[Treatment of osteoporosis with a new retard-preparation of sodium fluoride (author's transl)]. 25 female patients with different forms of osteoporosis (progredient form in elderly patients, steroid osteoporosis, involutive osteoporosis) treated during a period varying between 1 to 24 months with a new compound preparation containing 25 mg sodium fluoride and 200 mg L-ascorbic acid per tablet. The daily dose amounts to 2 tablets. Clinical success was observed in 18 patients, X-ray controls showed increase of bone density in 8 patients. In 3 cases it was necessary to discontinue treatment because of side effects (2 patients with pains in the bones and joints, 1 patient with stomach troubles). Late side effects have not been observed. At present the treatment of certain forms of osteoporosis with sodium fluoride is the only effective therapy of this disease.


Effect of temperature on alanine uptake by membrane vesicles isolated from a psychrophilic marine bacterium. The effect of temperature on the membranes of Ant-300, a psychrophilic marine bacterium, was studied by measuring alanine uptake by isolated membrane vesicles. Uptake was observed from 0 to 35 degrees C. The maximum initial rate of uptake occurred at 25 degrees C although more alanine was ultimately taken up at temperatures from 10 to 20 degrees C. An ARRHENIUS plot of these data shows a single infection point at 7.8 degrees C. Within 10 min, over 50% of the alpha-aminoisobutyric acid taken up by whole cells at 5 degrees C was lost after a temperature shift to 25 degrees C. Vesicles preloaded with alanine at 5 degrees C did not become leaky when shifted to 25 degrees C. In addition, exposure of the vesicles to 25 degrees C for 30 min did not affect subsequent alanine uptake at 5 degrees C. The data obtained suggest that the loss of the uptake and permeability control functions of membranes from psychrophilic bacteria at elevated temperatures is not due to degeneration of the membrane itself, but rather to a control or regulatory mechanism associated with whole cells.


Serum mineral changes due to exogenous ATP and certain trace elements in experimental diabetes. The intravenous injection of zinc or manganese chloride immediately before and 15 minutes after alloxan or dithizone prevented the usual hyperglycemia observed 24 hours after induction of diabetes. Injection of zinc chloride in alloxan diabetes led to normalization of sodium while zinc, copper, iron and magnesium remained high and calcium and potassium remained low as in alloxan. In case of dithizone diabetes, the administration of zinc salt led to an increase in serum zinc, magnesium and potassium and to a decrease in serum calcium while the sodium level returned to normal. Manganese plus alloxan led to a normalization of serum zinc, copper, potassium and sodium. In the case of dithizone plus manganese only magnesium was raised while the other elements were unchanged when compared to animals injected with dithizone only. Chromium and cobalt lowered the blood glucose to a certain extent however it did not affect most of the elements. The same changes occurred in all elements as with alloxan or dithizone alone. Pretreatment with ATP led to a normalization of serum zinc, copper, magnesium, sodium and potassium, while in case of iron it remained high and calcium remained low as that found in alloxan diabetic rats.


[Fructose tolerance and utilization in healthy and chronically diseased liver]. In 12 patients with liver cirrhosis (LC) and 11 normal subjects (N) equimolar (0.75 g/kg/h for 4 hrs.) 14C-(1)-glucose and 14C-(1)-fructose infusions were administered. When given fructose, N and LC showed only a small increase of serum-glucose and -fructose concentrations in steady state. In N and LC the total fructose clearance was significantly higher than the total glucose clearance. No differences were found between N and LC. The metabolic clearance was equal in both groups when given fructose, whereas during glucose infusion lower in LC than in N. 30% of the infused 14C-fructose were recovered in 14C-glucose. The renal loss in both groups was higher for glucose than for fructose. A more extensive renal 14C-excretion during infusion of 14C-fructose was due to a higher 14C-lactate excretion.


[Sulfites in infusion solutions].

[Sulfites in infusion solutions]. 9 commercially available high-calorie carbohydrate solutions were investigated for their sulfite content. It became evident that 6 manufacturers of infusion solutions add varying amounts of sulfite to their solutions. We consider such an addition to be unnecessary and risky from the toxicological point of view.


[Effect of caffeine on motor reactions and visual-mental processing time]. The effect of coffee without and with caffeine (200 mg) on the performance of "awake" respectively "fatigued" subjects was proved. 5 females and 7 males (22 to 32 years) were chosen for the cross-over double-blind study. Motor reaction time, visual-mental processing time, reading-speed and reading-errors were recorded. Further experiments under aggravated conditions were carried out. In the morning ("awake") caffeine increases the efficiency of all parameters excepted the reading errors. At night ("fatigued") the increase by caffeine is insignificant. Even in some subjects caffeine decreases the speed of reading and increases the number of errors. Under test-conditions, which were aggravated by strong acoustical disturbance, caffeine does not improve efficiency, compared with caffeine-free coffee. Overriding into the range of decreasing performance in spite of increasing central activity was not found under any test-condition.


[Nutritional states in a medical clinic]. The nutritional state of 168 patients in a medical clinic was determined with the following parameters: Weight/height index, triceps skin fold, arm muscle circumference, creatinine/height index, albumin, prealbumin, transferrin and cholinesterase. Using these parameters we found that 51.2% of these patients were suffering from malnutrition (26.2% marasmus, 7.7% kwashiorkor-like syndrome, 17.3% marasmic kwashiorkor). Triceps skin fold, arm muscle circumference and creatinine/height index were the most precise parameters to confirm marasmus. Prealbumin and cholinesterase are especially recommended to determine acute protein deficiency, albumin to confirm chronic protein deficiency. It was also possible to demonstrate the deleterious effect of malnutrition on the immunological system of the patient through determination of the absolute lymphocyte count in peripheral blood and intracutaneous testing with streptokinase-dornase, mumps skin test antigen and candida vaccine.


Chemical and biological studies on banana fruit. Chemical and biological evaluation of both the edible and nonedible portion of banana fruit was carried out. The possibility of using the nonedible portion (peel) as animal feed was also explored. The results showed a remarkable difference concerning the chemical composition of both the edible and nonedible portions. The amino acid contents were proved to vastly deficient with regard to the indispensable amino acids with exception of phenylalanine which was found in good amounts in the edible portion (pulp). The biological results demonstrated that neither the pulp nor the peel portions yielded good P.E.R. values when used at 6% protein level. The P.E.R values showed negative values which amounted to -1.75, -5.85 and -4.67 for the pulp and peel diets respectively. Incorporation of the stock diet to the peel diet resulted in a slight increase which amounted to 6% in both male and female rat groups.


[Diaplacental transfer of verapamil in guinea pigs (author's transl)]. Verapamil (1--50 mcg/kg/min) was given to guinea pigs by intravenous infusion for 30 minutes. The average clinical dosage amounts to 1 (0,5--2) mcg/kg/min. At doses of 1--10 mcg/kg/min we could not find pharmacologically effective concentrations of verapamil in plasma, although concentrations in mother rose corresponding to administered doses. Only at dosage 50 mcg/kg/min we found comparatively to the mother low, but clearly measurable concentrations also in fetal plasma. That means: Verapamil, administered to guinea pigs--hemomonochorial placentation like man--in dosage, given for tocolysis does not appear in fetal plasma with pharmacologically effective concentration.


[The maternal and perinatal mortality and morbitity in attendance to Caesarean section in the period from 1956--1976 at the UFK-Jena (author's transl)]. In the period from 1956--76 1 468 caesarean sections were accomplished at the UFK-Jena. 44 043 children were delivery during the 21-year period. The number of caesarean sections rose from 1,08% to 1956 to 10,8% in 1976. The fetal indication in 1956 was zero, on the other side it amounts to 34,3% in 1976. First place of the maternal indication in the 21-year period took in the cephalo pelvine disproportion. In the same time the maternal mortality in attendance of caesarean section was 12,3%. Considering the period between 1969--76, the maternal mortality fell to 2%. Maternal morbidity diminished from 1965 and obtained 23% in the period between 1974/1976. The feverish childbed took in the first place of the maternal morbidity (30%). The perinatal mortality fall from 28,57% in the period between 1956/1958 to 3,71% in the period between 1974/1976. The perinatal morbidity we could'nt state certainly. In 8,3% we found perinatal morbidity by acidosis. 5,5% of children, delivered by caesarean section needed medical care. 16,4% of all children were either small for gestational age or immature. The problem of caesarean section as an important method for termination of labor is discussed.


[The inhibition of coagulation in cord plasma (author's transl)]. 203 Plasma samples from the umbilical vein were tested for their inhibitory activity in coagulation. Disturbance of the assay by the presence of thrombocytes, fibrin(ogen) degradation products and by storage was avoided by an improved preparation method of the plasma. The mean inhibition was dependent on the way of delivery (spontaneous, by vaginal operation or by caesarean section). The mean inhibition was also dependent on birth weight and on the duration of gravidity. A possible mechanism for the generation of the inhibition is discussed.


[Anatomy of cervical changes at the end of pregnancy (author's transl)]. The problem of anatomical changes in the uterine cervix at the end of pregnancy is discussed and contrasted to the anatomy of the uterine corpus during pregnancy. The muscles of the uterine cervix have proven functionally unimportant in contrast to earlier held views. However, the function of the myometrium of the uterine corpus has its well known significance. Very important changes appear, on the other hand, in the connective tissue of the cervix. The collagen and the ground substance are metabolized completely. As a consequence, the resulting structural transformation allows rapid dilatation of the cervix during delivery. We have to admit that, unfortunately, we have no causal explanation for the overal control of this connective tissue transformation either by hormones or by the autonomic nervous system.


[New possibilities of drug therapy for herpes simplex infections of the skin]. Jodo-desoxyuridine (IDU) of different concentrations in different vehicles can shorten the duration of primary infections and recurrences of herpes simplex virus (HSV) infections to about one third. Therapeutical failures can be due to the development of IDU resistence. Ethyl-desoxyuridine (EDU) in a gel base was found to reduce the mean duration of acute herpetic lesions to about 50%. 42 recurrences of 16 patients with herpes labialis and 36 recurrences of 10 patients with herpes genitalis were observed and statistically evaluated. In cold sores 0,3% EDU-gel had similar effects as the 2,0% EDU-gel, what shortened significantly (0,001 less than p less than 0,01) the duration of skin lesions. In herpes genitalis both concentrations had good effects. 0,3% EDU-gel reduced the healing time significantly (p less than or equal to 0,05). Remarkable was the quick disappearence of subjective complaints in all treated patients. Side effects were not observed.


[Pharmacokinetics of lidocaine after intramuscular injection in patients with acute myocardial infarction (author's transl)]. The kinetics of lidocaine after i.m. injection (M. deltoideus) of 300 mg were studied in patients with acute myocardial infarction in the course of 4 hrs.; another patient received this i.m. dose after being pretreated with 100 mg lidocaine i.v. The antiarrhythmically effective threshold concentration in plasma (1.5 mg/l) was reached after an average time of 5.5 min by 9 out of 10 patients. The mean value of maximum concentration after 30 min was 3.6 mg/l in 10 patients and the mean duration for exceeding the threshold (1.5 mg/l) was about 2 hrs. The elimination half-life for lidocaine valued 1.77 hrs. The toxic threshold concentration of 6 mg/l was exceeded for a short time by 3 patients without any side effects; in three other patients suffering from side-effects no relation to high plasma levels of lidocaine was observed.


[Electrophysiologic effects of dobutamine on cardiac conduction system (author's transl)]. The electrophysiologic effects of dobutamine (D) (3 and/or 6microgram/kg/min), a new beta1 stimulator, was studied in 12 patients with different disturbances of rhythm (sinus-node dysfunction, AV-block, sinus-bradycardia, paroxysmal tachycardia) utilizing His-bundle electrography and right atrial pacing. During infusion of D sinus-rate (HR) increased significantly from 61 to 71/min. Not only in cases with enhanced sinus-node-recovery-time (SKEZ) both, the absolutely (p less than 0.05) and the corrected SKEZ(-18%,-26%) were reduced by D otherwise the calculated sino-atrial-conduction time (SACTc) was shortened only in single cases. No effect could be registered in intraventricular (HV) conduction time, whereas the AV-nodal conduction time (AH) was significantly (p less than 0.05) reduced, more effect was seen at increasing stimulation of heart rate. The intraatrial conduction time (Ah-t) was shortened not significantly. In connection with reduced AH-interval the maximum of conduction frequency of the AV-node was significantly enhanced (10%, 13%). D shortened the refractory-period (RP) of atrium and AV-node, the effect was significant (p less than 0.05) only in the functional-RP of the atrium and relative RP of the AV-node.


[Coronary aneurysm with rupture into the right atrium (author's transl)]. A case of a double aneurysm of the left circumflex coronary artery with rupture into the right atrium is described. Additionally, the clinical symptoms of coronary aneurysms and the possible complications are discussed.


[Ventricular rupture during acute myocardial infarction (author's transl)]. In a series of 523 consecutive patients with acute myocardial infarction (AMI) 112 died; among these were 18 with rupture of the free wall of the left ventricle (HR) (group RU); two other cohorts were formed: one sample of all patients with acute (transmural) myocardial infarction (group KO) and another cohort of death of AMI in 1976 (EX). 1. patients with HR are significantly older than the KO group; there is no difference in age compared to the patients who died of AMI other than HR (group EX). 2. Women with AMI have a higher chance to die of HR than men. 3. The RU group has significantly more often clinical signs of congestive heart failure than the control group. 4. Cardiogenic shock is significantly more frequent in the RU-group than in the control group. 5. All deaths (EX + RU) have worse hemodynamic data than the control group (KO). 6. Elevated blood pressure (before and after AMI) could not be identified as a risk factor for HR in our patients. 7. In the course of AMI, death in pump failure occurs significantly later than heart rupture.


[The usefulness of range-gated pulsed Doppler echocardiography. A review (author's transl)]. Single-crystal RGPD Echocardiography has clearly become a useful noninvasive ultrasonic method which enlarges the capabilities of investigating the heart. Recording of flow direction and showing disturbed flow allows additional clarification and confirmation of various diagnoses. This single-crystal technique does not allow flow quantification at the present time. The TIH and auditory signal displays of Doppler shift as presently utilized in commercial devices allow qualitative observation but require much experience in test performance and evaluation. The future here is probably in the area of spectral analysis. Present instrumentation employs M-mode echo for Doppler sample localization. Drawbacks include inprecise sample beam localization and non-variable sample volume size. Further, standardization of the Doppler signal is necessary. Combination with 2-D echo in the future will allow more precise sample beam localization and accuracy in flow quantification. The latter area has particular promise and is under investigation but is not yet commercially available.


[Removal of an acute occluding coronary thrombosis by means of a Sones-catheter (author's transl)]. In a 60-year-old male patient thrombotic occlusion of a dominant right coronary artery was recanalized by means of a Sones-Catheter (8F) two hours after the clinical onset of myocardial infarction. Before recanalization the inferior wall of the left ventricle was akinetic. After recanalization this akinesia and the clinical symptoms of myocardial infarction was almost completely relieved. As evidenced by ECG and enzymes there was only a minor necrosis of the inferior wall. After one week ventricular function angiographically was completely normal. In the right coronary artery there was a 50 percent proximal stenosis, thrombi were completely abolished. Possible implications of this case are discussed.


[Report of a family with Holt-Oram syndrome (author's transl)]. Report of a family where the typical symptomatology of Holt-Oram syndrome can be documented over three generations. Holt-Oram syndrome is an autosomal-dominantly inherited disease, characterized by cardiac malformation, mainly septal defects, av-conduction disturbances, malformations of the upper limbs, mainly the radial ray and sometimes by vascular hypoplasia. According to the literature, these symptoms can be seen in variable expressivity in the family reported. Differential diagnosis of the entity and genetic counsel of symptomatic patients and their normal relatives are discussed.


[Benzylpenicillin-induced leucopenia in subacute bacterial endocarditis (author's transl)]. In the high-dose benzylpenicillin treatment of subacute bacterial endocarditis leucopenia can develop in rare cases. Often it is paralleled by anemia, sometimes also by a decrease in the number of platelets. Myalgia, gastric discomfort, or a sore threat deserve interest as premonitory symptoms. In every case this treatment inevitably needs through hematologic control.


[Transvenous retrieval of central embolized fragments of venous catheters (author's transl)]. The industrial supply with complete venous catheter sets facilitated central venous techniques via various peripheral venous entries. The complication rate by pneumothorax, hemothorax, hemopericardium after perforation of a cardiac cavity and central embolism of catheter fragments are rather rare. Nevertheless the indication for central venous catheterization procedures should be calculated critically in every case because of the hazard of venous thrombosis and embolism or sepsis, which occurs more often. Perforation of a cardiac cavity by venous catheters leads to lethal sequelae in more than 60%. Central embolism of venous catheter fragments without perforation is followed by serious complications in most cases. Therefore the retrieval of the embolized fragment should be attempted by trasvenous technique or by thoracotomy. For the transvenous retrieval a special forceps or the transvenous Dotter retrieval set were very useful in our experience. Centrally embolized catheter fragments were drawn back in three patients after transcutaneous puncture via the femoral vein with two-plane X-ray control.


[Psychophysiological time series study of 54 patients with cardiovascular diseases during rehabilitation. Evaluation, group differences, and periodicities (author's transl)]. In the course of a cardiac rehabilitation program 36 patients with myocardial infarction and 18 patients with functional cardiovascular disorders have been studied for 4 to 6 weeks. Data included daily self-report scales of condition, mood, bodily complaints, and daily routine. Physiological variables (blood pressure, heart rate, ventilation, respiratory gas exchange) were measured three times weekly under different conditions (breath holding, hyperventilation, reaction time, multiple reaction test). Analysis of variance indicated positive effects of the rehabilitation program for physiological as well as psychological variables. There were no obvious differences in state change between groups but there were some differences in the average level of variables. Time series analysis by means of autocorrelations revealed circaseptane periodicities which may be interpreted as a reflection of the exogene weekly rhythms.


Esophageal hiatal hernia and esophagitis: results of the median arcuate ligament repair. In properly selected patients, success with the median arcuate posterior gastropexy for hiatal hernia and gastro-esophageal reflux can be anticipated in more than 95% of patients and the recurrence rate is markedly lower than in patients treated by modified crural repair.


Adolescent blood pressure in Richmond, Virginia, schools. The blood pressure of 3,166 adolescents was measured periodically in Richmond during the period 1974-1977. The subjects were students in public and private schools and ranged in age from 14 to 18 years. Analysis of the readings showed minimal differences relating to age, sex, school and race but a strong correlation with obesity. Only two organic renal causes of hypertension were discovered. A 3 1/2-year followup of 902 students indicated significant tracking, with a correlation coefficient of .385 for systolic and .305 for diastolic pressure. At the conclusion of the study, 340 students (10.7%) were identified as needing followup for hypertension.


[The levels of heavy metals (Cd, Cu, Hg, Ni, Pb, Zn) in brook trouts from the River Leine in the area of Göttingen (West Germany) (author's transl)]. In order to evaluate the load of heavy metals (Cd, Cu, Hg, Ni, Pb, Zn) imposed on the River Leine by the city of Göttingen (medium-sized town) the content of heavy metals in fish samples (which had been collected at two points on the River Leine, upstream, respectively downstream of Göttingen--Fig. 1) were determined by Atomic Absorption Spectroscopy. Analysis of heavy metals in brook trout (total fish, flesh, and liver) showed a statistically significant definite increase in some heavy metals, caused by the sewage from the city of Göttingen. In the flesh only Cd in the liver Cd, Hg and Zn and in the total fish Cd, Cu and Zn had been increased significantly. All the values of heavy metals in the flesh were lower than the suggested maximum allowable concentrations.


The use of a digital oscillator densimeter for the determination of reaction rates of bacterial proteases. A digital oscillator densimeter technique for measuring the density of casein solutions at different concentrations, temperatures and pH values was used. The technique was also used to compare the rates of protease-catalysed reactions of two bacterial proteases using casein as a substrate. Enzyme activities using reaction rates of proteases determined by this method were compared with a standard method for protease activity.


[Acute death from scalding: vital reactions (author's transl)]. After a boiler explosion on a ship 12 men with cutaneous scalding of 90-100% of body surface were found dead. 15 other fatalities occured after different intervals. This investigation deals with the histomorphologic changes in those 12 cases of instantaneous death. The most important findings consisted of: 1. Thermal injuries of the skin with multiple subcutaneous and corial bubbles, intravascular heat coagulation, and edema in the transitional zone to the undamaged submucosa. 2. Coagulation necrosis of the tracheal and bronchial wall extending to alveolar ducts in central parts of the lung. Marked congestion and edema in the deeper layers of the mucosa. Hemorrhagic alveolar and interstitial edema of the lung. Striking congestion of the pleura parietalis saving up the recessus diaphragmaticus. 3. Acute nephron-nephrosis and periglomerular microangiopathy. Interstitial edema of the myocardium, degeneration of myofibrils. Acute vacuolar degeneration and swelling of hepatocytes. Phagocytosis of detritus by the RHS. 4. Swelling of endothelium and edema of the vascular walls. Intravascular fragments of erythrocytes, platelet aggregation and fibrin thrombi. The fatal cours in these cases is considered to be due to a fulminant shock syndrome.


[C6-polymorphism of the sixth component of complement: application to paternity cases (author's transl)]. The results of a study of the polymorphism of the sixth component of human complement by means of isoelectric focusing in polyacrylamide gels with subsequent C-dependent lysis in an agarose overlay containing C6 deficient rabbit serum are reported. The allele frequencies obtained (C6A = 0.613, C6B = 0.379, C6R = 0.008) are in good agreement with those previously published. The mode of inheritance in 47 families with 173 offspring as well as 26 mother-child combinations is in agreement with a formal genetical model: "C6A, C6B, C6A1 and C6B1 at an autosomal locus". The inclusion of this system into a blood group expertise in Germany can be recommended.


[Obligation to medical treatment as a possibility of medical and social supervision (author's transl)]. In lectures of forensic medicine and in jurisdiction the patient's decision to release his secret records of medical examinations and treatment is considered to be an intangible right. Actually this privilege is only existing for the rich patient who can afford it to resign economic help in daily life and in case of illness, disablement and of incapability of earning his living. The population of our social state is largely subjected to obligations to disclose, tolerate and cooperate. In Civil Right, Social Right and in Labour Law theoretically this cannot be enforced, but it is forced in fact by refusing social and insurance accomplishment. If a young person refuses medical tests, a veto of employment will result. An employee will not get a position in an industrial firm where a medical department had to be established according to the law, or in the public service, if he refuses medical tests. In the attempt to extend the social insurance system to the whole population and to extent medical service in industry to all employees within certain time, there is no longer space for avoiding the social pressure for medical good conduct. Wanting to live a civil life one has to obey those directions. The postulation of lecturers and of High Courts concerning the patients decision on medical examination and treatment has only explanatory value and does not consider medical insurance and labour aspects. Further legal restrictions of this fundamental rights exist in Criminal Law.


[Precision of estimating the time of death by mathematical expression of rectal body cooling (author's transl)]. A representative material of experimental rectal cooling curves proves the basic validity of the model described by Marshall et al. for the mathematical expression of body cooling. For defined conditions of cooling as a relating standard the values of the exponents needed for the solution of the formula closely correlate with the weight of body to be raised to the -0.625 power. For applying in forensic cases a prescription easily to be used for the chosen relating standard of cooling is given for the computing of the time of death with permissible variation. From the first experiments of different conditions of body cooling to be met in forensic cases the possibilities of extending the range of application are derived.


[Effects of alcohol in the embryo, fetus, and newborn infant (author's transl)]. At delivery the newborn infant of a drunken mother had a bloodalcohol concentration of about 2.0%. The elimination rate was calculated to be 0.08%/h. The infant exhibited obvious features of an embryofetal alcohol syndrome. Several cases from literature are cited with ethanol given for therapeutic purpose in obstetrics and bloodalcohol concentration exceeding to 1%-2%. This means that values up to 2% in newborn infants without any other pathological findings should not solely be accepted as cause of death in forensic cases.


[Behaviour of p-nitrophenol-glucuronide in hydrolysis with mineral acids (author's transl)]. The behaviour of p-nitrophenol and synthetic p-nitrophenol-glucuronide with mineral acids has been investigated. With sulfuric acid (33%) about 93% of the glucuronide derivative have been hydrolysed; the solution was heated in open vessel for 15 sec. With hydrochloric acid (6%) only about 65% of the conjugated p-nitrophenol have been converted to the free form. No losses were detected, when free p-nitrophenol was treated under the same conditions. Three other methods of hydrolysis have been applied.


Embolism of heart tissue to the middle cerebral artery as a complication of heart surgery. After suture closure of an intraarterial septal defect an atrioventricular block occurred in a 6 years old child. Therefore, the suture was removed and the defect closed by a Dacron patch. The sinus rhythm returned. After the operation convulsions occurred, the patient died after 16h which was considered to be due to cerebral air embolism. Autopsy confirmed a correct operation, but the right middle cerebral artery has been found to be completely occluded by heart muscle and pericardial fat tissue.


[The correlation analysis of amino acids: an aid in the diagnosis of chronic polyarthritis?]. This report is concerned with the correlation analysis of plasma amino acids as a possible tool to differentiate between healthy people and patients with rheumatoid arthritis (RA). Out of 450 theoretically possible correlations between plasma amino acids 95 statistically significant correlations were found in normals whereas 184 correlations were observed in RA. When the method reported here was used to find out whether an unknown sample originated from RA or normal, only one out of 40 RA-samples was incorrect. In controls 3 out of 14 failed. The possibility to use this method for common diagnostic problems is indicated.


[Elimination half-life and serum protein binding of the anti-rheumatism agent naproxen in kidney failure]. Serum protein binding of naproxen is considerably reduced in patients with renal insufficiency. The hypothetical plasma concentration at time zero and the half life are not significantly altered in uremic patients in comparison with healthy subjects when the drug is given orally. This suggests an increased pharmacodynamic action in uremic patients when the drug is given in the usual dosage, since the pharmacologically active unbound part must then be increased.


[The effect of yttrium-90 radio synovectomy on the intra-articular xenon-133 clearance in rheumatic joint diseases]. Nine inflamed knee joints out of eight patients were examined before and after intraarticular injection of yttrium-90 silicate colloid, in order to find out the effect of radiation synovectomy on the perfusion of the joints. These joints and the untreated contralateral knee joints were examined as to the clinical status and the fast component Tf of the xenon-133 clearance was determined as a means of the perfusion of the synovium. A linear correlation exists between the clinical status of the knee joint and the perfusion as determined by Tf measured three months before and after injection of yttrium-90. Also the joints without any radiation synovectomy showed this correlation. Three months after radiation synovectomy with yttrium-90 there was still no therapeutic effect apparent in the majority of the inflamed knee joints (seven out of nine). At this stage there still existed a hyperaemia. Therefore, it seems that on the whole three months are too short a period to judge the therapeutic effect.


[The problem of Bechterew's disease from the viewpoint of social security]. Ankylosing spondylitis has a medically well defined clinical picture. It was investigated how often the social security has to deal with it with regards to pension and treatment. The investigations were based on the statistics of the "Verband Deutcher Rentenversicherungen" and 2 groups of the "Landerversicherungsanstalt Rheinprovinz", and the number of individuals who in 1969/70 received a pension because of this disease (n = 157) or received a treatment payed by the social security. The pensioners were observed over a period of 7 years. 21.7% had died and 27.4% were receiving a pension because of disability. Most of the insured persons who had died had not had treatment. From the insured persons who had had treatment 7 years earlier (n = 971) 3% had died and only 16% had applied for a pension, almost always with success. It is pointed out that in case of medical diagnosis the discrepancy between objective finding and the patients' willingness to work must be considered together. There are considerable doubts with regards to drawing any epidemiological conclusions from these results.


[The problem of joint sarcoidosis].

[The problem of joint sarcoidosis]. Joint symptoms in sarcoidosis are early manifestations of this systemic disease; patients with such symptoms, however, are seldom examined by a rheumatologist. The authors investigated 72 patients in whom a definite diagnosis of sarcoidosis had been made at the 1. University Clinic for Tuberculosis and Respiratory Diseases. Joint symptoms were found in 75% of the patients. In those with erythema nodosum they were found in 94%. Acute onset of the disease was found in more than 50% of the patients with erythema nodosum. Objective joint abnormalities were noted in 28% of the patients without erythema nodosum and in 67% of the patients with erythema nodosum. The talocrural joints were most frequently affected (32%). The laboratory investigations included the erythrocyte sedimentation rate, mucoprotein-tyrosin, blood calcium, uric acid, gamma globulin levels, latex fixation test, the Waaler-Rose hemagglutination test and alkaline phosphatase. The results of the laboratory tests and of the clinical findings were compared with those already published. Sarcoidosis is always a possible diagnosis in mono-and oligarticular arthritides of the talocrural joints in middle aged patients, particularly in women with erythema nodosum. The diagnosis is confirmed by enlargement of the hilar lymph nodes on CXR and by a negative tuberculin reaction.


[The biochemical mechanism of action of proquazone with special reference to the metabolism of connective tissue (biochemical studies for the determination of antiinflammatory effectiveness)]. A method is proposed to determine the specific radioactivity of proteokeratan sulfate and proteochondroitin sulfate after incorporation of 35SO4 and 3H-glucosamine. Proquazone inhibits the incorporation of 35SO4 in proteochondroitin sulfate and also in proteokeratan sulfate. Also the incorporation of 3H-glucosamine in proteokeratan sulfate and proteochondroitin sulfate is inhibited. A mechanism is proposed in which Proquazon inhibits the core protein synthesis of proteoglycans and the secondary biosynthesis of the glycosaminoglycan chains. In our opinion the action of an anti-inflammatory drug is based on the inhibition of the proteoglycan synthesis in the anabolic phase of the inflammation.


[Our experience with the nephrourological care of children]. 1. A successful medical care for nephro-urologically ill children can only be guaranteed by efficient cooperation.--2. For more than 5 years there has been close collaboration in this field between the Department of Urology and the Department of Pediatrics in the Berlin-Friedrichshain Hospital.--3. In evaluating our experience some basic conditions are described which may serve as prerequisites for a successful cooperation.--4. Details of the content and organisation of cooperation between different clinical specialities vary according to local conditions.


[Fractures of the forearm in children; operative treatment (author's transl)]. The knowledge of the special characteristics of fractures in childhood determine the method of treatment. Within 2 1/2 years 162 fractures of the forearm were treated, 23 of them by open reposition. The specialities of the different anatomical regions and the best way of treatment are discussed. Conservative and operative methods complement each other to obtain the best result while the risk for the little patient is reduced.


[Bone scan of acute hematogenous osteomyelitis in childhood (author's transl)]. A variety of 99m-Tc-phosphate compounds are sensitive and reliable for scintigraphic diagnosis of bone diseases. Therefore bone scan has become a safe method for evaluating patients with suspected acute hematogenous osteomyelitis. So we were able to perform early and adequate treatment without evidence of bony changes in the radiograph. Quantitative regional measurements with a relative uptake ratio was found to be a clinically useful parameter in the follow-up of osteomyelitis.


[Indication for limb replantation (author's transl)]. The indication for replantation of traumatised limbs cannot be forced into any scheme. Each single case has to be critically considered as individual problem with main reference to age, sex, general condition, profession and motivation of patient and personal competence and qualification. A factor of central importance is the amputated part itself. The following facts are of special interest: which extremity is afflicted, the level of amputation, the extent of local tissue destruction, the duration of ischemia and measures of preservation.


[Alteration of serum enzyme activity after trauma and/or bacterial infection (author's transl)]. Our clinical and experimental study is based on the evaluation of the changes in enzymatic activity produced by surgical, traumatic and infectious agression. To this end we have evaluated the activity of the transaminase (GOT-GPT), malic dehydrogenase (MDH), lactic dehydrogenase (LDH) and creatine phosphokinase (CPK). The details of our study are based on a total of 175 patients and 82 animals (dogs). Our results show that the highest rate of enzymatic activity was in proportion to the seriousness of the wound (lesion) produced. The clinical course-index developed from the activity of CPK and MDH allows us to evaluate and predetermine the course which our patients and our animals were to follow.


[Different indications for endoprotheses of the hip joint (ceramics (Al2O3) or internal shells?) (author's transl)]. The internal shell endoprothesis for the hip joint after Wagner has considerably limited the indications for the implantation of ceramic endoprotheses to patients under 60 years, because less bone substance has to be sacrificed. Furthermore there are indications for ceramic endoprotheses in cases of substance defects of the femoral head and neck, to some extent also in cases of dysplasia and protrusio acetabuli, and by loosening traditional total hip endoprotheses.


[Therapy of fracture-dislocations of the humerus head]. Dislocated fractures of the head of humerus are rare and prognostically unfavourable. In elderly patients only functional therapy should be practiced. Surgery attempts to make operative reduction of the dislocation and careful fixation of the head of humerus. Endoprotheses may relieve the patient from pain, but cannot restore active mobility due to the lack of muscle insertion.


[Nutrition of pregnant women (author's transl)]. The increase of energy supply during pregnancy by about 300 kcal (= 1.3 MJ) applies only to the last three months. During lactation an additional energy supply of about 800 kcal (= 3,3 MJ) is required. At the beginning of pregnancy the individual body weight is recommended to be within the standard limits of optimal weight depending on body height, body structure and body composition. On this base the individual energy supply should be estimated. Data, basing on physiological values refer to the daily intake of protein, fat and carbohydrates. Furthermore, reliable recommendations are given as to the intake of calcium, phosphorus, iron, zinc, magnesium, iodine, sodium, potassium and chloride for pregnant as well as lactating women. Approximate values are supplied for other essential minerals. The vitamin supply during gravidity and lactation is studied in detail, especially as to the vitamins A, D, E, B1, B2, niacin, B6, folic acid, B12 and ascorbinic acid. Unsystematic substitutions of vitamins and minerals during gravidity are not indicated. Finally common basic principles for nutrition of pregnant women are laid down.


[The clinical picture and pathogenesis of cervical pregnancy]. A report is given on a true cervical pregnancy connected with placenta percreta destruens in the sixth month of pregnancy in a twenty six-years old woman after her first pregnancy had been interrupted. A pathogenetic correlation between the induced abortion and the cervical pregnancy seems to be very probably. A damaged cervix probably offers the fertilized egg a more convenient oppertunity for the nidation. The prognosis of those dramatic ectopic pregnancies firstly depends on the early decision on carrying out hysterectomy in order to stop the dangerous bleeding.


[The possible role and task of the round ligament in the mechanism of labor]. The following conclusions were drawn from thorough checks of anatomic, histological and clinical data as well as from palpation findings and their statistical evaluation regarding the function of ligamentum rotundum in pregnant uterus: 1. Changes of the round ligament were found to be correlated with the occurrence of various forms of labour insufficiency as well as of abnormal presentation and position. Such pathological conditions would be attributable to developmental anomalies of the round ligament, its instability, and cicatrisation following inflammation and surgery and resulting asymmetrical position of the uterus. --2. Clinical experiences obtained by the author is likely to suggest that pathological position of the round ligament would rule out spontanous labour.


[Labor and puerperium of the adolescent patient. A 15-year study from 1951 to 1975]. Among 32459 deliveries from 1961 to 1975 at the Gynaecology Department of the Martin Luther University in Halle there were 194 adolescent mothers under 18 years of age. This corresponds to a percentage of 0,6%.--These "adolescents" were compared with an equal group of primiparae between 22 and 24 years of age.--There were no essential differences in the delivery procedure between the adolescent and the control groups. Operations to speed up delivery had to be performed less often in the adolescent than in the control group. The quota of premature deliveries amongst the adolescents which stood a 16%, was higher than in the control group, where the quota amounted only 9%. In both groups no differences were found in the perinatal mortality rate.


[The change of cervical state during pregnancy (author's transl)]. The causality between late abortion respectively premature birth and cervical insufficiency is proven. The prophylactic and therapeutic cerclage can be a contribution to a reduction of the frequency of premature births. A sound knowledge of the physiological state of the cervix uteri during pregnancy is necessary for a well-timed indication. This problem was confirmed by a study with 258 longitudinal examinations (134 nulliparae, 124 parae). There was no significant difference between the two groups of patients. The change of the cervix uteri is described in 45 cases of cervical insufficiency without labour. In most of the cases the disease developed from a physiological initial or intermediate stage within a short time. Short-term controls are necessary in case of divergency from the physiological state.


[Experiences in diagnosis of placenta praevia by ultrasonic B scanning (author's transl)]. In a clinical experiental report the ultrasonic placentography is evaluated as a very reliable method in the diagnosis of pathological insertion and in the differentiation between the low lying placenta and the placenta praevia. In late pregnancy a control examination is required to find a favourable development as a result of the placental migration.


[The effect of preventive cesarean section in breech presentation on perinatal mortality]. This study is based upon 1229 infants delivered from breech presentations who were investigated for the influence of the prophylactic Caesarean section carried out with primiparae after their 36th week of pregnancy in 1972, on perinatal mortality. The periods under report, i. e., 1966 to 1971 and 1972 to 1975, were compared with one another. The incidence of Caesarean sections carried out in breech presentations increased from 11.6% to 52.2%. With a premature birth rate of 22.1% and 20.9%, respectively, the uncleaned perinatal mortality decreased from 109.2% to 96.5%, whereas the cleaned one dropped from 73.3% to 64.2%. As to mature infants delivered vaginally or by Caesarean section, there was no significant difference in death rates. The worse prognosis for breech presentation infants given birth by pluriparae could be confirmed. The high portion of underweight infants amounting to 78.0% and 82.9%, respectively, in the total number of perinatal deaths illustrates the main problem of the breech presentation births.


[Screw electrode for fetal monitoring (author's transl)]. A screw-electrode for the cardiotocographic monitoring is described. Starting from the demands of an efficient screw-electrode the electric and mechanical attributes are explained. The clinical results demonstrate the efficiency of the new electrode. It takes of a feto-fetal ECG.


[Ptyalismus gravidarum].

[Ptyalismus gravidarum]. Report is given about a case of Ptyalismus gravidarum. The data found in literature about the theories of etiology and the possibilities of therapy are discussed. The use of psycho-therapy is advised.


[Report on a computer based evaluation of 1,800 cases of abortion]. 1800 cases with interruption of pregnancy are subjected to a computer analysis by means of a data-adjusted medical record for patients with interruption of pregnancy, which is in use in our hospital since 1975. The age distribution reveals a frequency peak between the ages of 35 and 38 years. The striving for a 2-children family is evident. Operating complications occurred in 1.1 per cent of the cases only, 0.4 per cent were perforationes and 0.7 per cent were lacerations of the cervix. This is due to the general application of the vacuum aspiration and the preferred performance of the operations up to the 10th gestational week. The great significance of the application of effective contraceptives is emphasized, since 48 per cent of the women had renounced contraceptives without any reason. Over 40 per cent of the women had employed contraceptives previously, but later on they had abandoned such means, 20 per cent of these women without a special cause. The physician's responsibility for the education of the women is stressed.


[Problems of sigmoid diverticulitis in the female and its differential diagnostic delineation from the left-sided adnexal tumor]. In the last three years 42 patients with complicated diverticulitis were treated surgically. There were 18 women in all. Nine of these women were believed to have gynecologic disease because of the palbable pelvic tumor and were hospitalized at the Gynecologic Department. 2 patients underwent an exploratory operation by gynecologic surgeons based upon preoperative diagnosis of ovarian mass. The diagnosis at operation in all two cases was perforated sigmoid diverticulitis. Another three of the nine patients had initally emergency exploratory operations by gynecologic surgeons based upon diagnosis of pelvic mass. Also here the diagnosis at operations were perforated sigmoid diverticulitis and they underwent emergency primary resection of the perforated sigmoid by surgeons. In all the cases of complicated diverticulitis the surgical proceature was the primary resection; the anterior resection was combined with a temporare transverse colostomy.--Diverticulitis is an important differential diagnosis of a left pelvic tumor in women with or without clinical and laboratory indications of infections and history of diverticulitis.


Further progress with oncolysis due to apathogenic clostridia. Cl. onc. apathogenic for human beings and small animals is not able to cure tumor-bearing hosts. Combined treatments with local X-irradiation and local HFH have decreased the death rate of Harding-Passey-Melanoma-bearing mice. A cure rate of ca. 20% has resulted for the first time in such experiments. The survival time has increased significantly, however relapses occured on the sites of transplantation which finally killed the animals. Therefore it was tried to repeat the threefold-combined treatment. The animals with a relapse tolerated such a second and third series well. After the second series of treatment some animals became free of relapse and some after the third series. That means, if repeating treatment with local HFH, local X-irradiation, and i.v. spore-application of Cl. onc., it is possible to cure the Harding-Passey-Melanoma of the mouse at a high percentage.


[Enzymatic mechanisms of the oncolysis by Clostridium oncolyticum M 55 ATCC 13.732 (author's transl)]. After a short review of older attempts at explanation of the oncolysis by Cl. oncolyticum M 55 a new theory will be presented. In connection with new results of enzymological investigations the metabolic correlations between the tumor cell and the vegetative clostridial cell and the consequences of the results for an oncolytic therapy will be demonstrated.


[Salmonella freiburg: a new salmonella-serotype (3,10:1,Z13:1,2) (author's transl)]. A new Salmonella serotype (S. 3,10:1,Z13:1,2) was isolated from a stool specimen of a 13 year old immigrant from Narpan, USSR. The strain was finally identified as a new Salmonella, Subgenus I, on August 10, 1975 by Prof. Le Minor, International Salmonella Centre, Paris. The organism was introduced into the Kauffmann-White-Scheme, Supplement XX, as S. freiburg.


The problem of interaction of shigella with epithelial cells. A review and analysis of data on the investigation of factors concerning the initial events of interaction of Shigella with epithelial cells: attachment of penetration are presented. In the experiments with 3H-labeled bacteria it was shown that although common pili confer adhesive properties to bacteria but the penetration of Shigella into the cell is not increased. It was stated that LPS of Shigella O antigen plays an important role not only in interaction with cellular and humoral factors of the macroorganism defence but also in an initial stage of attachment of bacteria to the membrane of epithelial cells. However LPS of O antigen does not provide the penetration of the agent into the cell. In filtrates of virulent strains of Shigella flexneri, in contrast to those of smooth mutants and hybrids, lacking penetration ability, a biologically active factor (BAF) of protein or lipoprotein nature which reduced the LD50 of virulent and avirulent bacteria in infection of chicken embryos on chorioallantoic membrane, decreases ID50 and complicates the course of the infectious process in conjunctival infection of guinea pigs with virulent Shigella strain was revealed. S. flexneri transductant with a restored ability to induce kerato-conjunctivitis restored an ability to produce the BAF as well. Comparison of these data with the findings of other investigators was carried out. Perspectives of interpretation of penetration mechanism of Shigella into epithelial cells are discussed.


[Humoral factors in the regulation of the natural resistance of the body in toxic lesion of the liver]. The dynamics of natural resistance factors (complement, lysozyme, the bactericidal potency of blood serum) were found to be similar in rabbits with the toxic lesions of the liver resulting from the administration of carbon tetrachloride and in intact homologous rescipients receiving the serum of poisoned animals. Simultaneously a decrease in the complement titre and an increase in lysozyme activity and in the bactericidal potency of blood serum were observed. The effect thus revealed could be suppressed by treating the serum with contrical, a polyvalent proteinase inhibitor.


[Stability of the immunogenic properties of plague vaccine strain EV, Research Institute of Epidemiology and Hygiene line, during long-term storage]. The experiments in guinea pigs showed that the immunogenic properties of plague vaccine strain EV, line NIIEG, freeze-dried in 1947 and stored under vacuum without animalization, remained unchanged for 30 years. The subcultures prepared from this train showed, after three passages in guinea pigs, good immunogenic properties which preserved for 6--10 years (the term of observation). After 30-years storage the stock culture of strain EV, line NIIEG, can be used for the preparation of NIIS live plague vaccine.


[Action of cyclophosphane on the formation of hemagglutinins and of nonspecific immunoglobulins in a microbe-free state]. A total of 39 germ-free and 28 conventional germ-free Fisher rats were used to study cyclophosphamide-induced specific (hemagglutinins) and nonspecific (IgG2) immunosuppression. Most pronounced effect of the drug was observed in germ-free animals. 180 mg/kg of cyclophosphamide completely suppressed hemagglutinin formation for at least 8 weeks.


[Detection of the capsule of staphylococci isolated in urological diseases]. In studying the cultures isolated from urological patients the seed material was found to yield a high proportion (40%) of coagulase-negative, white staphylococci. Capsule-forming organisms constituted 58.8% of the isolated Staphylococcus aureus. As the presence of capsules is indicative of pathogenicity of staphylococci, in urological diseases the presence of capsulary strains in urine should be taken into consideration.


[Membrane protein spectra of staphylococci from a comparative physiological aspect]. Membrane protein spectra, obtained by electrophoresis in the system polyacrylamide gel--sodium dodecysolfate, were studied in 14 staphylococcal strains with different properties. The proteinograms of membranes were shown to be useful as an additional criterion in the identification of staphylococci. Fractions and their combination characteristic of all the strains and their separate groups were revealed in the protein spectra of staphylococcal membranes.


[Heteromorphism of corynebacteria. II. Microcells]. The formation of microcells is one of the manifestations of the heteromorphism of Corynebacterium. It can occur in 6 ways, of these, 3 are possible during septation (chaotic septation of gigantic macroforms, irregular multiseptation of elongated organisms, and microcells appearing as inserts at the sites of the septum formation), and 3 in undividing cells (microcells at the edge segments of the protoplast, exogemmation, endogemmation). The analysis of the ultrastructure of microcells indicated the possibility of their independent existence for a certain period of time.


[Immunological mechanisms of specific hyposensitization in allergic diseases of an infectious nature.. I. Hyposensitization with autovaccine]. Immunological processes in 17 patients with infectious allergic bronchial asthma accompanied by chronic respiratory tract infection were studied in dynamics resulting from the hyposensitization of the patients with autovaccine. Specific sensitization was shown to produce stable clinical remission. The therapeutic effect of this method was ensured by a simultaneous hange in non-specific cellular and humoral immunity. A stable therapeutic effect was observed gainst the background of activated immunological processes and weakened sensitization.


[Reliability of the disinfecting action of pulse electrical discharges in water treatment]. The irreversibility of the damaging action of pulse electric discharges (PED) on microorganisms in the process of the disinfection of water was studied. The experiments with standard E. coli culture showed that bacterial cells remaining alive after being subjected to the action of PED eventually died the sooner, the higher the temperature of the medium was. In any of the "blind passages" made within 7 days no growth of the test microorganism was observed. The use of enriched fluid media and 10-day incubation did not ensure the preservation of proliferation ability of the cells after the action of PED with the parameters used in the experiment.


[Syndrome of constant muscle fiber activity (Isaacs syndrome)]. Two cases with expressed signs of a permanent muscular tension in the extremities with fasciculation (the Isaacs syndrome) and difficulties in self-service are described. In both cases the diagnosis was verified by typical EEG changes and a good effect from the use of a diphenylhydantoin or finlepsin.


[Status of connective tissue in progressive muscular dystrophies]. 60 patients with different forms of neuromuscular disorders were examined. Morphological studies of skeletal muscles and of diurnal excretion with urine of acetic GAG were carried out. It was established that the changes in the stromal connective tissue in the progressive muscular dystrophia appear in the early stages of the disease and affect both the essential substance and the fibrillar structures. The excretion with the urine of acetic GAG was increased. In denervative amyotrophy the changes became apparent against the background of marked clinical symptoms. The data obtained may be important for a differential diagnosis of progressive muscular dystrophy and denervative amyotrophy, and for the development of differential drug therapy.


[Variability of hereditary spinal amyotrophies]. Under conditions of the former isolate in 13 patients from 8 families hereditary spinal amyotrophy of adults was revealed, which is not in compliance to any other forms of this disease. The disease manifests in several generations of families at the age of 30--40 years in the form of anterior horn lesion to the cervical level in combination with the moderate "bulbar" and pyramidal disorders. The development of the disease is slow. The main type of inneritance is dominant. Histological study of a lethal case demonstrated the anterior horn lesion and the secondary character of amyotrophy.


[Neuromuscular disorders in hypothyroidism]. The authors conducted a clinico-electrophysiological study of 177 patients with hypothyrosis of different etiology in order to investigate the nature of neuromuscular disturbances in this disease. Neuromuscular disturbances in these patients are shown in the form of hypothyroid myopathy, hypothyroid pseudomyopathy, combinations of hypothyroid myopathy with pseudomyopathy and hypothyroid pathological muscular fatiguability. The mechanism of origin of this pathology is considered and the efficiency of complex treatment of neuromuscular disturbances in hypothyrosis is demonstrated.


[Clinical variants of essential tremor]. On the basis of a study of 100 patients with essential tremor from 54 families, 3 clinical variants of this disease were distinguished: classical monosymptomatic form characterized by tremor; a form where tremor is combined with other little marked extrapyramidal symptoms; a form where tremor is combined with little marked symptoms of cerebellar structure insufficiency.


[Spinal mechanisms of movement disorders in torsion dystonia (electromyographic analysis)]. A clinico-electromyographical study of 25 patients with torsion dystonia was carried out. The author studied evoked responses of the muscles of the lower extremities (H-reflex, M-response, F-wave) during the electric stimulation of the tibial nerve and the general electric muscular activity both at rest and in hyperkinesia. Two types of changes in the electromyographic data were revealed in the examined patients. It is suggested that there are certain differences in the neurophysiological mechanisms of motor disturbances in torsion dystonia. The role of the spinal apparatus in the development of dystonic hyperkinesia is considered.


[Attack-like course of schizophrenia in light of remote follow-up]. On the basis of a follow-up study of 146 schizophrenic patients preserving the development in the form of outlined attacks up to senility it was established that the recurrent development occurs only in 7.8% of the cases (more rarely than in the general population of schizophrenic patients). In some cases the transition from a recurrent development to an attack-like progressive form was observed. In most patients with recurrent schizophrenia in the late age the attacks cease. The analysis of the patients with attack-like progressive schizophrenia showed that the increase of defect occurred only in young and middle age and despite the repeated recurrence in involutional age and senility, the development of the disease on the whole remains non-progressive.


[Nosologic position of confabulatory-paraphrenic psychoses of old age]. Three groups of elderly patients were studied. The state of these patients was characterized by confabulatory-paraphrenic delusion which developed for the first in senility. The nozological character of the first two groups of patients did not cause any doubt about their close connection with senile dementia. The third group of patients varied only by the presence of the confabulatory-paraphrenic delusion without any signs of endogenous or senile-atrophic processes. The comparative study of the psychopathological traits of confabulatory-paraphrenic delusion in all patients showed that in all three groups there was a similarity of this symptomatology. Besides, the type of personality traits and hereditary loading in all three groups of patients appeared to be similar. It is suggested that nosologically studied group of psychoses in old age developing only with confabulatory-paraphrenic delusion without endogenous or organic dementia first appearing in seniscence should be referred to be senile dementia.


[Catecholamine metabolism in various compensatory manifestations of epilepsy patients]. The authors studied the catecholamine metabolism with an additional use of the function loadings by insulin and adrenalin in 77 epileptic patients who were ill for a long time and had marked disturbances in mental activity. The study was conducted in dynamics. The authors revealed a considerable activation of catecholamine metabolism in patients with acute psychotic states during dysphoria and in periods close to attacks against the background of typical, for the studied group, depression of the sympathoadrenalin system. The differences in the nature of reaction to the functional loadings, changing in various stages of the disease development and reflecting, to some extent, the compensatory possibilities of organism were registered.


[Neutropenia in epilepsy patients].

[Neutropenia in epilepsy patients]. Blood neutrophils were studied in epileptic patients. Differentiation of neutropenia induced by epilepsy from neutropenia due to anticonvulsants enabled one to reveal that incidence of the latter amounts to 6%. Differentiation of drug-induced neutropenia (54 observations) depending on the pathogenetic mechanism or origin (tonic and allergic), features of the blood picture and the nature of the disease course (stable, recurrent, transitory) is of special importance for diagnosis and choice of therapeutic tactics.


[Epidemiologic-rehabilitation aspect of borderline neuropsychiatric disorders in students]. The prevalence, treatment and rehabilitation of students with border-line neuropsychic disturbances were studied in higher educational establishments. The intensive indices of the morbidity and incidence of border-line states amounted to 6.9 and 19.3 per 1000 students. Among the students of humanitarian faculties the number of the patients with border-line states was 6 times as great as compared to technical students and 3 times as great as compared to the students of biomedical and physico-mathematical departments. The authors recommend that the main attention in the rehabilitation of students with border-line neuropsychic disturbances should be attached to the outpatient programmes as they are the most effective for this group of patients. It is also recommended to organize specialized rooms of mental hygiene for students.


[Function and structure of narcological services for an urban population]. The author describes the experience in activities of the system of narcological profile institutions in Leningrad, determines their function and structure, gives a definition of a new, combined principle of a prophylactic medical examination for patients of a narcological profile. A prophylactic medical examination of patients according to their residence in addition with a prophylactic medical examination at a place of work of chronic alcoholic patients in a condition which makes it necessary to isolate organizationally narcological service as an independent type of specialized medical service for the population.


[Clinical diagnosis in degenerative diseases of the spine]. A new qualitative condition "illness" arises when its quantitative state attains a certain level (appearance of degenerative spinal changes). The qualitative verge is conventional, dynamic. The changes in the spinal defensive mechanisms shown by nervous system lesions and circulatory disorders may be regarded as its verge. Long-term remissions, appearing in a reverse transition of the qualitative verge may be considered as a clinical recovery in stabilization or even eventual progress of degenerative spinal changes. It is inadmissable to identify spinal degenerative processes with diseases produced by them. Varied and phasic clinical symptomatology appearance of long-term remissions, availability of the most informative methods of study for each phase, the effectiveness of therapeutic approaches and preventive measures, as well as the interests of differential diagnosis permit to consider the clinical manifestations of separate stages in the degenerative process as specific nozological forms regardless of their common vertebrogenic origin. The formulation of a clinical diagnosis depends to a large extent upon the generally acknowledged classification of the nervous system.


[Analysis of the distribution of ABO system blood groups among patients with spinal osteochondrosis syndromes]. The paper contains a comparative analysis of the distribution of the blood groups of the ABO system in 1731 patients with syndromes of spinal osteochondrosis and in 9013 representatives of the population. Besides the frequency indices the authors studied as well the index of a relative morbidity A/O the "racial-biochemical" Hirshfeld index and the relationship of the frequency of group 0 to the sum of frequency in the A, B, AB group. It was demonstrated that there was a significant drop in patients with spinal osteochondrosis of the frequency of the 0 group and an increase of the group A. These deviations demonstrate a correlation with the sex, age by the onset, localization of the process longitudinally to the spine and hereditary loading (cases of repeated cases in the family). The revealed regularities may be considered as evidence of the influence of the genotype on the development of spinal osteochondrosis as well as one of the mechanisms determining the immune response in this disease.


[Pathogenesis of symptomatic facial hemiatrophy]. The data on clinical and electroencephalographic examination of 19 patients are presented. The patients developed facial hemiatrophy after they had sustained ganglionitis of the superior cervical sympathetic ganglion, stem encephalitis, trifacial neuralgia (neuritic stage), tumours of the Gasserian ganglion and syringobulbia. A pathogenetic relationship between the development of symptomatic facial hemiatrophy and lesions of the vegetative and somatic apparatus in the cerebral (mesencephalotruncal area) and extracerebral (superior cervical sympathetic ganglion) structures of the nervous system is noted.


[Facial neuritis in middle-aged and elderly patients]. The progress of facial nerve neuritis was studied clinically in 59 patients of middle and old age with atherosclerosis and arterial hypertension. The patients were divided into 3 groups. An inflammatory genesis of prosoplegia was established in the first group (12 cases). The second group (24 cases) showed symptoms of the inflammatory process with a predominance of vascular insufficiency. This circumstance hampered elucidation of the etiology of the disease, but pointed to crucial significance of vascular factors in the development of prosoplegia. The third group (23 cases) demonstrated a vascular nature of prosoplegia. It is assumed that the importance of insufficiency in the blood supply of the facial nerve in the etiopathogenesis of prosoplegia in most patients should be reflected in the approach to its treatment.


[Role of functional interaction between the facial and masticatory muscles in the genesis of synkineses in patients with neuritis of the facial nerve]. The electromyogram of orbicular muscles of the eye and masticatory muscles was studied in 19 patients with facial nerve neuritis and 11 normals. In a maximum contraction of the masticatory muscles, the orbicular muscles of the eye showed an activity equal to about 9% of the maximum amplitude of the orbicular muscles. Similar activity in the paretic muscles was not decreased. The development of secondary synkinesia is postulated.


[Cerebral strokes. Incidence and mortality]. The paper presents data concerning the incidence of brain strokes and the mortality rate. These indices were received for the first time on a large population by the method of brain stroke register. The frequency of brain strokes during one year equaled to 2.5 cases, the mortality rate 1 case per 1000 population. Genuine indices of the incidence and mortality rates for different age groups were established. They appeared to be relatively high in people over 60 years. The mortality coefficient is higher in females. In brain infarctions the frequency and mortality is higher than in brain and subarachnoidal hemorrhages.


[So-called small-scope delusions].

[So-called small-scope delusions]. Analysis of psychopathological traits of the paranoiac syndrome in 60 patients with late schizophrenia permitted to distinguish certan signs which can be allocated to the differentiation of late schizophrenia from other delusional psychoses in the elderly. The following differential signs were underlined: initial symptoms, such as rudimentary cenesthopathia, stable insomnia, etc., preceding the formation of delusions; appearance of episodic exacerbations in the form of short-time acute paranoiac states; a combination of paranoiac delusion with stable phasic affective disorders; unusual possession of delusional patients expressed in bizarre delusional behaviour, etc. Using this example as a model, the necessity of further profound and differentiated psychopathological studies of syndromes distinguished as predilective for old age is indicated.


[Masked depression in the ambulatory-polyclinic section of the general medical network]. Some results reported concerning patients with masked depressions (MD), detected in one of the district consultative-diagnostic centers (DCDC). Masked depressions were established in 22.7% of patients who were consulted in the center during one year. Studies on the past history and motions of MD patients in the system of the city public health network, the psychopathological and nosological structure of MDs, controversial clinical evaluation in psychiatric institutions demonstrate a relatively large number of MDs in therapeutic and diagnostic work in general. The conclusion is made about the necessity of new forms in delivering care in this population and, in particular, of feasibility of including a psychiatrist in the staff of DCDC. This would make it possible to set up in the future psychosomatic wards of an intermediate type between a somatic and psychiatric hospital with open doors.


[Severity of depression (clinico-statistical study)]. A total of 218 patients from 19-40 years of age with different depressions were examined. Four types of depressive disorders were distinguished: neurotic, hypopsychotic, psychotic, depressive-paranoid. It was demonstrated that depressive conditions of various severity possess differential symptoms with significantly different probabilities. Each clinical group had a certain set of differential symptoms, the amount and syndromal-diagnostical value of which was in a direct correlation with the affect severity. Signs of depression got complicated only to a certain limit. In depressive-paranoid syndrome there was a splitting of the depressive symptomatology: enhancement of some symptoms and alleviation of others.


[Use of sleep deprivation for the purpose of treating protracted depressive states]. Sleep deprivation therapy was used in 30 patients with protracted, resistant depressive phases within the framework of manic-depressive psychosis. All patients demonstrated some improvement, which lasted from several hours up to 3 days. Changes in the state were mainly expressed in mood swings and to a less extent to the sphere of thinking and motor acts. A course of sleep deprivation (6-8 nights without sleep with an interval of 2-7 days) was administered to 19 patients, of them 7 patients demonstrated a stable improvement. Recording depressive symptomatology by the scale of intensity showed significant positive changes according to the following parameters: mood, thinking, motor acts, interests, sociability. The highest effect was seen in patients with melancholic pictures and significantly worse in depressive-anxious and depressive-obsessional syndromes.


[Comparative clinico-epidemiologic study of schizophrenic patients living in the central region and far northeast USSR]. The paper deals with comparative clinico-epidemiological studies on populations of schizophrenics, living in some districts of Moscow and the Far North-East of the USSR. It was shown that the clinical picture of schizophrenia in the North-East regions of the country is characterized by a milder development, a prevalence of relatively light psychopathological syndromes and attack-like forms of the disease. It was also demonstrated that the working capacity of patients in the North is higher, which is also related to the forms of development of schizophrenia and the microsocial conditions of this region.


The national qualifying examination for certification of nurse anesthetists: a report covering six examinations--November, 1975-June, 1978. Since 1975, the Council on Certification of Nurse Anesthetists has been responsible for the National Qualifying Examination Program, an essential component of the process whereby graduates of accredited nurse anesthesia educational programs gain certification in this nursing specialty. The following report has been prepared to share information about the examination program, including the results of the past six examinations.


[Vertical echoencephalography in the diagnosis of space-occupying brain lesions]. Vertical probing used in addition to horizontal probing in echoencephalographic examination of patients allows more exact localization of the volumetric process, especially one situated parasagittaly. Transducers of three frequencies, 0.88, 1,76, and 2.64 m. c. s., are used in the examination of patients. It is shown that transducers with higher frequencies, 1.76 and 2.64 m. c. s., have advantages over a transducer with a frequency of 0.88 m. c. s.


[Treatment of occlusive hydrocephalus of nontumor origin by endoscopic means]. In 11 patients whose ages ranged from 3 months to 5 years occlusive hydrocephalus of nontumorous genesis was treated surgically with the use of endoscopy. Perforation of the floor of the third ventricle, lamina terminalis, and commissures of the fornices and bougienage of the cerebral aqueduct were carried out. One patients died in the postoperative period, in the other 10 patients the immediate result was good. The follow-up of the catamnesis of 9 patients showed that a stable positive effect was produced in 8 of them. The endoscopic method is simple, causes little trauma, and is sufficiently effective as a method of surgical treatment of hydrocephalus of nontumorous genesis in childhood neurosurgery.


Legal aspects of anesthesia charting.

Legal aspects of anesthesia charting. To the anesthesia practitioner, the possibility of malpractice claims constitutes a very real and ever-present problem for it lies within the risks inherent in the administration of anesthesia. Since the areas of anesthesia which may be subject to suit are legion, the problem of malpractice becomes too complex to afford easy answers. Clearly, though, it is a problem all too serious to ignore. This article examines one aspect of the problem: the importance of good documentation in anesthesia.


[Experimental anatomic basis for tentorium cerebelli incisions]. The histotopographic features of the structure of the upper and lower layers of the tentorium cerebelli and the range of the age and individual variability of its dimensions were studied on 152 preparations. The main neuro-vascular structures are located in the lower layer of the tentorium. Two extreme forms of the structure of the neuro-vascular bundle are distinguished: main-line and spreading. Various localizations of the tentorial bundle are described: lateral, medial, and separate bilateral. A zone of the tentorium cerebelli that is relatively poor in vessels and nerves and comparatively favourable for incision is established. Measurements of the tentorium cerebelli according to age and sex made it possible to determine the optimum length of its incisions.


[Spinal cord hypothermia in neurosurgical practice]. Spinal cord hypothermia was conducted in 113 patients. It led to a decrease of bleeding from the tissues during the operation, reduced edema of the spinal cord, diminished spasticity of muscles, improved motor function of the affected limbs, and alleviation of the pain syndrome. Hypothermia of the spinal cord also caused changes in motoneuron excitability and circulation, both local and general, and shifts in body thermoregulation.


Preoperative and postoperative use of clonidine with neurolept anaesthesia. The abrupt cessation of clonidine therapy can induce a withdrawal syndrome. This may also appear immediately after anaesthesia if clonidine medication is discontinued during the operation day. We studied (1) whether the withdrawal syndrome occurs postoperatively as often as otherwise when clonidine therapy is discontinued, and (2) the action of this clonidine withdrawal on the circulation as compared to patients who received clonidine without interruption during the operation day. During the recovery period in 2 out of 10 patients in whom clonidine medication was discontinued, a hypertensive crisis occurred, which was relieved by clonidine readministration. Clonidine given with premedication eliminated high rises in blood pressure during anaesthesia. During the recovery period, the regular intramuscular administration of the same dose of clonidine as the patients had used orally decreased blood pressure to almost normotensive levels. The slightly increased urinary catecholamine excretion and plasma renin activity in these patients might, however, indicate that the circulatory homeostasis was disturbed in some degree. The results suggest that it is important to give clonidine continuously, even during the operation day. The dose may be the same as, or preferably somewhat smaller than that which the patients have previously received orally.


Local anesthetics: importance of mode of application, concentration and adrenaline for the appearance of nerve lesions. An experimental study of axonal degeneration and barrier damage after intrafascicular injection or topical application of bupivacaine (Marcain). Local anesthetics are designed for application in or close to nerve tissue. In spite of their wide clinical use, surprisingly few investigations deal with the neural toxicity of modern local anesthetics. In this experimental study, the effects were investigated of intrafascicular or topical application of the long-acting local anesthetic bupivacaine on the rabbit sciatic nerve. Axonal degeneration was histologically evaluated and a fluorescence-microscopic technique used to detect lesions in the blood-nerve barrier. Topical application of bupivacaine in clinically recommended concentrations around the nerve caused no detectable nerve injury, while intrafascicular injections caused considerable axonal degeneration and damaged the blood nerve barrier. Axonal degeneration was the same after injection of physiologic saline solution and bupivacaine 0.5%, but it increased with increasing bupivacaine concentration and especially with the addition of adrenaline. On the other hand, the acute effects of intrafascicular injection, as visualized in the barrier experiments, changed little with the addition of adrenaline, indicating that it is the injection trauma itself which is deleterious. It is concluded that intraneural injections should be avoided and that plain bupivacaine solutions should be routinely used.


Regional lung function and central hemodynamics following normovolemic hemodilution in the dog. Regional lung function, using xenon 133-radiospirometry, and central hemodynamics were studied following normovolemic hemodilution with dextran 70. Normovolemic hemodilution to hermatocrit values of 25% increased cardiac output and pulmonary blood volume significantly. The systemic oxygen transport and mixed venous oxygen tension were unchanged. The acute hemodilution did not significantly change the distribution of ventilation or prefusion within the lungs. It is hypothesised that a tendency to an increase in arterial oxygenation is due to a reduced interstitial pressure in the basal region of the lungs, resulting from water absorption by the hyperoncotic dextran used for hemodilution.


Prevalence and prognostic significance of coma after cardiac arrest outside intensive care and coronary units. In 181 patients resuscitated from cardiac arrest, the prevalence and duration of coma were registered and related to the site of occurrence of cardiac arrest, cardiac rhythm during arrest, age and clinical outcome of the patients. Coma was most frequent after cardiac arrest outside the hospital, as 84% of these patients were comatose for more than 1 h and 56% for more than 24 h; the corresponding values for patients with cardiac arrest in general wards were 63% and 30%, respectively, and for patients with cardiac arrest during ambulance transport, 80% and 44%. Permanent brain damage was extremely rare if the coma lasted less than 6 h (1 out of 62 patients), and relatively rare with a coma duration between 6 and 24 h (5 out of 34 patients). Of the patients, 85 remained comatose for more than 24 h and only 7 of them were discharged alive, all with cerebral impairment of a severity increasing with the duration of the coma. None regained consciousness after more than 7 days' coma, and a total of 80 patients died in coma, 20 with signs of cerebral death. Older patients were more vulnerable to coma than younger ones, but coma as such was not more frequent. We found no differences in coma after asystole and ventricular fibrillation. Problems concerning the selection of patients who have a chance of survival, although comatose after cardiac arrest, are discussed.


Cerebral circulatory and metabolic stimulation with nitrous oxide in the dog. Reconfirmation by the simultaneous measurement of cerebral blood flow using direct and Kety-Schmidt methods. In both the presence and the absence of nitrous oxide (57%, end-tidal), cerebral blood flow (CBF) was measured by a direct method in dogs, and compared to an indirect method (Kety-Schmidt method), using argon as the tracer. Eighteen comparisons were made in five dogs at flows ranging from 45 to 123 ml per 100 g per minute. There was no systematic difference in CBF between the direct and indirect methods, and the ratio of direct CBF to indirect CBF was 1.03. The cerebral circulatory and metabolic stimulation effect of N2O in the dog was reconfirmed.


Arrhythmias during halothane anesthesia IV. The influence of a single dose of suxamethonium. The effect of a single dose of suxamethonium on cardiac rate and rhythm during halothane anesthesia with babiturate induction was studied in a prospective, triple-blind trial with 28 patients. No atropine was given and patients were not intubated. A slight but significant preponderance of sinus-bradycardia without hemodynamic consequences was found in the group given suxamethonium. Suxamethonium did not provoke ventricular ectopies or conduction disturbances. It is concluded that in anesthesia with barbiturate induction, but without atropine or intubation, the use of a single dose of suxamethonium is a safe procedure with regard to cardiac rate and rhythm.


ECG electrodes. A study of electrical and mechanical long-term properties. The long-term properties of commercially available ECG-electrodes were studied by investigating the parameters: polarization potential, electrical impedance, adhesion, and skin reactions during a period of 7 days. As expected, the most stable polarization potentials were obtained for Ag/AgCl electrodes. Certain simple disposable electrodes showed large polarization potential variations. The most stable electrode impedance was obtained for disposable electrodes with stable adhesion and equipped with an electrode cup or similar. Unchanged adhesion and mechanical properties during the test period were shown by the disposable electrodes with a large self-adhesive collar.


The normal juxtaglomerular apparatus in the human kidney. A morphological study. Out of 49 serially studied juxtaglomerular apparatuses, 6 typical variants from two normal human kidneys were reconstructed graphically. The agranular Goormaghtigh cells filled the entire space between the macula densa, the afferent and the efferent arterioles and the glomerular mesangium. The Goormaghtigh cells were always in direct contact with all the other structures. They also invariably continued into the glomerular mesangium. The distal tubule regularly showed widening in the macula densa segment and, at this level, there was considerable variation in the shape of the distal tubule. Direct contact between the macula densa and the hilar arterioles was not always present, the area of contact was usually greater with the afferent than with the efferent arteriole.


Light- and electron-microscopic observations on the closure of the secondary palate with the primary palate and the nasal septum. Closure between the secondary palate and the primary palate and between the former and the nasal septum was studied in the Syrian golden hamster at light- and electron-microscopic level. Sequential changes in the epithelia before, during and after the closure of the primary and the secondary palate were described. A characteristic epithelial thickening was observed prior to epithelial fusion between the nasal septum and the secondary palatal shelf. Fusion of the opposing epithelia was characterized by formation of desmosomes. An unilateral or bilateral empty space was observed on each side of the epithelial seam, and it was suggested that this may represent the incisive foramen in the adult.


Ganglia formation of the peripheral nervous system. Embryologic studies have shown that the ganglions of the peripheral nervous system are formed by the neuroblasts from the central nervous system. The histotopography of the neurons and their segmental communications with the central nervous system are established experimentally (segmental section of the ventral roots and resection of the spinal nodes: 100 experiments). It is proved that the neurons, which communicate with the definite segment of the spinal cord, are diffusely distributed in the ganglion mass.


[Ultrastructure of the normal human adrenal cortex]. Electron-microscopic investigations on the human adrenal cortex have been carried out in order to elucidate ultrastructural differences in the various zones. These studies indicate that certain differences in the ultrastructure of the mitochondria may be particularly useful as criteria to differentiate the three cortical zones. In this regard, the appearance of two types of mitochondria in the zona glomerulosa as well as in the zona fasciculata is of obvious interest. The probability of a relationship between the activity of the different cortical zones and the predominant presence of one form of mitochondria has been suggested. In addition, ultrastructural transformations following stress situations as well as problems dealing with the so-called 'dark and light cells' and the basal membrane are discussed.


Mechanical structure and function of the craniofacial skeleton of the domestic dog. Masticatory habit is a major factor determining the morphology of the craniofacial skeleton. The craniofacial skeleton essentially comprises a series of bony stress-bearing bridges forming a structural framework. The structural framework of the skull of dog has been described as a rigid trestle-like structure; it can be illustrated by mechanically removing nonresistant areas of bone. It is then found that a framework is produced which is partially rigid (cranium) and partly flexible (rostrum). It is postulated that the flexibility of the rostrum acts to absorb shock and it is suggested that the primate postorbital bar is developed in response to craniofacial morphology which increases compressive bite forces.


[Electron microscopic study of the effect of colchicine on limb bud cartilage in organ culture (mouse embryos)]. Limb buds of 11-day-old mouse embryos were cultured. On day 5, 0.1 mM colchicine was added for 3, 6, 12 or 24 h in vitro. 3 or 6 h after application of colchicine, electron-dense granula appear to an increasing extent. These granula can be interpreted as collagen-containing secretion granula and as an indication of a secretion inhibition. The peripheral localization of the granula groups speaks for an effect on the actual discharge of the secretion after having passed the Golgi apparatus. Additional effects of colchicine are fragmentation of the Golgi apparatus and an increased occurrence of bundles of fine filaments. Since only few microtubuli occur in the periphery of the chondroblasts and recent studies indicate an influence of colchicine not only on the microtubule system, a site of action at the functional unity 'cell membrane-microfilaments' is discussed. 12 or 24 h after colchicine application, the contents of the congested secretion granula change. The occurrence of cross-striated structures indicates an activity of procollagen peptidase in the granula in the case of secretion inhibition. In addition, cytolysosomes (autophagic vacuoles) develop. The occurrence of polymorphism of the granula contents under these conditions is attributed to an effect of lysosomal enzymes.


Increased coronary collateral blood flow. A possible mechanism of action for betahistine-HCl. beta-Histine-HCl has been shown to be effective in modifying the size of developing myocardial infarcts. In the present study the hypothesis that beta-histine increases the flow of blood through collateral channels and thus supplies blood to ligated areas of the myocardium was investigated in the dog. The methods used were measurement of retrograde coronary blood flow and angiography after coronary artery ligation. beta-Histine administration for 6 h increased retrograde blood flow 68.2--91.0% over controls. Coronary angiography demonstrated the existence of collateral channels 200--400 micrometer in diameter within the myocardium after ligation and 4 h of beta-histine administration.


Histochemical analysis of mucosubstances and cytochemical studies of the Golgi region and the secretory granules of the normal gerbil gallbladder principal cells. The mucosubstances of the gallbladder epithelium of the Mongolian gerbil have been analyzed histochemically. The results indicated that they are composed of carboxylated and sulfated glycoproteins. A closer study of the principal cell structure with ultrastructural and cytochemical technique localized the glycoproteins to the glycocalyx, lysosomes, Golgi complexes, immature and mature secretory granules and basement membrane. Acid phosphatase activity was found in the lysosomes, immature granules and the irregular cisternae of the internal region of the Golgi apparatus. It is suggested that the acid-phosphatase-containing internal Golgi membranes may correspond to the GERL (Golgi-endoplasmic reticulumlysosomes).


[Ultrastructure of the secretory parenchyma of the postanal gland of the coelacanth, Latimeria chalumnae Smith]. Latimeria chalumnae Smith, the only surviving crossopterygian, possesses a well-developed, unpaired, postanal gland whose function is as yet undocumented. The availability of tissues suitable for ultrastructural and histochemical studies from the recent International Comores Expedition has permitted a reappraisal of the comparative morphology and functional hypotheses relating to the postanal gland. The richly vascularized tubuloacinar postanal gland is composed of cells which show the characteristic specializations of active ion transport. These include complex and extensive development of basal and lateral cell membrane infolding (cisternae) which are closely associated with numerous large, dense mitochondria. Histochemical studies have shown a high level of ATPase activity within the gland cells. These features of the postanal gland correlate well with those of the rectal glands of elasmobranchs and suggest a similar role in ion excretion and osmoregulation.


Evolution of the pineal gland in the adult chicken. The structural pattern of the pineal gland in the hen corresponds to a more advanced stage of the evolution which began in an early period of the animal's life. This evolution corresponds mainly to the transformation of the large follicular cavities into cellular 'rosettes'. The parafollicular layer disappears from the rosette wall which thus remains with only one row of cells (A and B pinealocytes). The cellular hypertrophy and the great development of the pinealocyte organelles in the adult pineal gland makes us think of this gland as a functionally active organ. This functional activity must have remained during the entire period of the time studied (1--5 years), due to the ultrastructural uniformity found and due to the fact that we could not observe any type of degenerative process in the gland.


Vascular supply of the testis of the camel (Camelus dromedarius). The origin, pattern of distribution and the length of the convoluted part of the testicular artery were examined by blunt dissection and by the preparation of arterial casts with vinylite. The testicular artery originates from the abdominal aorta just cranial to its bifurcation and forms compact coils and reveals a tortuous course in the region of the pampiniform plexus and along the attached border. The artery divides at the caudal extremity of the testis into 2--4 branches. The epididymal artery, which is a branch of the testicular artery, was seen to anastomose with the deferential artery, but no anastomosis occurs between these arteries and the testicular artery. The convoluted part of the testicular artery was 20 cm in length, but when unravelled totalled 240 cm. This is not affected by seasonal variations. The possible significance of these results was discussed and compared with similar findings of other mammals.


[Transformation of the rete ovarii into a rete testis and the epoophoron into an epididymis after experimental sex reversal in Gallus domesticus]. Transformation of the rete ovarii into a rete testis and of the epoophoron into an epididymis after experimental sex reversal in Gallus domesticus is described. After castration of female chicks, the medulla of the left ovary and/or the right gonadal rudiment develop into a testoid or an ovotestis. From general view, this is observed as sex reversal. In case of formation of a testoid, the epoophoron develops into an epididymis and the rete ovarii develops into a rete testis which consists of intra- and extratesticular and intracapsular parts. Thus, a luminated duct system is developed which allows the transport of semen. In case of formation of an ovotestis, the discontinuously side-by-side located parts of the rete ovarii and of the epoophoron are maintained.


[The effect of subtotal vagotomy of the plexus myentericus (Auerbach) on the function of the intramural nervous system. A quantitative histochemical examination in white laboratory mice]. The effect of a subtotal vagotomy on the function of the intramural nervous system of different parts of the intestinal tract is studied by means of quantitative measurements of the acetylcholinesterase (AChE) activity. By sham vagotomy it was possible to explore the effect of narcosis and laparotomy on the intramural nervous system of the intestine. Vagotomy is followed by a decrease in AChE activity of the ganglionic cells in all parts of the intestinal tract. A minimum of activity, about 50% of the normal concentration, is attained at the 16th postoperative day. After this time, a continual increase in AChE activity, along with a reactivation of the function of the ganglionic cells, can be observed. 90 days after vagotomy the ganglionic cells of the intramural nervous plexus show a normal enzyme activity. These results support the hypothesis that most of the cells of the myenteric plexus build up an autonomic nervous plexus, which is stimulated in an excitatory way by the vagus nerve and which will be inhibited by sympathetic stimulation.