may recognize on an averbal plane the needs of the patient and may be able to make them available to her verbally.


[Current developments in genetics and their implications concerning the problems of social deviations]. A review of historical developments in the field of human genetics reveals much conflict between those espousing and hereditarian position and those maintaining an environmentalist point of view. A confusion of political, propaganda, and ideological objectives with those of science has had deleterious effects on the field of human genetics, and upon the willingness of some disciplines to accept genetic contributions to the understanding of human behavior. Modern thinking in behavioral genetics rejects the Nature-Nurture dichotomy as incorrect and meaningless. The phenotype cannot be inherited; it develops as a function of interactions between the genotype and the environment. It is convenient to think of hereditary contributions to behavioral traits as fixing a reaction range; the genotype may be viewed as determining an indefinite but nevertheless circumscribed assortment of phenotypes. There have been numerous studies seeking to ascertain the genetic factors in a variety of mental disorders. The mental disorder most thoroughly studied from a genetic standpoint is schizophrenia. Three recent studies of adoptees, two in Denmark and one in America, have indicated the importance of hereditary factors in schizophrenia. Biological relatives of adoptees diagnosed as schizophrenic were more likely themselves to have suffered schizophrenic-spectrum disorders than were biological relatives of non-schizophrenic adoptees. Adoptees whose biological parents were schizophrenic or manic depressive were more likely to themselves be diagnosed schizophrenic than were adoptees whose biological parents had no psychiatric history. Children born to hospitalized schizophrenic women and who were placed for adoption shortly after birth were more likely to be schizophrenic than were matched control adoptees born to non-schizophrenic mothers. In studies conducted in Denmark, Schulsinger has also employed the adoptee method in studies of psychopathy. Diagnostic criteria were developed to reliably identify 57 cases of psychopathy from among 507 adoptees with known mental disorders. A non-psychopathic group of matched control adoptees was also formed. Mental illness among the relatives of these adoptee cases (biological and adoptive relatives) was ascertained through a careful search of psychiatric records. Psychopathic spectrum disorders were found to be more than twice as prevalent among biological relatives of the psychopathic index cases than was the case for biological relatives of the control cases. The percentage of affected cases among adoptive relatives was nearly equal for both study groups. Thus, this study provides a demonstration of the possible importance of genetic factors in the etiology of psychopathy. Other attempts to assess hereditary and constitutional aspects of criminal behavior have been made. These include twin studies and also Eysenck's study of the heritability of behavioral traits including extraversion, introversion, and emotionality.


[Evaluation of the aggressiveness in a group of adolescents from Puerto Rico]. This study is aimed at analyzing from a phenomenological and descriptive viewpoint, the psychodiagnostic and behaviour validity of the legal categories: "delinquents/non-delinquents" and "violent delinquents/non-violent delinquents", as compared to certain features of their personality which determine a violent behaviour in adolescents. To this end, the Rorschach records and the sketches of three groups of Puerto Rican adolescents, have been analyzed and compared. The results  of the projective test, statistically compared, showed some significant differences between delinquent individuals and non-delinquent individuals, while the differences between violent delinquents and non-violent delinquents are not meaningful. These results prove that the psychodiagnostic modality "violence" is a standard feature of the delinquent group and it can be neither considered no included in the legal category of "violent crimes". However, different interpretations are possible and several ways for additional thorough studies and investigations can be envisaged.


[Social unsuitability in the developmental age. Hypothesis for new structures helping social adjustment]. In this report the Authors analise, according to their different competences, from a psychiatric, psycho-sociological, and of judicial politics point of view, a case of neurosis of conflict during adolescence, with an anti-social development, regarding which it has been ascertained that the measures of restoration, which have been adopted, have failed their purpose. They have, as a matter of fact, paradoxically fixed the subject even more in his anti-social condition, not giving him the possibility of escaping the psycho-pathological destiny of negative sociopatic deviation. The Authors, in this report, reflect upon the meaning of the Institutes of restoration and punishment in the light of the new re-educational conceptions, pointing out their limits. They long for the institution of supplementary structures of little dimensions in the bosom of the family, well integrated with the school, the working milieu, and the local community and wish the structures of restoration for anti-social disadaptations to stop from being static Institutions far from the real social problems of a democratic life, in order to become centers of social democratic life and places of comparison, according to a dialectic method of knowledge, between subculture as deviation (which is not always negative) and the dominating culture with its needs and rules.


[Genetics and criminology: a new concept]. The early history of criminology was one of interaction with genetics and biology, but since the sociological school emerged in the 1920's there has occurred a major split between sociological criminology and biology. Behavioral genetics as it has developed since 1950 has great relevance to criminology in terms of neurological and brain functioning, learning processes, violence and the XYY syndrome, and the sociopathy. A new interdisciplinary research effort must be undertaken in order to look at the interaction of genetics, human behavior, criminal law and criminology. If criminology is interested in learning, motivation, aggression and behavior, it must incorporate the new genetics into its theoretical structure.


[Organized and professional crime: a comparative approach]. After a short preliminary statement of a terminological character, the authors review the basic features of professional and organized crime, also in relation to historically well defined aspects of it, of the "crime-syndicate" type. The tracts differentiating in this sector the European criminality from the North-American one are identified, and the most significant examples of criminal organization active in recent times especially in Great Britain are illustrated. The survey is carried out taking into account the quantitative and qualitative evolution of the phenomenon and probing further into the value and function that the various categories of crime operators assume in the most modern forms of organized crime. A special attention is devoted to the activities of particular importance that precede and follow the perpetration of crimes. The problem of the professional and organized crime is also viewed in the light of the difference existing in the various European countries, and of the easy access to international connections which afford to this type of crime quite a comprehensive scope of action and which involve a greater difficulty of the activities carried out by the authorities of the various countries. The authors finally emphasize the gravity of the new forms of crime that are being committed especially in the business field, and urge all those concerned in criminological problems to devote their attention to the phenomenon, delving further into the connection it has with the deviance theory.


[Deliquency: an alternative to melancholy]. The authors by illustrating three cases of deviant behaviour (of which two followed up in psychotherapy), and referring to the figure of the "criminal urged by a sense of guilt" described by Freud, declare that criminality may represent an alternative to melancholy. They also state that the antisocial behaviour is the most economical "solution" for the subject possessed by the sense of guilt originated by the Super-Ego for the unconscious ambivalence conflicts towards the parental figures. In fact, perpetrating a crime the delinquent is punished for a crime whose importance is lower than those conceived by their fantasy (incest, parricide) by a tribunal that does not apply the lex talionis, unlike the Super-Ego. The authors finally point out that criminality not always represents the "solution" of a neurotic conflict and this is due to the fact that the "choice" is also dependent upon the socio-economic conditions of the various subjects.


[HBs antigen and antibody in Barcelona]. The frequency of HBs antigen and antibody has been studied among three populations living in Spain: blood donors, hospital staff, renal deficient hemodialyzed patients. Total results and those given with reference to age, sex, place of birth and residence are compared to each other and to those obtained for populations living in Languedoc.


Measurement of total and regional renal blood flow by means of a videodensitrometric method. The total and regional blood flow conditions within the kidney were studied by videodensitometry. Animal and human investigations indicate on high accuracy of the method. No extra instillation is needed in the roentgen laboratory. The addition of physiolgical data is suppost to continue an additional diagnostic mean with presumably great clinical significance.


Renal function studies after donor nephrectomy. The remaining kidney undergoes compensatory hypertrophy after donor nephrectomy. Studies have shown that immediate increases of renal plasma flow (RPF) and glomerular filtration rate (GFR) take place. No studies of tubular functions in kidney donors have previously been published. Nine elderly kidney donors with a mean age of 55 years (range 48-71 years) underwent the following studies before and 6 and 12 months after nephrectomy: GFR, RPF, maximal tubular secretion of para-aminohippurate (TmPAH), net acid excretion after 3 days of ammonium chloride loading and test of the urinary concentration ability. RPFP and GFR decreased postoperatively to a mean of 61 and 63.5 per cent respectively, with a rise of the filtration fraction (FF). TmPAH decreased considerably less, to 76 per cent 6 months postoperatively and 86 per cent 12 months postoperatively. The TmPAH/GFR ratio changed from 0.77 to 0.95 and 0.99 postoperatively. The excretion of acid was slightly reduced concerning the NH4+-excretion but the values for H+-excretion and urinary pH were unchanged. The remaining kidney after donor nephrectomy shows the well-known increases in RPF and GFR. Energy-dependent proximal tubular functions such as TmPAH increase even more, indicating an altered glomerulotubular balance. Distal tubular function such as acidification and urinary concentration ability are essentially unchanged.


The effect of surgical trauma, ischaemia and ureteral occlusion on renal blood flow and function. An experimental study in the rabbit. The influence of surgical trauma on renal blood flow and renal function was examined in lightly anaesthetized rabbits. The renal vessels were catheterized and the dye-dilution technique was used to measure renal blood flow and cardiac output. The renal fraction of the cardiac output, the total peripheral vascular resistance, and the renal vascular resistance were calculated. Glomerular and the tubular function was evaluated by measuring the extractions of 51Cr-EDTA and of 125I-Hippuran. A decrease in cardiac output was accompanied by a diminution in renal blood flow. The renal blood flow and the renal fraction of the cardiac output were reduced initially, regardless of whether surgery or puncture of the kidney were performed. When the alpha-adrenergic receptor sites were blocked with phenoxybenzamine, however, the renal fraction of the cardiac output remained stable. It was therefore, concluded that during general anaesthesia the sympathetic tonus or the concentration of plasma catecholamines increased, causing vasoconstriction in the kidney. Manipulation of the renal artery seemed to stimulate vasoconstriction in the ipsilateral kidney by a direct effect. Localized spasm of the main renal artery cannot be assumed to have caused alterations in the renal blood flow and the renal fraction of the cardiac output, as prevention of spasm by topical application of local anaesthesic did not offer protection against these alterations. A decrease in glomerular and tubular function occurred initially, indepently of surgical trauma, but could be prevented by blockade of the alpha-adrenergic receptors sites. This argues for a renal vasoconstriction including the afferent arterioles. Renal function was not much influenced by traumatization of the renal artery. A reduction in function was, however, seem when the traumatization was preceded by topical application of a local anaesthetic or by blockade of the alpha-adrenergic receptors sites. This findings seems difficult to explain. The renal artery was occluded for varying lengths of time with the aid of a balloon catheter, and the effect of temporary ischaemia on renal blood flow and function was examined. Prolongation of the period of continuous ischaemia from 15 to 60 minutes resulted in a progressive increase in the postocclusive hyperaemia, but in a successive reduction in the renal function. Compared with 30 minutes of continuous occlusion, 30 minutes of intermittent occlusion caused slight hyperaemia, but the same degree of reduction in renal function. One day after 30 minutes or 60 minutes of ischaemia, renal blood flow was within the range of normal flow. After 30 minutes of occlusion, renal function was re-established seven days later, whereas after 60 minutes of ischaemia, function was still severly impaired. Fourteen days after 60 minutes of occlusion, renal function was partly restored, being 50% or less of the normal. No juxtamedullary shunting of importance could be demonstrated in the present investigation...


Dialysis therapy of terminal uraemia in insulin-requiring diabetic patients. A 5-year material comprising 26 insulin-requiring patients with terminal uraemia is reported. The patients were treated with protein restriction, peritoneal dialysis and haemodialysis with a view to kidney transplantation. Changes in cardiac state, diabetic retinopathy, insulin requirements and blood sugar during treatment are described. In addition, dialysis complications are described. It is concluded that by the use of dialysis treatment such patients can be helped to an acceptable life while waiting for a transplantation.


Direct cell mediated lympholysis in man. Cellular cytotoxic capacity of 100 normal, healthy blood donors. The cellualr lymphocytotoxic capacity of 100 normal, healthy blood donors were investigated by the Direct Cell Mediated Lympholysis (DCML) test. The scorings were found to be distributed according to the normal, exhibiting a mean value of 0.1 Cr-51 release %, and an upper 1% significance level of 10.1 release 1%. It is concluded that lymphocytes from the peripheral blood of blood donors may well be used as negative biological controls in DCML testing of immunologically primed patients (e.g. after allotransplantation).


Serum gastrin in patients with azotemia. Gastric acid secretion was determined by a pentagastrin test and serum gastrin concentration was determined by radioimmunoassay before and eight times during the first three hours after a test meal in six male azotemic patients and in nine male controls. The mean basal gastric acid secretion was higher, but not significantly so, in the patients than in the controls. The stimulated gastric acid secretion was equal in the two groups. The mean serum gastric concentration was found to be higher in the patient group than in the controls both in the fasting state and after the test meal. The interpretation of the results and the possible relevance of the results in deciding what prophylactic gastro-duodenal operation patients with high ulcer risk should be subjected to prior to kidney transplantation, is discussed.


Experience with different types of fistulas and shunts for hemodialysis. Three alternative methods to obtain access to the circulatory system for hemodialysis has been used. The Cimono-Brescia fistula is the method of choice and is almost always successful if the vessels are intact. The femoral Quinton-Scribner shunt has proved unreliable and dangerous. The subdermal vein graft is a useful and acceptable alternative if the vessels of the upper limbs have been destroyed.


Genetic influence on saline consumption and salt hypertension as exhibited by the response of various rat strains and sub-strains. Female rats of 2 Sprague-Dawley sub-strains and of the Wistar and Fischer 344 strains were sensitized to the hypertensogenic effect of excess salt by removal of 1 kidney and by being given 1% NaCl solution as their sole drinking fluid. One of the Sprague-Dawley sub-strains (SPD) and the Wistar (CFEP) rats developed progressive saline polydipsia of equivalent degree, blood pressure rose, and about half of the members became hypertensive during treatment. Rats of the other Sprague-Dawley strain (CFNP) also showed a progressive saline intake; but although they drank substantially less saline, the incidence of hypertension among them was increased by 50%. Animals of the Fischer 344 strain displayed neither saline polydipsia--the intake remaining relatively constant at a very low level throughout the experiment--nor hypertension. Salt hypertension appears to be affected by genetic factors in at least 2 ways, one of which regulates the quantity of salt ingested (salt appetite), while the other controls the susceptibility to salt excess or perhaps to hypertension per se. Fischer 344 rats have the ability to restrict the volume consumption of saline; their resistance to enforced high salt intake has yet to be established.


The role of the surrounding tissue in the propagation of waves through the arterial system. A theoretical analysis of the flow in arteries is presented, taking into consideration the role played by the surrounding tissues in determining the speed of propagatoion and the damping of the blood pressure pulse. This study was undertaken (a) to exhibit a method of computing the flow properties with a more nearly accurate model, (b) to see if the displacement on the skin would be related to the arterial wall displacement, and hence to pressure, velocity and flow rate of blood in the artery, and if it is likely to be measurable. It was found that the pressure of the 'viscous' part in the surrounding tissue increases the pulse velocity and the damping of the wave over the values found by other models which considered only thick-walled elastic tubes with no surrounding tissue. This study also shows that measurements on the skin can provide information about changes in arterial circulation due to diseases such as: edema, arteriosclerosis and others where the Young's modulus for either the arterial wall or the surrounding tissues is altered.


Information processing limits: the effects of information load and age. As a test of the effects of age and information load Ss performed a visual and auditory discrimination task under conditions requiring division of attention. Amount of stimulus information was determined by the number of stimulus alternatives which could occur in a set of trials. Performance by 12 Ss over age 40 was impaired in comparison to 12Ss under age 40. Performance for all Ss was a function of amount of information, but there was no Age X Information Load interaction. It has been reported in the literature that age-related performance decrements are correlated with task complexity. These data indicate that amount of information is not a critical dimension of task complexity as it contributes to age-related performance deficits.


Biochemical studies on mammalian cardiac muscles: I. distribution pattern of myoglobin in different chambers of the heart of some mammals. The myoglobin content of atria and ventricles of hearts of some mammals has been studied. The hearts of various mammals exhibit variations in their myoglobin concentration in contrast to earlier reports on various mammals. A definite gradation in the distribution pattern of myoglobin in mammalian cardiac muscles with Left atrium less than Right atrium less than Right ventricle less than Left ventricle, is discernible. There seems to be a close correlation of ventricular myocardium and their functional requirements.


The influence of electric fields red blood cells. The effect of electric fields as related to red blood cell sizing techniques, hemolysis, mobility, and general behavior is examined. A review is made of the varying theories concerning these effects. In addition, the physical ramifications of electric field experimentation is viewed. Criticisms are made with regard to technique and lack of consideration for certain experimental variables.


The use of metal microelectrodes in broad-band recording. We checked to what extent the voltage-current relationship of a microelectrode is linear. In the linear domain we measured the impedance characteristic of the electrode. We measured the frequency response curve and the phase characteristic of the electrode and amplifier system.


Wound healing in X-irradiated mammalian skin. Certain parameters of wound healing were investigated in mouse skin given 950 rads and 3325 rads of X-irradiation at various times relative to wounding. Increased inflammation, delayed dermal regeneration, and delayed contraction were noted in all irradiated groups. The activation of surrounding hair follicles, a process that usually accompanies wounding in mouse skin, occurred earlier, over a shorter elapsed time, and over a greater area of skin in animals irradiated prior to wounding than in the controls or in those irradiated and wounded simultaneously. Epidermal mitotic activity in wounds made at the time of irradiation was initially depressed but recovered by the second postoperative day. Wounds in pre-irradiated animals gave an unexpected result. They responded with an immediate burst of mitotic activity without the usual 24-hr lag that was seen in controls. In the pre-irradiated specimens a substantial number of cells appeared to die after dividing.


[The interrelationship between histologic and ultrastructural changes in the liver in the presence of pathologic states]. A study was made of liver cells of cirrhosis-affected patients and those with portal hypertensia due to subhepatic block. It was shown that the extent of cellular injury was directly related to the pattern of pathological process in the liver. In the case of active cirrhosis, the necrobiotic processes observed might be due to changes in the structures providing cellular metabolism. With stable cirrhosis, the changes observed suggest abnormalities in cell synthesis, in addition to the rise in aerobic respiration. The analysis of the data obtained in the cases of subhepatic block without cirrhosis showed a sufficient functional activity of liver cells.


[The electrical structure of normal liver tissue]. The electrical coupling between cells of mouse liver was investigated in vitro. The membrane potential of liver cells is 15--30 mv immediatly after dissection, and increases to 40--48 mv within 4--7 hours. This level of membrane potential is constant during the next 2--3 hours. The mean input resistance varies within 189+/-9 and 613+/-+25 kohm to be higher in preparations examined in summer than in winter time. The cytoplasm of liver cells is equipotential. The reducing of potential from intracellular source is not exponential. This potential distribution is well approximated by a solution for the two-dimentional model of the liver lamella, when characteristic length is 500 mcm. On the basis of this model the outher membrane resistance and functional membrane resistance were found to be 700-2100 and 1.2 ohm-cm2, resp.


[Proliferation kinetics of NK/Ly tumor cells after single and fractionated irradiation with fast electrons]. With single irradiation, the inhibition of tumor cell division and DNA synthesis was more pronounced than with fractionation irradiation. In fractionated schedules, the dose increase per fraction, and the interval prolongation between fractions, with decrease of the number of fractions (within the same time of irradiation), enhanced the effect of radiation. Yield of pahologic mitoses and extent of morphologic injury of cells was less expressed with fractionated irradiation and did not depend on the schedule of fractionation of the total dose.


[Changes in the volumes of the nucleus, cytoplasm and the entire hepatocyte during recuperation from different kinds of lesions]. Independently on the kind of lesion, large hepatocytes are localized at the periphery of the liver lobules. The cells reach their maximal volume after a partial hepatoectomy or during cirrhosis development. Decrease of the volume occurs after the blockade of the Kupffer cells with ink. After restoration of bile secretion, histological liver structures repair. The change of nuclear-cytoplasmic ratio depends on the kind of lesion and the type of restoration.


[An electron microscopic study of lamp-brush chromosomes and the products of their activity during rabbit oogenesis]. An ultrastructural study of the rabbit oocyte nucleus was started from the early diplotene and extended to the large growth period to include the bilaminar follicle stage. During the large growth, the rabbit oocytes do not develop to the dictyate or "resting" stage, but remain at the diplotene. At the period preceeding the large growth (the early diplotene) lampbrush chromosomes are revealed made of the central axis 50 nm in diameter wish lateral fibrils. The aggregation of long loosely arranged fibrils makes the chromosome matrix. In the fibrillar zone of the chromosome, numerous roundish granules ca 45 nm in diameter and dense granule accumulations ca 0.15 mkm in diameter were visualized. Large fibrogranular bodies (1--2 mkm in diameter) are seen in association wish chromosomes. All these extra-nuclear bodies that appear on chromosomes differ in their size and pattern. These, likely as the nucleoli, may be considered as morphological expression of the genic activity of lampbrush chromosomes.


[Morphofunctional types of synapses in the neurosecretory cells of the carp preoptic nucleus]. The ultrastructure of synaptic endings of the neurosecretory cells of the nucleus preopticus was examined in adult Cyprinus carpio L. Two of synpatic endings occur: type I--small agranular vesicles and large granular vesicles, type II--only agranular vesicles. The functioning of the nucleus preopticus neurosecretory cells in Cyprinus carpio L is presumably controlled by the synpatic endings of the adrenergic (synaptic endings of type I) as well as of the cholinergic (synaptic endings of type II) origin. By visual and morphometric methods different kinds of synpatic endings are distinguished among both the types of synapses according to their particular functional states. A quantitative analysis of the correlation of these kinds of synpatic endings allows a suggestion in respect to the state of the synaptic apparatus on the perikaria of neurosecretory cells.


[The origin and possible role of microvesicles in olfactory receptor cells]. Microvesicles and spherical particles have been described in the bulbs of receptor olfactory cells of Acipenser ruthenus. Two pathways of the origin of the above vesicles have been followed. These structures derive at the stage of differentiation from non-ciliary to ciliary cell type. The first of the pathways involves the autolysis of microfibril bundles produced during the regression of microvilli. The other one includes micropinocytosis induced on the basis of regressing microvilli. Taking into account the genesis of the microvesicles of the receptor cell bulb, it is concluded that they cannot contain a mediator able to modify membrane ion permeability in response to the specific stimulus of the odorant.


[Germ cell cycles during sex inversion in chick embryos]. A study was made of the germ cell cycles of 11 days old embryos injected male or female hormones on the 4 th day of incubation. The cell cycles duration in genetically male 11 days embryos treated with esradiol-benzoate was close to that registered in oogonia of both treated and non-treated female embryos of the same age. The testosterone propionate injection caused an acceleration of the genetically male sex cell proliferation and a decrease of the reproduction rate of the female sex cells. It is proposed that under normal conditions female sex hormones inhibit a hypothethic factor that determines the decrease of cell proliferation during the male embryo development.


[Progressive polyploidy in mouse liver following repeated hepatectomy]. Mouse liver regeneration after partial hepatectomy results in sharp changes of ploidy classes towards the increase of high ploidy cells and the decrease low ploidy ones. These changes retain during three months. Each following partial hepatectomy (till 3 times) intensifies the hepatocyte polyploidy with appearance of cells with 32--64 ploidy nuclei. The cell polyploidization stimulated by repeated regenerations is similar to that observed in normal postnatal liver growth.


[The relationship between the frequency of participation of acrocentric chromosomes in formation of satellite associations and the duration of human lymphocyte cultivation with phytohemmaglutinin]. All acrocentrics were shown to take part in the formation of satellite association at the 52nd, 72nd and 90th hr of human lymphocytes culturing, in the first mitosis with equal frequency but having different associative capacity in further mitoses. It seems likely that a single nucleolus in the lymphocytes at initial stage of activation, the high frequency of satellite associations, and a random participation of acrocentrics in the associations in first mitosis are due to that all acrocentrics form association in small lymphocytes which are sensitive to PHA.


[Indices of mitotic cell division in sebaceous glands]. The main indices of mitotic cell division in rat sebaceous glands (external auditory meatus and tarsales gl.) were studied autoradiographically using H3-thymidine and with colchicine method. The duration of mitotic cycle and its separate phases, the number of cells involved in the proliferative pool, as well as the turnover of terminals of the epithelium in both the glands were stated to be nearly identical. The duration of the mitotic cycle was: T -- 28.1 hour; tG1 -- 18.64; tS -- 6.3; tG2 -- 1.80; tM -- 1.34 hours. The proliferative pool (Pc) -- 31.45%, turnover of the basal layer cells -- 89.25 hours. These indices for the stratified epithelium of excretory ducts were respectively; T -- 33.0 hours; tG1 -- 21.74; --8.06; tG2 -- 1.6; tM -- 1.6; Pc -- 26.8% and the turnover for the cells of the basal layer -- 123 hours. Thus, the sebaceous glands are to be regarded as organs where a rapid renovation of epithelia cells occurs.


[Morphologic and biochemical heterogeneity of lysosomes]. By means of isopycnic centrifugation in the continuous density gradient of sucrose two subfractions of lysosomes were isolated from rat liver homogenates: a "light" one (with the floating density p=1.13) and a "heavy" one (p=1.24). Electron microscopic, enzymatic and electron microscope enzymatic analysis of the isolated subfractions showed that the "light" subfraction consisted mainly of newly-formed primary lysosomes, while the "heavy" one was presented by secondary lysosomes. Parallel biochemical investigations demonstrated a considerable enzymatic heterogeneity of the two lysosomal subfractions: the "light" subfraction was characterized by a high specific activity of acid DNase, acid RNase and beta-galactosidase, and by almost total absence of beta-glucosidase activity, while the "heavy" one was characterized by a high specific activity of beta-glucosidase, beta-glucuronidase and beta-N-acetylglucosaminidase. Possible causes of enzyme heterogeneity of rat liver lysosomes are discussed.


[A cytophotometric and karyometric study of the granular cells of the rat brain. I. Granular cells of the cochlear complex and cerebellum]. Two cell types can be distinguished in granular cells of the chochlear complex of the rat by the form of their processes and the structure of the nuclear chromatin. It is shown cytophotometrically that the majority of the granular cells of the cochlear complex and in the cerebellar cortex are diploid. However, some cells contain DNA amount close to tetraploid. Some correlation between the size of the nucleus and its DNA amount was discovered both in the cerebellar cortex and in the cochlear complex.


[Cytoplasmic cisterns structurally linked with the plasmalemma in the hepatocytes of mice of different lines]. Structures of the granular endoplasmic reticulum and narrow canals formed by smooth membranes were found in the cell membrane of male mice belonging to strains CBA, C57BL and L-NZB/BLN. The canals were seen connected with plasma membranes. Under the conditions of CC1(4) poisoning of CBA and C57BL mice, these canals were transformed to gigantic cytoplasmic vacuoles. Their cavities were communicated with the extracellular space. It still remains unclear if the membranes of these canals belong to the cytoplasmic membrane or to the endoplasmic reticulum.


[Karyotypes of spontaneous human abortuses and several aspects of their phenotypic presentation]. In all, 172 human spontaneous abortuses were examined: 75 cases from the 1st trimester of pregnancy (all were karyotyped), and 97 ones--from 2nd and 3rd trimesters (59 cases were karyotyped). 31 cases of chromosomal anomalies were revealed. The incidence of chromosomal anomalies among the 1st and 2--3rd trimesters of spontaneous abortuses was 40.0+/-7.5 and 1.0+1.0%, resp. The general incidence of chromosomal anomalies among this series of spontaneous abortuses was equal to 18.0+/-2.9%. The question of phenotypical manifestations of chromosomal aberrations in spontaneous abortuses is discussed. The influence of gene structure of aberrant chromosomes on phenotypes of abortuses is supposed.


[Experimental basis for the use of ascending cholegraphy in gunshot wounds of the liver]. In experiments on animals and isolated livers from human cadavers an opportunity of using a direct ascending cholegraphy for roentgenological diagnosis of gunshot injuries of the liver was studied, rather demonstrative roentgenograms, photographs given in the paper being obtained.


[Treatment of fractures of phalangeal and metacarpal bones by the method of intraosseous metallic osteosynthesis]. The results of treatment of fractures of phalangeal and metacarpal bones of hand in 83 patients are analysed. Indications and contraindications to metallic osteosynthesis in fractures of phalangeal and metacarpal bones are described.


[Treatment of exudative pericarditis in children]. Three case reports of successful treatment for exudative pericarditis in children are presented. These were the result of staphylococcal pneumonias or acute hematogenic osteomyelitis. The treatment comprised punctures or drainage of the pericardium with lavage of its cavity with solutions of antibiotics and hydrocortisone against the background of general therapy. Late results were studied within the terms from 3 to 5 years. All children made good recovery.


[Torsion of the testis and spermatic cord in children]. The authors report 16 cases of torsion of the testis and 3 cases with twisting of the testicular appendix. Fifteen children with torsion of the testis and one child with twisting of the testicular appendix were operated upon. Late results were followed up in 14 cases within the terms from 6 months to 7 years. Atrophy of the testis was not observed in children, operated upon in earlier terms of the affection, irrespective of the degree of the torsion. In late patients' admission to the hospital even small size torsions resulted in testicular atrophy in 4 cases. To improve the results of treatment in children with torsion of the testis early operative interventions are greatly advocated.


[Complications of jejunal peptic ulcers]. Under observation were 192 patients with peptic ulcer. In 72.4% of patients complicated peptic ulcers were noted. The frequency and character of complications is changed depending on the method of surgery previously performed--in peptic ulcer, developed under conditions of gastric resection, these are more frequent and of a more grave character than in peptic ulcer of gastroenteroanastomosis. Among complications the first place is occupied by penetration with subsequent occurrence of profistulas (25), and then gastroenterocolonic fistulas (13%). Pentration of jejunal peptic ulcer in the free abdominal cavity is observed comparatively rarely, according to the authors' findings this complication was noted in 3.6% of cases. Bleeding peptic ulcers were observed in 45% of cases, in more than a half of them hemmorrhage was profuse. No malignant transformation of jejunal peptic ulcer was observed.


[Results of clinico-roentgenological comparisons in dumping syndrome after vagotomy]. The authors have compared clinical and roentgenological data in 39 patients with the dumping syndrome. It is assumed that the conditions for the dumping syndrome to develop would arise more often after the truncal and proximal vagotomy and following the Billroth-II gastric resection.


[Acute pancreatitis in the sequestration phase]. Pathoanatomical, pathogenetic and clinical characteristics of acute pancreatitis in a sequestration phase are given. Under observation were 95 patients with purulentputrid sequestration of the pancreas and retroperitoneal cellular tissue and 20 patients with postnecrotic pancreatic cysts. Some features of the operative treatment in different kinds of sequestration are described.


[10-year experience with the treatment of duodenal ulcer by vagotomy]. The results of vagotomy associated with drainage operative procedures in 450 cases are analysed in detail, 274 of them being followed up for 3 years and longer. The authors revealed no essential advantages of selective vagotomy compared with the truncal one.


[Cancer of the gallbladder].

[Cancer of the gallbladder]. In the paper, the materials of clinical observation over 57 patients with the bladder cancer and the results of analysis of autopsy reports of 64 patients died from this lesion are presented. Cancer of the gallbladder affected mostly females (6 times as frequently as males) aged over 50 years. Only in 59% of cases the bladder cancer developed against  the background of cholelithiasis. An absence of typical symptoms in cancer of the gallbladder resulting in late recognition of this lesion is emphasized. The prognosis both after radical and palliative surgical procedures is rather poor. Only some patients survived for 2 years after the operation. Without the operation the survival would not exceed 3 months since establishment of the diagnosis of cancer of the gallbladder. For more early recognition of cancer of this localization special and instrumental methods of diagnosis are largely advocated, while as a prophylactic measure--timely cholecystectomy for chronic cholecystitis.


[Individual differences in the location of the gallbladder and extrahepatic bile ducts with regard to selection of surgical approach]. The investigation was performed on 150 human cadavers nonfixed in formalin. The results of the investigation were compared with the data of clinical studies in 52 patients with acute and chronic cholecystitis and surgical procedures in them. The data obtained allowed the following considerations: to expose the gallbladder with ducts in patients with an elongated-narrow chest and small epigastric angle, as well as in a transitory form of its structure, incisions made near the costal arch (Kocher, S. P. Fedorov incisions) seem to be more rational, whereas in a broad and short chest with a large epigastric angle incision of Rio-Branco, Kalinovsky, Cherni and upper median one are felt to be preferable.


[Motor function of the gastrointestinal tract after extensive resection of the small intestine]. A functional and roentgenological investigation of the motor-evacuative function of the digestive tract has shown that resection of the small intestine with construction of an entero-enteroanastomosis is followed by a delayed passage of a contrast suspension in the remained portions of the small intestine. Further, there occurs a delay in evacuation of the contrast food suspension from the stomach in marked hypermotor dyskinesia of the small and large bowel. Following resection of the small intestine with an ileo-transverse anastomosis hypermotor peristalsis was observed. The passage of chymus from the small intestine into the colon lasted 1--2 hours. The cecal portion of the colon at the site of ileo-traansverse anastomosis was enlarged sacwise and turned into a reservoir for permanent stasis of the bowel content. The ileocecal portion regulating the chymus income into the colon plays a decisive role in intensity of compensatory-adaptive processes following resection of the small intestine.


[Suppurative complications after prosthesis of the abdominal aorta and main arteries]. The classification of a local wound infection, developed after reconstructive operations on the abdominal aorta and its distal branches, is given. Among 245 reconstructive-restorative procedures there were 14 cases of deep local wound infection associated with an exposure of vascular grafts. A system of measures for prevention of infectious complications has been elaborated. It comprised strict observation of the asepsis rules, an improvement of the technic of surgical intervention, lessening of the duration of surgery and blood loss. Special attention is given to the technic of closure and management of vascular wounds, prophylactic application of antibiotics of a wide spectrum of action. In development of the wound infection it seems rational to accomplish an active drainage of the wound with local and general administration of massive doses of specific antibiotics, proteolytic enzymes, antiseptics and then to close a vascular graft by viable tissues. Should these measures fail, then a bypass shunting and removal of the infected prosthesis is indicated.


[Anatomical and technical possibilities for the restoration of blood flow in the inferior mesenteric artery]. As a result of the analysis of interrelationship between the inferior mesenterial artery trunk and upper mesenterial artery and its intestinal branches, as well as a comparison of the diameter and length of the mentioned vessels on 73 cadavers of adult persons of both sex, in most cases (in 66 of 73) there was noted an association of favourable in position and parameters conditions for anastomosing the inferior mesenterial artery. In experiments on 17 human cadavers different variants of revascularization of the left colon were accomplished.


[Indications for surgery of mobile cecum]. In the paper, the problems concerning a frequency of anatomical variants of the right colon fixation, their clinical manifestation as the "mobile cecum" syndrome, and indications to surgical therapy of the latter are considered. Indications and contraindications to fixation of the ascending colon are given.


[Resection of the esophagus in cicatrical stenosis with simultaneous creation of esophago-gastric anastomosis]. Based on the author's personal experience with 24 esophageal resections with simultaneous right-sided intrapleural gastroesophageal anastomosis in patients with cicatricial strictures after a chemical burn, it is suggested to revise a negative attitude toward this method of esophagoplasty and widen indications to it in cicatricial strictures of the middle and lower portions of the esophagus.


[Diagnosis and treatment of dilatation of subcutaneous veins of the lower limbs, caused by compression of the external iliac vein]. 400 patients with venous varicosity of the lower limbs were studied using functional tests: phlebotonometry and combined methods of phlebography. It was found that in 43.3% of investigations valves of profound veins were partially or totally insufficient. Among subjects with valve insufficiency in 55 cases venous varicosity was conditioned by extravasal compression of the external iliac vein. The causes of compression of the latter were a cross-passing artery, fibrofascial bands and a drooping edge of the inguinal ligament. Retrograde femoropelvic phlebography in a bending posture of a patient and comparative phlebotonometry of the femoral and iliac veins proved to be the basic methods of diagnosis of a true cause of the varicosity.


[Clinical aspects, diagnosis and treatment of albuminous osteomyelitis]. According to the authors' data the literature offers only single reports concerning the problem of albuminose osteomyelitis. The authors observed 7 patients including 5 children. There were 5 male patients and 2--females. In 6 cases the pathological process involved the left femur, in 1--the right. The main symptoms of the disease were as follows: pains, the presence of tumescence, extended network of subcutaneous veins, local rise of temperature, an impaired function of the involved extremity. Roentgenologically, thickening of the periosteum was found in 5 cases, localized foci in the medullary cavity of the metaphysis--in 2 cases. There was noted an increased activity of alkaline phosphatase, elevation in the level of sialo acid, leucocytosis, increased sedimentation rate, large amount of protein in the exudate (by 31% on an average). In 5 patients wide incisions till the bone with subsequent drainage were made, tumescence was punctured in 2 patients (2--3 times), a plaster dressing was applied, patients were given a diet rich in protein and vitamins, and also physical therapy. The immediate and late results have been studied in all patients followed up for the period from 4 months to 5 years. There were noted no cases of recurrence.


[Method of determination and classification of surgical risk]. The authors have elaborated their own five-grade classification of a surgical risk, based on evaluation of 2000 case reports. All patients and surgical interventions are subdivided into 5 typical groups in terms of increasing hazards inherent in a surgical intervention. The authors differentiated minimum (I), moderate (II), marked (III), considerable (IV) and maximum (V) indices of surgical risk. The suggested classification is simple and objection enough. By means of the latter it is possible to choose beforehand the extent and character of the intervention, to delineate its provision, to obtain some comparative data on the advantages and shortcomings of different methods of anesthesia, reanimation, rehabilitation of patients and final results of treatment in surgical patients.


[Kidney function in patients with ulcer disease and cancer of the gastrointestinal tract before and after surgery]. A correlation between indices of the renal function before and after the operation has been made in patients with ulcerous disease and cancer of the gastrointestinal tract. It is the authors' opinion that a correction of the water-salt metabolism, adequate replacement of blood loss and some other measures prevent considerably the occurrence of renal insufficiency.


[Pure doctrine and exact technic?].

[Pure doctrine and exact technic?]. There is a theoretical attitude in psychoanalysis that can be described as "pure teaching" (E. Wiesenhütter), and a practice that can be described as "exact technique". An important point, in which theory and practice seem to be in harmony is the rejection of agitating and the request of an anonymous neutrality concerning the psychoanalyst. The research serves the discussion about this coupled conception. Freud has imprinted theory and practice concerning this subject, but he himself was sovereign in the use of it. In the daily process of psychoanalysis, teaching and technique are always coming up with new questions in the concrete situation. They only asymptotically reach the point of absolute pureness and exactness. The author is selfcriticizing the psychoanalysis in the subjects mentioned above. He points out that flexibility in teaching and technique does not at all imply a revisionism of psychoanalysis; only when it is evident for psychoanalysis that a well-weighed theory is necessary as well as the relevant practice for the theory, there will be the greatest possible freedom for both of them.


[Time problem in Freud's psychoanalysis]. The influence of Freuds' work on the formation of psychological theory is especially based on the biographical system of Psychoanalysis. The aspect of historical order distinguishes his system of theoretical relations. The inspection of Freuds' scriptures shows that he through all his research was confronted with the problem of psychological time (in opposite to the term of "physical time"). The contrast between the time of existence and the identity of person clarifies the principle of the lack of temporality of repressed experiences as denied personal history.


[Desire and self-worth].

[Desire and self-worth]. Correlation between the experience of pleasure and selfesteem of neurotic patients is examined, based on practical knowledge in the therapeutic area. The embittering of essential parts of later self- and identityfeeling by cultural discrimination of primary pleasure of oneself during the early childhood is shown by a clinical case. Primary selffeeling is degraded into guilt and fear and cannot be replaced by secundary satisfactions. Finally the ambiguous aspects of pleasure in psychoanalytic theory are deomonstated which recently have found a more obvious contour in the polarisation between narcissism and object relation. - The question about the essence of pleasure is left open.


[Relationships between cerebral organic and reactive disorders in childhood and adolescence]. The causes of psychic disorders must not only be discerned either reactive or organic. The perception of stimuli from the environment, the experiences a child makes, are worked up in the brain, which functions can be divided into a lot of singular abilities. The observation of their organic conditioned disorders shows, how behavioral disorders and mislearning may develop and also, how they will be misunderstood and disapproved by the environment. This fact is as well an explanation for the formation of neuroses on the bottom of an organic brain disfunction as also for the origin of psychoses being secundary disturbances of the relation to reality, considered from a new point of view. Both, neuroses and psychoses originate in constellative interaction of brain organic and reactive factors.


[Changes in the psychic factor structure of schizophrenics after release from the hospital]. When studying the "postremission syndrome of exhaustion" in schizophrenics changes in mental factor structures after the patients' discharge from hospital were assessed by performance intelligence scales and check lists of emotional states. Test scores obtained at discharge and 8 weeks afterwards were factor analysed separately. Differences in factor structures of the two matrices represented mainly by independence between emotional and intellectual functions at discharge and negative associations between these factors 8 weeks later could not be completely compensated by similarity rotations of the two factor matrices thus indicating genuine changes in factor structures rather than effects due to methodological procedures.


[Expression between empiricism and speculation.  A reply to Herman Schmitz' article "Understanding of expression as body communication" and also a contribution to the phenography of expression. I]. The present article tries to show, that the positions of H. Schmitz, advocated in his note "Ausdrucksverständnis als leibliche Kommunikation" (1972) are: 1. not new, 2. superfluous, 3. untenable, unserviceable, and therefore altogether worthless. In connection with the critical analysis of the author's statements we suggest a) the use of descriptive wording that is more exact, b) more clarification concerning the theory of expression.


[Bases of psychosomatic medicine].

[Bases of psychosomatic medicine]. The theoretical and therapeutic concept of psychoneurosis is no longer the only pathogenetic framework for the theory of psychosomatic diseases. Some fundamental differences exist between psychosomatic diseases and psychoneurosis. The interdependencies between psychosomatic influencing factors and the corresponding somatopsychical (pathophysiological) correlates for different diseases are presented. It is shown that to a certain extent conditional chains are preformed in the somatic sphere which, once they have been initiated and maintained by psychosocial releasing factors, possess a peculiar somatisation tendency. In addition the multi-factorial level of analysis is pointed out by the example of modern CHD research (prospective epidemiology and multivariate statistics). In conclusion the relation of psychoneurosis to psychosomatic medicine is commented. Regarding this, the de- and resomatisation model according to Schur is specially taken into account.


[Heart as mirror of the soul (findings and status)]. It took a period of five thousand years to proceed from the assumption of the heart being the origin of life, and "seat" of soul to today's point of view, that heart function is a mere indicator of psychophysic activation. Both advanced electronic technologies and mathematical procedures had to be developed to be able to separate the informational constituents of the cardiac signals. Even today the problems of specificity concerning the different variances and patterns are not solved at all. Many failures in research derive from overestimation of single values in correlational statistics. There are indications that, on the basis of consequent application of pattern recognition techniques, it would be possible to obtain major progress in the field of psychophysiological covariance research.


[Results of research on psychosomatic correlations]. In psychosomatic research there is a lack of multivariate studies based on samples that are adequate for statistical analysis. The present study is concerned with two samples of male students (N=107 and N=100) who took part in an extensive physiological and psychological assessment in order to find out psychosomatic patterns. Results indicate that correlational analysis including factor analysis too is insufficient to meet the complexity of the data. Multivariate classification procedures, in particular hierarchical grouping analysis, prove to be more useful in this respect. Some conclusions regarding diagnosis and therapy of the general psychosomatic syndrome are discussed.


[Qualitative and quantitative differentiation of symptoms using the Rasch model]. Well known qualitative and quantitative differences of cardiac pain were tested by the RASCH-Model to find out whether this test would be able to indicate differences within any kinds of diseases. This ability of differentiation could be corroborated for the RASCH-Model. By making a destination of the measure for the accordance of the sensual quality of a single patient with that of a special group of diseases, it is possible to test the same diseases also in the question of the quantitative equality.


[Expression between empiricism and speculation. Remarks on R. Kirchhoff's article by the same name]. Kirchhoff's objections are proved to be totally mistaken and untenable. The deficiencies of his argumentation are classified; especially are discerned: false quotations, distortions, imputations, unfair exactions, contradictory assertions, and ignorationes elenchi. Author's position, as it is attacked by Kirchhoff, is confirmed and made more plain. Possible topics of a more fruitful discussion with Kirchhoff are sought. His epistemological proposals of systems of orientation ("Bezugssysteme") may be suitable for that purpose, provided that their logical and terminological defects are removed.


[Psychodynamic factors in disk irritations]. The patients here concerned had a faulty psychical development. During the caracter-building period of early childhood they were unable, to assert themselves sufficiently enough to be accepted, or to feel that they are loved. Therefore they tried by means of overcompensatory efforts in the sense of extreme adjustment to others, to make up for this lack. Increasingly confined, as a preponderant attitude they finally developed a forced "assistant" pose (W. Schwidder). Under these circumstances the personality of the patients could not develop sufficiently in the way, that they were able to make free decisions by maintaining legitimate interests of selfassertion. As a rule, they did not experience their own subconscious, arbitrary strong protest against their overwhelming neurotic obligations, especially as their "backbone" did not make possible the establishment of any suitable or sufficient representation of their own desires or needs corresponding to the largely obsessional structure of most patients. The vicious circle, leading to the loss of inner balance makes understandable the determinant preponderance of self defense against complete exhaustion of strength. Therefore the necessary relaxation cannot be acquired and at the same time the fixation of the bodily ailments becomes unavoidable. In comparison with the study of Reischauer, with regard to our patients there cannot be established any special imperilled type; by these patients, however, a specific failure in trying to master their lives becomes a probability. By reason of our experiences, even though they are limited and still to be tested in other ways, conservative measures, which stimulate the activeness of the patients are to be preferred. If one interrupts that sort of pliant texture operatively-unless their is an urgent indication-unprofitable results must be expected, which correspond to orthopedic experiences. In the case of chronic manifestations and unusually deep fixation of the syndroms in the psychical area, no real improvement is obtained by psychoanalytic measures. Also, if one should succeed in transferring the patients in the acute state to a mental therapist in spite of the rapid reduction of their somatic pain complex, the prognosis for the more functionally concerned ones would then be burdened cosiderably by the long period of difficult differentiation against the largely somatic progression of the discs.