[Column chromatographic enrichment of "glucose-6-phosphate dehydrogenase vienna" (author's transl)]. Further biochemical investigations were performed in a case of glucose-6-phosphate dehydrogenase deficiency--called the "Vienna" deficiency variant on account of its biochemical characterization. It was found that the "Vienna" deficiency variant shows increased enzyme protein at a reduced specific activity. Gel filtration on Sephadex-G-200 produced a molecular weight identical with that of the normoenzyme; the different cochromatographic behaviour on hydroxylapatite appears attributable to a sequence modification of the amino acids.


[Endoscopic retrograde cholangio-pancreaticography (author's transl)]. Significant advances have been achieved in the exploration of various pathological conditions of the biliary ducts by the introduction of retrograde cholangiography as diagnostic tool in this department. This investigation has proved to be very promising in view of the valuable information gained at little risk to the patient. Furthermore, retrograde pancreaticography has improved diagnostic accuracy in pancreatic diseases. However, these results should only be assessed in conjunction with the complete clinical picture and history.


[Haemodynamic changes in acute myocardial infarction following high doses of furosemide (author's transl)]. Haemodynamic measurements were carried out after administration of furosemide to 10 patients suffering from acute myocardial infarction and congestive heart failure. It was observed that a transient deterioration in cardiac function (decreased cardiac output, increased enddiastolic pulmonary arterial pressure and increased pulmonary and systemic resistance) occured in the pre-diuretic stage in these failing hearts. After the onset of diuresis the haemodynamic parameters showed a reversal of the previous trends (increased cardiac output, decreased enddiastolic pulmonary arterial pressure and pulmonary resistance). The consistently lower enddiastolic pulmonary arterial pressure in the diuretic phase as compared with the pre-diuretic value ensured an improvement in cardiac haemodynamics. An attempt was made to interpret the haemodynamic results in the light of the Frank-Starling's curve.


[A new design for a totally artificial heart: the ellipsoid heart (author's transl)]. Thromboembolic complications represent the main limiting factor in cardiac replacement by totally artificial hearts in calves at present. Thrombus formation within artificial hearts is caused by the appearance of stagnation areas. The ellipsoid heart eliminates stagnation areas by virtue of its production as a one-piece membrane. The heart is driven pneumatically and functions as a diaphragmatic blood pump. The stroke volume is 178 cm3 and the maximal cardiac output 15.8l/Min. Three acute experiments demonstrated a high degree of haemodynamic efficiency without compression of, or interference with surrounding structures, especially the inferior vena cava or the right atrium.


[The effect of "standardized forced diuresis" (SFD) on serum and urinary electrolytes(author's transl)]. The effect of standardized forced diuresis (SFD) on the serum and urinary electrolyte levels was investigated in 10 cases of severe self-poisoning with hypnotic drugs. Diuresis was initiated by furosemide and maintained at an hourly urinary ouput of 2 litres. Fluid and electrolyte substitution was carried out with a standardized electrolyte solution. Initiation and termination of the SFD was performed abruptly. The mean values of sodium, potassium, chloride and phosphorus in the urine varied widely at the beginning of the SFD, while the calcium and magnesium values varied only slightly. During SFD, urinary stabilization occured at a particular ionogram, in correlation to the electrolyte concentrations in the infusion fluid and with only minimal individual variation. Owing to this satisfactory correlation, none of the patients developed signs of electrolyte disturbances, so that no correction of the infusion constitution was necessary. The abrupt termination of the SFD prevented electrolyte disturbances in the recovery phase.


[The value of urinary enzyme determinations in systemic lupus erythematosus (author's transl)]. During a period of 4 years urine samples from 54 patients with systemic lupus erythematosus (SLE) were repeatedly analysed for the activities of lactate dehydrogenase (LDH), leucine aminopeptidase (LAP) and alanine aminopeptidase (AAP). Increased  urinary enzyme levels were consistently found in 8 patients with severe lupus nephritis and the nephrotic syndrome, as well as in 9 patients with chronic lupus nephritis resistant to therapy. A further group of 9 patients with lupus nephritis responded favourably to immunosuppressive therapy with arrest of kidney-damaging processes; a concomitant normalization of urinary enzyme levels was observed, giving an accurate reflection of the progression of the disease. Another 14 SLE patients showed raised enzyme levels preceding the development of clinical signs of nephropathy. The last 14 SLE patients displayed neither nephropathy nor altered enzyme activities. The determination of urinary enzyme activities is, therefore, considered to be a useful supplement to the routine biochemical analyses performed on the urine in cases of SLE.


[LDH isoenzymes and gastrin in achlorhydri (author's transl)]. Several haematological findings (especially the values of serum LDH and its isoenzymes) were compared with changes in the gastrin level in pernicious anaemia. While vitamin B12 substitution therapy led to normalization of the anaemia and of the enzyme levels, gastric atrophy and, hence, the elevation in serum gastrin levels remained unchanged. Determination of serum gastrin, therefore, provides a valuable tool for the verification of the diagnosis of pernicious anaemia in treated cases.


[Considerations on the information content of diagnostic tests (author's transl)]. The value of a diagnostic test lies in its ability to support the doctor's efforts to detect a certain disease. The aim is to achieve the highest possible probability that the disease is correctly diagnosed by means of the test. Doctors are not always aware of the extent to which a test can contribute to the final diagnosis. This contribution, the information content of the test, can be calculated by various algebraic manipulations. An example (carcinoembryonic antigen) is given, which demonstrates the significance of certain terms such as true and false positive results or likelihood and, moreover, the application of Baye's theorem.


[Clinical aspects of cystinuria and its treatment by thiola (author's transl)]. Cystinuria is an inherited disorder of amino acid transport affecting the epithelial cells of the renal tubules and the gastro-intestinal tract. Treatment consists of the prophylaxis of recurrent urolithiasis, which is the clinical manifestation of the disease. Long-term treatment with alpha-mercapto-propionyl-glycine (MPG; Thiola) promises to be successful. 3 cytinuric patients with recurrent urolithiasis underwent treatment over a period of 6 months. Therapy was controlled by regular follow-up investigations of the urinary excretion and serum levels of cystine and di-basic amino acids. The results did not indicate any permanent decrease in cystine excretion. No recurrence of renal calculi was observed. The possibility is discussed of a direkt mechanism of action of the drug on the metabolism of the involved amino acids.


[Extra-articular manifestations of chronic polyarthritis]. Although the chronic destructive joint processes dominate the clinical picture of chronic rheumatoid arthritis, it must not been forgotten that the disease is a systemic one, whereby certain organs or organ systems are affected either clinically or subclinically. The various possible pathogenetic mechanisms are discussed and the particular type of patient with rheumatoid arthritis who appears to be prone to extra-articular manifestations is described. Subsequently, the individual organic manifestations and the clinical picture are discussed, as well as the incidence and significance of these features.


[The implementation of a computerized documentation system for the evaluation of spa therapy in patients with rheumatoid arthritis (author's transl)]. A previously-described documentation system for articular examination was applied to evaluate the results of spa treatment in 20 patients with rheumatoid arthritis during 3 separate treatment periods. Physical joint findings were documented and indices were compiled by means of a computer before, during and after treatment with thermal water the first year, normal water the second year (or vice versa) and without baths at all in the third year. These indices were compared statistically. Each kind of treatment produced a statistically-significant improvement in the disease, there being no significant difference in the results achieved by the 3 therapeutic regimens.


[Cytogenetic investigations in patients receiving an intraarticular injection of gold-198 (author's transl)]. The chromosomes of lymphocyte cultures from the peripheral blood were investigated in 10 patients (rheumatoid arthritis, ankylosing spondylitis, osteoarthrosis of the knee) before and at short-term intervals (1 day, 3 to 4 days, 14 to 18 days) after the injection of gold-198 (5 to 20 mC; usually 8 mC; average particle size 300 A) into the knee-joint. The number of structural chromosomal abberrations increased markedly in 4 of the 10 patients. On the first day after the gold injection the mean aberration rate was significantly higher than the control value (Chi2-5.18; df=1; P less than 0.05). Most of the observed aberrations were chromatid aberrations and this finding is discussed.


[Congenital polyfibromatosis: clinical and genetic studies]. Clinical and genetic investigations were performed on seven members of a family suffering from multiple hereditary fibromatosis. These studies indicate that the responsible gene appears to be coupled and transmitted with that of the rhesus system, located at chromosome one. The diagnosis, differential diagnosis and therapy, as well as histological alterations are pointed out and the importance of hormonal factors is discussed.


[Subclavian vein catheterization in traumatic surgery (author's transl)A1]. The new Cavafix system was employed for puncture and catheterization of the subclavian vein in 100 casuality patients undergoing surgical intervention. Excellent results were achieved not only in emergency cases with severe shock and hypovolaemia, but also in hospitalized patients requiring long-term infusion therapy. This system proved easy to handle even by doctors inexperienced in the use of such techniques and, hence, the incidence of complications was within the range reported in the literature.


[The treatment of osseous rupture of the posterior cruciate ligament (author's transl)]. 3 cases are reported of successful surgical treatment of isolated osseous rupture of the posterior cruciate ligament. Fixation was undertaken with 2 crossed wires leading from the popliteal fossa to the anterior aspect of the tibia. The advantage of this method is that the popliteal fossa does not have to be reopened 6 to 8 weeks later when the wires are removed.


[Percutaneous reduction of fractures of the neck of the radium in children by means of a steinmann nail (author's transl)]. Percutaneous reduction of fractures of the neck of the radius or of epiphysiolysis with displacement can be achieved in children by means of a Steinmann nail. No additional means of fragment fixation seems to be necessary. Fracture healing is ensured by cast immobilization. Functional results are equivalent to those after conservative treatment.


[Iatrogenic tissue damage and its treatment (author's transl)]. Modern medicine with its manifold therapeutic possibilites brings many side effects which might result in tissue damage. 8 cases of iatrogenic tissue damage seen over a period of 5 years are presented and discussed. Measures for correction and reconstruction are proposed.


[Scalp avulsion injuries (author's transl)]. In a recent scalp avulsion injury, the scalp should always be re-implanted without delay if at all available. Subsequent normal hair growth can hardly be expected, but at least an original skin replacement has been effected. The reconstruction of only a part of the scalp should be performed in such a way that the hairless area is situated in the centre. The surrounding hair will cover this centre part. Rotation flaps in the region of the scalp follow other rules than apply to all other areas of the body. If applied correctly, good results can be achieved because of the excellent blood supply.


Preferential inhibition of herpes-group viruses by phosphonoacetic acid: effect on virus DNA synthesis and virus-induced DNA polymerase activity. In tissue culture phosphonoacetic acid (PAA) specifically inhibited DNA synthesis of human cytomegalovirus (CMV), murine CMV, simian CMV, Epstein-Barr virus, and Herpesvirus saimiri. Fifty to one hundred micrograms per milliliter PAA completely inhibited viral DNA synthesis with no significant damage to host cell DNA synthesis. In vitro DNA polymerization assays showed that 10 μg/ml of PAA specifically inhibited partially purified human CMV-induced DNA polymerase, while little inhibition of host-cell DNA polymerase activity was found. The specific inhibition of herpes-group virus DNA synthesis with little toxicity to host cells suggests that PAA has great potential as an antiherpesvirus therapeutic agent.


Viral hepatitis in the Air Force.

Viral hepatitis in the Air Force. The reported incidence of viral hepatitis in the Air Force has increased over the past 10 years. The total number of days lost from duty has declined as has the average number of days lost per case. Distribution of USAF reported cases has been roughly equally divided among the three diagnostic categories, in contrast to the total United States reported distribution. Relatively few USAF cases have had a documented history of drug abuse since we began collecting this information, and the proportion of these cases has steadily declined. Finally, these diseases still represent significant economic and operational costs to the Air Force so that prevention and control remain important items of concern to commanders and the medical service.


Viral hepatitis in the United States Navy and Marine Corps. Two analyses of the Navy and Marine Corps experience with viral hepatitis are reported. The first is longitudinal in nature and shows that over the past 100 years the syndrome has been common and at a relatively steady rate of 100-400 cases/100,000 average strength/year. The second is an examination of cases in calendar year 1974 for demographic, geographic, and occupational patterns. There is a strong inverse relationship between disease occurrence and age. Each type of viral hepatitis shows a distinct geographic distribution. Navy personnel in health-related occupations had a greater risk of acquiring viral hepatitis than did other persons on active duty. Differences among other occupational groups were found, but valid interpretations could not be made because of the small numbers of cases in each category.


Viral hepatitis: problems of incidence and control in military personnel. (A) Hepatitis B virus (HBV) is now the major cause of infectious viral hepatitis in U.S. military personnel and probably also in the civilian population over 15 years of age. (B) The incidence of icteric, viral hepatitis is much higher in U.S. military personnel than in comparable age groups in the civilian population. The 17-to 20-year-old enlisted men show the highest rates. (C) In parts of the world (e.g., U.S.A., Germany) where most of the inapparent infection is caused by the adw subtype of HBV, most of the acute clinical disease is caused by the ayw subtype. In the U.S.A. and Germany, 95% or more of HB(s) Ag isolates from U.S. military personnel with acute hepatitis is ayw. (D) It may be many years before one can expect to have sufficient data for a decision as to the possible availability of an effective HBV vaccine. Accordingly, a decision is urgently needed regarding either the immediate use of the best practically available hepatitis immune gamma globulin, that can be prepared by modern techniques, for the prevention of hepatitis in U.S. military personnel or postponement of such use until an adequate and properly controlled trial can be carried out in active duty military personnel in an area of high incidence.


Yale studies of patient care. I. The evaluation of the febrile patient. Observations are reported on the variation in evaluation and management of 216 episodes of fever in 690 patients on four services of a university hospital. Twenty-two percent of febrile episodes were not commented upon in the medical record. Thirty percent of all fevers and 14% of antibiotic-treated fevers were not evaluated with microbiologic cultures. The extent of evaluation varied with service and varied directly with the height of the fever and the clinical recording of abnormality in temperature.


[Protein crystals and tubuli bundles in yeast cells. IV. Biochemical and electron microscopic studies of the induction of alcohol dehydrogenase (ADH) crystals]. Cells of Saccharomyces carlsbergensis H 60 synthesize alcohol dehydrogenase (ADH) in media containing 2% lactat, 1% ethanol or 0.1% glucose. Crystals may be induced in protoplasts of these cells. Increase of glucose concentration in the medium results in diminished ADH synthesis and decreased tendency for crystal formation. Repression of ADH synthesis by glucose results in the formation of a protein (MG 110000 D), the significance of which is discussed. Early stages of crystal formation inside the cell are demonstrated electronmicroscopically. At first dense material accumulates between opposite membranes of neighbouring mitochondria. Within mitochondria frequently membrane bundles occur in close vicinity to crystals. These ADH-crystals arise from this material.


[Disturbances of consciousness of old people from internal view (author's transl)]. Any unconsciousness and especially that of old people refers to direct danger to life and requires immediate medical intervening. A diagnostic plan will not be adequate in association to the multifariour etiological factors and can delay in a special case the beginning of an aimed therapy. The unconscious patient must have a clinical treatment. The author describes the diagnostic of the most important comatose states in the age.


[Changes depend on age in electromyogram -- studies about parameter of motor unit action potentials in normal subjects of different age (author's transl)]. In normal subjects of different age groups electromyographically several muscles were examined. The motor unit action potentials were registered and parameters of those were evaluated manually and digitally. For all examined muscles was found an increase in the duration of potentials with the age. The increase was greatest in the younger and older age groups. An interpretation of these findings is given.


[Ageing an expression of interrelation between organs and tissue of organism (author's transl)]. The authors starts from results of investigations carried out by himself, dealing with biological cell criteria of organ cultures after the donor animals had been X-rayed on their entire bodies. He discusses the problem whether ageing is an inherent character in all cells. After juvenile rats had been X-rayed, organ cultures of their milts and kidneys showed alterations analogous to those of "old" donor animals. These alterations could not be detected if the animals were killed immediately after X-raying and the cultures were taken then. The alteration of biological cell criteria are discussed as an expression of interrelations between organs and tissues of organism.


[On the metabolic heterogenity of the cartilage tissue (author's transl)]. Autoradiografic studies with 3H-thymidine, 3H-proline and 35S-sulfate in different cartilage tissues from rabbits and rats (articular and epiphyseal cartilage of the knee; costal, xiphoid and tracheal cartilage) were performed. The following results were obtained: The proliferative zone of the epiphyseal plate of young and adult animals is limited to the superior part of the columnar cartilage. The articular cartilage shows no proliferative zones but single S-phase-nuclei in all layers seldom were found. In the adult animals a decrease of DNA-synthetising chondrocytes in all investigated cartilage tissues and a narrowing of the proliferative zone could be detected. 3H-proline and 35S-sulfate in proliferating chondrocytes of the bone cartilage border line and in chondrocytes of the subperichondrial area increasingly were incorporated. Possible causes of the regional differences in the uptake of the used precursors were discussed and the significance of the metabolic heterogenity of the cartilage tissue for aging and pathological processes was pointed to.


[Age dependent changes of biosynthesis of proteins (author's transl)]. The activity of KC1-washed ribosomes from the liver and the kidney of rats in a poly(U) dependent cell free system with [3H]-phe-tRNA as phenylalanine donor is highly increased by the cytosolic fraction from liver, brain, kidney and testicles. The activity of the cell sap of these tissues decreases significantly with increasing age of the rats from which the cytosolic fractions were prepared. Ribosomes do not undergo age dependent alterations with regard to their activity in poly(U) systems supported by cell sap from rat liver. The results are discussed with regard to age dependent change of the content of cytosolic translation factors.


[Ageing-changes in collagen -- biosynthesis of collagen (part II) (author's transl)]. In the present three parts of the survey on ageing-changes in collagen physical and chemical qualities are discussed at first. Further a summary on questions of the biosynthesis of collagen, changes of the collagen metabolism in the ageing organism organism and changes of the ripening collagen in the living organism is given. Following in vitro-ageing-changes of collagen and causes of the changes of the ageing organism are described. A summarizing appreciation of the ageing-changes in the collagen finishes the survey.


[Development and organisation of cardiorespiratory function testing in GDR (author's transl)]. Acute and chronic respiratory diseases amount to a remarkable portion of all cases and days of disability. The systematic care especially for the chronic respiratory diseases has become the task of the Out Patient Departments of Pulmonary Diseases and Tuberculosis in cooperation with the general practitioners and physicians for industrial medicine. The diagnostics of chronic respiratory diseases among which more than the half of all cases gets to chronic bronchitis, pulmonary emphysema and bronchial asthma has still to be qualified. Function testing allows to subdivide chronic bronchitis in nonobstructive and obstructive forms and to gain measurable and comparable assessments of cardiopulmonary limitations of efficiency. By oxyergotensiometry and examination of the diffusion capacity disturbances of ventilation, perfusion and diffusion and combinations of these can be analyzed by blood-gas analysis, ergometric examination and testing of diffusion capacity. Those investigations can be supplemented by determination of breathing mechanics. The development of cardiorespiratory function testing will take place step by step in different levels of accomplishment. These levels have to cooperate for getting an optimal picture of a disease. The extension of the methods of pulmonary function testing in the lung hospitals and the chest clinics since 1970 is reported.


Models of respiratory insufficiency in view of lung function diagnostics and pathogenetic analysis (author's transl). Organizing principles of lung function diagnostics and of research in the field of pathophysiology of respiratory insufficiency are developed starting from fundamental requirements, which are practical effectivity, scientific basement, technical development and teamwork of specialists in a complementary system. Technique of screening level, primary oriented of effectivity, is based on the simple monoalveolar model of ventilation. Basal lung function diagnostics, primary oriented on objectivity, representing the total of pulmonary impairment is based on the model  of arterial hypoxemia. Condition and limitations of these models are discussed preparing its substitution by models of complex lung function analysis in the higher level diagnostic system.


[Pathophysiology of respiratory disturbances in children (author's transl)]. Physiological conditions of respiration in children are defined especially by - relative hyperventilation because of high oxygen uptake per body surface, - relative narrow and soft airways with high tendency to obstruction, causing atelectasis, pneumonia or severe bronchiolitis. It is useful to differentiate between bronchiolitis and spastic or asthmatoid bronchitis, the latter being sensible to Adrenalin and developing to asthma of adults. Characteristical signs of asthmatoid bronchitis are bronchial hyperreactivity, increased airway-resistance and residual volume, decreased FEV 1, pulmonary compliance, arterial PO2 and PCO2 with signs of pulmonary inhomogeneity. Mucviscidosis, starting from abnormal viscosity of bronchial secretion, is functionally characterized by similar signs, so are increased RV with air-trapping, decreased FEV 1, VC, PO2a and pulmonary inhomogeneity. Diffuse progressive interstitial pulmonary fibrosis (HAMMAN-RICH) of acute type being mostly lethal in children up to 2 years of age and of subacute type in older children shows diffusion disturbance and characteristical ventilation disturbance with reduction of inspiratory reserve volume and enlargement of functional residual capacity but normal FEV 1. Disturbances are sensible to corticoid-therapy.


[New aspects in the pathophysiology of bronchial asthma (author's transl)]. Bronchial asthma is a polyetiological syndrome. Not only different immunological reactions (atopic reactions, immune-complex reaction, cell mediated sensitisation) but also unspecific mechanisms are of importance. Bronchial obstruction becomes manifest with bronchial spasm, edema, and dyscrinia especially in the small airways. Methods are described for diagnosis of small airways obstruction. Inhomogenous bronchial obstruction is of paramount importance for the disturbances of oxygenation.


[Experimental model of bronchial asthma (author's transl)]. Allergic asthma-like attacks were induced in guinea pigs by intraperitoneal injections of Ovalbumin and following inhalation of Ovalbumin aerosol. The animals were narcotized, tracheotomized and a small catheter was placed in mid-oesophagus. The quantities: oesophageal pressure, respiratory flow and tidal volume were measured and recorded on magnetic tape during spontaneous breathing. A technique was applied for automated computation of the parameters of respiratory mechanics using a digital computer. The parameters compliance, resistance, work of breathing and power of breathing showed typical pathological variances and characteristic response-curves in the experimental phases during and after the asthma attacks. These parameters became normal after the injection of Alupent.


[Tonus of respiratory muscles in acetycholine hypotonia (author's transl)]. The importance of respiratory muscles in relation to circulation and ventilation was investigated in acute hypotonia after acetylcholin injection. The tonus of respiratory muscles was assessed by measuring the circumference of chest and abdomen. Changes of volume of the body cavities were examined by body plethysmography. A significant relation between the increase of circumferences of the chest and abdomen and increase of lung volume was registered. The authors conclude, that the tonus of the respiratory muscles determines the volume of chest and abdomen and influences the distribution of blood.


[Disorders of breathing and following gas embolism of the CNS in rats (author's transl)]. We could produce an acute respiratory insufficiency after injection of O2, CO2 or N2 into the arteria carotis. This resulted in apnea, increase of blood pressure, changes of respiratory rate and coma. The paralysis of the respiratory centre was reversible in some cases by artificial ventilation.


[Animal models of chronic lung diseases (author's transl)]. General aspects of experimental work modelling chronic lung diseases are described starting from experimental lung emphysema and silicosis in rats. Bodyplethysmography was used for the evaluation of the respiratory functions.


[On the epidemiology of recurrent and chronic brochopulmonary diseases-an examination of about 18000 children. 2. Investigations in the district of Quedlinburg (author's transl)]. Report of an epidemiological study in the district of Quedlinburg. This district comprises parts of the mountains of the Harz and an area in front of the Mountains. 4544 children were examined in the age-groups 5.-6., 8.-9., 11.-12. and 14.-15. years of life. In 3,4% of all children a chronic or recurrent nonspecific lung disease was discovered (in 2,5% a recurrent bronchitis, in 0,48% a chronic bronchitis and in 0,24% bronchial asthma). With increasing age the number of diseased children decreases. Differences in the frequency of the diseases between boys and girls could not be found. There were no differences in the rate of the diseases between the towns with somewhat higher degree of air pollution (Quedlinburg and Thale) and the other parts of the district. The frequency of bronchitis however was significantly higher in the mountains of the Hartz than in the lower situated territory, perhaps due to the rougher climate in the mountains.


[On the epidemiology of recurrent and chronic bronchopulmonary diseases-an examination of about 18000 children. 3. Investigation in the district of Merseburg (author's transl)]. In the district of Merseburg, characterized by a very high degree of air pollution, we have examined 4445 children of the following 4 age-groups 5.-6., 8.-9., 11.-12., and 14.-16. years of life. As a result we found 3,04% of them suffering from recurrent bronchitis, 0,34% from chronic bronchitis and 0,43% from bronchial asthma. The frequency of morbidity on recurrent and chronic bronchitis lowered with increasing age of the children. In asthma, however, this relation did not exist. There were no differences of the frequency of chronic or recurrent bronchitis between the two sexes, but boys suffered much more often from asthma than girls. In places with a high degree of air pollution the frequency of morbidity was significantly higher than in places with somewhat lower air pollution.


[On the epidemiology of recurrent and chronic bronchopulmonary diseases-an examination of about 18000 children. 4. Investigation in the cities of Halle and Halle-Neustadt (author's transl)]. In Halle, an old city, and Halle-Neustadt, a town built in the past 10 years, our investigation was performed on 4418 children. We ascertained chronic or recurrent nonspecific bronchopulmonary diseases in 3,1% of them. 2,4% suffered from recurrent bronchitis, 0,4% from chronic bronchitis and 0,3% from bronchial asthma. Significant differences in the morbidity between the sexes were found only in asthma: boys were fallen ill twice often than girls. The frequency of morbidity lowered with increasing age significantly. Between Halle and Halle-Neustadt significant differences existed: in the old parts of Halle (especially in the centre, the eastern and southern districts) there were much more sick children than in the newly-built town.


[On the epidemiology of recurrent and chronic bronchopulmonary diseases-an examination of about 18000 children. 5. Investigations in Wolfen and Bitterfeld (author's transl)]. Bitterfeld and Wolfen are towns with extremely polluted air, due to important plants of the chemical industry. In two different actions we examined 3634 children of four different groups of age. As a result we found 7,8% of them (281 children) suffering from chronic or recurrent nonspecific bronchopulmonary diseases (7,0% suffering from recurrent or chronic bronchitis, and 0,8% from bronchial asthma). The rate of morbidity was the same in both towns. It was significantly higher than in the other districts examined by us (Halle, Merseburg, Quedlinburg). In contrast to the other districts we found in Bitterfeld and Wolfen only an insignificant decrease of the morbity rate with increasing age of the children.


[Frequency of chronic bronchitis-results of epidemiologic research in the GDR (author's transl)]. The frequency of chronic bronchitis among 33000 persons, selected by randomization, between 35 and 64 years of age, living in 4 large cities and 24 selected districts with different air pollution levels in GDR was investigated. A chronic bronchitis questionnaire and measurement of FVC, FEV1, PO2 were used to test each person, partially broncho-provocation-tests with histamin aerosols were performed. According to this investigation 6% of the men and 2.8% of the women suffered from CNSLD. In this group of diseased persons 50% showed obstructive disturbances of ventilation, 20% signs of decreased physical fitness due to respiratory disorders and 10% a manifested respiratory insufficiency.


Respiratory symptoms and lung function disturbances in a polluted area of the Netherlands, compared with a rural area. In an epidemiological field survey of CNSLD 1800 men and women aged 15-64 were studied in a rural area and an industrial area. In each person a standardized interview, lung function tests, cardiac examinations, analysis of the phlegm and chest X-ray were performed. The interview conducted with the standard questionnaire gives very good information regarding chronic effects of smoking and atmospheric pollution. Spirometry seems to be a sensitive method for registering an acute disturbances caused by air pollution.


[The 2nd decree on prevention and control of tuberculosis; new tasks and perspectives for pneumonology in GDR (AUTHOR'S TRANSL)]. At July 1st the tasks of the former chest clinics, now integrated into the polyclinical system as polyclinical departments for respiratory diseases and tuberculosis are fixed and declared by decree and 3 regulations in the field of pneumology. This new orientation is part of the general development of socialist public health system concerning all reactes of health care. The unity of prevention, diagnostics, treatment and surveillance (metaphylaxis) will be emphasized in all respects. The 3 regulations concern the tasks of the polyclinical departments for respiratory diseases and tuberculosis, mass x-ray examinations and BCG-vaccination.


[Frequency of disturbances of pulmonary function in 4 cities of the GDR (author's transl)]. 8369 men aged 35-64 were surveyed in 4 cities. The levels of FVC, FEV, pO2a were examined in connection with the standard questionnaire. The problems of lung function testing in epidemiological studies are discussed.


[Functional diagnosis of CNSLD in epidemiological surveys-results of the population study in Halle 1974 (author's transl)]. The problems of lung function testing methods in epidemiological studies were assessed in a study population of 853 men aged 40-70. The Helium-rebreathing-method, the X-ray densitometry, the oxygen-method were evaluated for the estimation of the residual volume in epidemiological conditions. The Pneumotest was proved for measurement of unequal ventilation. The necessity of reference values for these methods is discussed.


[Rhinomanometric findings during brine aerosol inhalations (author's transl)]. Brine aerosol inhalations cause reactions of the nasal mucous membrane and the submucousal vascular bed as is shown by rhinomanometric examinations of healthy persons and patients suffering from various kinds of rhinitis. Changes in the resistance as a whole differ from those in partial resistances. The reactions are depending on the form of inhalation, the spectrum and concentration of the aerosol, climatic parameters and the pathophysiologic condition of the nasal mucosa.


[Clinical treatment of tracheoesophageal fistulas due to foreign bodies (author's transl)]. Swallowed foreign bodies, fixed in the esophagus, are not uncommon in childhood. Their symptoms, complications, diagnosis and treatment are discussed. An expectant attitude is justified in regard to smaller fistulas and in big fistulas due to foreign bodies up to the remission of the localized inflammatory reaction. The present surgical methods are reviewed in the light of recent literature and a case study of a child cured by segmental resection of the trachea.


[The main principles in the organization of pulmonary care in USSR (author's transl)]. It is reported on the systematic development and on the graduated distribution of tasks in the field of pneumonology in the different stages of medical care. The greatest importance has the physician in the basic care, the therapeut in the territory. He is advised in diagnostic and therapy by the pneumonologist in the special departments of the polyclinics. These will get the assistance of the special hospital institutions of the districts and countries. Connections to the antituberculosis network exist at several places of the country. They are favoured in future development.


[Experiences with the mediastinoscopy for the diagnostics of silicosis (author's transl)]. 122 patients, suspicious for silicoses, with a history of silicogen dust exposure, radiological changes and restricted lung function values were examined by mediastinal biopsy for securing the diagnosis. In 82 patients (67,2%) a silicosis could be confirmed by histological examinations of the mediastinal lymph nodes. A close association between silicosis in the lungs and in the lymph nodes is empirically suggested. If the histological findings were in compliance with suspicious radiological changes and patients history, silicosis was acknowledged as an occupational disease. In patients with beginning silicotic changes in the peripheral two upper lung fields associated with an hilar hyperplasia, a higher proportion of positive results could be found. The most positive alterations were found in the lymph nodes of the right hilus. The mediastinoscopical findings in other parts proved not to be so yielding. Therefore, in cases with anatomical difficulties the surgical examination should not be extended to other parts.


[Preventive chemotherapy in persons with silicosis and silicotuberculosis (author's transl)]. In some countries extensive research is carried out on preventing tuberculous disease by administration of INH. In GDR since about 1960 chemopreventive measures were taken in cases of silicosis and silicotuberculosis too. More than 2000 patients of the Magdeburg Pneumoconiosis Center were followed-up from 1960 to 1969. The high risk of tuberculous disease of 21% in the group of silicosis patients without administration of INH could be reduced to 14% after preventive administration of INH. However, such clear effects were observed only under optimal conditions, that is sufficient dosage, duration and reliability of treatment. On the base of these results and other publications patients with silicosis with and without tuberculous residues should be included into the programmes of preventive chemotherapy of the chest clinics.


[On the epidemiology of recurrent and chronic bronchopulmonary diseases-an examination of about 18000 children. 1. Planning and organization of the investigation (author's transl)]. The planning and organization of an epidemiological investigation is reported to find out the frequency of chronic nonspecific lung diseases (CNSLD) in childhood as a whole and in special groups of age. By investigating regions with different air pollution we tried to study the influence of air pollution on the frequency of childhood lung diseases. Therefore, we examined nearly 5000 children in the city of Halle and in the districts of Quedlinburg, Merseburg and Bitterfeld. The children belonged to the age-groups 5.-6., 8.-9., 11.-12. and 14.-15. years of life in nearly the same number. The investigations were performed by different groups of investigators. However, by equal terms of reference and uniform evaluation of the results by two of us the results of the four districts are comparable with each other.


Biological effects of transfatty acids.

Biological effects of transfatty acids. Transfatty acids are geometrical isomers of the naturally occurring cis-fatty acids, and their molecular configuration is more like that of the corresponding saturated fatty acid. In view of the large amounts of trans-acids in commercially prepared margarines, metabolic studies with trans-acids have received a great deal of attention. Although there are differences in the absorption and digestion of trans-acids and although considerable amounts are deposited in various tissues, no definite signs of toxicity have been observed. An important finding is the increased requirement for essential fatty acids in animals fed high levels of trans-acids. In recent work carried out in Kummerow's laboratory, aortic lesions were found in swine fed large amounts of trans-acids. Evaluation of the data suggests that factors other than trans-acids, per se, may have been responsible for the occurrence of the lesions. As yet, there does not seem to be any valid reason why trans-acids should be excluded from the diet as long as their intake is associated with a high enough level of essential fatty acids in the diet.


[Metabolic effect of coffee and caffeine]. Coffee and its most important constituent, caffeine, may not only stimulate the function of many organs but also increase the metabolism in the body. These effects require a higher energy production which is mainly obtained from striated muscles by glycogenolysis and from fat tissue by lipolysis. Sutherland and Butcher were able to demonstrate that these degradation processes are primarily caused by an increase of cyclic 3,5-AMP. - In this connection caffeine and other methylxanthines are of special interest because these compounds also increase the intracellular amount of cyclic 3,5-AMP. This effect may be caused by an inhibition of phosphodiesterase, a release of catecholamines with resulting stimulation of adenylcyclase or by competitive inhibition of adenosine. At the present time it cannot be said which of these mechanisms primarily is involved in the in vivo effects of caffeine and other methylxanthines.


Amido black dye binding of alfalfa and forage legume protein. Although dye binding has been suggested for the determination of alfalfa protein content, a standard method has not been advanced. More data are necessary on the conditions required for the dye-protein reaction. Reaction times of 8, 12 and 24 hours and reaction temperatures of 50, 55, 60 and 65 degrees C were selected to obtain dye binding values (DBV) with the Foss Pro-Milk apparatus. A correlation of 0.88 with macro-Kjeldahl values was obtained. 60 degrees C and 24 hours reaction time can be considered conditions yielding maximum DBV. It is suggested to develop a standard method for the routine measurement of forage legume content.


[Utilization of xylitol in the isolation-perfused myocardium of the rat]. 1. In the rat heart muscle, only 3 to 4% of the oxygen-consumption can be referred to xylitol utilization. With xylitol as only substrate the heart is working under substrate deficiency conditions. 2. Diabetes mellitus does not improve the xylitol utilization in the rat heart muscle. 3. The data are compared with the activities of xylitol degrading enzymes in the heart muscle.


[Ultrasonic determination of subcutaneous adipose tissue and body fat]. We measured with the ultrasonic reflexion method the breadth of the subcutaneous adipose tissue at the following anatomical sites: subscapulare, triceps and on the lateral margin of the m. pectoralis on the chest. The percentual body fat can be calculated from the formula: % body fat = 22 - log / 2 - sum of the breadths on the three sites / -20.5 If we measure also the breadth on the abdominal point the % body fat is 22 - log / 1.5 - sum on the four sites / -20.5. The so calculated numerical results are with the skinfold measurements in best correlation.


[Teratogenic and mutagenic studies with caffeine in the animal experiment]. Principles of teratogenic and mutagenic actions are defined. The recent experimental studies with laboratory animals, and our investigations with caffeine-sodium benzoicum and with soluble coffee in pregnant rats and mice showed no teratogenicity. The results are compared with specific teratogenic effects of cytostatic agents. A teratogenicity of caffeine can be excluded, a mutagenicity in animal experiments can also not be proved.


[Multichannel EEG spectral analysis of the caffeine effect]. By means of multichannel Eeg spectral analysis the central effects of caffeine have been investigated during a controlled factorial study with 9 male volunteers. The effects of coffee and caffeine solution with equal concentration, decaffeinated coffee and hot water have been compared on the basis of analysis of variance. The factorial experimental design implemented a randomization concerning the sequence of substances as well as days of week. The principal findings are following: coffee and caffeine solution of equal concentration on the one hand cannot be readily distinguished concerning their Eeg effects, on the other hand the decaffeinated coffee and hot water exhibit very similar Eeg effects. Very marked differences, however, have been found between the two groups of substances. Coffee and caffeine solution both produce a remarkable, highly significant reduction of theta-amplitude, dominant theta-frequency and theta-frequency-variation. The alterations within the alpha range are mainly increase of dominant frequency and decrease of amplitude. These findings may be interpreted as signs of remarkable activation and elevation of vigilance. It should be pointed out that the Eeg effects of caffeine, as well as those of other compounds with central effects, are characterized by topographically different effects. These are not only quantitative, but partially qualitative differences.


[Metabolism studies with coffee and caffeine in healthy subjects, diabetics and patients with liver disease]. Peroral application of caffeine or theophylline causes a significant increase of the free fatty acids and the free glycerol of the serum; blood sugar and cholesterol are not influenced. FFA and free glycerol decrease during the day by food intake, blood sugar and triglycerides rise. The ingestion of coffee (1-3 cups) does not influence fat and carbohydrate metabolism. To induce a significant increase of lipolysis and of serum triglyceride levels high caffeine doses (1000 mg) are required. Summarizing the data presented, the authors conclude that coffee intake (at dosages compatible with normal nutrition) does not deteriorate glucose tolerance and does not interfere with the fat metabolism. Our findings are confirmed by epidemiologic investigations which have shown that coffee intake is no risk factor for myocardial infarction.


[Psychologic study of experienced coffee effect]. In dealing with the psychological effects of coffee a distinction is drawn between three components of the subjective or experimential effect: the primary effect, which relates to the perception of the coffee beverage; the secondary effect, which stems from the ergotropic effect of coffee; and the tertiary effect, which is due to visceral sensations and which is a major contributor to the experience of digestability and wholesomeness. Results pertaining to these three components, their interaction, and their correlation with physiological and behavioral effects of coffee are discussed. The variability of research findings relating to the secondary effect is explained on the basis of the psychological activation theory. Relevant motivational, attitudinal, and moderator effects, which psychological coffee research will have to take into account, are described. Methods already available for psychological coffee research, including suitable techniques of experimentation and measurement, are presented together with three illustrative examples.


[Transitional symptoms, adverse effects and incidents in hormone-substitution therapy]. Patients underlying the permanent endocrine substitution need a particular control and a competent conduction on account of their endangering by intercurrent events. Highly specialised knowledge of the physician and intensive collaboration of the patient from this reciprocity lead to essential aspects of the prophylaxis of the crisis-like exacerbations exhibited in detail. The optimum substitution is supplemented by issuing information and emergency cards. When the patient possesses such cards they will become of decisive importance in an urgent therapy necessary outside the controlling facility.


[Objectivation of the cardiac insufficiency load index--a comparison between spiroergometry and stretch-index]. It was shown that reduction in exercise capacity because of latent heart insufficiency could be significantly demonstrated by the so-called pre-ejection index PI, measured under conditions of rest. On the other hand, normals did not show any significant interrelation between PI and parameters related to exercise capacity, obtained by spiroergometric measurements. The pre-ejection index PI is a non-invasive parameter which compares the pre-ejection period in upright and supine posture. Since spiroergometric measurements could not be made under vita-maxima conditions, PI values were compared with parameters of submaximal exercise. Exercise was performed on the bicycle ergometer, with oxygen consumption and heart rate being recorded. Measuring results also revealed that by means of the pre-ejection index the necessity and effectiveness of glycoside medication may be objectively defined. Measuring techniques are described and statistically processed data are presented.


[Measurement of kidney concentrating ability in children with nonrenal glycosuria]. In non-renal (diabetic) glucosuria we did not find any statistically real relations between the concentration of glucose in the urine and cryoscopically measured osmolality in children with healthy kidneys. The close negative correlation of the conductance of the urine to the concentration of glucose is not only to be explained by changes of the viscosity, but is an expression of an increased re-absorption of sodium as a result of a compensatory hyperaldosteronism. In renal insufficiency the electrolytic conductibility of the urine is lower than the borderline area of the normal, even when under influence of the glucose excretion the osmolality of the urine is still to be found normal. Thus also on the conditions of a considerable glucosuria we can further judge the concentrating ability of the kidney in diabetes mellitus with the help of the measurement of the conductance of the urine.


[Problem of catheter-embolism following subclavian puncture]. The catheterisation into the subclavian vein is important in the intensive therapy and for the prolonged parenteral nutrition. Numerous complications are described. In 300 catheterisations into the subclavian vein we observed 3 damages of catheters. The causes damages of catheters are investigated with the help of experiments. Recommendations to the prevention of the damage and the embolism of the subclavian catheters are given.


[X-ray findings in bones of patients with chronic renal insufficiency under chronic hemodialysis program]. In the chronic dialysis program, taking into consideration the duration of the dialysis, we sought in 25 patients (average age 34 years) for the radiological signs of the uraemic osteopathy, of the ectosteal calcification and the vascular calcification of the type Mönkeberg. In our patients a radiologically visible affection was to be proved at a duration of the dialysis of more than 3 months. Size and kind of the alterations depended on the age of the patients. In patients younger than 40 years we established an accumulation of isolated soft tissue or osseous processes, in patients older than 40 years the combination of multilocular osseous changes with calcification of the soft tissue or vascular calcium was of interest. Calcifications of the vessels of type Mönkeberg we could not find in patients younger than 40 years also at a duration of the dialysis of more than 1 year. This work shall be starting point of further observations on patients with chronic renal insufficiency during the course of dialysis, especially after changing of the calcium content of the dialysis solution.


[Differentiation of organic heart diseases and functionally conditioned cardiovascular disorders with special reference to heart-ache]. Functional cardiovascular disturbances are very often in daily practice. Making of the diagnosis is possible by the exclusion of organic heart diseases, the behaviour and the special personal structure of the patient. Functional cardiovascular disturbances may manifest themselves as disturbances of the cardiac rhythm, circulatory dysregulations and so-called heart-aches, in which cases most different variations are possible. They coincide isolately, but also additionally with organic heart diseases, which emphasizes the necessity of thorough examinations. In detail the author enters into heart-ache and its differentiation in concomitant unspecific changes of the final part in the ECG.


[Significance of mental factors in paroxysmal ventricular tachycardias]. In this paper is reported on two cases of paroxysmal ventricular tachycardia. The clinical and paraclinical examinations did not reveal any organic heart disease, the psychological one, however, found a very severe neurotic personality disorder. Antiarrhythmic drugs were ineffective in both cases. Meanwhile one female patient went through a brief psychotherapy which dismissed the arrhythmia.


[Simultaneous incidence of chronic dissecans aortic aneurysm and bidirectional tachydardia]. In a 68-year-old patient during a therapy with digitalis and saluretics with maintenance doses a severe cardiac insufficiency develops. After intravenous injection of K-strophantoside temporarily a bidirectional tachycardia developed which enforced a discontinuation of the K-strophantoside therapy. A deterioration of the cardiac insufficiency caused the resumption of the strophantine treatment under the protection of novocamide (procainamide) and panangine (magnesium asparagin. anhydr. and calcium asparagin. anhydr.) without reappearance of a bidirectional tachycardia. The patient died of a severe cardiovascular insufficiency. If the bidirectional tachycardia appears in severe cardiac insufficiency a continuation of the treatment with K-strophantoside can be tried under the protection of antiarrhythmic drugs.


[Problems of idiopathic congestive cardiomyopathy]. It is reported on the course of an idiopathic congestive cardiomyopathy in a younger man which could be observed during three years. After a longer period free of symptoms acutely appeared the signs of a myocardial failure, in which case disturbances of cardiac rhythm at length caused death. In detail the clinical fingings, pathologo-anatomical changes as well as the differential-diagnostic considerations are discussed, which are important for the demarcation of the other forms of the idiopathic and secondary cardiomyopathies.


[Quintary hyperparathyroidism].

[Quintary hyperparathyroidism]. The quartary and quintary hyperparathyroidism is observed following a primary hyperparathyroidism, in which the removal of the adenoma of the parathyroid did not lead to a reduction of the process of the disease. The nephropathy which developed during the basic disease and continued to exist after the operation leads to repeated consequences for the mineral metabolism which cause a condition of parathyroidal load and after this again an adenomatous process. The author adopts a definite attitude to the problems of heuristic biochemical parameters and generally to the question of such consecutive reactions.


[Studies on the functional ability of swine liver perfused with human blood in machine recirculation attempt. Experiment design, elimination of indocyanine green, galactose, bilirubin and ammonia, synthesis of urea, bile secretion]. In 11 machine experiments of recirculation the abilities of survival and functioning of livers of dwarf pigs perfused with human preserved blood were tested with the help of the eliminations of indocyanine green, galactose, bilirubin and ammonia from a closed circulation. Further urea-nitrogen were measured as indicator of the urea synthesis and bile secretion. The perfusion of the animal livers was carried out in 9 cases only through the portal vein. The values of the blood flow were between 0.4 and 1.0ml pro g liver tissue and minute in portal pressure values about 15 cm water column. Two recirculations were carried out with additional flow through the hepatic artery with about 1/5 of the whole blood flow. The results of the experiments described prove a pretty good functional performance of the perfused with human blood livers of dwarf pigs during several hours. The different animal livers, however, showed at the beginning as well as during the further course of the perfusion clear differences concerning their functional capacity. Decrease of the blood flow values below 0.5 ml pro g liver tissue lead to functional loss. The additional flow through the hepatic artery yielded no better results, compared with the only perfusion of the animal liver through the portal vein.


[Studies on the functional ability of swine liver perfused with human blood in machine recirculation attempt. 2. Behavior of serochemical parameters]. In the present paper is reported on the behavior of different serochemical parameters in heterologous perfusion of the liver of pigs. The perfusion of the animal livers was carried out with preserved human blood in 11 recirculation experiments (closed machine circulations). In addition to this an empty circulation with human blood without attachment to an animal liver was carried out, whereby otherwise the arrangement of the experiment was the same, in order to take into consideration the effects of the blood traumatisation in the interpretation of the results. The enzymes GOT and LAP proved as sensible indicators of the lesion of the liver cells occurring in the perfusion of the liver of the pigs. The behavior of the mitochondrial GDH as well as of the lysosomal enzymes SP and BETA-GC which scarcely increased during the recirculations in the perfusate blood, however, allows the conclusion that there did not appear a severe lesion of the liver cells (necrobiosis) during several hours of perfusion. A cholestasis did not develop during the perfusions, when one takes as basis the behavior of the enzymes AP, GGTP and AAP indicating cholestasis. Compared with GOT the enzyme GPT showed by far less elevations in the perfusate blood so that with increasing duration of the perfusion the De-Ritis-quotient significantly increased. Increased LDH-activities above all revealed the increasing during perfusion haemolysis and less reliably a lesion of the liver of the pig. The increase of ADA  in the perfusate blood proved as nearly exclusively conditioned by haemolysis. Total protein, albumins, immunoglobulins, cholinesterase and thymol turbidity test remained unchanged in the course of the perfusions.


[Billroth II. Surgery of the stomach].

[Billroth II. Surgery of the stomach]. In different intervals 220 patients were examined after a resection of the stomach with Billroth's second operation. 179 of them spoke about complaints of different degrees of severity. The cases in question were an early dumping syndrome in 83 patients, which, with the exception of 7 patients, could be removed by simple dietetic measures, such as the elimination of incompatible foodstuff. Again and again the symptoms could be evoked by provocation with it. The method described by Henley proved as correcting operation. Apart from a few exception the fitness for work was not restricted by Billroth's second operation. In shift work or severe physical work a change of the working place was striven for. The body-weight which was reduced already before the operation again increased after operation in 50%, but reached the normal only in 20%. Recidivation ulcera and anastomositis of a suture were rare findings. Stump gastritis is no own clinical picture. Also in this case in histologically still normal mucous membrane earlier histochemical changes develop in the sense of a chronic gastritis with a reduction of the adenosin triphosphatase, the acid tissue phosphatase and succinodehydrogenase.


[Comparative examinations of stomach and duodenum with the use of Buscolysin and Cerucal]. The administration of buscolysin and cerucal in the pharmacoradiography of the stomach and the region of the small intestine was tested on every 50 patients. In these cases the differentiated range of action of the two preparations was shown. Buscolysin can be regarded as remedy of choice for the hypotonic duodenography, whereas cerucal is conspicuously suited for the functional diagnostics especially of the regions of antrum and bulb. By the aimed administration of the two preparations a complex functional diagnostics of stomach and duodenum is possible.


[Results of fibrogastroscopic and gastrobioptic examinations after acute acid burn]. The fibrogastroscopic and gastrobioptic examination of 101 patients after acute intoxication with corrosive substances (vinegar essence, sulphuric acid, hydrochloric acid, lyes a. o.) revealed in all cases a chemical erosion of the gastric mucous membrane of different degree, also in such a case, where there existed neither clinical nor radiological symptoms of the corrosive gastritis. Endoscopically the erosions of the mucous membrane were classified into three degrees of severity: Insignificant erosions were characterized by reddening and swelling of the mucous membrane, foamy phlegm and fluid, medium erosions by numerous puncti-form erosions on the hyperaemic oedematous mucous membrane covered with fibrin, severe erosions, finally, by haemorrhages and dark-gray necrotic areas. Pathohistologically in easy erosions were found a serous or catarrhalic-serous inflammation on the 1st to 5th day, a transition of proliferative processes in regenerative ones on the 6st to 10th day and a complete reparative regeneration on the 11th to 20th day. In medium erosion there existed a catarrhalic or catarrhalic-fibrinous inflammation with erosions on the 1st to 10th day; the regeneration of the mucous membrane took place on the 21st to 30th day. Severe erosions were characterized by a phlegmonous-ulcerous or ulcerous-necrotic inflammation between the 16th and 30th day and the reparative-fibrotic transformation of the mucous membrane between the 31st to the 60th day. After severe erosion no restitution ad integrim took place. There developed either a chronic atrophic gastritis or, when an excessive cicatrisation is present, a stenosis of the prepylorus. A control of the patients including endoscopic examinations which are performed to 6 months after easy erosion, up to one year after medium erosion and up to 5 years after severe erosion, is of importance for the estimation of course, therapy and prognosis.


[Mathematical statistical evaluation of the trends of biological parameters during intermittent therapy]. Principle and method of the mathematico-statistical evaluation of an intermitting therapy are explained at the example of the cholestyramine treatment in incomplete obstruction of the bile ducts. The behavior of a biochemical parameter-e.g. the alkaline phosphatase activity and the cholesterol content of the serum-during this time is described with a total approximation function which is subdivided into several partial regression functions. The changes of the biochemical parameter during several periods with and without therapy, respectively, my be characterised and statistically judged from different points of view, e.g. as trend. Thus the clinical test of medicaments gains more objectivity, selectivity, dynamics and individuality. Thus in the example described the effect of cholestyramine (cuemid) decreasing the pathologically increased alkaline phosphatase activity and the increased cholesterol content of the serum and a return to the initial values and a slight deterioration, respectively, after discontinuation of the medicament with a probability of error up to alpha less than 0.001 on one patient could be proved.


[X-ray presentation of small intestine invagination during fibroma by means of trochoscopy]. The roentgenologic diagnosis of tumours of the small intestine often depends on accidental findings. In the case of a 50-year old female patient the indication to operation could be made by the demonstration of the complication (invagination). For the roentgenologic research for tumours in the area of the small intestine, when the result is negative, apart from the oral filling in every case the trochoscopy with transition of the contrast medium into the terminal ileum must be demanded.


[Initial changes in the vascular metabolism and their relations to atherogenesis]. In a survey initial changes of the metabolism of the vascular wall under the influence of atherogenic noxae in the animal experiment are described. Already a short time after the effect of atherogenic noxae (so-called proliferative phase) the activities of respiratory mitochondrial enzymes in the cells of the smooth muscles of the tunica media of the aorta are considerably reduced in different species. It is a clue to the fact that a hypoxically induced defect in the arterial wall is to be taken into considerations as a pathogenetic factor for arteriosclerosis. Up to now there are no exact proofs for the fact that a transition to a high rate of glycolysis would be predisposing for the appearance of arteriosclerotic changes. The influence of a hypoxia on the vascular wall is not only restricted to the cellular energy metabolism, but stimulates also other cellfunctions. Under hypoxic conditions the synthesis of fatty acids in the arterial tissue is increased. Several authors are of the opinion that a continuous increased supply of lipids overchanges the processes of the cellular regulation which are responsible for the metabolisation of the lipids. The transition into the proliferative phase is characterized by increased insertion rates or transformation rates for different substances in the activated myointimal cells which focally or generally leads to a proliferation or migration into the intima. The proliferating cells distinguish themselves by high activities of different oxidative enzymes which is to be regarded as a reference to an increased readiness of connections rich in energy, according to the high synthetic capacity of these multifunctional mesenchymal cells.


[Significance of clinical and functional diagnostic findings for the physical rehabilitation ability of the patients with heart infarct]. In 75 patients with condition after myocardial infarction or chronic ischaemic heart disease, respectively, was tested to what extent from clinical and functional-diagnostic findings prognostic estimations concerning the regaining of a cardiocirculatory functional capacity corresponding to age are possible by a complex rehabilitation programme. A daily ergometer training lasting eight weeks which was individually dosed was in the centre of rehabilitation. It was shown that from the findings of ergometry with permanent ECG-registration the effect of rehabilitation, as a rule, can be predicted.


[Clinical studies on kinking of the neck-vessels]. A survey is given of the clinical course of 273 patients hospitalised at one of the departments for internal diseases of a general hospital because of cerebral lesions of different pattern and origin. By means of angiography carried out on 60 patients kinking of the extracranial arteries was proved in 18 cases. Ten patients were submitted to reconstructive vascular surgery: 7 of them are symptom-free. Signs, symptoms and possibilities of surgical or conservative treatment are discussed.


[Progression of rheumatoid arthritis].

[Progression of rheumatoid arthritis]. In order to recognize courses with high and low progression in rheumatoid arthritis deviating from former approach the values of a locomotor function test were used which do not belong to the dispersion region for the adequate classes of duration of a disease. With the help of a material of an electronic data processing study of 1,000 cases with ascertained diagnosis correlations between high progression and, among others, following criteria could be ascertained: male sex, old age, early beginning of the disease, manual trades, unfavourable functional values and very much changed laboratory values including high titres of the rheumatoid factor. In this method there was no relation to the duration of the disease, as it was existing with other methods of the determination of progression which were comparatively included into the investigation.


[Nephrotic syndrome after treatment with penicillamine in Wilson's disease]. In a 33-year-old man with Wilson's disease a nephrotic syndrome appeared as a severe complication under penicillamine therapy. Under strong observation and exact controls of protein in the urine, leucocytes, differential blood picture and thrombocytes after interruption of the medication and retrogression of the side-effects a retarding new stabilisation of penicillamine can take place. Other side-effects of penicillamine observed as well as control measures under a long-term treatment with penicillamine are briefly discussed.


[Hemodynamic aspects in the evaluation of heart function using systolic time intervals]. Not invasively determined systolic time intervals give references to the left-ventricular function. Restrictions result from the fact that the systolic time intervals are differently influenced by haemodynamic factors. The inotropic state, the pre and after load, the stroke volume, the frequency as well as the sympathoadrenal system have an effect on the systolic time intervals. In addition to this come specific changes of the haemodynamics by valvular lesions and by pharmaca effective on heart and circulation. In as far about established systolic time intervals clinically usable data concerning the disturbed left-ventricular pumping function may be received, was reported on. On principle with certain restrictions a usable separation of groups between normal and disturbed cardiac function is possible. The judgment of the individual case is restricted due to considerable disperions of individual values. Also by an improved measuring technique as well as by tolerance tests the evidence could not convincingly be improved. On the other hand, with the help of the index of isometric contraction after Rentsch (preejection period in the erect position divided by preejection period in lying position) a separation into normal and beginning left ventricular dysfunction is possible in a well reproducible way.


[Diagnosis of coronary insufficiency using bicycle ergometry]. The bicycle ergometry has proved as screening test for the diagnostics of the latent coronary insufficiency. Taking into consideration well-known prerequisites, indications, contraindications, the criteria of withdrawal and the ECG criteria in coronary insufficiency own results and experiences from an analysis of 1,000 bicycle ergometries are presented and compared with literary data.


[Cholegraphy with protracted mechanical infusion as a method of routine]. 250 out-patients were examined by mechanical 30 min slow-infusion cholegraphy with 20 ml jodipamide (Adipiodon). Only 1.2% slight and 2.0% distinct side effects were established. The frequency and severity of these reactions were less compared with the usual intravenous cholecystography. The described method of investigation may be recommended for use.


[Electroencephalographic findings in liver function disorders]. Abnormal rhythmisations in the EEG are described in hepatoportal encephalopathy as an expression of a disturbance of more profound cerebral structures. The EEG gives an actual information about the state of the cerebral functions of all stages of a hepato-cerebral decompensation and allows a reliable prognostic estimation during the observation of the course. Practically significant are also bioelectric findings of a disturbance of the cerebral function with clinically symptom-poor course in compensated liver cirrhosis or obstructive icterus.


[Humoral immune reaction in chronic liver diseases]. In 60 patients with a morphologically ascertained chronic liver disease and 40 hepatologically examined patients with a healthy liver of a control group the quantitative determination of the immunoglobulin and the immunofluorescence-serological determination of antibodies against nuclei, smooth musculature and mitochondria were carried out. Only in one female patient with a chronic active hepatitis out of 51 patients with morphologically ascertained liver cirrhosis or chronic active hepatitis antibodies against nuclei and smooth musculature in a level of the titre of more than 1 : 40 and only in 2 female patients with a primary biliary cirrhosis antibodies against mitochondria could be proved in a level of the titre of more than 160. Titres of antibodies lying below were found in the group of patients with liver diseases and the control group in the same frequency, so that an autoimmune form of the cryptogenic cirrhosis could not be differentiated. The proof of antibodies against nuclei and smooth musculature of a high titre in connection with an isolated increase of the IgG is of special diagnostic importance for the autoimmune form of the chronic active hepatitis; the same is the case in the proof of antibodies against mitochondria of a high titre in connection with an isolated increase of IgM.


[Indications, adverse effects and complications of lithium therapy]. The application of lithium preparations in the therapy and prophylaxis of recidivations of affective psychoses has essentially gathered in point in psychiatry during the last years. Apart from the discussion of the indication, the contraindication and efficacy especially concomitant appearances, side effects and dangers as well as their influencibility are demonstrated, the knowledge of which is of importance also for the physician not dealing with psychiatry.


[Objectivization of the protamine sulfate test through photometric measurements]. The demonstration of monomeric complexes of fibrin in the blood is regarded as a secure sign of an increased consumption of coagulation factors in the sense of a consumption coagulopathy. As a simple and sensitive method for the demonstration of these intermediate products of the coagulation the protamine sulphate test proved its worth in clinical practice. The subjective judgment of this test-tube test frequently becomes difficult in the borderline region between normal and pathologic. On the basis of own comparative investigations it could, however, be demonstrated that by means of photometric measurements an objective and exact evidence about the result of the protamine sulphate test can be made. It is referred to the advantages in the judgment of the course of a consumption coagulopathy during the treatment.


[Diagnosis and therapy of Crohn's disease]. Crohn's ileocolitis is an etiologically unclarified inflammatory disease of the alimentary canal, which is in most cases arranged in segments, may concern all segments, but above all may take place in the inferior ileum and the adjacent segments of the colon. The diagnosis which formerly was certainly made too infrequently is difficult, but histologically it is to be ascertained by typical granulomas of the epitheloid cells. The disease which extraordinarily often is connected with recidivations demands a consequent conservative combination therapy with salazopyrine and cortisone, in acute exacerbations and in formations of fistulae an additional prescription of bactericidal broad spectrum antibiotics is necessary. Resistent courses justify the application of immunosuppressive drugs. The indication to operation is critically to be given and to be restricted to the resection of stenosing narrowings of the lumen.


[Studies on the diaplacental transmission of Masugi-nephritis in the rabbit]. A diaplacentar transmission of the Masugi nephritis or the evocation of a clinical picture similar to the congenital glomerulonephritis could not be achieved in rabbits. Also, the juxtaglomerular index-values of the experimental group did not show a significant difference referred to the control group.


[Alanine aminopeptidase and creatinine excretion under various conditions of diuresis in man]. In 10 female test persons Volhard's water and concentration experiment was carried out. It exists a highly significant correlation between the alanine aminopeptidase activity and the creatinine concentration in the urine. The relation of the two factors to the urine minute volume is hyperbolic. The creatinine in the urine may be regarded as a favourable reference parameter for the excretion of alanine aminopeptidase.


[Post-traumatic meningitis due to Pasteurella multocida]. The clinical data of a 14-year old female patient with posttraumatic meningitis by Pasteurella multocida are reported. The behaviour of the isolated strain is recorded in cultural and biochemical aspect as well as in animal experiment. The importance of the infection with Pasteurella multocida is lined out and the possible origin of the disease in the reported case is discussed. Finally some problems of special bacteriological diagnosis are explained and hints are given in this respect.


[Value and worthlessness of clinical studies in the diagnosis of brain death]. Death was ever determined on the basis of extinguished partial functions of the entire organism (partial death). In intensive medicine with its possibilities of reanimation, with its possibilities of artificial maintenance of breathing and circulation the individual death of man is equated with his cerebral death. It comes only under conditions of reanimation and nearly always shows a clinically recognizable development. Practically above all "the syndromes in the forefield of cerebral death" are of interest as well as its obligatory and optional symptoms, the valency of which was critically tested. A 5-year-analysis (1969 to 1973) of 487 deaths in an internal intensive therapy unit (18% of mortality) was shown that causes, frequency and age distribution of the mortal conditions of disease as well as the average survival time of 4.5 days, in which cases, however, 43% of all deaths occurred within the first 24 hours, very rarely caused us to establish the irreversibility of the loss of the cerebral function on account of an  organic dysfunction, but rather resulting from the question of the interruption of an absurd reanimation.


[Cardiopulmonary diagnosis in patients with ischemic heart disease]. It may be established that the complex cardiopulmonary functional diagnostics in patients with chronic ischaemic heart disease obtained the following essential results: 1. The ergometrically achieved total functional capacity is clearly decreased in all age groups compared with the healthy persons, the differences are highly significant. 2. The proof of a coronary insufficiency got by the electrocardiogram after work is to be regarded as a factor limiting the functional capacity. 3. 72% of the patients reveal under load a PAEDP increased more than the normal of 25 Torr. After exclusion of a respiratory insufficiency these findings must be regarded as a disturbed myocardial function. 4. Thus the increased PAEDP under load apart from the well-known triad (angina pectoris under load, decreased total functional capacity, pathological ECG after work) is a sensitive and decisive factor for proving the disturbed cardial function in chronic ischaemic heart disease.


[The value of the diastolic pulmonary arterial pressure for the estimation of the cardiac functional capacity in patients with myocardial infarct]. From 4 weeks to several months after infarction the patients revealed an altogether clearly decreased total physical functional capacity compared with healthy persons. Behaviour of pulse and blood pressure as well as ventilatory indices in comparable Watt-degrees did not reveal any significant differences compared with persons with a healthy heart. The stroke volume pro surface and the heart-time-volume did also not reveal any determinable deviation concerning the mean values compared with normal persons. In patients with compensated infarction the pulmonary arterial pressure in rest was, as a rule, within the normal. However, under load it increased more than in healthy persons. Patients with decompensated infarction revealed a PAEDP in rest between 20 and more than 30 Torr. The question about a critical PAEDP under load should further be pursued. The ECG gives reliable limiting findings in functional examinations.


[The effect of an ambulatory long term training on performance, metabolic and coagulation parameters after myocardial infarct]. It is reported on the results of a training treatment for outpatients after myocardial infarction which was carried out twice a week during one and a half year, compared to a control group without physical conditioning. Out of 30 patients 14 continuously took part in the training lessons. In contrast to the control group in the training group a clear increase of the working capacity, a slight decrease of the body-weight, of the blood pressure in rest and of the triglycerides in the serum as well as a favourable influence on the glucose tolerance could be proved. The serum cholesterol level and the coagulation parameters did not change significantly. One patient of the training group and one of the control group died. One patient of the training group and one patient of the control group suffered a reinfarction.


[The objective gradation of stenosing coronary artery processes by means of the quantification of pathologic-anatomical data and their relations. 2. Development and presentation of the model]. In order to objectify the judgement of the coronary arteriosclerosis the influence values position x obstruction on the left side and on the right side as well as the mass of the heart are mathematically valued with the aim to achieve a good separation between the infarction group and the control group and an insignificant false coordination of test persons. The optimation carried out for this purpose must be brought into accordance by means of technically ascertained recognitions and necessary practicability concerning valuations which are to be proposed. According to the results obtained on 174 test persons an obstruction on the right side below 50% has a higher importance than on the left side. In the positions of the obstruction the proximal as well as the medium third of the right coronary arteries a higher valuation must be ascribed. Compared with this the trunk of the left coronary artery has a significance corresponding possibly to the proximal third of this vessel. A more insignificant importance than hitherto taken into consideration belongs to the medium third of the left coronary artery. The valuations proposed lead to a highly significant improvement of the separation ability in contrast to the comparable valuations. The false coordination of the test persons at the same time decreases to 11 in the group with infarctions and to 2 in the control group. This equals 10.1 or 4.5%, respectively. In the present number of patients the barriers of the ostium and the type of supply have no statistically ascertained influence on the separation ability.


[Studies on the specificity of alanine aminopeptidase and its variants in the serum in hepatobiliary diseases]. After examinations on a mixed number of patients (236 patients) the increases of the activities of the alanine aminopeptidase in the serum with relatively high certainty may be traced back to diseases of the liver and of the bile ducts. The hepatobiliary specifity is disturbed only by generalised dermatological diseases, especially eczemas. Changes in the electrophoretic pattern of the serum alanine aminopeptidase are also relatively specific for diseases or lesions of the hepatobiliary system. In 11 of the 12 anomalous zymograms of the alanine aminopeptidase observed among 236 patients the aimed search resulted in an alteration of the hepatobiliary system.


[Comparative intravenous and cholangiographic infusion studies in chronic diseases of the bile ducts]. Compared with the intravenous cholangiography the infusion cholangiography is the more effective and unambiguous investigation method of the gallbladder and the bile ducts. It considerably enlarges the diagnostic possibilities in the area of the bile ducts. A serum bilirubin level of more than 2 mg/100 ml allows positive cholangiograms by means of the infusion method, but is nearly always the cause for negative findings in intravenous application. In a hypalbuminaemia lower than 3 g/100 ml, in an increase of the alkaline serum phosphatase, of the serum transaminase and a pathological retention of bromsulphalein the bile ducts cannot be demonstrated also in the infusion cholangiography. A 20% glucose solution is sufficient as solvent in the infusion cholangiography. In the negative case the cholecystography and the intravenous cholangiography may be supplemented and enlarged by application of the infusion cholangiography as a more evident method of X-ray examination.


[Physiotherapeutic viewpoints in progressive scleroderma]. The hitherto given recommendations for physiotherapy in progressive sclerodermia are in most cases undifferentiated. Proceeding from the aims of an influence of sclerodermic changes of the tissues, a prevention of restrictions of the movement and an improvement of the general condition a classification of suitable physiotherapeutic measures is recommended.


[Long-range therapy of hypertension].

[Long-range therapy of hypertension]. In 572 patients with hypertension a long-term therapy with alpha-methyldopa (Dopegyt) was carried out and this preparation was found to be highly effective. The preparation decreases the blood pressure in standing position as well as in lying position reducing mainly the peripheral vascular resistance. It is well absorbed orally. As a rule, the minute output of the heart is maintained without acceleration of the heart rate. An orthostatic hypotension was only rarely to be observed and only in a very small degree. With the help of the isotope renography could be proved that the treatment with alpha-methyldopa causes no reduction of the blood supply of the kidneys, wherefore alpha-methyldopa can be successfully applied in patients with hypertension and renal failure. Side effects appeared very rarely. During the application of 34,550 tablets of alpha-methyldopa only once a haemolytic anaemia was observed. In patients with a severe hypertension the combination alpha-methyldopa (Dopegyt) + etacrynic acid (Uregyt) evoked a distinct decrease of the systolic and diastolic blood pressure.


[Therapy of chronic ischemic heart disease and arterial hypertension by means of beta-receptor blockaders]. 50 patients with stenocardias in persisting arterial hypertension, of them 33 manifest coronary diseases, were orally treated with doses of propranolol up to 400 mg/die during a longer period. In the majority of the cases a good to very good therapeutic effectivity was to be proved in hypertension as well as in chronic ischaemic heart disease. The own favourable results of the treatment justify the estimation that proporanolol may be regarded as therapeutic remedy of choice in patients with simultaneous hypertension and chronic ischaemic heart disease. Moreover, a collective of 45 patients with different cardiovascular diagnoses under the new selective beta-receptor blocker Bonnecor (practolol) was observed. It is reported on first experiences in the sense of an intermediate information.


[The frequency and form of manifestation of liver damage under INH therapy]. It is reported on 305 clinically examined patients with the diagnosis of a functional colon syndrome. In 65 patients somatic diseases were found to be the possible triggering factors. In contrast to a comparative group in the other 240 patients in the former anamnesis more frequently allergies, appendectomies and chronic application of purgatives were to be established. The most frequent complaints were irregularity of defaecation in form of spastic obstipation (62.9%) or diarrhoea (35.4%), intolerance to foodstuff (100%), pain in the colon(66.7%) and meteorism (65.4%). The 4th decennium was most frequently concerned in men as well as in women.


[Diabetes mellitus, hyperuricemia and pyelonephritis]. The following groups of patients are discussed. 1st group: 51 patients with diabetes mellitus and chronic pyelonephritis, 2nd group: 15 patients with diabetes, hyperuricaemia, adiposity and pyelonephritis. It was established that in the first group pyelonephritis was therapeutically well to be influenced by antiobiotics and chemotherapeutics after stopping of diabetes. In the second group the success was less satisfactory and it was also to be achieved retardedly on account of the massive renal lesion, by the combination of diabetes and uricopathy. The clinical syndrome of diabetes mellitus, hyperuricaemia and adiposity is discussed.


[Latent diabetes mellitus in families with diabetes and ischemic heart disease]. In 30 diabetics and their nearest relations (44 persons) the immunoreactive insulin (IRI) was examined and a routine glucose tolerance test was carried out as well as in patients with ischaemic heart disease (more than 100 patients). The control group consisted of 30 healthy volunteers. An analysis of the results was performed taking into consideration the degrees of severity and the duration of the diabetes as well as the age of the patients. A conclusion was drawn that the exhaustion of Langerhans islets occurs relatively early during "juvenile" diabetes. A clear decrease of the IRI corresponding to the degree of severity and to the duration of diabetes can be observed. In the nearest relations of the diabetics a normal IRI-level and in a relatively little percentage latent forms of a diabetes were detected. In patients with ischaemic heart disease however, the non-manifest forms of diabetes were by far more frequent. It is considered that more precise tests should be applied in laboratory diagnosis of latent diabetes mellitus in hereditarily aggravated persons in the mentioned respect.


[Experiences with cytostatic treatment of malignant tumors]. The methods and the results of the cytostatic permanent and impact therapy, of the partial synchronisation as well as of the cytostatic combination treatment are described, taking into special consideration inoperable or metastasized solid tumours. From the study which was carried out during a period of 15 years results that a combination treatment referred in the individual doses to body weight and blood picture apparantly achieves better results than the other forms of therapy, whereby the risk of complications is relatively low.


[Experiences in short-term dialyses with 2 capillary dialyzers in parallel and serial circuit in 2 and 3 shift operations]. It is reported on experiences made in 200 short-term dialyses with every 2 capillary dialysators. 167 dialyses of which 112 were performed by means of parallel arrangement and 55 by means of serial arrangement of the dialysators are analysed in detail. In their effectivity of dialysis the two variants proved to be nearly equivalent, in which cases the series-connection is of practical advantage. In two shifts of nurses up to 3 shifts of patients could be treated. In the large area dialysis an adaptation  of the dialysate and a more intensive control of the patients must be performed. Advantages and disadvantages of this method are discussed.


[General aspects of cytostatic therapy of hemoblastoses]. In haemoblastoses the chemotherapy is able to achieve remissions and prolongations of the survival time. The combined or polychemotherapy, respectively, is here comparatively more effective than the monotherapy. In haemoblastoses the concept of the maximal destruction of tumours (induction therapy) could be realised by means of consolidation and maintenance therapy. The prediction of the therapy effects by inclusion of different host parameters (morphology, immune state, age, sensibility test) may only approximately be done. In the induction and maintenance of the remission the supportive therapeutic measures play an essential role. By the development of selective cytostatic drugs and further utilisation of the results of molecular-biological experiments further ameliorations of the therapeutic situation are to be awaited.


[New diagnostic and therapeutic aspects of lymphogranulomatosis]. The prognosis of lymphogranulomatosis has improved by the considerably improved diagnostics as well as the modern radiological and polychemo-therapeutical methods. Today the average survival time is between 4 and 5 years. But survival times up to 15 years and more are described. Apart from the early diagnosis, into which according to the opinion of many internal specialists the otorhinolaryngologists must be included more than it was hitherto the case, nowadays the modern radiotherapy with explorative laparotomy and splenectomy and the perhaps following combination chemotherapy might bring a further improvement. Growing age, histological types with a small number of lymphocytes, too late diagnosis and deficient control decrease, however, signigicantly the chances of surviving. Certainly, in future more modern methods of chemotherapy must be used. The same applies to the treatment of the developing immunoinsufficiency and the eventual further performance of the cytostatic treatment in the sense of a maintenance therapy. From the modern point of view the way taken might lead to still higher survival times. In as far immunotherapy will be of greater importance already in the next years is not yet to be decided at present.


[L-alanyl-L-proline-dipeptidase and glycyl-L-valine-depeptidase in malabsorption syndrome]. On the basis of comparative determinations of the activities of dipeptidases and disaccharidases of the mucous membrane of the small intestine (proximal jejunum) clear correspondences between the morphological findings and the biochemical parameters were the result. L-alanyl-L-prolin-dipeptidase and glycyl-L-valin-dipeptidase as well as lactase, saccharase, maltase and trehalase were determined in altogether 45 children with various malabsorption syndromes of different age in different stages of disease. Diminutions of the activity of the dipeptidases were to be proved analogously to maltase, saccharase and lactase, too, in most cases of subtotal or total villous atrophy. From the results conclusions may be derived to the restricted ability of protein absorption in chronic disease of the small intestine.


[Necrobiosis lipoidica diabetricorum and serum lipids]. Necrobiosis lipoidica diabeticorum is briefly described. Its high coincidence with hyperlipoproteinaemia in casuistic reports from the literature as well as in about half of the 22 cases observed in our clinic can be taken in favour of possible relations between these conditions. Disturbances of fat metabolism may even be considered important for pathogenesis of necrobiosis in general, the more as at least no optimally regulated fat and carbohydrate metabolism can be achieved by best therapeutic control of carbohydrate parameters in juvenile diabetics. Microangiopathia diabetica seems to exist from the very beginning of diabetes mellitus and may ne a basic etiologic prerequisite for the development of necrobiosis. Topical conditions of certain body regions are said to take part in final precipitation of necrobiotic spots.


[Determination of hepatic indocyanine green (ujoviridine) clearance using the slope-method]. 1. The technique of the functional test of the liver by means of the indocyanine green (ujoviridine) test suggests to express the results of the test as a result of clearance on the basis of the slope-clearance. 2. The analysis of the curve of disappearance of the test substance in the serum could not always be traced back to a simple exponential function in a group of clinically healthy control persons (10 women at the age of 10-24 years). For the better estimation of the slope-clearance, therefore, the rinsing effect of the liver should be preferred by means of the analysis of a composed (twofold) exponential function. 3. In the two investigation methods the results of the clearance values were not symmetrically distributed so that as parameters of estimation at first only the mean values of density are used. 4. According to this only orientating study the values of the ujoviridine clearance are below 720 ml/min, assuming a simply exponential rinsing function, or 500 ml/min, respectively, taking as a basis the composed exponential rinsing function below the mean values of density.


[Adrenergic processess and partial secretion of the stomach]. The stimulation of alpha- and beta-adrenergic processes by epinephrine, phenylephrine and isoproterenol increases the hydrochloric acid and gastric juice secretion (as well as the secretion of gastric juice components is decreased under the influence of the alpha-adrenergic blocking agents dehydrobenzperidol and beta-adrenergic blocking agent propranolol. However, propranolol essentially reduces the acid components secretion not affecting greatly the alkaline components secretion of the patients with a high basal secretion. As a result the P/NP-ration is decreased.


[Increased insulin-sensitivity as a 1st indication of Addison's disease in a juvenile diabetic patient]. Case report on a 25-year-old patient with diabetes mellitus which is difficult to be controlled. Relapsing vomitting, loss of body-weight, retention of substances normally contained in the urine, hyperpotassaemia, hypernatraemia as well as an increased insulin sensitivity render an additionally existing morbus Addison probable. Confirmation by means of the determination of the Porter-Silver chromogenes. It is referred to the apparantly frequently not understood syntropy in diabetes mellitus and Addison's disease. An autoimmunological process is discussed.