[Effect of destruction of midbrain raphe nuclei on elaboration and preservation of heterogeneous conditioned reflexes]. The destruction of the midbrain raphe nuclei in rats results in a gradual drop of serotonin content in the brain. Its moderate drop, which setts in on the eighth day after ablation of the raphe nuclei, is not attended with any disturbance in elaboration of motor alimentary and defensive conditioned reflexes, while the retention of motor alimentary conditioned reflexes is sharply deteriorated. After a sharp reduction of serotonin content in the brain, which is observed on the fifteenth day after the operation, the animals lost their capacity to elaborate either motor alimentary or denfensive conditioned reflexes.


Intensive care unit in the University Teaching Hospital, Lusaka. A retrospective study for the year 1975. A retrospective study was made of cases admitted to intensive care unit at U.T.H. at Lusaka in 1975. Injury accounted for the majority of admissions and deaths. Head injury alone or in combination with other injuries was the commonest cause of admission and death. This study is hoped to help those who will work in the new intensive care unit and also to help those hoping to open similar units in Zambia.


[Hydroperoxide degradation by oat isomerase. Investigation of the reaction mechanism (author's transl)]. Oat isomerase is inhibited by hydroxyoctadecadienoic acids (monohydroxy acids) to a degree comparable with inhibition by linoleic acid hydroperoxides (LHPO). Hydroxy acids seem to combine with the enzyme like LHPO do. In an experiment on LHPO breakdown by isomerase 1-14C-hydroxy acids were added and it was examined whether the epoxyhydroxy acids are formed by an intermolecular or intramolecular mechanism. In this experiment 1-14C-labeled trihydroxy acids were formed; they arise from the hydrolysis of epoxyhydroxyoctadecenoic acids formed on their part by isomerase effected LHPO-breakdown. It was determined that at least 70% of LHPO are converted by intermolecular reaction.


[On the lipoperoxidase-isomerase-system from oat. Experiments for enzyme separation (author's transl)]. It was attempted to separate isomerase and lipoperoxidase activity from oat by means of gel and ion exchange chromatography and by isoelectric focusing. The molecular weight of the enzyme fraction tested was found to be of the order of 3 X 10(6) daltons. By ion exchange chromatography and isoelectric focusing the enzyme fraction with lipoperoxidase and isomerase activity could be separated into isoenzymes. These isoenzymes continued to exhibit both enzymatic activities. The lack of success in achieving of separation and the high molecular weight lead to the conclusion of the asistence of a close interrelation between the two enzymes or possibly of a bifunctional enzyme complex.


[Flavonols and flavones of vegetables. VIII. Flavones of carrot leaves (author's transl)]. The flavonoid constituents of carrot leaves (Daucus carota L. ssp. sativa) were separated by means of cellulose column chromatography, and the following compounds were obtained crystalline and identified by usual procedures: luteolin 7-beta-D-glucoside as the main flavon, luteolin 4'-beta-D-glucoside, luteolin 7-beta-D-glucuronide, apigenin 7-beta-D-glucoside, apigenin 7-rutinoside, chrysoeriol 7-beta-D-glucoside. Luteolin 7-rutinoside also was identified, but could not be obtained crystalline.


Multiple myeloma at the University Teaching Hospital, Lusaka: a retrospective study. A retrospective study of the clinical and laboratory findings in sixteen cases of multiple myeloma seen at the University Teaching Hospital, Lusaka between March 1972 and July 1976 was carried out. The majority of cases presented in the fourth and fifth decade of life. The commonest presenting symptom was bone pain and bone tenderness was the commonest physical finding. The majority of patients were anaemic and hypoalbuminaemic. Bence Jones protein was detected in only one case.


[Health education. Educational approach to change]. There is currently a widespread interest in health education and a need to better understand the bases of the educational approach to health problems. This paper examines therefore some concepts and methods underlying health education work. It is important that health education objectives are closely related to the effects of human behaviour (what people do for their health) on health outcomes. One can, for example, identify health behaviours which are consequential to health promotion, disease prevention and health care utilization. They provide a focus for educational interventions. Secondly, the strategy of health education is based on the assumption that health practices (or their underlying factors) are subject to change through educational and information methods. This health education is essentially a process of change through education and may involve a more general process of educating the public for health, or a more specific attempt at modifying particular health practices. Applying health education to health problems requires an understanding of the communication process and its components. A number of characteristics which may facilitate or hinder communication are discussed. Finally, health education is more than a services of unstructured influences on people's behaviour. It is a planned strategy involving several stages of change. Also, to be fully effective, health education interventions should be integrated in health programmes and services together with other public health mesures.


[Knowledge of attitudes and expectations: a prerequisite for effective health education]. Some global results are presented here several studies of psychosociology conducted in Lorraine; they deal with attitudes and expectations of the people about their health and are obtained from a special factor analysis. This method, of a descriptive nature, allows us to understand the pluridimensional universe of some of the representations considered and particularly to determine how each representation is connected with the others and how they are assembled within the whole system so as to establish typologies. The observation is made, notably by means of 2 projections on situational maps, that axis 1 establishes a bi-polarity among the wider tendencies such as medecine, physicians, health which corresponds, roughly speaking, to an opposition between "some collar" workers and "white collar" cadres, fatalists and non-fatalists. Less clearly appears a double splitting within the group of cadres and whtin the group of workers, the latter being less favored in the field of medicine and health. We can thus perceive 4 sectors where constellations of variables are organized and which correspond to typologies of attitudes. In fact, whether we rely on socio-professional stratifications or on mentalities, we must, to be efficient, take into account associations of attitudes as well as expectations, constructed according to this method, before starting selective actions of health education.


Ketalar its use by a single operator.

Ketalar its use by a single operator. Ketalar (Ketamine Hydrochloride) was used as the sole anaesthetic agent by a single operator in fifty cases of uterine evacuation. The procedure was easy in use, and safe. It was noted that Ketalar caused a significant increase in tone of the uterine musculature, obviating the need for oxytocic drugs. The incidence of emergence phenomena was low. The patients, and staff were well pleased with the outcome.


[Health education. Power of information for purposes of public interest]. Just as publicity contributes to develop the economic activities, so must do social propaganda for the health field also. But the latter has its own particular constraints. Used along, information reaches rapidly its limits, as long as it is not backed up by changes in regulations, specific to each relevant theme. On the other hand, a deliberate policy involving both information and new regulations can yield the most rapid and spectacular results. As for any investment, it is needed to try to evaluate the efficiency of information campaigns; some indicators must be chosen in order to follow up adequately individual changes in terms of knowledges, opinions and behaviour regarding the topic presented; explorations, surveys and analyses of quantitative and qualitative data have to yield major results, to be integrated in a synopsis. As an example, an a priori study done by the author is presented dealing with the effectiveness of a national scale anti smoking campaign developped in France (in 1976), the effects of which having been consistent with the forcasting ones.


[Health education within the scope of family-health evaluation]. Multiphasic health screening an increasingly used preventive tool, may represent major milestones in health natural history of individuals as well as groups (in addition to their own specific goals) in terms of basis for a preference educational action. Based on their own experience in such a screening Center in France working mainly with families, the operating of the health screening itself is shown by the authors to offer a nice back up for health education. The concluding talk with families, specific to this Center's policy yields a unique opportunity for all family members to ask questions on their health problems, as well as for each physician involved to promote changes in their health behaviour. This kind of educational action is exacting for the physician, who has to be able to hear and to communicate easily, and who has to be specifically trained for it.


[Health education: team work at school]. In this field, team work is invaluable, as the relevant frame for both content and method to be permanently readjusted to various levels imposed by the specific objectives. The better the members of this team are integrated into the educational system, as straff members of a service, the deeper the impact of the programme.


[Control of penicillamine therapy in patients with chronic polyarthritis through urine disc electrophoresis]. D-penicillamine treatment of 50 patients with rheumatoid arthritis with negative ANF tests, was followed by means of protein disk electrophoresis of the urine. In the beginning the urine proteins were analysed every 4 weeks, later at intervals of 3 to 6 months. A glomerular proteinuria, caused by an immune-complex nephritis, can be recognized very early by this method. A glomerular proteinuria was the reason for discontinuing the treatment in 10 of the 50 patients (8 seropositive, 2 seronegative), drug fever occurred in one case with seropositive arthritis. Protein disk-elektrophoresis of the urine is an appropriate method to recognise renal damage earlier than with any other known routine method.


[A technic for the differentiation of 2 metabolically different cell components, in homogenates or tissue sections, from the distribution of lactate dehydrogenase isoenzymes]. The authors report a mathematic-statistical calculation method for a differentiation analysis of LDH-isoenzyme distribution and the results obtained thereby. The necessity for the development of an improved method of analysis for isoenzymes stems from the fact that even homogenates of very small tissue samples (smaller than 1 mg wet weight) show remarkable statistical inhomogenicity in the distribution of the different fractions. This indicates that cells with very different isoenzyme distribution make up the homogenates and that a cellular inhomogenicity exists and that the origin of isoenzymes is non-uniform, respectively. The previously used description of LDH-isoenzymes is thus insufficient, mis-represented and needs a better differentiation. After representation of the theoretical basis for a differentiating method for analysis of two enzymatically different main cell components (A and B), results from embryonic, adult, degenerated, and malignant tissues are presented and discussed. It is shown that in normal and mature tissues there are always two cell components with different isoenzymes next to each other. It seems that via their metabolites there is a correlation between these apparently metabolically different cell components and they seem to be responsible for the biological homoeostasis over the period of life. Presumably the two cell components produce different glycosaminoglycanes (GAG) and collagen types. In connective tissue certain decoupling mechanisms between the cell components seem to be responsible for the self perpetuation and the chronic course of pathological processes.


[Body image in pregnancy].

[Body image in pregnancy]. Many women show a remarkable change in body experience during the second period of pregnancy; the enlarged abdomen is no longer perceived as such but as a child. These women have the impression that the child is growing forward and that they are themselves behind the child, sometimes also that the ventral body boundary has moved dorsally--less frequently even behind the child. This change in body experience should be considered as a kind of separation of the child from the mothers body, which can be more or less complete and which is interpreted as a gradual dissociation of the child from primary narcissistic mother child unit; this appears to be useful as a preparation for the birth and for the subsequent mother-child relationship. Factors which may influence the degree of dissociation are discussed. Self perception and awareness of other gravidae are particularly sensitive during pregnancy. The showing off the pregnancy in a sense of self-disclosure is an emotionally important act.


[Effect of sodium fluoride on DNA metabolism during therapy for osteoporosis]. The influence of sodium fluoride therapy on semiconservative DNA-synthesis and DNA-excision repair was investigated in lymphocytes of the peripheral blood of 6 patients with osteoporosis. The daily dose of sodium fluoride was 25 mg in the first week, and subsequent 50 mg during a period of 15 to 37 weeks. No significant effect on the tested parameters was found in 5 subjects. One patient showed significantly inhibited DNA-repair in the lymphocytes up to the ninth week, but during subsequent therapy normal values were obtained in this patient also. In conclusion sodium fluoride seems to have no effect on DNA-metabolism in lymphocytes of patients with osteoporosis.


[Studies of disinfection of hemodialysis instruments]. Fever reactions in dialysis patients may partly be traced back to the transmission of pyrogens from the rinsing solution compartment into the sanguiferous system. The pyrogen concentration increases with the germ contents of the rinsing solution, which, therefore, should be kept as low as possible by suitable desinfection measures. For the artificial kidney Gambro AK 3 a hot water desinfection of 90 minutes at 90 degrees C or a formalin desinfection of 30 minutes, respectively, for the artificial kidney Leuven IIIC the formalin or peracetic acid desinfection of 30 minutes each proved to be sufficient.


[Serum glycoproteins as an index of protein metabolism in advanced chronic kidney failure]. The results of our investigation show that in patients under conditions of haemodialysis as well as under conservative therapy the changes of the serum levels of haptoglobin and transferrin are more clearly and less difficult to be recognized than those of the total protein and albumin level. Therefore the serum glycoproteins with a short half-life period may successfully be used as index of the protein metabolism in patients with chronic renal insufficiency as well as additional factor for the assessment of the therapeutic success.


[Automatic data processing in our dispensary care for patients with nephrolithiasis]. It is reported on an advantageous mechanical data processing in nephrolithiases, which was organised by the authors and is performed in form of a "nephrolith-dispensary-card" with filtration of the data and mechanical questioning.


[Abnormal grief reaction].

[Abnormal grief reaction]. Pathological grief reactions following the death of a child are reported on the basis of five case studies. In contrast to acute grief reactions these pathological syndromes are of long standing. One parent had not truly accepted the death of the child. The denial of reality is sometimes a defence against aggression towards the deceased, because of his having left one behind. The mourning process comes to no end but remains in its initial phase. At the same time the life of the mourner stands still, as in the house and the family everything is left unchanged. Family interactions alter, particularly between the parents. For the genesis of these grief syndromes the following is of relevance: The death occurs at a time, when another child cannot replace the one who died. Mature independence had not been reached by either parent or child. Death destroyed expectations that this child would succeed in that which the parent had been unable to achieve. The parent had not seen the child after death--a gap in the continuity of experiencing which made acceptance of the irreversibility of the loss even more difficult.


[Psychosomatics of myasthenia].

[Psychosomatics of myasthenia]. The therapeutic experience with myasthenic patients is difficult. It is suggested to interprete myasthenia gravis as psychosomatic illness because of lower conflicttolerance, onset by emotional situations, abnormous patterns of behaviour and personality, and suspected neuro-psychological disturbances. In our pilot-study with 13 patients we found disturbances in early childhood, sexual behaviour and dreaming. The intelligence (I.Q.) had a high average. 11 patients showed abnormous personality, 9 patients a pathological Benton-Test, perhaps an information of higher cerebral disorder. Supportive psychotherapy of myasthenic patients in close cooperation with neurologists is proposed.


[Solitary renal cyst as a focus of sepsis in a child]. Report on a 9-year-old boy with infected solitary cyst of the kidney on the left, resulting from this chronic relapsing sepsis with abscess of the spleen, perforation of the abscess into the left subphrenium, subphrenical abscess, basic empyema of the pleura on the left, purulent system of the fistulae in the left upper retroperitoneum. Causative organism: staphylococcus aureus. After 6 successless attempts to command the process from the flank side section, the transperitoneal radical operation with extirpation of the spleen, resection of the cyst and removal of the left upper retroperitoneum was carried out. After transient improvement acute relapse of the sepsis after 6 months with subcutaneous abscesses and empyema of the ankle joint on the left. Causative organism again staphylococcus aureus. Under repeated surgical, antibiotical and general treatment rapid and final disappearing of the sepsis. Since 3 1/2 years free from recidivation.


[Benign cystic teratoma (dermoid cyst) of the ovary perforated into the urinary bladder]. In a 25-year-old female patient with right-sided adnex tumour and inveterate infection on the urinary tract a benign cystic teratoma (dermoid cyst) perforated into the lumen of the urinary bladder could diagnosed cystoscopically. As therapeutic method of choice the tumour with the adjacent part of the wall of the urinary bladder was operatively removed. The histological investigation confirmed the right ovary as starting point of the tumour. Pathogenetic and etiologic points of view of the perforation of dermoid cysts of the small pelvis into adjacent hollow organs are discussed in short. When a perforation into the lumen of the urinary bladder is present, among others the clinical symptoms of the flux of hair and fatty paste with the urine belonging to this give good diagnostic references.


[An objective method for forming diagnostic sub-groups of ulcer patients]. 79 ulcer patients were arranged in 6 seb-groups by means of a Q-analysis. Relevant items of their self-images in the Giessen-Test selected through factor analysis were the basis of this sub-grouping. Description of the sub-groups was based on factor analysis of 5 dimensions and discriminance analysis of 3 dimensions obtained in the self-perceptions and self-images. The patient's view of his illness, his social status and his physical ailments were also included as dimensions of the 6 sub-groups. A clinically obtained typology of the characteristics of these sub-groups was checked and verified.


[Unusual mesenchymal mixed tumors in the kidney region]. On the basis of four cases of extensive benign mesenchymal renal tumours (angiomyolipomas), of which three were histologically ascertained and the fourth was detected during the diagnostics of a case of Pringle-Bourville's disease, the general symptoms as well as the problems of the angiography in benign renal tumours are explained. The coordination of the angiomyolipomas to the choristomas is discussed. It is referred to a conservative-surgical approach in small tumours and to long-term controls, respectively, in clinically symptomless incidental findings.


[Case contribution on the clinical aspects and therapy of retroperitoneal xanthofibrogranuloma]. The retroperitoneal xanthofibrogranuloma is a rare disease with still unclear etiology. The clinical symptoms are uncharacteristic and in connection with laboratory-chemical and radiological findings let us first think of a malignoma. According to our opinion the therapy of choice is the radical as possible removal of the xanthofibrogranuloma, which is in most cases only possible with simultaneous nephrectomy. A superradicality is not necessary. The prognosis is good.


[Simultaneous diagnosis and simultaneous therapy in a clinical-psychosomatic station]. According to modern understanding, bodily, spiritual and social symptoms are seen as the expression of a kind of transmissive disturbance. One could just as well speak of a disturbance in the cybernetic control systems. In this context we understand simultaneous diagnostics and therapy as a proper technique for the understanding and treatment of psychosomatic illnesses. In simultaneous diagnostics and therapy, it is not a matter of adding-up the various symptoms, but rather a matterof an independent method of integrating the various areas. As can be seen in a statistical evaluation of the patients in the clinical psychosomatic station in 1975, a few characteristic tendencies could be traced. By a listing of the frequency of complaints and the correlation with somatic findings, a somatic diagnosis could be found in 60% of the patients. With 36% of the patients no definite connection could be found between the somatic diagnosis, that is the clinical diagnosis, and the main complaints. Besides that, the duration of the symptoms was determined. Important new viewpoints were found in the psychological area in a total of 27 patients and in the somatic area in a total of 19 patients.


[Burst abdomen (author's transl)].

[Burst abdomen (author's transl)]. The so called "burst abdomen" is a very serious complication in the course of wound healing. Local factors are of modifying influence. In our own material the number of wound dehiscences has decreased due to the use of non-absorbable suture material and carefull pre- and postoperative therapy in regard to the compensation of disturbances of protein and electrolyte metabolism. Since a causal influence on processes of wound healing is not possible, these factors are of special importance.


[Experiences with a biological adhesive system (fibrin) in the dressing of kidney parenchymal wounds (animal experiment and 1st clinical experiences)]. We report on investigations describing the use of a biological adhesive system for tissue adhesion and local haemostasis. This system consists of highly concentrated native fibrinogen and thrombin. Clotting factor XIII is admitted for reinforcement of the fibrin network. In experimental partial kidney resection this system was used with excellent results. This experience led to successful application of this method in 15 patients who underwent partial nephrectomy for various diseases.


[Laser and wound healing (author's transl)]. Orientating experiments upon rats did not give any information about a specific effect of laser beams on wound healing. The same results were achieved by infra red photoradiation. Further research with histological and histochemical tests will be necessary.


[Is curative treatment of breast cancer necessarily connected with radical mastectomy after Rotter-Halsted? (author's transl)]. Lokal recidivation rate in carcinoma of the female breast represents besides the 5- to 10-years survival rate an important parameter for primary surgical treatment. At the Chirurgische Universitätsklinik Tübingen radical mastectomy in the Rotter-Halsted technique as well as extended radical mastectomy were abandoned because they did not improve the survival rate. Surgery of the female breast is now performed according to different stages of the carcinoma. A comparative study in non-selected patients of our hospital showed that local relapse of the breast cancer did not depend on surgical technique, if the tumour was removed with a sufficient safety distance and postoperative megavolt radiation was performed.


[The department system in surgery (author's transl)]. The organisational model practised at the Department of Surgery at Hannover Medical School during the last 8 years has proven practicable, efficient and largely satisfactory to all of the staff. It is derived from Anglo-Saxon prototypes, differing from these, however, in a considerable participation of the residents in questions essential to their progress. The modalities of cooperation within the Department are presented in detail and ways and modalities for avoiding intra- and extradepartmental friction are discussed.


[Postoperative haemolytic jaundice due to deficiency of G-6-PD (author's transl)]. A case of postoperative haemolytic and cholastatic jaundice after cholecystectomy with no G-6-PD activity is reported. Enflurane is supposed to be the cause in this postoperative jaundice. Considering the fact that Glucose-6-Phosphate-Dehydrogenase deficiency is quite common depending on the patients' origin, this cause must be taken into account and the G-6-PD activity of the erythrocyts should be determined.


[Pulmonary embolism (author's transl)].

[Pulmonary embolism (author's transl)]. The most frequent causes of pulmonary embolism are emboli originating from thrombi out of veins of the lower extremities and the inferior V. cava, mainly relating to patients with malignomas. The clinical picture is dominated by insufficiency of the heart and the lungs. The ECG shows pseudo-coronary changes. Half of all cases do not result in immediate death. There is enough time for investigation, diagnostics and adequate treatment. Angiography of the pulmonary artery is of utmost importance. Good results can be achieved by fibrinolysis (urgent conservative treatment) via a catheter in the pulmonary artery.


[Carcinoma of the stump after gastric resection for gastric ulcer and adenomatous polyps (author's transl)]. The authors followed up 123 patients with carcinoma of the gastric stump. In this report 39 patients were analysed with carcinoma that developed after stump resection for gastric ulcer or polyps; 35 were operated on including 20 radical operations. The authors conclude that in residual and recurrent carcinoma of the gastric stump as well as in diffuse and mixed initial carcinoma stump extirpation should be the method of choice. For primary exophitic growing and especially in old and weakened patients it is more advisable to perform subtotal resection than stump extirpation.


[Reconstruction in bronchial stenoses of tuberculous origin (author's transl)]. Most of all bronchogenic stenoses are not caused by tumours but by tuberculosis. To diagnose stenoses of the bronchi bronchoscopy and bronchography are extremely helpful. The information the give is of decisive influence concerning adaquate reconstructive surgical measures. Early and late results of 108 patients operated on for tuberculous bronchial stenoses are reported. No mortality.


[Hyperbaric oxygenation, its perspective in cardiac surgery (author's transl)]. The present state of hyperbaric oxygenation permits now its application in surgery, reanimation and internal medicine. 153 patients underwent hyperbaric oxygenation: in 135 cases for cardiac surgery in combination with extracorporal circulation, in 18 cases due to urgent indications (air embolism, delivery of woman suffering from severe heart failure).


[Surgical treatment of the Dumping-syndrome (author's transl)]. We observed 106 patients suffering from severe dumping syndrome after gastric resection. For remedying the authors performed Billroth-I reconstruction, the Sacharov-Henley operation, antiperistaltic interposition of a short jejunal segment and practiced a new method of their own: interposition of a long iliac segment. The results obtained are reported.


[Soave operation in congenital and idiopathic megacolon (author's transl)]. 70 infants and children (1,5 to 10 years of age) underwent a Soave-operation, 3 deaths. bad 1, satisfying 4, good 62.


[Explorative laparotomy and splenectomy for staging Hodgkin's disease in children (author's transl)]. We recommend explorative laparotomy with splenectomy in the field of Hodgkin's lymphoma even in childhood. Operation is an early therapeutic and diagnostic method enabling further treatment to be made in relation to the stages of the disease. A chance of better survival seems to exist in children with Hodgkin's disease.


[Spontaneous or idiopathic colonic perforation in the newborn (author's transl)]. The present research informes about aetiology, pathology, clinic and therapy of spontaneous or idiopathic perforations of the colon in the newborn. According to our experiences it is a matter of a multifactorial proceeding like perforations in other parts of the gastrointestinal tract. The hitherto existing clinical and experimental experiences indicate that the ischemic component plays an important part in the aetiology of this disease. Only the knowledge of the polyaetiology of idiopathic perforations--which are more properly subsumed under the term necrotizing gastroenterocolitis--and an early diagnosis by a gynaecologist or a pediatrician as well as an early surgical intervention can save the lives of those newborns.


[Postoperative rupture of the abdominal wall in children (author's transl)]. An evaluation of 105 cases of abdominal wound rupture is reported which represents 1.9% of a total of 5,552 laparotomies performed in children during the years 1960 to 1975. Most ruptures occurred in infants. Prior to other reasons, the frequency seems to depend on the original disease. 23% of the cases, predominantly newborns and infants, had a lethal course.


[Funnel chest operation and age (author's transl)]. Analysing 199 cases of funnel chest operations the following proposals are to be discussed: early operation of boys in a modified Ravitch-technique with transverse osteotomy of the anterior sternum-wall, resection of the xiphoid process and fastening of the perichondrium to the pectoral muscles. The cosmetic indication excludes a late operation. If any late operations are performed they should be considered only for girls. Stabilisers should be used only in case of later operations, recurrences and asymmetrical forms. No operation should be performed in case of genetic defects (malformationsyndrome, flat-chest and channel-chest). The therapeutic results should be made objective by means of the sagittal inner thorax-diameter after Stucki. The submammary incision should be omitted.


[Ureteric lesions in childhood (author's transl)]. Diagnosis in these cases is particularly difficult. By early intravenous pyelography the site of the injury can be located and presence and function of the contralateral kidney be proved.


[Impulse-cytophotometric studies of spermatozoa for the demonstration of fertility disorders]. Sperm populations from 65 patients with fertility disturbances were investigated by pulse cytophotometry. The determination of the cell number showed 21 normospermias, 14 hypospermias, 19 oligospermias, 9 polyspermias, and 2 cryptospermias. As controls were used sperm samples of fertile men. The pulse cytophotometric DNA histograms were made full use quantitative and qualitative. The results of these investigations represent a methodical contribution for the diagnosis of fertility disturbances of men.


[Examination of male sterility].

[Examination of male sterility]. There is a description of the main principles for the exploration of male fertility and the evaluation of the results thus obtained. In spermiological investigation the importance of an objective evaluation of sperm motility is emphasized. There is a well-arranged outline of the lower standard limits and the average spermiological values in ejaculates of normal fertile men as well as the nomenclature, both the one used in Prague Institute of Sexology and the suggestion of the international nomenclature given by the Andrology Club.


[Significance of the ascorbic acid test in the determination of ovulation in sterility patients]. The study is engaged with the possibility to use ascorbic acid value for better determination of ovulation in sterile patients. We investigated the acid excretion in 8-hour-urinary-portions of 21 patients following daily application of 600 mg ascorbic acid from the 4th to the 20th day of menstrual cycla. Comparing the results to morning temperature, spin--and fern phenomenon of the cervical mucos and biopsy of the endometrium we found the excretion minimum in 61,9% 2 till 3 days before rise of the morning temperature and at the end of the praeovulatory phase. Correlation between ascorbic acid metabolism and ovulation are under discussion.


[A new technic using polyethylene tubing in oviduct occlusion]. To preserve the tubal patency after tuboplasty the polyethylen prosthesis remains without passing the intramural part of the tube inserted into the ampulla of the tube only ewith a lenght of 3 to 5cm- avoiding decubitus or any other instrumental damage on the tubal lining. The correct insertion of the prosthesis as well as of the tubal patency may be controlled by instillation of a methylen blue solution. After removing the prosthesis the tubal patency would be preserved by hydropertubation with a solution containing antibiotics.


[Terminology and chemotherapy of the so-called endodermal sinus tumor]. In addition to a discussion on the histogenetic, terminological and clinical problems concerning the so called endodermal sinus tumor a typical case in a far advanced stage is reported. Chemotherapy with vincristine and adriblastine was not able to influence the deleterious course of desease. Anyhow, since little is known about the effect of chemotherapy on the so called endodermal sinus tumor, this report might be of advantage.


[Studies on the recording of cytostatic effects on organ cultures of squamous cell carcinoma of the uterine cervix]. Organ cultures are a suitable in vitro test--object for pretherapeutical testing of cytostatic resistance on carcinomas of the cervix uteri. The decrease of activity of lactic dehydrogenase and isocitric acid dehydrogenase, determined histochemically, can be used to monitor cytostatic effects at the cultivated tumour. In preparing chemotherapy schedules for advanced cervical carcinomas, cytostatic agents provedly ineffective in vitro should be avoided.


[The differentiated perinatal care for high-risk pregnancies (author's transl)]. The grounds for a change in the organisation of perinatal care in CSSR were the for years stagnating perinatal mortality and high of the perinatal morbidity. Since the modern diagnostics and effective therapy of the high-risk pregnancies represent considerable demands upon the instrumental and personnel equipment, a system of a differentiated ambulatory and institutional care for pregnant women and newborn has been worked out, that will ensure the maximal care to those who need it. The differentiated care for woman in the course of pregnancy and labour and for the newborns in the first weeks of life is divided into three degrees: basic for all, increased for risk cases and specialized for selected complications. The selection of risk cases is performed by means of simple screening methods, a further selection of the most serious cases by means of special diagnostic methods. The system of differentiated care has been worked out and checked in one of the Prague's districs with 200,000 of inhabitants under the guidance of the Institute for the Care of Mother and Child, Prague-Podolí. Now it is being introduced in all districts of the country.


[Injury hazards in deliveries using the Shute forceps (analysis of 1016 forceps deliveries)]. Report about 1016 deliveries by means of the parallel forceps (W. B. Shute). This group contains pathologic-anatomical results of 30 stillbirthes or died newborns. Accordingly to the classification in subarachnoidal, subependymal or subdural hämorrhage there are only in two cases signs of obstetrical brain damage. The hypoxia is the most important reason of intracraniale haemorrhage. In order to an objektive indication, without progredient signs of fetal hypoxia the extraction by means of parallel forceps is not dangerous. We have used the instrument for extraction as well term as preterm infants with good results.


[Comparative intranatal and postnatal electrocardiography in normal labor]. The comparison of intranatal and postnatal electrocardiograms shows, that in spite of the hemodynamic important transposition of the infant circulation are no remarkable differences in the electrocardiogram. Remarkable is also the resemblance of electrical axises in the intranatale and postnatale ECG, at which we report particularly on the estimation of the electrical axis of the fetal heart, introduced by Larks. The estimation of this axis in the fetal ECG and its position call the attention as additional diagnostical criterion in some cases to an intrauterine fetal distress or a congenital heart disease.


[Social consequences of birth in adolescents]. 234 Austrian women gave birth to a child in the years 1972--74 before the age of 18. 95 of them were invited to an interview and interrogated about changes in their life-situation due to the birth. The general attitude was, if they could choose again the date of the first pregnancy they would prefer after 20 years. No correlation was found between early menarche and early sexual intercourse. For 60 of the women pregnancy was the reason for their marriage. Most of the young women had experience with contraceptives, but did not use them for different reasons. After the birth of the child most of them took the pill, but there are 11 women left without any contraception, exposing themselves to the risk of a repeat pregnancy. Young age at birth has an impact upon pre-vocational training: either through interruption of the training or through total discontinuation of their education. A possible solution of the present unsatisfactory situation for young pregnant women and their social problems are interdisciplinary projects for the guidance of adolescents in some centers in the USA.


[Quantitative alterations to resorption villi of normal human placentae in the course of gestation (author's transl)]. A total of 45 placentae of different gestatory age were used to study, after clinically and anamnestically normal pregnancy and by a morphometric method, the quantitative behavior of individual parts of the placental barrier in the course of gestation. For this, hematoxylin-stained preparations and enzyme-incubated semi-thin sections were used. The increase in the percentage of fetal vascular surface with a simultaneous decrease in the relative percentage of villous surface (when determining the ratio of villous surface surrounded by maternal blood to the fetal vascular surface) up to the 28th week of gestation must be considered an expression of an increase in the capability of function. The simultaneous distinct decrease in the average number of Langhans cells and the reduction of their less differentiated forms in favor of those showing a higher degree of differentiation allow to make the conclusion that around the 28th week of gestation conditions in individual villi are, in general, similar to those prevailing in term placentae between the 37th and 41st weeks of gestation. The results obtained from the basis of quantitative studies of the placentae of premature infants and babies born at term after different gestatory risks.


[Macroscopically determined placentary conditions in the case of underweight neonates (author's transl)]. The placentary conditions (weight of placenta, placenta/infant weight index, kind of attachment of the umbilical cord and allantochorial vasculature) of underweight neonates (eutrophic premature infants and hypotrophic babies born at term), which were macroscopically determined under routine clinical conditions, are compared with those of eutrophic babies born at term after clinically and anamnestically normal pregnancies. Significantly lower weights of placenta and significantly higher placenta/infant weight indices of underweight neonates must be differently assessed for prematurely born babies and hypotrophic infants born at term. The significant increase in the case of underweight neonates of the disperse type of allantochorial vasculature does not suggest any significant relations to either lower weights of placenta or lower weights of newborn infants within the individual classification groups. There is no increase in the number of marginal-velamentous attachments of umbilical cords in the case of underweight neonates. Also, reference is made to the limited importance of macroscopically determined placentary conditions to individual cases.


[Use of a microtiter-system for the determination of the antibiotic susceptibility of staphylococci with tetrazolium salts (author's transl)]. Antibiograms of staphylococci were determined in a microtiter-system (fig. 1) within 4 h. The reactions could be clearly demonstrated by the use of tetrazolium salts. The procedure proved to be particularly useful for quantitative studies.


[Experimental infection of mice, gerbils, and rats with mycoplasms from canine pericardium and cardial value (author's transl)]. Mycoplasms isolated from heart valves (A. laidlawii (A 42 Hzbtl)) and pericardium (M. canis (A 56 Hzkl)) of dogs were investigated for infectivity of rats, mice and gerbils (Meriones unguiculatus). In mice the species M. spumans (PG 13), M. maculosum (PG 15), M. edwardii (PG 24) and M. molare (H 542) were investigated too. The mycoplasmas were inoculated by oral, subcutaneous, intravenous and intraperitoneal route. Intraperitoneally the mycoplasmas were given without and with complete and incomplete Freund adjuvants. The injected Mycoplasmas did not produce any disease and could not be reisolated from rats and gerbils. From mice A. laidlawii (A 42 Hzbtl), M. canis (A 56 Hzkl) and M. edwardii (PG 24) could be reisolated after intraperitoneal administration in emulsion with complete and incomplete Freund adjuvants. Whereas M. canis (A 56 Hzkl) and M. edwardii (PG 24) could be reisolated from lung, liver and spleen only, A. laidlawii (A 42 Hzbtl) was present in heart muscle too. In histological investigations the mice which got A. laidlawii (A 42 Hzbtl) intraperitoneally with complete Freund adjuvants showed focal lymphocytic infiltrations in the myocardium.


[Investigations on the carcinogenic burden by air pollution in man. XVI. Formation of combined carbon black and benzo(a)pyrene aerosol (author's transl)]. Two methods for the preparation of carbon black aerosols have been investigated: incomplete combustion of acetylene, acetylene + benzene and other hydrocarbons as well as a "resublimation" of amorphous carbon. The first method was developed for generating soot aerosols in animal experiments, but the latter method needs more basic investigation. Using radioactive acetylene and benzene the produced soot aerosol could be labelled by 14C. Benzo(a)pyrene aerosol was prepared by means of a vapour condensation and was also radioactive labelled. With a combination of both generators, a combined carbon black and benzo(a)pyrene aerosol was prepared. The benzo(a)pyrene amounts bound to the soot were in the range of from 1 ng to 50 microgram per 1 mg soot. Experiments dealing with adsorption and desorbtion of benzo(a)pyrene on soot in the gas phase have shown, that benzo(a)pyrene is relatively tightly adsorbed and cannot be easily or completely desorbed.


[Parallel determination of blood lead levels and clinical investigation of children with surgical diseases in an endangered area (author's transl)]. In an industrial area with heavy metal-processing industry investigations were made on 203 children with surgical diseases, questioning whether there is a correlation between blood lead level on one hand, and kind of disease, season of year, load by lead fall-out in the residence on the other hand. A correlation between blood lead level and amount of lead fall-out in the residence of the patients could not be proved.--Seasonal changes did not influence the height of the average blood lead level.--Stress situations like operations and serious diseases had no significant influence either. Parallel determination of 139 blood samples in two institutes showed essential differences in the individual results.--Conclusions of earlier investigators in the same industrial area could not be proved in essential items as mentioned above.


[To the behaviour of cadmium and lead in children with a different cadmium or lead burden]. An epidemiological study of 413 randomly chosen children in age of 2--14 years living in an industrial town is presented. According to their place of residence they were either burdened with cadmium from a forge or with lead from the traffic. The different burden was refelcted not only in the blood lead level but also in blood cadmium level respectively. Both contaminants showed in their separate effects the same behaviour. The intensity of the absorption of lead or cadmium respectively influences not only the relationship between blood lead level or blood cadmium level and the other parameters (Pb-H, Pb-U, Cd-H, Cd-U, d-ALA-U) but also the distribution of these parameters.


[Induction of the immunologic response in vitro]. Immunological response (primary and secondary) was induced in a suspension of mouse splenic cells on nutrient media containing embryonic calf serum or serum against the erythrocytes of an animal--the lymphoid cells donor. The in vitro immunological response was accompanied by a specific increase in a number of the hemolysin-forming and rosette-forming cells. The optimal for induction of the immunological response in vitro was a dose of 10(7) erythrocytes per 1 ml of the culture. It was shown experimentally that antierythrocytic serum could be used instead of the embryonic calf serum to induce the immunological response in vitro. An increase in the count of rosette-forming cells and no increase of the hemolysin-forming cell count was observed on the nutrient media without 2-mercaptoethanol.


[Morphologic and histochemical responses of the body to introduction of C1. botulinum toxin. V. Response of locus coeruleus cells of the brain to introduction of the toxin of C1. botulinum type B]. After the per os administration of 1Dlm/ml of botulin, type B. there were observed at the period of development of the limb paralysis and myasthenia morphological changes in the locus coeruleus cells expressed in the development of a more pronounced than normal perinuclear clarification and some nuclear basophilia. Histochemical study of succinic dehydrogenase, acid phosphatase, cholinesterase, and catecholamines pointed to the intensified neuron metabolism of the locus coeruleus; this could serve as an indication of enhanced energopacemaker function of this nucleus in hypoxia which occurred.


[Immunologic and morphologic characteristics of experimental infection with Mycoplasma pneumoniae]. Pathomorphology of experimental M. pneumoniae infection in 3-week-old guinea pigs was characterized by an early cytopathic action of the causative agent on the bronchial and the alveolar epithelium, and also by progressive infiltrative-proliferative changes in the bronchovascular and interstitial tissue of the lungs against the background of morphological reconstruction in the immunogenesis organs. Immunological and histomorphological study of reinfected guinea pigs pointed to the presence of delayed hypersensitivity features in the response cellular-tissue reactions.


[Critical analysis of different concept of causation in infectious pathology]. The author presents critical analysis of different views on the problem of causation in the infectious pathology. The groundlessness of identification of individual causative factors with the cause was demonstrated. The dialectic conception on the cause of a specific interaction of the external (pathogenic causative agent) and of the internal (the organism reactivity) is substantiated. In considering the causation principle in the teaching on infectious diseases is substantiated. In considering the causation principle in the teaching on infectious diseases the author distinguishes: 1) causative (etiological) factor as one of the sides of interaction 2) the cause--a specific controversial process of the interaction of the sides leading to a new sequence; 3) conditions--factors influencing the interaction realization; 4) sequence--the result of interaction characterized by the origination of the disease or of the infection carrier state. The dialectic way of cognition should course from the study of the causative factors to their interaction, and through it to detection of the essence of the infectious process with the internal contradictions inherent to it. The methodological significance of the principle of causation in the investigation of the pathogenetic infection mechanisms and in the substantiation of rational diagnostic, therapeutic and prophylactic measures is presented.


[Dry medium for determining the beta-galactosidase activity of enterobacteria]. Differential diagnosis of enterobacteria is based on the determination of beta-galactosidase enzyme, hydrolyzing lactose in the nutrient substrates; however, the tests suggested for its determination are time consuming and their use in practice is limited. Dry nutrient medium prepared by the authors containing o-nitrophenyl-betaD-pyranoside was tested on 1625 strains of enterobacteria in comparison with the Le Minor's ONPS test used at present. The results of beta-galactosidase determination by the, mentioned methods proved to coincide (significance level greater than 95%); this permits to recommend the method described--in dry nutrient medium--as a differential-diagnostic test for the identification of enterobacteria.


[Detection of L forms of Vibrio cholerae in the water of open water reservoirs]. L-forms of cholera vibrios were isolated from the river water for the first time. The presence of L-forms in water permitted to suppose that such variants served as one of the forms of cholera causative agent preservation in the external medium.


[Study of the relationship between the trace element content and the physiological properties of Salmonella typhi during submerged cultivation]. The content of trace elements in the cells served as one of the characteristics of physiological condition of the population. The character of the changes in the trace elements content depending on the rate of the microbial multiplication pointed to the importance of the mineral sources of nutrition for the development of the cells analyzed.


[L forms of Streptococcus in the cultures of blood from patients with rheumatic fever in the active and inactive phases]. It was shown that L-forms of streptococci were constantly isolated by means of the method used by the authors from patients with rheumatism, irrespective of the activity and the course of the disease. The data obtained pointed to the presence of septicemia caused by the L-forms of streptococci in patients with rheumatism both at the active and inactive phase. In this connection it should be noted that modern clinical criteria of the activity of rheumatic process are unreliable.


[Epidemiological and immunological study of the foci of measles infection]. Anamnestic data in respect to measles failed to correspond to the results of serological examination of contacts at the foci of the given infection. The collective immunity level in children's institutions is inadequate for the prevention of measles outbreaks. The incidence of the disease depended both on the level of immunity among the children and on the duration of presence of the source of infection in the focus. Live measles vaccine protected 90 percent of the vaccinated children from contracting the disease in the foci. At the very beginning of the postvaccinal period immunization defects were revealed in 26.5 percent of the vaccinated children who fell ill with measles. Morbidity index among the vaccinated individuals constituted 3.8 percent. One of the causes of measles contraction by the vaccinated individuals was the loss of postvaccinal immunity. Systematic control over the antimeasles immunity level with the aid of serological investigations is necessary for the purpose of detection of persons sensitive to measles in children's collective bodies.


[Intensity of the epidemic process of whooping cough under conditions of mass immunization over a period of many years]. On the basis of analysis of whooping cough incidence in 1959 to 1975 in Moscow the authors present characteristics of the epidemic process under conditions of planned many-year immunization of children against this infection. Whooping cough morbidity proved to undergo significant changes-from sharp falls the first 8 years of immunization to a relative stabilization with a gradual reduction the last 5 years. Marked seasonal and periodic elevations persist against the background of reduction of morbidity. Preschool- and schoolchildren are equally involved in the epidemic process; the most frequently involved are nonvaccinated children aged 1 year and 4 to 10 years, which lost postvaccinal immunity. Further reduction of the severity of whooping cough and increase in the number of unimanifested forms of the infection was noted. This was apparently connected not only with immunization, but also with the reduction of the virulence of H. pertusis detected in studying the cultures isolated in Moscow from 1967 to 1974. The intensity indices of the epidemic process in whooping cough pointed to the necessity of using a more effective vaccine for the protection of children from whooping cough, despite the noted reduction of morbidity, and diminished severity of the course of the disease, and of the causative agent virulence.


[Study of allergic reactions in the body after experimental smallpox vaccination]. Experiments on guinea pigs demonstrated a mixed cellular-humoral character of allergy in smallpox vaccination. The ratio of cellular and humoral components depended on the site of the vaccina application. Skin manifestations in smallpox vaccination (hyperemia, infiltration, papula) were due to the multiplication of the virus proper, increased sensitivity of the surrounding tissues to the live vibrio, and specific immunological reconstruction. The skin of the sensitized animal after the anaphylactic shock in response to the intracardiac injection of the challenging dose of the vaccine virus acquired areactivity to its subsequent application.


[Study of the chemical and immunogenic properties of the capsular Staphylococcus aureus antigen. 2. Evaluation of the immunogenic properties of the capsular antigen in experiments in vitro]. Albino mice were immunized with a purified capsular antigen isolated from the S. aureus strain 1193/74. The presence of specific anticapsular antibodies in the sera of animals were determined by two methods: 1) by conversion of diffuse growth of a homologous strain into compact one, and 2) by determination of opsonic index in phagocytosis of homologous staphylococci by human neutrophils. It was revealed that antibodies converting the microbical growth were absent in the sera of normal mice and reached the highest level after the second antigen injection; opsonins were present in the sera of normal mice in widely varying quantities; their maximal level was noted after the 3rd immunization.


[Genotypical characteristics of the immunological Vi-antibody maturation depending on the effect of Vi-antigen deposit in the body]. The authors carried out a comparative analysis of the changes in the antibody synthesis and their immunological maturation in the immunization with various doses of the Vi-antigen of linear rats differing by the capacity to deposit this antigen. August rats with a high capacity to deposit the Vi-antigen (in comparison with Wistar rats in which this capacity was less)  were characterized by an increased level of highly avid antibodies. The interlinear differences were found in the character of the changes in the antibody synthesis depending on the immunizing dose of the antigen. Genotypical peculiarities of the immunological maturation of the antibodies were demonstrated. The authors suppose that the described phenomenon was genetically determined and referred to the factors determining the individual immunological reactivity. In the choice of the optimal immunizing doses of the antigens the authors recommend complex determination of the antibody level and the degree of their avidity.


[Participation of secretory antibodies in the protection from influenza]. Two collective bodies (319 persons in all) were under observation from October, 1974 to March, 1975 for the purpose of studying the problem on the participation of antibodies of the respiratory tract secretion in the protection from influenza virus, type A, infection. During the influenza epidemic outbreak there was revealed a reverse relationship between the antibody concentration in the nasal cavity secretion and the incidence of the disease, and also an interaction between the antibodies of the secretions and the serum in the influenza protection.


[Protective effect of cellular immunity in experimental Flavivirus infections]. Experiments were conducted with the tick-borne encephalitis (TE) virus; confirmation of a protective action of cellular immunity in mice was obtained. Administration of sensitized splenocytes to the animals together with the virus was accompanied with an increase of their mean survival or with the reduction of mortality in comparison with control animals given nonimmune or destroyed cells. The protective action of the effector cells was not connected with the intensification of antibody formation in the recipients. A high specificity of cellular immunity was noted in experimental flaviviral infections. The presence of common antigens in the TE and Langat viruses was revealed with the acid of cross splenocyte migration inhibition test (CSMRT). There was also revealed a difference of these viruses from the viruses of yellow fever, Dengue type 2, or Sindbis. The results of studying of the specificity of cellular immunity in the CSMRT found confirmation in experiments with adoptive transfer of splenocytes. Cross protection was caused only by splenocytes sensitized to the TE and Langat viruses.


[Study of the methods of specific desensitization therapy in immediate hypersensitivity to Streptococcus under experimental conditions. 1. Immunological data]. Three series of experiments were conducted on 427 guinea pigs. A model of allergy of the immediate type was obtained by 3-fold subcutaneous injections of 2 mg of lysed streptoallergen with an imcomplete Freund's adjuvant. The effect of allergens (corpuscular--vaccines, lysed, and streptoallergens after Ando-Verzhikovsky) varying by physico-chemical properties was studied in the first experimental series. The best hyposensitizing action was produced by vaccine used for the study of the influence of various doses on the sensitized organism. Two doses were approved: the threshold one (diluted 10 times) and the subthreshold one (diluted 10000 times). The use of the threshold doses caused reduction of increased sensitivity of the immediate type. In the III experimental series this dose was injected subcutaneously, intradermally, and intravenously. Subcutaneous method proved to produce a more marked hyposensitizing action in comparison with other methods.


[Value of the immunological indicators in the study of the health status of the chemical industry workers]. The use of some humoral, cellular and barrier immunity indices in the examination of practically healthy persons having an occupational contact with the complex of pesticides and grisine, an antibiotic intended for fodder revealed the presence of changes in various non-specific immunological reactivity links. The detected changes in the indices of the ingestive and digestive function of neutrophils could be interpreted as a compensatory reaction of the organism in response to the action of chemical agents, whereas reduction of lysozyme content and the appearance in the microbial pattern of deep dermal layers of mannite-splitting and hemolytic froms of microbes pointed to the presence of the first unfavourable shifts in humoral and barrier immunity factors. The indices of immunobiological reactivity were found to be sufficiently sensitive and could be used as auxillary tests of prenosological diagnosis of pathology of chemical etiology.


[Effect of leukocyte cation proteins in vitro on the activity of the pathogen of meningopneumonitis]. A study was made of the influence of cation proteins from the lysosomes and nuclei of rabbit polymorphonuclear leukocytes on the survival of the causative agent of meningopneumonia in vitro. As revealed, the greatest antibiotic activity was possessed by the nuclear histones and the low molecular basic proteins of lysosomes. Biological significance of the detected effects is discussed.


[Cerebral syndromes in acute pneumonias]. The paper deals with an analysis of some clinical and electrophysiological (EEG, EMG, REG) studies in 300 patients with focal and croupous pneumonia accompanied by the nervous system lesions. The authors distinguish clinical syndromes of the nervous system lesions in acute pneumonia. It was possible to demonstrate a certain correlation between the character of electrophysiological data and the severity, localization of pneumonia, and the prevalent lesions in different parts of the nervous system. It was also possible to show the role of acute general cerebral oxygen insufficiency due to disturbed respiration and concomitant acute cardiac insufficiency in the pathogenesis of nervous system changes in acute pneumonia. In such cases there is an anoxic brain anoxia with an insufficient oxygen supply of the cortex, brain stem formations and the spinal cord.


Pulmonary edema and pneumonia as symptoms of a secondary stem syndrome in strokes. The clinico-anatomical analysis of 162 patients with strokes demonstrated the correlation of frequency and severity of changes in the lungs (edema-pneumonia) from the expressiveness of the secondary stem syndrome and the severity of secondary changes in the brain stem due to its dislocation, edema and disturbances of brain circulation in the brain stem substance, both in hemorrhages and strokes in the cerebral hemispheres. Pulmonary edema-pneumonia can be referred to one of the symptoms of the secondary stem syndrome developing against the background of a strong dislocation of the brain stem and accompanied by either the damages of hypothalamus nuclei or blood influence on the walls of the 3d ventricle in parenchymatous-ventricular or subarachnoid-parenchymatous hemorrhages.


[Ultrasonic flow metering in the diagnosis of occlusive lesions of the extracranial portions of the carotid arteries]. The paper is concerned with the results of a new method of investigation--ultrasound fluometry, based on the Doppler effect. This method was applied in patients with atherosclerotic lesions of the carotid arteries. The authors studied 57 patients in the acute stage of the ischemic stroke and 32 patients with chronic insufficiency of the brain blood supply. The report describes the principle of the ultrasound debitmeter action. Some features of a total and subtotal occlusion and stenosis of the extracranial part of the carotid artery and the features of collateral circulation were detected. The authors point of comparable data of ultrasound fluometry and contrast angiography, and the valuability of ultrasound fluometry for the determination of indications to angiographic studies. The advantage of the new methods is the possibility of its use in outpatient practice and in hospitals for evaluating the effectiveness of the used treatment as well as for observing cerebral hemodynamics during the postoperative period.


[Ultrastructural changes in the liver in hepatocerebral dystrophy]. The authors studied the character of subcellular changes in the liver of 15 patients with hepato-cerebral dystrophy and compared them with 5 patients with hepatocirrhosis of a non-hereditary etiology. The mitochondrias suffer most severily from cell organella. Their pathology is more characterized by changes connected with the increase of electronic density and to a lesser degree by swellings. The correlation between the occurrence of electronic dense mitochondrias and the increased hepatocytelipid infiltration is marked. The ultrastructural study has confirmed a preventive role of the lipofuscin complex with cuprum. The main reason of the development of hepacirrhosis in hepato-cerebral dystrophy is the accumulation of cuprum nonutilized by pathogenetical mechanisms--lesion of mitochondrias, tissue hypoxia, necrosis of hepatocytes. The capability of neutralization and withdrawal of cuprum can determine the severity and rapidity of the development of the disease.


[Functional state of the kidneys of patients with severe cranio-cerebral injuries]. A study of 147 patients with a severe brain trauma demonstrated that in 84,3% of the renal cases there was a transient drop in the function, accompanied by a decrease in the glomerulus filtration and asotemia. The role of the catobolic process in the development of asotemia is being marked. The report contains a table for the estimation of the degree of renal insufficiency. In an assessment of the renal functions it is important to analyze each biochemical index and to select the correct time of such examinations.


[Clinical picture and localization of foci of softening in the brain following vertebral artery thrombosis]. The authors conducted a clinico-anatomical analysis of 45 observations with thrombosis of the  vertebral arteries. In the majority of cases thrombosis of the vertebral arteries was isolated. In 5 observations it was combined--with thrombosis of the carotid artery (2 cases), with the middle brain artery (2 cases) and with the posterior cerebellum artery (1 case). In one observation thrombosis of the right innominate, subclavian, general carotid and vertebral arteries was diagnosed clinically and angiographically. Thrombosis of the vertebral arteries occurs in the presence of expressed atherosclerotic changes in the brain vessels with acute stenosis.


[Surgical treatment of hypertensive intracerebral hemorrhages]. A total of 95 patients operated for hypertensive intracerebral hemorrhages during the first 3 days following the stroke were studied. The average amount of the postoperative lethal outcome was 46% and in the last years--26%. The analysis of the observations demonstrated that in hemorrhages into the cerebral hemispheres (the most frequent hemorrhages) a vital prognosis and evidences for operation are mainly determined by the depth of hematoma position in relation to the internal capsule, a degree of blood hemorrhages into the ventricles, state of brain magistral arteries (carotic, vertebral-basilar) and the brain stem. Cerebral angiography is a very important examination method facilitating the determination of a hemorrhage cause, its localization, expressiveness of dislocation phenomena, as well as the character and degree of changes of the brain magistral arteries (atherosclerotic stenoses, exaggerations, ansae, hypoplasia). The determination of a vital prognosis of a stroke with conservative and surgical treatment with the aid of a computer permits to solve the problem of evidences for an operation more basically.


[Clinical structure of institutionalization in schizophrenic patients (rehabilitation aspect)]. The results of the studies of hospitalism formation in 173 patients with continuous-progressive schizophrenia which have been treated in the mental hospital for the period of 10-35 years, are presented. Six clinical variants of hospitalism depending upon unfavourably influencing factors of long-term isolation, inadequate medical therapy and hyperguardianship are distinguished: aspontaneous, apatho-abulic, asthenic, variant of hyperguardianship and overcautiousness, variant of a negative attitude towards a discharge, mixed. The depiction of the clinical variants of hospitalism at the remote stages of schizophrenia permits to use more differentially and effectively prophylactic measures and rehabilitative programs in relation to the patient's long-term hospitalizations.


[Post-hospital rehabilitation center of a psychiatric hospital (clinical, organizational and economic aspects)]. The authors generalize a 3.5th year experience of postclinical rehabilitation of mental patients with unfavourable forms of the disease and significant psychic defects in a special rehabilitative center which functions on the basis of an agricultural enterprise (a state farm). The organizational and methodological principles of post-clinical rehabilitation are given. On the basis of the examinations of 88 patients the authors analyse the results of their rehabilitation in the clinical, working and social aspects. The economic effectiveness of the rehabilitative center activity and its influence on the level of psychiatric service organization is evaluated.


[Day hospital and night dispensary as intermediate links in the system of psychiatric services]. The author considers the peculiarities of day and night hospitals as centers of partial hospitalization which have independent functions in the differentiated system of psychiatric service and along with this permits to solve tasks more effectively which are raised by comprehensive practice before the system as a whole. The general principles of the organization of day and night hospital activities are formulated and advantages of their use in the treatment of early prepsychotic manifestations of schizophrenia and the initial forms of mental diseases are substantiated.


[Assessment of the effectiveness of rehabilitation measures in day hospitals working in the framework of the territorial-team system]. In conditions of a wide use of psychopharmacological drugs the main trend in the activities of a day hospital is prevention of admissions to a mental hospital by elimination of relapses and exacerbations in these patients. Partial hospitalization and consolidation of the results of hospital treatment (stabilization of remissions in the patients, treated in a hospital) must be accomplished with the aid of a complex of psycho-social influences against the background of psychopharmacotherapy. In order to stabilize remissions patients with different types and depths of remissions may be transferred from a mental hospital to a day hospital. To eliminate relapses and exacerbations patients with different types of remissions may be referred to a day hospital. A day hospital functioning in the framework of the team-territory system is a leading organizing link in rehabilitation of mental patients.


[Experience with the use of a complex of therapeutic-rehabilitative measures in rural psychiatric hospitals]. A total of 100 chronic mental patients with schizophrenia, epilepsy and oligophrenia who had stayed in a rural hospital for a long time, were treated with restorative therapy including the complex of influences: psychopharmacological drugs, differential regimens of treatment and supervision, psychotherapy, treatment by employment and entertainment, exercise therapy and occupational therapy. The use of this complex demonstrate the improvement of the mental state in 82 patients, 30 patients could be discharged from the hospital. The role of the psycho-social influences for the mollification of pathological symptomatics characteristics of the chronic contingents of patients is discussed.


The structure of pre-messenger RNA and messenger RNA from erythroid cells. Pre-mRNA fractions (greater than 45 S) were characterized by electron microscopy. High salt concentrations (0.2 M ammonium acetate, pH 8) yield linear molecules of different length (0.5--17 micrometer). In 10% of the molecules a compact-nonlinear contour (cn-contour) is detectable at one end. A significant enhancement of the number of cn-contour carrying molecules is observed after binding pre-mRNA to poly(U)-sepharose. The terminal cn-contour could be the depiction of a secondary and/or tertiary structure including the poly(A)-tail. 9 S globin mRNA appear in 80% with virtually the same cn-contour as detected in pre-mRNA molecules. After denaturing the mRNA in 80% formamide--4M urea in connection with heating to 90 degrees C from 10 min, a percentage of 77% of stretched, linear molecules results. This structural transformation is reversible when the denatured RNA is precipitated and redissolved in 0.2 M ammonium acetate. 73% of the stretched molecules are characterized by a mean length of 0.44 micrometer. This value is twice as high as commonly assumed for a globin mRNA chain.


[Nitrogen-economy and synthesis of serine and glycine in reticulocytes]. Amino acids constitute the main substrate of the reticulocyte. The amino acid pool of reticulocytes represents a characteristic selection. The composition of the amino acid pool is dependent on maturation. From the preferential oxidation of short-chain amino acids one would expect a ratio about of 5:1 between the oxygen consumption and ammonia formation. If one corrects for NH3-formation by the deamination of nucleotides the ratio between the oxygen consumption and NH3-formation is about an order of magnitude higher than the theoretical ratio. The small liberation of NH3 in energy production from amino acids results from the re-utilization of their alpha-NH2-group for the synthesis of serine and glycine, while the C-skeleton stems from glucose. Serine is formed via OH-pyruvate and OH-pyruvate. Serine and glycine serve preferentially for synthesis of hemoglobin. In reticulocytes there exists a compartmentation of glycine which accounts for differences between serine and glycine in isotopic experiments. From the time dependent change of the specific activities of pulse-labelled serine and glycine one may calculate that the serine synthesis amounts to 15--30% of the glucose utilization.


Activity of the respiratory inhibitor RF in human red cells in anaemia. Stroma-free haemolysates of red cells from patients with acute or latent anaemia inhibit the NADH oxidase activity of submitochondrial particles from beef heart. The inhibitory activities appeared significantly more frequently in anaemic patients than in normal persons and are likely due to the action of a factor which is identical or similar to the inhibitory protein RF present in rabbit reticulocytes. The possible use of the inhibitor assay for clinical purpose is under discussion.


[Purification and characterization of the respiratory inhibitor RF from rabbit reticulocytes]. In the stroma-free hemolysate of rabbit reticulocytes there exists a respiratory inhibitor (RF) of protein nature. It could be purified by the following procedure: (NH4)2SO4-precipitation leads to DEAE-Sephadex A-50-chromatography leads to isoelectric focusing leads to gelfiltration on Sephadex G-200. In addition to the activity the identity of the inhibitor could be proved immunologically at all steps of the purification. A molecular weight of about 80,000 was determined by gelelectrophoresis in the SDS-mercaptoethanol-system. The protein has an IP of 5.55--5.65 and consists of one polypeptide chain. This could be shown both by SDS-gelelectrophoresis and by estimation of only one N-terminal amino acid residue (glycine). Only after oxidation with performic acid the amino acid analysis of the protein gives reproducible values. The sum of weight-% is about 80 (without Tyr). The polarity of the protein with 41 mol-% agrees with the polarity of soluble globular proteins investigated by other authors. Acid hydrolysis without preceeding performic acid oxidation gives a sum of amino acid residues of only 35--45 weight-%, the glycoprotein nature of the inhibitor could be shown by staining the SDS-gels with Schiff's reagents and by carbohydrate determination with anthrone reagent.


Creatine during bleeding anemia of rabbits. In bleeding induced anemia of rabbits an increase of creatine in the red cells occurred, which in some cases amounted to more than 5-times the normal concentration. In all but one case plasma creatine rose as well. Reticulocytosis, increased O2-consumption of the red cells and an increased level of erythropoietin indicated active erythropoiesis and a shift towards a younger cell population. Whether the rise of red cell creatine is solely due to a higher proportion of young cells remains an open question.


[Studies on the vitality of human bone marrow during collection and deep-freeze preservation]. The cryoprotective effect of dimethylsulfoxide, glycerol and polyethylenglycol during freezing and thawing of human bone marrow was investigated by eosin staining test, an acridinorange fluochrome staining test and by RNA- and DNA-synthesis tests. In these tests the overall yield of vital nucleated cells, referred to the number in the absence of cryoprotectants and freezing and thawing, amounted to 50% with dimethylsulfoxide, 30% with glycerol, and 10% with polyethylenglycol. With dimethylsulfoxide and glycerol the loss of vital nucleated cells is almost entirely due to the addition of cryoprotectants. Polyethylenglycol freezing and thawing also leads to a great loss of vital nucleated cells. The results with dimethylsulfoxide show that the currently employed techniques of punction, preparation, freezing and thawing of bone marrow are suitable for clinical application.


Some unusual properties of globin-mRNA isolated from rabbit reticulocytes. Globin mRNA isolated from rabbit reticulocytes showed an unusually high molecular weight for the beta-chain mRNA (280000 daltons), a large difference between the molecular weight of the alpha-chain mRNA (230000 daltons) and the beta-chain mRNA and a dense and compact structure in the electron microscope (average length of the molecules 0.14 micron), which can be transformed to a linear structure (average length of the molecules 0.44 micron corresponding to a molecular weight of about 420000 daltons). The poly(A)-tail of the mRNA estimated by polyacrylamide gel electrophoresis with poly(A)-markers as reference substances has a size between 12 and 52 nucleotides. The mRNA works as a good template in the cDNA-synthesis with reverse transcriptase and full length copies of the mRNA were obtained by this reaction. The cDNA hybridizes to an amount of 70% with the globin mRNA at a 1:4 cDNA/mRNA ratio.


The role of red cell membrane in the regulation of glycolysis and the 2,3-bisphosphoglycerate-cycle. Pyruvate and K-ferricyanide stimulation of net ATP and 2,3-bisphosphoglycerate synthesis is very probably due to enhancement of glyceraldehyde 3-phosphate dehydrogenase activity. Significant peculiarities in the K-ferricyanide effect and its depression by non-penetrating-SH inhibitors at low concentrations were noted and suggested that membrane-bound enzymes play a substantial part in the synthesis of ATP and 2,3-bisphosphoglycerate. Experiments with isolated ghosts showed their ATP-and 2,3-bis-phosphogylcerate-building capacity. Pulse-labeling with 32P-Pi and determination of specific radioactive in intracellular inorganic phosphate and ATP-gamma-P demonstrated that the ferricyanide-stimulated compartment utilizes only intracellular inorganic phosphate for ATP (and 2,3-bisphosphoglycerate) synthesis, and does so only when extracellular inorganic phosphate is present.


Interrelationship between energy metabolism from various substrates and the 2,3-bisphosphoglycerate bypass in human erythrocytes. Metabolism of the substrates D-ribose, xylitol, D-Xylulose, D-fructose, D-glucose and mixtures of these compounds were studied in human erythrocytes. The metabolic rates obtained with the various substrates affected the intracellular levels of ATP and 2,3-bisphosphoglycerate. Small amounts of substrate utilization resulted in a decrease of the ATP and more pronounced of the 2,3-bisphosphoglycerate concentration while carbon utilization rates beyound 14 microgram atom C/ml packed cells/120 min yielded constant levels of ATP and 2,3-bisphosphoglycerate. From these results it can be concluded that a carbon utilization rate of 14 microgram atom C/ml cells/120 min is able to cover the ATP requirement of the red cells under steady state conditions. Based on the carbon utilization rates obtained with the various substrates and the rates of 2,3-bisphosphoglycerate decomposition an attempt is made to calculate the contribution of the 2,3-bisphosphoglycerate bypass to substrate metabolism. In case of xylitol as substrate the decrease in the 2,3-bisphosphoglycerate content provides the regeneration of NAD thus facilitating uptake and metabolism of xylitol.


The molecular function of hemoglobin as reflected in ligand binding data: analysis of data on erythrocytes. Hemoglobin oxygen binding data on erythrocytes at diffrent pH, PCO2 and bisphosphoglycerate concentrations have been analyzed in terms of an extended version of the Herzfeld-Stanley model of 1972. The binding of oxygen to subunits when the tetramer is in the quaternary oxy conformation was found to be insensitive to moderate changes in pH and pCO2 (0.71 +/- 0.05 mm Hg-1). Utilizing this circumstance it has been possible to obtain, for the first time, unique estimates of energy parameters related to hemoglobin cooperativity and effector action. At 37 degrees C, pH 7.2 and pCO2 22 mm Hg the following parameter values were obtained: The allosteric constant: (1.5 + 0.4)-10(4); the oxygen binding constant of the deoxy state: (5.4 +/- 0.3).10(-3) mm Hg-1; the 2,3-bisphosphoglycerate binding constants: (3.3 +/- 1.3).10(3)1. mol-1(deoxy), (1.3 +/- 0.5).10(2)1. mol-1 (oxy). Quarternary transition most likely takes place after binding of the second O2 molecule. Following the concepts of Perutz the results suggest that (1) protons and carbon dioxide act as constraint effectors and/or as quaternary effectors; (2) the difference in total conformational energy between the two quaternary ligand-free states is almost exclusively confined to molecular constraints and very little to the difference in quaternary conformational energy. The consistency of the results indicate that the model may be regarded as a useful tool for the description of the functional interrelations in the hemoglobin oxygenation process as reflected in oxygen binding data.


[Viability, ATP and 2,3-DPG content of resuspended erythrocytes during several-week storage in cold]. Leukocyte-and thrombocyte-poor packed red cells obtained from ACD or. ACD-AG blood were resuspended to a hematocrit of about 55% and stored at 4 degrees C. The resuspension solution consisted of xylitol, inorganic phosphate, bicarbonate, adenine (A) and guanosine (G) solved in water. In one case glucose, citrate and sucrose were also added, in another one, sorbitol. The 2,3-DPG and the ATP level remained for a longer period in the sorbitol-xylitol-medium than in the glucose-xylitol-medium. The ATP content in the red cell suspension was higher than in packed cells. Higher ATP values were obtained in red blood cells from whole blood with adenine and guanosine. The survival rate of resuspended red blood cells in glucose-AG-citrate-sucrose medium was about 80--85% after 3 weeks of storage and 77% after 6 weeks with a higher range.


[Behavior of adenine nucleotides in stored blood with addition of adenine and guanosine]. ACD stored blood was substituted with adenine, guanosine or both during usual storage conditions. In weekly intervals concentrations of ATP, ADP and AMP were estimated. From the obtained values it was suggested that the substitutions of adenine and guanosine probably lead to synthesis of the three measured adenine nucleotides. The apparent additive effect of adenine and guanosine upon ATP concentration probably is caused by the simultaneous measurement of GTP and ATP in the used nonspecific method. Under these conditions GTP would have significance for the survival of erythrocytes stored in ACD-AG-medium.


[Studies of antimycin-A-resistant respiration of erythroid cells]. In bone marrow of rabbits and in erythroid cells of other species there exists an Antimycin A-resistant respiration. Its mechanism corresponds to that postulated for the Antimycin A-resistant respiration of rabbit reticulocytes.


Studies on the functional significance of mitochondrial bound hexokinase in rabbit reticulocytes. Mitochondria from rabbit reticulocytes contain about 50% of the total reticulocyte hexokinases. The proportion of mitochondrial hexokinases may be changed under different metabolic conditions. Mitochondrial bound and soluble hexokinases exhibit different kinetic properties (KMATP and glucose-6-phosphate inhibition). The respiratory rate of isolated reticulocyte mitochondria in the presence of glucose depends on the glucose-6-phosphate concentration, as the ADP generation by the endogenous hexokinases is strongly inhibited by glucose-6-phosphate. In the experimental system all intermediary states of mitochondrial respiration can be adjusted between the state of maximal activity (state 3 or active state) and the controlled or resting state (state 4) by different glucose-6-phosphate levels. The stationary levels of the extramitochondrial adenine nucleotides in this experimental system have been measured. The rate of mitochondrial respiration and ATP formation depends on the extramitochondrial ATP/ADP ratio. At ratios of about 10 and lower the mitochondria are in their maximum phosphorylation state, at higher ratios the mitochondrial ATP formation is controlled by the extramitochondrial ATP/ADP ratio. It is postulated that the close intercounnection between the mitochondrial hexokinase and the mitochondrial ATP forming system in reticulocytes is of funcitonal significance for mitochondrial-cytosolic interactions in rabbit reticulocytes and probably in other types of cells with mitochondrial hexokinases, too.


A peptide containing aspartic acid, glutamic acid and serine in calf brain synaptic vesicles. Free amino acids and other amino compounds in calf brain synaptic vesicles were identified and determined by thin-layer chromatography and ion-exchange chromatography. The vesicles contained ten identified amino acids with glutamic acid, aspartic acid, taurine and gamma-aminobutyric acid in the highest concentrations, and also cysteic acid (or cysteinesulfinic acid), glutamine, alanine, serine, glycine and lysine. The vesicles also contained certain unknown acid-labile, ninhydrin-positive compounds, one of which was a peptide yielding, after acid hydrolysis, about 40% aspartic acid, 30% serine, 15% glutamic acid, 10% glycine and possibly some alanine and lysine. The concentration of the peptide in the vesicles was as high as that of all the other amino compounds together.


Dumping syndrome and diarrhoea after vagotomy. The frequency and severity of the post-vagotomic dumping syndrome and diarrhoea were studied in 470 cases. After vagotomy the incidence of the dumping syndrome is lower and that of diarrhoea higher than after conventional gastric resection. The dumping syndrome occurred in 8.30 percent [39 cases], but only three patients belonged into the severe group [0.80 percent]. The frequency of post-vagotomy diarrhoea was 11.49 percent [54 cases] of which six belonged into the severe group [1.34 and 1.04 percent, respectively]. The possibility respectively of preventing or reducing the frequency of these side-effects is discussed.


Experimental anastomosis of small vessels with plastic tubing. Forty experimental anastomoses have been prepared with the help of polyethylene tubes on the hearts of 10 human corpes, 2 pigs and 16 dogs. In dogs the left internal mammary artery was anastomized with one of the coronary branches of the moving heart without extracorporal circulation. The plastic tube was moved in the vessel by means of a thread attached to the end of the tube and the tube was retrieved by the same thread before the closure of one of the suture lines. The method is illustrated on schemiatic diagrams and its advantages are pointed out.


[Complex therapy of plastic induration of the penis]. The data of 56 patients with plastic induration of the penis treated at the Department of Urology of Semmelweis University Medical School are presented. After a survey of the literature and of the therapeutic possibilities the surgical solution worked out by the authors recommended. Conservative treatment alone cannot secure a cure and its pre-operative application will not improve the chances of a cure. A palpable knot is the indication for surgery. Postoperative cease on ultrasonic treatment. If for some reason (concomitant illness, oppositions of the patient to operation) only conservative treatment can be applied, ultrasonic therapy is believed the most suitable.


[Ultrasonic diagnosis of bladder tumors]. A total of 63 patients was examined by echosonography and allowed to determine the localization and size of the tumour particularly in progressed cases. The picture appearing on the video tube could be stored for about one hour and photographed for documentation. The method is considered reliable, but it is stressed that its result can be evaluated only together with those of tests applied in urology. The echo test is harmless and has no contraindications.


Infrared spectrometric analysis of urinary calculi. The composition of urinary calculi was studied by means of infrared spectroscopy. Analysis of 150 calculi has shown that their infrared spectrum offers quick and reliable results and the method helps to plan the therapy. Organization of a central laboratory for calculus analysis is recommended.


Haemodynamic and respiratory changes accompanying haemorrhagic shock in thoracotomized dogs. Haemorrhagic shock was induced after thoracotomy by bleeding into a reservoir and the reduction of systemic blood pressure to 40 mm Hg. After two hours the blood was retransfused. The haemodynamic and respiratory changes due to the haemorrhage and retransfusion were noted during the two hour shock period and one hour after transfusion. The results were as follows: 1. Pulmonary mean and systemic mean pressure during haemorrhage and retransfusion do not change in parallel; 2. there is a rapid rise in pulmonary arterial [PA] and pulmonary capillary [PC] pressure during retransfusion; 3. cardiac output and its pulmonary fraction decrease during shock and cardiac output failed to normalise on retransfusion of the lost blood; 4. pulmonary vascular resistance, pulmonary total resistance increase significantly at the end of the shock period and after retransfusion; 5. shunt volume, alveolo-arterial O2 difference, the difference in arterio-alveolar co2 tension and dead space ventilation increase; while 6. o2 consumption and CO2 production decrease; 7. arterial blood gas values alone do not indicate those serious metabolic; circulatory and respiratory changes which develop in the lung during shock; 8. effective pulmonary compliance and the plasma oncotic pressure decrease, indicating interstitial oedema; 9. the primary mechanism responsible for the disorder during shock is not entirely clear but beside a number of other factors, the importance of the hypoperfusion of the bronchial circulation is stressed; 10. the conclusions permit a certain insight into the pathogenesis and therapeutic possibilities of the adult respiratory distress syndrome.


[Prevention of reflux esophagitis after total gastrectomy]. The experience gained in animal experiments and on human material with the surgical modification used to ensure the prevention of reflux oesophagitis and improved functioning of the residual stomach, is presented. In animal experiments it was possible to prevent reflux oesophagitis and the weight gain was also more favorable than after oesophago-duodenostomy and Longmire's operation after which reflux-oesophagitis developed without exception. Seven such operations have been performed on man; one of the patients operated upon more than 7 years ago is still free from complaints. In order to assess the true value of the operation, conditions of absorption, conditions of absorption have to be studied in animal experiments and more experience has to be gathered on human material.


[Operability and prognosis of rectosigmoid cancer]. The data of 571 rectosigmoidal cancer patients treated between 1959 and 1972 analysed to establish the factors hindering operability. The most important factor was a belated diagnosis. Suggestions are made for early diagnosis to improve the rate of early operations and thereby the prognosis.


Incidence of cholelithiasis after truncal and selective vagotomy. In order to establish the incidence of cholelithiasis after vagotomy, the patients operated upon in the period January 1st 1966, to December 31st 1971, were reexamined. The incidence of cholelithiasis was 12% after truncal and 2.4% after selective vagotomy, thus complications involving the gall bladder are more frequent after truncal than after selective vagotomy.


[Use of the internal mammary artery in myocardial revascularization]. A total of 3409 cadavers was studied for changes of the internal mammary artery; sclerosis stenosis and occlusion of the vessel were quite exceptional. This fact is believed to be of importance from the aspect of myocardial revascularization by mammary-coronary anastomosis. Anastomoses were performed on cadavers; the vessels 1.5 to 2.5 mm in diameter were easy to suture.


Herniation of the heart after intrapericardial pneumonectomy. Acute cardiac herniation after a radical rightsided pneumonectomy occurred in a 69-year-old man. Approximately 40 cases from the literature are discussed. Early recognition and emergency treatment are essential for patient survival of what showed to be a preventable complication of lung resection.


Gentamycin in cardiac surgery.

Gentamycin in cardiac surgery. Gentamycin concentration in the serum, pericardial fluid, auricle, valve and papillary muscles of 14 patients subjected to cardiac surgery was determined after intramuscular administration of 80 mg of the drug. Fifty to 140 minutes after administration the mean level in the serum was 6.0 mcg/ml, in the pericardial fluid 0.6 mcg/ml, in the auricle 5.8 mcg/g, while after 120 to 240 minutes in the valve 1.2--9.6 mcg/g and in the papillary muscles 2.0--3.6 mcg/g of gentamycin was measured. Consequently, an efficacious gentamycin concentration can be achieved in the cardiac tissues but not in the pericardial fluid which makes gentamycin excellently suited for the prevention and treatment of the infectious complications of heart operations.


Laser treatment of coumarin-induced skin necrosis. Favourable results have been achieved by low energy He--Ne gas laser in the treatment of coumarin-induced extensive skin necroses. Two illustrative cases are reported.


Ovarian actinomycosis developed during the use of a plastic intrauterine contraceptive device. The case of a primary ovarian actinomycosis developed during the use of a Szontágh--Szereday type plastic IUD is presented. After a radical operation the patient was discharged in a good condition but 40 days later had to be readmitted because of a pelvic and abdominal wall abscess. After local surgery and massive penicillin treatment she is free of complaints. It is assumed that the IUD had a pathomechanical role.


[Changes in kidney function in abdominoperineal rectum excision under halothane anesthesia]. In 17 cases of abdomino-perineal rectum extirpation performed under combined intratracheal halothane anaesthesia, the volume of urine and the osmolality of serum and urine were determined. Though urinary volume decreased significantly, its osmolality did not rise. According to the operational stress this type of operation can be divided into an: 1) intra-abdominal and a 2) perineal phase. In the secretory and concentrating capacity of the kidney, again two phases can be distinguished. Owing to the great operational stress patients with deficient renal function often develop renal failure. It is stressed that such patients close observation, careful hydration prior to operation and the administration of diuretics are of particular importance.


[Changes in hydroxybutyrate dehydrogenase and lactate dehydrogenase ratio after urologic operations]. In 58 patients subjected to urological surgery a statistically significant correlation was found between the repolarization disorder of ischaemic origin on the ECG and the changes in the alpha-HBDH/LDH ratio. After extensive interventions and particularly in aged subjects, the level of the LDH iso-enzyme of myocardial origin may rise without myocardial infarction. The rise is due to myocardial ischaemia, as proved by the ECG.


[Ultrasonic diagnosis of kidney diseases]. Applied concomitantly with other methods ultrasonic testing is claimed to furnish reliable results in the diagnosis of renal disease. A total of 177 cases with radiologically confirmed urologic renal disease were tested by means of the ultrasonic method. Of the cases 128, [72.3%] were renal tumours and cysts. The echo-tests involves no risk, can be performed on outpatients, and repeated whenever necessary without special preparation.


[Urographic evaluation of Vx2 kidney carcinoma and control implantation in rabbits]. The development of Vx2 carcinoma induced in the kidney of rabbits was followed by urography. First the X-ray anatomy of the renal pelvis in the rabbit is described, pointing out the differences against the human pattern. Urography is easy to carry out and to evaluate, and it revealed some sign of the turnover in 75,6% of the cases in the third week and in 100% after 21 days. The radiological symptoms are described and classified. These symptoms are not specific but call attention to the progress of carcinoma.