[Differentiation and identification of mycobacteria by means of thin-layer chromatography of their lipids. II. Application for the classification of slowly growing mycobacteria: M. avium and M. intracellulare (author's transl)]. Experiences with the thin-layer chromatography of mycobacterial lipids for the differentiation of the species M. avium and M. intracellulare are described. Details of the procedure used have been published in a recent paper. The 61 strains investigated belong to 16 different serotypes. Twenty of the 21 strains of M. avium present three distinct lipid patterns corresponding to the serotypes 1, 2 and 3. One strain had an aberrant lipid pattern suggesting that serotyping was at fault. The results obtained with 40 M. intracellulare strains of the serotypes III, IV, VI, VII, Davis, Watson, Howell, Chance, Boone, Yandle, Wilson, Altman and Arnold show that a differentiation by thin-layer chromatography of their lipids--using two different developing solvents--is possible. In allbut one case there was a complete correspondence between classification by lipid analysis and the results of serological typing. The distinction between M. avium and M intracellulare on the basis of species specific lipid patterns is not possible. This supports the conclusion that M. avium and M. intracellulare appear to be the same species having a number of distinctive serotypes.


[Physician's decision making in evaluation of tuberculous patients assessed by a questionnaire (author's transl)]. By a questionnaire 88 chest physicians were asked anonymously for their opinion about 15 cases of tuberculosis with various problems (choice of chemotherapeutic regimens, duration of treatment, rehabilitation and other aspects) in regard to first or repeated treatment and in chronic tuberculosis. It can be demonstrated, that in the overwhelming number the evaluation of the cases is done with safety and that the recommendations of the advisory board for chest diseases and tuberculosis are noticed.


[The influence of rifampicin on the lymphocyte stimulation (author's transl)]. In 7 PHA--and PPD stimulated lymphocyte cultures from healthy human donors the maintained immunosuppressive effect of Rifampicin was investigated. Concentrations of 5-200 mug RMP/ml culture medium were used. A significant decrease in the transformation rate was found at 20 mug/ml and higher concentrations. A vitality examination (trypan blue staining) on lymphocytes after 72 hours cultivation in a RMP-containing medium with the same concentrations showed no increase of stained cells as compared with the controls. It is suggested that the observed inhibition of lymphocyte reactivity is to be attributed to an immunosuppressive effect of RMP and not to a toxic influence.


[A contribution to the symptomatology of diffuse interstitial pulmonary fibrosis (DIPF) (author's transl)]. Diffuse interstitial pulmonary fibrosis was detected in 64 patients (33 males and 31 females). The diagnosis was obtained in each case from the anamnesis, the clinical findings, the chest X-ray, disturbances of the respiratory function, and from the progress of the disease. The analysis of the material produced the following parameters ranging from indicative to typical: Dry cough was reported by 70% of the patients as being trouble-some. Dyspnoea on exertion and at rest existed in 95%, and gradually increased during the progress of the disease in 76,5% of these cases. On auscultation ear-near crepitant rale was heard in 78% above the affected pulmonary parts. In 62 patients (96,5%) the radiogram showed disseminated streaky-reticular as well as finely to coarsely mottled infiltrations. In more than half of these cases (53%) an increase in severity was observed during the follow-up. A predominantly restrictive disturbance of ventilation existed in 85,5%. Exclusive restriction was found in 65,5%. Effort hypoxemia was detected in 92% of our cases which was especially impressive when the arterial oxygen pressure at rest was within the normal range. The electrocardiographic findings seemed to be less unequivocal. All in all it can be stated that in the synopsis of its manifestation DIPF can be positively identified by clinical means. This fact as well as therapeutical problems are discussed taking available publications into consideration, and respective conclusions are drawn for the clinician.


[Environmental aerosol and human health (author's transl)]. In the modern way of thinking, the influence of environmental aerosol on human health represents a partial problem of the manifold interrelations between biological, chemical, and physical environmental factors in terms of their combined and complex effect on the human organism, including the socio-economic environmental conditions. As regards the air as an environmental factor, two fundamental problems are being dealt with in some detail under this particular aspect: the relation between exposure and effect, and the conception of limiting values for the protection of human health. The traditional conception of "one cause--one effect" is inappropriate for dealing with this complex set of problems and has to be replaced by the "many causes--many effects" principle while paying heed to nonspecific as well as indirect effects on the health and well-being of man. The difficulties encountered in clarifying the relation between exposure and effect, and in assessing air pollution from the hygienic point of view are pointed out, and an outline of the present state of knowledge and of the experimental and epidemiological methods of research as applied in this field is given. In conclusion the principles for the determination of air-hygienic standards are expounded.


[The effect of caffeine on the resorption and various central effects of ethanol]. Caffeine given in a dose of 400 mg one hour before 1 g/kg ethanol did not influence the course of blood alcohol levels in male volunteers. Furthermore, caffeine did not improve psychomotoric skills impaired by ethanol. Two cups of coffee ingested 30 min. after ethanol (0.5 g/kg) caused a statistically significant increase of blood ethanol levels one hour afterwards (from 0.49 to 0.61%). This may be due to an accelerated absorption of ethanol caused by the ingestion of warm fluid.


Coffee consumption and mortality in a community study--Evans Co., Ga. Total mortality showed no association with heavy coffee consumption in the four race-sex groups of Evans County. Deaths from coronary heart disease in WM, WF and BM showed no statistically significant differences between the two coffee consuming groups. Sex differences in cerebrovascular death rates, consistent in both races, suggest the possibility for a female excess of stroke deaths among coffee drinkers, and a "protective" effect of coffee drinking among males. Thus, in an area of the United States which has been designated the "Stroke Belt", neither the cardiovascular nor the cerebrovascular death rates seem strongly nor consistently related to coffee drinking habits. Although the number of deaths (339) is fairly large, representing a 13% mortality in this community over a four and one-half year observation period, the classification in four race-sex groups with further division into the groups with different coffee drinking habits limits each stratum to rather small numbers. In addition, 86 cases of CHD and CVD were diagnosed during lifetime already and, therefore, were excluded from the prospective mortality study. Confidently to refute or confirm the allegations of a detrimental influence of high coffee intake on ischemic heart disease one would need larger numbers. But in the light of our most important finding--that mortality from all causes is not increased in the high coffee consuming group--the finding of increased ischemic heart disease death rates with high coffee consumption would have to be compensated by a provocative, lower rate for other causes of death.


[The effect of caffeine on the serum insulin level during intravenous glucose tolerance test in patients with chemical diabetes]. Nine mild male diabetic patients were studied by intravenous glucose tolerance tests with and without pretreatment with caffeine. The dose of caffeine was 90 mg given as 195 mg of caffeine citrate. The parameters measured were blood glucose and serum insulin. Caffeine given 2 hours previously did not affect the mean glucose disappearance rate of the group, however, those with the highest rates did show a reduced rate after caffeine. Insulin levels showed a decrease particularly during the first five minutes after glucose. This finding was present particularly in those patients who exhibited the larger first peak. It is possible that a relationship exists between the magnitude of the caffeine effect upon early insulin secretion and the glucose disappearance rate.


[The effect of coffee and coffee components on the stomach muscle]. The isolated stomach muscle strip preparation works well when given pure compounds which are stable and non-toxic. When complex test mixtures such as coffee are used, however, the results are more difficult to interpret. This is probably due to non-specific effects of such mixtures, e.g. induction of changes in organ bath pH, etc. In spite of the above remark, differences in the effects of decaffeinated and normal instant coffees were clearly seen. The so-called "wholesome" coffees gave results identical to those obtained with normal instant coffee. In general, coffee induced muscle contraction followed by relaxation. Choline (possibly together with potassium) would appear to be responsible for the contractions observed, and caffeine for the relaxation.


[Danger to human health from mycotoxins]. The review paper summarizes our knowledge on the influence of the intake of mycotoxin containing foodstuffs on human health. The greatest attention is given to the aflatoxins. The results of epidemiological studies on the occurrence of primary liver cancer in Thailand and different regions of middle and southern Africa are described.


The effect of chromium III on the intravenous glucose tolerance of rats given diets of different protein values. The effect of chromium administration on glucose utilization was investigated in 32 rats fed either high or low protein diet. In rats fed a low protein diet of NDpE% 4.3 the glucose removal rate increased significantly following the administration of chromium. However, the administration of chromium has no effect on the glucose removal rate in rats fed high protein diet of NDpE% 10.1. The glucose removal rate of rats kept on a diet of high protein value free from chromium was significantly higher than those kept on a low protein diet. Chromium deficiency did not appear to be the only responsible cause for the impaired glucose tolerance in animals fed low protein diet. It could be concluded that both chromium supplementation and protein ingestion promote insulin secretion.


[The sulfur dioxide in various population groups in the German Federal Republic]. In direct nutrition surveys, mostly with precise weighing methods, the SO2 intake was estimated in 10 groups of population in the FRG. The averages in the groups are in comparison with the FAO/WHO recommendation very low. This result was also found in most of the people in surveys. From group to group there is a wide range and in the groups too. The highest intake in sulfur dioxide has a group of winegrowers with 0.88 mg/kg body weight and day.


[Interactions between nutrition and drugs]. It is only recently that the question of interaction between nutrition and drugs has been investigated. Generally there are two ways by which such an interaction may occur. On the one hand the food-intake and its composition may influence the effects of drugs by altering their pharmacokinetics. In most cases the abosrption of drugs and thereby also their biological effects are decreased when they are taken together with food, by only a few drugs the opposite effects have been observed. Furthermore the biotransformation of drugs may be inhibited by giving a diet poor in proteins. A diet rich in meat or in vegetables may also influence the urine pH in the more acid or basic direction and in this way the renal excretion of drugs may be changed considerably since drugs are generally either weak organic acid or bases. On the other hand drugs may also interfere with the availability and utilization of certain nutrients e.g. vitamins, electrolytes or trace elements. Such interaction could be observed when giving for example antibiotics, alcohol, contraceptives, anticonvulsives or laxatives over a long period. Deficiency of certain nutritional factors or even diseases can then be the consequence of such interactions.


Phytochemical and nutritional studies on pigeon pea and kidney bean cultivated in Egypt. 1. The preliminary phytochemical screening of the two seeds established the presence of carbohydrates and/or glycosides, flavnoids, unsaturated sterols and/or triterpenes, saponins, trypsin inhibitors and haemagglutinins. In addition, it established the absence of cardenolides, tannins, alkaloids and oxidase enzyme. 2. Certain pharmacopoeial constants, including moisture, ash, acid-insoluble ash, water-soluble ash and crude fibre were determined. 3. The two seeds were subjected to successive extractions with different organic solvents such as petroleum ether (50-70 degrees C), diethyl ether, chloroform and ethyl alcohol. The successive yields of extractives were determined. Examination of the crude extracts showed that petroleum ether extract contained sterols and/or triterpenes, while ether, chloroform, and ethyl alcohol extracts contained reducing substances. 4. General analysis of the two seeds for proteins, fats, carbohydrates, fibre and ash contents were carried out and the results were given in g/100 g dry seeds. Pigeon pea contained 25.2 g protein, 170 mg calcium and 8.9 mg iron. The protein content of kidney bean was 23 g, while calcium and iron contents were 134 mg and 8.02 mg respectively. 5. Extractions of the proteins using different solvents such as cold water, hot water, saline buffer pH 7 and sodium hydroxide was the best extractant. 6. The amino-acid content of the two seeds, whether raw or cooked, showed that they were deficient in methionine, cystine and tryptophan. Other essential amino acids were present in amounts higher than that given by the FAO provisional pattern. 7. Cooking the seeds by the popular methods used in the country resulted in an increase in the amounts of the amino acids, threonine, leucine and isoleucine, while the other amino acids present remained unchanged or decreased. It was also observed that cooking the seeds destroyed the trypsin inhibitors and haemagglutinins found in the two seeds.


[The catabolism of infused maltose in man]. The use of intravenously administered maltose was tested in 9 healthy human subjects and 3 insulin-dependent diabetic patients. The concentration of the blood sugar has not been influenced by the administered maltose. The concentration of maltose in the blood increases up to 170 mg/100 ml blood depending on the rate of the maltose infusion. The excretion of maltose in the urinis correlated with the applied dosis and with the blood maltose concentration. Under our experimental conditions 20 to 30% of the administered maltose have been excreted and 7.5 to 23.4% have been oxidized within 8 hours. The highest rate of degradation was about 40 mg maltose/min/human subject and is reached 2 hours later than the peak concentration of maltose in the blood. The metabolism of maltose is reduced in insulin-dependent diabetic patients. In these patients only 3% of the applied maltose have been oxidized and 51% excreted in the urin within 8 hours. Therefore, this disaccharide cannot be recommended as carbohydrate source of parenteral nutrition in insulin-dependent diabetic patients. The balance of intravenously administered maltose is not satisfactory in healthy adult humans, too. Infusion of maltose solutions have no real advantages over the infusions of oligosaccharide solutions.


[Effect of maltose, following long-term intravenous infusion, on the metabolism]. 6 healthy subjects received a 20% electrolyte containing maltose solution over a period of 6 hours. The concentration of maltose rose up to 109 (76-215 mg/100 ml). During the infusion period 3,7 (1,9-7,7) g maltose were excreted. The concentration of glucose and insulin was not altered, although the renal glucose loss was 20,2 (7,5-38,7) g. In the same period 49,8 +/- 13,2 mval potassium and 135,4 +/- 35 mval sodium were eliminated. Maltose induced an osmotic diuresis which was not caused by hyperglycemia. Such a type of osmotic substance has not been described before.


[Metabolic effect of a parenterally administered fat emulsion with middle-chain triglycerides in healthy men]. Within 3 hours, 10 healthy male volunteers were infused 500 ml of a 5 percent emulsion in which 25 percent of the fat proportion had been replaced by MCT-fats. As expected, the ketone body concentration in the blood rose, while pyruvate remained constant and lactate dropped. The results show that, basically, a MCT-containing fat infusion is suited for parenteral nutrition and, because of their specific properties, medium chain triglycerides may be used as rapid energy donators.


[Tests with human volunteers on parenteral utilization of maltose]. Intravenous infusions of maltose were performed using human volunteers. Four volunteers received maltose in a dose of 0.25 g/kg bodyweight and hour during eight hours. A follow-up period of three hours was added. Six volunteers received maltose in a dose of 0.125 g/kg bodyweight and hour during twelve hours. Only with the lower dose of maltose (0.125 g/kg b.w.) a steady state is reached after six hour continuous infusion. However even under these conditions maltose concentration in blood reaches the high concentration of 70 mg/100 ml. Using the double infusion rate, no steady state is attained when the infusions lasted for eight hours, despite maltose concentration in blood measured 150 mg/100 ml at this time. By measuring different metabolic parameters (fatty acid concentration, phosphate concentration) it is shown that parenterally applicated maltose is metabolized in the human. On the other hand, adverse reactions were not observed. The concentrations of uric acid and bilirubin remain constant and the activity of SGOT is not altered. Renal excretion of sugar measures 25-35% of the maltose administered parenterally. It is concluded that the glucose in urine stems from direct intra tubular hydrolysis of maltose achieved by the neutral maltase of the kidneys. The lack of attaining constant blood concentration for maltose during the infusions and the high renal loss of sugar shows that maltose is not suited as the single substrate for parenteral nutrition. However, there remains the possibility to use maltose in combination with glucose substitutes. The metabolic behaviour of maltose is similar to glucose, it differs from glucose substitutes.


[Gas chromatographic analysis of amino acids in food]. 1. The methylester derivative of DNP-amino acid was examined by gas-chromatography and amino acid shown in fig. 1 was detected. 2. The gaschromatography was more sensitive than the ion-exchange chromatography, but detectable peaks were few, and it must be further studied. 3. The measurements of five amino acids in food were almost coincident with those obtained by the ion-exchange method in literatures.


The protein nutritive value of proteolan, a by-product of starch industry. The nutrient contents as well as the amino-acid pattern of the proteolan by-product were determined. The results showed the presence of 18 amino acids. Most of the essential amino acids are existing in optimal concentration with exception of the sulfur-containing amino acids which showed deficiencies. The animal experiments indicated high figures for the digestibility coefficient and low figures for both the biological and net protein-utilization values. Mixing the proteolan in equal proportion with barley rootlets, a by-product of malting, leads to a noticeable increase in the biological value.


[Fatty-acid pattern of serum lipids (standards for mothers, placentas and infants)]. The standard distribution of the fatty acids in the total lipids of serum was gaschromatographically defined in the respective umbilical cord blood of 24 mothers and their newborn babies, as well as in 20 placentas. The same examinations were made with 30 newborn babies on the day of birth, 14 children in the newborn stage, 22 young babies between 3 and 10 weeks old and 16 older babies between 4 and 12 months old. In the umbilical cord mixed blood of another collective (n = 10) the separation of the total serum lipids in the individual fatty fractions (neutral lipids, phospholipids, cholesterol esters) was also undertaken. The results were compared and existing differences were discussed. It was further established that an advance towards the adult's fatty acid pattern already takes place at an age between 4 and 12 months.


[Leading symptom: the M-gradient in electrophoresis]. A survey is given on development, proof and clinical importance of an M-gradient which is to be demarcated in the electrophoresis. A M-gradient refers to an excessive increase of the number of monoclonic immunoglobulins (= paraproteins). As investigation method the electrophoresis on agar or agarose, respectively, is best suited. The immunoelectrophoresis is necessary for the further differentiation into several classes and types as well as for the demarcation of pseudo-M-gradients. The proof of a M-gradient alone does not allow a diagnosis. M-gradients obligatorily appear in the plasmocytoma, in Waldenstroem's macroglobulinaemia and associated neoplasias of the lympho-plasma-cellular tissue. However, M-gradients can also be observed in carcinomas, chronic liver diseases and chronic inflammatory processes as well as in clinically healthy persons in individual cases. The differentiation according to the cause of the M-gradient is possible only then, when the total clinical picture is taken into consideration, in individual cases, however, according to the course of the disease.


[Psychological examinations in essential hypertension]. The influence of psychic factors on the blood pressure has been known since decenniums. In order to establish the psychic peculiarities of 25 male and 25 female patients, the complaint questionnaire of Höck and the Minnesota Multiphasic Personality Inventory (MMPI) was used. In 16 male and 21 female patients with the MMPI a neurosis could be established psychometrically. In female neurotic hypertonics the duration of the disease was three times longer than in non-neurotic hypertonics. The treatment of hypertension should not be exhausted in pharmacotherapy, but should also include the clearing up of the actual situation of life.


[Coexistence of psychoneuroses with organic diseases]. The increasing number of the coexistence of psychoneuroses with organic diseases may lead to several diagnostic difficulties and errors. It may occur that the physician by mistake diagnoses only an organic disease. In other cases it may also occur that the physician makes an opposite mistake assuming only a psychoneurosis. The aim of this paper was the discussion of these two possibilities of mistake on the basis of the own experience of the author.


[Training effects in the treatment of neuroses]. The whole kinetotherapeutic programme of a psychotherapeutic department--without systematic training in the sense of athletics--in more than half of the cases surprisingly leads to physiologic changes, as they are to be expected in a submaximal training. In significant correlation with this the quality of the rule of the circulatory parameter investigated (pulse rate) improves. In the majority of cases in which positive training and regulation effects developed the psychotherapeutic results were clearly positive, too. On the other hand only in less than half of all cases with clear psychotherapeutic improvement training effects could be proved. The psychologic effects of training are based on a reaction complex the most essential components of which are described.


[Ambulatory psychotherapy at the medical department of a district policlinic]. From the psychotherapeutic unit of the department of internal diseases of a district outpatient department some experiences and recognitions are reported. The autogenic training and the group psychotherapy are the methodical centre. 200 non-selected psychotherapeutic cases are analysed with regard to sex, age, profession and diagnostics of the neurotic symptomatology.


[Incidence and significance of psychovegetative syndromes--demonstration on an example of an internal medicine diagnostic station]. It is reported on 215 patients in whom after detailed somatic and psychodiagnostic examination in a ward of internal diseases the diagnosis of neurosis was made. The cases in question were 33.3% of the whole number of patients during a selected period. In the majority of cases (74%) organic functional disturbances were diagnosed, above all cardiovascular and gastro-enterological syndromes. The screening diagnostics especially with the help of questionaires of complaints allowed of a comparatively certain conclusion to the existence of a psychovegetative syndrome. Altogether 51 patients exhibited the picture of a functional organic linkage syndrome, i.e. in an organic disease a characteristic functional syndrome remained ascertained. The duration of the diseases was always several years, they were chronified, mostly by iatrogenic influences and labelled by an organic pseudodiagnosis. Among the therapeutic measures possible in practice already the diagnosing of a neurosis represents a decisive step.


[Clinical aspects and pathogenesis of paramyloidosis in plasmacytoma]. In the first phase of inhalation due to the sedimentation of droplets against the walls of the atomizer arises a high loss of fluid in the apparatus. When the air flow was regular a high scattering volume of the consumed fluid quantity from the remedy store container was obtained. In the short-time inhalation this method cannot be used for the estimation of the quantity of medicaments applied to the patient. An exact dosage is possible only by measuring the fog flow and when the exact density of fog is known. When the presuppositions mentioned are not given, the informations about the virtual density of fog which was calculated by means of the analysis of regression, may be obtained.


[Obesity and diabetes-morbidity--a prospective 5-year study]. In a prospective 5-year-study the development of adiposity was tested in a population group consisting of about 30,000 persons. It was shown that during the time of investigation the population decreased in its total number, the consumption of easily digestible carbohydrates and meat, however, increased. As it was established in 1968, the proportion of the adipose persons (more than 20% of the Broca-weight) and the percental average deviation from the Broca-weight (calculated in decennium classes) was more than in the comparable population groups in the GDR. Contrary to expectation the examination further showed that on an average men exhibited a trend to the increase in weight, but on the average women decreased in weight. In all age groups (with the exception of the 60- to 69-year-old persons) the proportion of obese persons was significantly lower in 1973 than in 1968. Unchangedly adipose are the diabetics who also have a by far higher average weight than the healthy population and who up to now do not reveal an inclination to the decrease in weight. With 2.9% the average frequency of diabetes is also adequately high.


[Functional and urinary analysis diagnosis of pyelonephritis]. For the practicing physician pyelonephritis is a frequently observed clinical picture which still has its diagnostic problems. With the help of a step programme a reasonable diagnostics is striven for which gives the possibility of an early recognition in the general surgery and a far-reaching clarification of the clinical picture in the out-patient department.


[Roentgen diagnosis of pyelonephritis].

[Roentgen diagnosis of pyelonephritis]. With the help of special literature and the results of own investigations the usability and evidence of radiological examination methods in the diagnosis of pyelonephritis are described. The high value of urography in the ascertainment of predisposing factors for pyelonephritis is emphasized. Subject of nearer considerations is the characteristic radiological feature of chronic pyelonephritis in its different developmental stages. Especially in connection with the decent radiological changes in the early forms of chronical pyelonephritis is referred to the necessity of an optimal collaboration between clinician and radiologist.


[Chemotherapy in pyelonephritis].

[Chemotherapy in pyelonephritis]. In the present paper the most important general directions of the chemotherapy of the acute as well as the chronic pyelonephritis are explained. In adult age actual acute pyelonephritides are rare. In most cases acute attacks of chronic pyelonephritides are in question. Also in the acute pyelonephritides for the initial therapy the application of highly effective chemotherapeutics is recommended which lead to high tissue and serum levels. The exclusive application of nitrofurantoin or an only symptomatic therapy is not indicated in acute pyelonephritis. Only a consequent therapy of the acute form of the course gives the possibility to reduce the number of chronic pyelonephritides. The most favourable conditions for the treatment of chronic pyelonephritis with the aim of stopping the chronic process or eventually even a cure are given by the long-term therapy. For the initial therapy according to the antibiogramme a tissue effective chemotherapeutic remedy is administered. This was followed by a long-term prophylaxis of about 6 months. Taking into consideration the therapeutic mechanisms of the preparations and the severity of the clinical picture always the least toxical antibacterial remedies should be administered. The most important chemotherapeutics for the therapy of pyelonephritis, their side-effects and the peculiarities of their use in renal insufficiency are discussed.


[Urolithiasis and its conservative treatment based on analysis of the calculi]. The exact analysis of urinary calculi is the condition for an aimed conservative therapy of urolithiasis. As standardized method of the analysis of urinary calculi the X-ray diffraction was introduced in the GDR. This investigation method allows a qualitative and quantitative analysis of the concrements. The possibilities of the conservative therapy of urolithiasis were explained. To this conservative treatment belong the treatment of a colic, the removal of a calculus, the litholysis and the prophylaxis of recidivations.


[Immunopathogenesis of glomerulonephritis]. After an introductory description of some morphological points of view the author enters into the mechanisms of the immunopathogenetic lesion in different forms of glomerulonephritis. Hereby Goodpasture's syndrome, the acute post-streptococcal nephritis, the membranoproliferative glomerulonephritis, the sclerosing forms and the so-called glomerulonephritis with minimal changes are particularly taken into consideration. It is tried to describe the clinical course and the pathomorphological changes.


[Comparative clinical and histological studies in the diagnosis of isolated proteinuria and hematuria]. In 311 patients with clinical suspicion to glomerulonephritis biopsies of the kidneys were performed. In these cases in 82% the histological or tentative diagnosis, respectively, of a glomerulonephritis could be made. As diseases preceding the glomerulonephritis relapsing tonsillitides are occupying the first place, whereas scarlet fever, otitides, furunculoses and sinusitides were observed more infrequently. Clinically cases of oligosymptomatic glomerulonephritis were more frequently observed than monosymptomatic ones. One fifth of the patients exhibited a restricted renal function or a proteinuria of 3 g/24 hours, in which case proliferatively sclerosing, diffusely proliferative and membranaceous forms occupied the first place.


[Clinical aspects of glomerulonephritis]. With the help of 260 bioptically ascertained cases of glomerulonephritis clinical characteristics for individual forms of glomerulonephritis are explained. Specific laboratory findings and functional tests are correlated to the bioptic findings and their valency for the individual groups of diagnosis discussed. As a result of the investigation 99% of all cases of disease may be recognized only by the examination of the urine, taking into consideration the interference of the individual symptoms.


[Treatment of glomerulonephritis].

[Treatment of glomerulonephritis]. Issuing from the importance of the glomerulonephritis and the different spontaneous course of the certain morphological forms of glomerulonephritis recommendations are given for the indication of a therapy of glomerulonephritis. For the prednisone, indomethazin, azathioprin and cyclophosphamide treatment therapeutic schemata proved in practice are recommended. The results of the therapy of 32 cases of glomerulonephritis treated with prednisone and of 125 cases treated with indomethazin are described. Two observations of a five-year-course in a rapid progressive glomerulonephritis and in a Goodpasture syndrome refer to a probably favourable therapeutic effect of azathioprin. Finally it is referred to the advantages of an additional immunofluorescence-histological examination of the renal tissue in 50 cases of glomerulonephritis observed during the course.


[Immature-cell leukoses in the adult age]. In form of a survey the author enters into selected questions of the etiopathogenesis, the pre-leucaemic phase, the epidemiology, the cytochemical subdivision, the clinic and therapy of undifferentiated cell leucaemia in adult age. The number of two-year sojourns in a hospital and other data are reported on the basis of an evaluation of the signature ledges of the clinical histories in the district Dresden. A study concerning the therapy carried out on 331 patients from six clinics of the GDR emphasizes the value of the polychemotherapy, in which cases according to the COAP- and ViDaP-scheme the results of the treatment are somewhat more unfavourable, compared with the results in the newest combinations of other authors.


[Effect of some choleretics on the hepatic flow and its composition in man]. Four choleretics, selected at random from the German list of medical preparations, were tested with regards to their influence on hepatic bile production and bile composition. The investigations were performed on patients with a T-drainage in the ductus choledochus after bile duct revision. Bile was collected after fasting (90 min) and after administration of the drugs to be tested (3 hours). The choleretics were administered orally in a dosage two to five times more than the recommended one. Besides the bile volume bile acids, cholesterol, bilirubin, bicarbonate, potassium, sodium and calcium were determined. None of the parameters could be definitely influenced by these drugs. On the other hand a pronounced increase in the bile flow as well as the expected change in the other parameters could be observed after standardized secretion-stimulation which had been additionally carried out in half of the patients (dehydrocholic acid, i.v., taurocholic acid intraduodenally, secretin i.v., meals).


[Immune response to HBsAg, HBcAg and e-antigen in patients with acute hepatitis and HBsAg carriers with and without liver diseases]. Humoral and/or cell-mediated (CMI) immune responses to HBAg components, human and rabbit liver specific proteins (HLP and RLP) and tuberculin were tested in patients with acute virus B and non-B-hepatitis, asymptomatic HBsAg carriers and HBsAg positive chronic active hepatitis (CAH). Furthermore, the presence of HBsAg, HBcAg and/or "e"-antigen has been studied in patients with sera and/or liver tissue. Asymptomatic HBsAg carriers are characterized by a status of immunological tolerance against HBsAg. HBcAg in liver nuclei could not be detected. All sera were positive for anti-HBc, some had anti "e". - Patients with uneventful acute virus-B-hepatitis developed CMI against HBsAg 4-6 weeks and anti-HBs 4-6 months after onset of the disease. Acute virus hepatitis without detectable HBsAg are defined as non-B-hepatitis by negative humoral and cell-mediated immune reaction against HBsAg 1-12 months after onset of the disease. - Patients with type B chronic active hepatitis are characterized by inadequate CMI against HBsAg without immune elimination of virus and virusantigens. Acute and chronic type-B-hepatitis showed temporary or constant CMI against HLP. These findings suggest an alteration or a carrier function of membrane antigens of virus infected hepatocytes or an induction of new membrane antigens by a virus. The results indicate that recovery from type B-hepatitis is associated with the ability to elicit a specific immune response to HBsAg. Furthermore immune responses to virus, virus antigens and virusinfected hepatocytes seemed to be the pathogenic principle of virus induced acute and chronic liver diseases.


[Diffusion disorders in patients with liver cirrhosis]. In 17 patients with cirrhosis of theliver and in 11 controls the pulmonary diffusing capacity for CO (DLCO) was determined at three different levels of alveolar oxygen tensions. The diffusing capacity of the alveolar membrane (DMCO) and the intra-pulmonary capillary volume (VC) were calculated following the formula given by Roughton and Forster. The following results were obtained: 1) Both DLCO and DMCO were lower (p less than 0,01) in the patient group than in the controls. 2) VC showed larger variations in thepatient group than in the controls (p less than 0,01). The mean values did not differ, however. 3) There was a significant linear correlation (p less than 0,001) between DM and 1/VC in the patient group (DM and VC in % of the predicted value). The results suggest, that a change in the configuration of the capillary bed may be responsible for the transfer defect found in cirrhosis.


[Toxic megaileum. Relapse of ulcerative colitis in the ileum following colectomy]. A 19 year old male patient suffered from ulcerative colitis and was colectomized 5 1/2 years ago. He presented now with an acute illness, characterized by massive discharges from the ileostoma, fever, leucocytosis, meteroism, melaena and a tender abdomen. A severe ulcerative inflammation of the total ileum was found. A "toxic megaileum" developed. At an operation the ileum was opened and drained. The patient recoverd under treatment with prednisolone, salazosulfypyridine, parenteral nutrition and Vivasorb. It is suggested that in this case the severe ileitis was due to the same disease which led to the total colectomy 5 1/2 years ago: ulcerative colitis.


[Difficult diagnosis of Crohn's disease]. It is often difficult to diagnose Crohn's disease because of the numerous clinical symptoms. In a retrospective study from 1963-1975 the initial diagnosis was examined in 101 patients with Crohn's disease. In 22% of the patients the initial diagnosis was correct, in 78% one or more wrong diagnoses were made. The most regular wrong diagnosis was colitis ulcerosa (30%). 41 patients were unnecessarily treated surgically before the correct diagnosis was established. The mean time from the on-set of the symptoms until the correct diagnosis was 3.6 years, the mean time from the first wrong diagnosis to the correct diagnosis, 2.9 years. In the later few years a decrease in wrong diagnoses, an increase in initially correct diagnoses and a shortening of the interval between beginning of symptoms until final diagnosis are recognizable. The possible reasons are discussed.


[Active transport mechanisms in the intestinal mucosa of the small intestine and their functional disorders]. The mechanismus of active transport in the small intestinal mucosa are discussed. A survey on the different defects of disturbed absorption is given and examples of 3 basic types of malabsorption are discussed.


[Adaptive changes in intestinal mucosa of the small intestine as a result of intraluminal stress]. Under physiological conditions, the intestinal mucosa is the site of a delicate balance between cell proliferation in the crypt region and cell desquamation at the villus tips. This balance can be deranged by a number of endogenous or exogenous factors, oneof which is the intraluminal contents. This review discusses the effects of different modifications of the luminal milieu on the structure and function of the mucosa. Following intestinal resection or loop transposition, the contents reaching the remnant or the transposed loop differ markedly from those with which they come into contact under normal conditions. Hyperplasia without zonal transformation then develops in the experimental loop. The villi do not become wider, and changes in the strucutre of the epithelium are not observed. There are conflicting resutls in the literature concerning the enzyme activities in the individual enterocytes resulting from this hyperplasia. However, the epithelium its functionally immature, since transport capacities measured in vitro are reduced. On the other hand, the hyperplasia of the mucosa is such that absorptive capacities in vivo, when expressed in terms of intestinal length, are larger than normal. When the intestine is subjected to prolonged infusion of lactic acid, the enterocytes are damaged and increased exfoliation results. A similar result is obtained in the blind-loop syndrome, where the accumulation of bile acids and bacteria provides the stress responsible for the destruction of the enterocytes, and in non-tropical spure, where the epithelium is attacked by noxious peptides in the diet. The first consequence of the accelerated desquamation is epithelial hyperplasia without zonal transformation, though the enterocytes are damaged - in contrast to those of the resected intestine - and apparently possess reduced enzyme activities. If the application of the stress is continued, a stage is reached in which the cell proliferation does not suffice to counteract the cell loss at the villus tips. Then a zonal transformation occurs whereby, despite the lengthened crypts, the villi become shorter and wider until, in extreme cases, the mucosa is completely devoid of villi. The transport capacity in vitro and in vivo - even when expressed in terms of unit-length is reduced, and good correlations exist between the reduction in function and the diminution in surface area of the intestine. In a self-emptying blind loop, the intestine is devoid of all contact with nutritional material. Under these circumstances, hypoplasia of the mucosa develops in which the enterocytes appear unchanged, though in extreme cases they may possess reduced enzyme levels, and the absorption capacity in vivo is consequently reduced.


[Corelations between thrombocyte count, clinical diagnosis, and liver pathology in chronic liver diseases]. In 1488 cases of chronic liver disease thrombocyte content of peripheral blood, clinical diagnosis and histologic findings of the liver biopsy were correlated. Ranging from fatty infiltration to fatty cirrhosis or from slightly active chronic hepatitis to active postnecrotic cirrhosis, according to the extent of the liver injury a significant decrease of thrombocyte-count was evaluated. In case of non-active liver disease and posthepatitic status a thrombocytopenia also could be found. Cirrhotic transformation or proliferation of the connective tissue mainly in the periportal fields and inflammatory activity showed a significant correlation to the frequency of a thrombocyte decrease. A pathogenetic relation is ascribed to an increased thrombocyte storage in the spleen depending on the extent of the liver injury and the alteration of the portal blood stream up to a portal hypertension. Our results indicate such correlations of liver injury, portal pressure and platelet-pooling to thrombocyte-count even if the causal dependency cannot be proved.


[Stomach motility and lyspafen].

[Stomach motility and lyspafen]. Studies of motility of the stomach in 10 test-persons resulted in a significant reduction of motility after a 2-day period of perorally intake of Lyspafen. The active motoric substance is diffenoxin-hydrochloride. An addition of 0,025 mg Atropin sulfate could increase the effect. The effect is independent of the clinical diagnose. A "runaway" could be explained by an intolerance against lactose. The waves of type I are less influenced, such as the frequency of the waves of contraction.


[Acute pancreatitis in Mycoplasma pneumoniae infections]. Report on a man of 29 years with acute bronchopneumonia, antibodies against Mycoplasma pneumoniae and acute pancreatitis lasting three weeks. In some cases M. p. must be considered to be the cause of acute pancreatitis.


[14CO2 exhalation tests. Diagnostic improvement in gastroenterologic diseases]. For evaluation of 14CO2-breath-tests the three most employed tests, namely glycero-14C-tripalmitate-test, 14C-lactose-tolerance-test, and 14C-glycin-cholate-test, were performed in healthy volunteers (n = 69), patients with chronic pancreatitis (n = 18), manifest malassimilation (n = 8), lactase deficiency (n = 15), and patients, in whom a disturbed enterohepatic bile salt circulation was suspected (n = 19). Usefulness of malabsorption tests was limited by many false normal results. Cholylglycin-breath-test on the other hand was sensitive, but clinical significance remained questionable. In our opinion simple performance and lacking discomfort are no sufficient arguments for 14CO2-breath-test.


[Determination of gestational age by sonar (author's transl)]. For some time it has been recognized that abnormal intrauterine development can lead to dissociation between maturity and external size and/or weight of the fetus. The results of pathophysiological and biochemical studies of fetal growth and nutrition have resulted in attempts to monitor and time every pregnancy at risk. The most recent information in the area of intrauterine development has shown that also organic and functional maturity of fetal organ systems can develop dissociated from gestational age. This observation points out the necessity for additional measures in order to achieve the goals of Planed obstetrics. The possibilities of ultrasound biometry for determining gestational age were presented. Taking normal and abnormal fetal growth and behavior into consideration, the use of ultrasonic diagnostic methods makes it possible to acquire concrete data regarding the size and maturity of some fetal organ systems. The methodological problems such as arise in clinical practice were explained and discussed in light of the most recent developments in equipment.


[Topography of a reference plane for ultrasonic thoracometry (author's transl)]. A method of ultrasonic thoracometry is reported which uses the veins of the fetal liver as landmarks. The fact that the umbilical vein running from the anterior abdominal wall to the "sinus venae portae" is visible in B-scan display is the given presupposition. In a study about topography of the vein system of the fetal liver in 50 cases the description of a so called "sinus-plane" for sonar thoracometry is given. This reference plane is shown to be identical with the "lower apertura of the fetal thorax" recommended by Hansmann and co-workers since 1971. Thereby the nowadays well established method of thoracometry in obstetrical routine work gets a more accurate definition in regard to it's topography. This is not only of theoretical interest but will improve the conditions for more accuracy and reproducibility of the method.


[A contribution to the weight determination of the fetus by combined kephalo- and thoracometry (author's transl)]. By comparison of the sectional area of the fetal head of the fronto-occipital level in the height of the biparietalic diameter and the cross sectional area of thorax in the level area of the ventrical it was tried to determine the exspected birth weight. A mean deviation of 8,9% was found. Below a birth weight of 2500 g the presented calculation is only valid to some extend as in these cases the dominance proved in fetal development grounds of the head of the fetus becomes apparent.


[Comparison of serum lipid concentrations in umbilical artery, umbilical vein and maternal vein blood (author's transl)]. Maternal serum lipids and lipids in umbilical artery and umbilical vein blood were examined immediately after delivery in order to relate maternal and fetal lipid metabolism. Total lipids, phospholipids, triglycerides, total cholesterol, cholesterol esters and free cholesterol were determined. The comparison of arterial and venous umbilical lipid levels showed a significantly higher concentration of phospholipids in the umbilical vein, indicating an enhanced flux of phospholipids from the placenta to the fetus. A positive correlation is established for the amounts of total lipids (p less than 0,05), triglycerides (p less than 0,01), phospholipids (p less than 0,05) and free cholesterol (p less than 0,005) between maternal and umbilical vein blood. It is suggested that free cholesterol passes the placental barrier unchanged. The other correlations are discussed as the expression of a factor influencing simultaneously the maternal and fetal lipid metabolism.


[Comparison of lipid concentrations in lung homogenates of newborns with and without hyaline membrane disease (author's transl)]. Quantitative and qualitative studies on lipids of the lungs were performed in babies who died during the perinatal period. The lungs were divided into organs with and without hyaline membranes respectively. Total lipids, phospholipids, neutral lipids, lecithins and sphingomyelins were determined. The fatty acid composition of total phospholipids and of lecithins is reported. A multivariate analysis of variance was used for the verification of significant differences in lipid content and in fatty acid composition with regard to the histological diagnosis. Taking at least two parameters (total phospholipids and C: 14-fatty acid or lecithin and C: 14-fatty acid into account, the two groups (lungs with and without hyaline membranes) were significantly different at the 5% level. The results are compared as well with the lipid content and composition of fatty acids of normal neonatal lung tissue as with observations regarding the lipids in amniotic fluid. The data obtained are discussed with regard to the development of lung maturity.


[Lipid composition in placental homogenates of mature, premature and small for gestational age newborns (author's transl)]. Total lipids, phospholipids, and neutral lipids were determined in the placentas of mature, premature and small for gestational age babies. In addition the phospholipids and neutral lipids were calculated as percentage of total lipids. The distribution of fatty acids in placental phospholipids is reported. The difference found in the concentration of placental lipids is statistically significant at the 5% level between the groups of premature and small for gestational age babies. The increase of neutral lipids and the reduced content of phospholipids in placentas of small for gestational age babies are discussed as a possible sign of placental insufficiency.


[Influence of allylestrenol on hpl serum levels in high-risk pregnancies (author's transl)]. 32 patients with high-risk pregnancies were treated with 3 X 5 mg of 17alpha-ally1-17beta-hydroxy-estr-4-ene (allylestrenol, Gestanon) daily. Only those patients entered this study, who had pathological HPL serum levels during two successive control investigations. In addition, cytological analyses of vaginal smears were performed before treatment was started. The patients were treated with allylestrenol until normal HPL levels were recorded, but at least during 14 days. HPL serum levels were estimated every second day through 14 days. Thereafter HPL assays were performed in weekly intervals. Determinations of HPL were done by radioimmunoassay. Analyses of vaginal smears were done weekly. Statistical analysis of HPL serum levels were performed by Student's-t-test. A statistical significant increase of HPL serum levels were registered during allylestrenol therapy. These results suggest that the pregnancy maintaining effect of allylestrenol is at least partly due to a stimulation of placental function. Analyses of vaginal smears indicate a progestational effect of the norsteroid.


Largactil (chlorpromasine) and cervical dilatation in primiparae. The effects of Largactil on cervical maturation and dilatation during induced labour in primiparous women were investigated. The obtained results suggest that Largactil has significant influence on the maturation and dilatation of the cervix in severely "neurotic" women relative to "non-neurotic" women.


[Changes in maternal cardiovascular parameter during tocolysis and in the dorsal position shock syndrome (author's transl)]. Maternal circulatory parameters and fetal heart rate were measured in 25 healthy pregnant women in the last trimenon during treatment with Fenoterol, Fenoterol in combination with Verapamil and Verapamil alone. Dosages were used in accordance with the tocolytic guidelines from Weidinger and Wiest. We were able to demonstrate that the betamimetic Fenoterol alone and in combination with the Ca++-antagonist Verapamil strongly increases the maternal heart rate an the maternal cardiac output whereas the peripheral resistance decreases accordingly. The average blood pressure stayed leveled, so that a decreased uterine blood flow cannot be assumed under betamimetics from the maternal cardiovascular point of view. However, there are indications for an increased placental blood flow during tocolysis. The betamimetic drug show no significant effect on the fetal heart rate. Additional application of the Ca++-antagonist Verapamil during tocolysis with Fenoterol (in dosages usually used for tocolysis) doesn't change cardiovascular reactions caused by Fenoterol. Change in position from supine to left lateral position caused a short term increase in the maternal cardiac output even noted in pregnant women without a clinically observed cavasyndrom. These changes of maternal cardiac output are comparable with those in orthostatic stress situations.


[Clinical research on a new corticoid-containing topical drug]. In the present paper, the clinical trial of a new difluorinated corticosteroid suitable for topical use is reported. Because of its proven efficacy in very different dermatoses, it is useful as a new reliable product for external use having a broad spectrum of indications. Altogether, 50 patients were treated for a number of dermatoses (various forms of eczema, neurodermitis constitutionalis among other rare skin diseases). Complications, especially skin lesions due to corticosteroids, were not observed. The availability of the test preparation in three different forms has the advantage that it is not only suitable for the primary dermatosis, but it can also be adapted to the various degrees of acuteness.


[Echocardiographic evaluation of left ventricular function during therapy with cardiovascularly effective drugs]. The task of this study was to examine the feasibility of applying echocardiography in determining alterations of left ventricular performance during administration of vasoactive drugs. Patients suffering from congestive heart failure were treated with Digitalis, other patients with normal hearts were subjected to infusion therapy of Isoproterenol, Propranolol, Verapamil and Calcium chloride. A new concept for interpretation of function curves relating the velocity of circumferential fiber shortening (VCF) and time was introduced to establish the inotropic, bathmotropic and chronotropic effects of vasoactive drugs to the myocardium. It can be concluded that echocardiography is a feasible tool in determining changes of left ventricular dynamics during administration of vasoactive drugs, in indicating the individual dosage of a vasoactive drug in each patient and the follow-up the course of the therapeutic success.


[Angiography of left ventricle following volume load and physical work in coronary disease]. In order to recognize and quantitate abnormalities in wall segment motion in 22 patients simultaneous measurements of isovolumic and ejection phase parameters were performed with the Millar-angiographic catheter at rest, after leg raising and during bicycle exercise. 6 patients had slight coronary heart disease (CHD) (group I), 16 patients had severe CHD (group II). During volume load in all patients of gr. II a decrease of peak measured velocity (Vpm) and the velocity of circumferential fiber shortening (Vcf from 1.4 to 1.1 circ/s, p less than 0.025) occurred. In gr. I Vcf increased (p less than 0.05). During exercise there was a high increase in Vpm and Vcf in gr. I (from 1.2 to 1.9 circ/s) whereas in gr. II no increase was observed. LVEDP rose to 29 mm Hg and ESV from 58 to 70 ml/1.73 m2. By increasing LVEDP during volume load underperfused areas became ischaemic and akinetic. During physical work the segmental abnormality can be less pronounced possibly due to the higher prestenotic pressure.


[Systolic time intervals of the left ventricle in neuromuscular diseases]. In 64 patients having neuromuscular disease and in 11 healthy persons, preejection period (PEP), ejection time index (LVETI) and PEP/LVET ratio of the left ventricle were studied by indirect method. PEP was significantly longer, ejection time index was significantly shorter and PEP/LVET ratio was significantly higher in patients with progressive muscular dystrophy than healthy persons. In 75% of patients having this disease LVETI was shortened and only in 30% of them Ecg abnormalities could be detected. These findings are postulated to be due to diffusely decreased contractility of the left ventricular heart muscle in progressive muscular dystrophy.


[Iron deficiency following implantation of a heart valve prosthesis]. In 44 patients with single or multiple valvular protheses of the heart, the problem of secondary iron deficiency due to mechanical hemolysis was investigated. In 17 cases, elevated serum transferrin values were noted, compared to elevated serum iron levels in only 6 cases. Therefore, treatment should be based on the more reliable transferrin values. Severity and duration of mechanical hemolysis did not seem to be correlated with the occurrence or the degree of iron deficiency.


[Pulmonary valve aplasia with ventricular septal defect. Hemodynamics and embryology]. The combination of absent pulmonary valve with ventricular septal defect, subvalvular pulmonic stenosis and aneurysm of the pulmonary artery presents a characteristic heamodynamic and clinical profile. It should be differentiated from other morphologically related cardiovascular malformations. According to the degree of right ventricular outflow tract obstruction, the circulatory pattern and the clinical picture is varying widely. We are differentiating an obstructive and a congestive form of the disease. An own case is demonstrated. After a short review of the literature the clinical and haemodynamic findings are discussed. The important role of the ductus arteriosus in fetal circulation is emphasized. The development of a huge pulmonary aneurysm and the premature closing of the ductus arteriosus are considered to be secondary to the serious disturbance of fetal haemodynamics.


[Methodical aspects of pneumatic segment plethysmography. III. Measuring tourniquet problems]. The question, to which extent utilization of different plethysmographic cuffs influenced the assessment of volume changes, was examined in 40 healthy individuals as well as by means of an experimental model. It could be shown that plethysmographic results varied significantly according to the design of the cuffs: 1.a) Utilization of short (19.5 cm) cuffs that did not cover the entire thigh circumference resulted in significantly lower arterial inflow and pressure-dependent venous capacity measurements as compared to long cuffs (48.8 cm). b) This result was confirmed by use of a newly developed "calibration-cylinder" demonstrating that use of the short cuff showed only 62.2% of the true volume change, use of the long cuff, however, 89.6%. Deficiency of thigh contact is discussed as possible etiologic factor for this difference. 2. The cover material of the cuff also influenced the results significantly since results could be improved from 62.2% to 86.9% (short cuff) and from 89.6% to 95.1% (long cuff) by use of double layer non-compliant cloth. The reason for this finding is thought to be the compliance of conventional cloth. 3. Comparison of two cuffs with identical shape and dimensions resulted in significantly lower volume changes using hard stiff rubber as compared to soft compliant rubber. These findings suggest some recommendations for optimal design of plethysmographic cuffs. Cuffs should not underestimate volume changes obtained with the "calibration-cylinder" by more than 10%.


[Influence of atrial contraction on stroke volume in pacemaker stimulation]. The contribution of the atrial systole to the stroke volume was studied in 12 patients with implanted pacemakers by means of impedance-cardiography. P-ST-intervals between 70 and 200 msec. increased the stroke volume as compared with systoles without preceding P-waves. A maximal stroke volume was observed with a P-ST-interval of 130 msec. The increase of the stroke volume by 33% justifies the application of atrial triggered pacemakers in selected cases, mainly in younger patients despite of the technical limitations of these pacemaker systems.


Oesophageal phlebectasis in an infant with pulmonary venous obstruction owing to a congenital heart defect. Clinical findings and postmortem examination of a newborn infant are reported. Prominent features were a complex congenital heart defect ("pre-mature closure of foramen ovale", with mitral and aortic atresia), causing severe obstruction to pulmonary venous return, pulmonary lymphangiectasis and oesophageal phlebectasis. The occurrence of oesophageal phlebectasis in infants with congenital pulmonary venous obstruction is reviewed and the pathogenesis discussed.


[T inversion in Friedreich's ataxia].

[T inversion in Friedreich's ataxia]. The electrocardiogram of Friedrich's disease shows pathological findings in all examined patients, mostly T-wave inversion. On the other hand cases of abortive Friedreich's disease and of cerebellar ataxia Nonne-Marie don't present any substantial alteration of ecg. To a minor extent roentgenological findings might suggest Friedreich's cardiomyopathy discussed as a possible result of a neuro-myo-cardiac process.


[Time serial study of orthostatic cardiovascular regulations]. In a repeated measurement design (16 times during 8 weeks) active orthostasis was investigated in a sample of twenty male students, utilizing a tilt table. Additional data included cardiovascular and pulmonary tests, psychological scales, items from a diary and meterorological data. Analysis of orthostatic time-series was carried out with hierarchical grouping analysis for heart rate and blood pressure. Results indicated three intraindividual patterns of orthostatic reaction called normo-, hyper- and hyporeactive. These patterns are independent of the known interindividual orthostatic reaction types. Analysis of variance of the described patterns revealed differences for physiological and meteorological data and some items of the diary. These results have been crossvalidated.


[Fast fluorimetric assay of chlortetracycline in meat and bone (author's transl)]. Antibiotics in biological materials, including tetracyclines, are determined usually be means of microbiological methods. Because of the low specificity and the time consuming procedure of the microbiological assays, we developed a fluorimetric method, which enables us to determine specifically the tetracyclines and to reduce the time for the assay down to 4 hours. Our method is based on the determination of tetracyclines published by Kohn (1961), which we modified for the determination of chlortetracycline in meat and bone. Tetracyclines are fluorescent compounds, whose quantum yields are very much enhanced in most cases by forming a complex with Ca2+ ions and by extracting it into an organic solvent. This transfer into acetic acid ethylester separates the chlortetracycline from interfering substances. The yield of chlortetracycline with the described method was about 80%, the sensitivity of the detection was about 0.5 ppm.


[Uptake of mercury by plants (author's transl)]. The uptake of merkury by plants and animals in the immediate vicinity of a chlor-alkali plant is determined. Thereby it appeared that plants take up mercury from the air and accumulate it in assimilation tissue. Uptake and accumulation of mercury are manifested by in vivo experiments.


[GLC-mass-spectrometrical investigation of the volatile components of wines vii. Aroma compounds of tokaj aszu wines b) organic acids (author's transl)]. An inventory of the organic acids detectable by liquid-liquid extraction has been made in different Tokaj wines. After the separation of the acidic compounds in the aroma extracts using Na2CO3 and after the derivatization with diazomethane 65 methylester have been separated by gaschromatography and identified by mass spectrometry. Using a special fractionation method organic acids, amino acids, carbohydrates and phenolic compounds have been isolated in different groups. After the derivatization of the components 50 organic acids have been quantitatively determined by gaschromatography. The compositions of the acids in the wines differ considerably. The quantitative differences are caused by the vintages, the method of production and the kind of storage. The possible biosynthetic pathways of the various acids are discussed.


[1H-NMR determation of ethanol in wine, winelike beverages, and liquors (author's transl)]. It has been demonstrated that a routinely employed quick test for the determination of ethanol in alcoholic beverages may be carried out with an accuracy of +/- 3% in the region of 0--80 Vol.-% ethanol content.


[Analysis of polysaccharides used as food additives iv. Gaschromatographic identification and determination of neutral components in polysaccharide-hydrolysates (author's transl)]. The monosaccharides, which are obtained by hydrolytic cleavage of the polysaccharid containing stabilisators, can be separated gaschromatographically by the way of their aldonitrilacetates. After hydrolysis, the mixtures are neutralized by an anion exchanger, evaporated to dryness, converted in pyridin with hydroxylamin to the aldoximes and hereafter with acetic anhydride to the aldonitrilacetates. Dissolved in chloroform, these compounds are used for gaschromatographic separations; only one peak is obtained for each sugar. This is a great advantage to the previous methods, where the anomeric constellations lead up of five peaks for one sugar compound and for complicated sugar mixture, it therefore was difficult to evaluate their gaschromatograms.


[The automated kinetic determination of enzyme activities and constituents of plants. 3. Determination of bromelain (author's transl)]. With bromelain as protease model a kinetic method, capable of automatization, is described for the assay of proteolytic activities. The method uses milk protein as a substrate. The volume of the test mixture is fixed to 1 ml; the readings are performed at 340 nm. With the bromelain preparation used (2 mAnson-U/mg) a linear decline of O.D. (deltaA/min) between 5 and 50 mug bromelain/ml is observed. Other proteases as well as protease inhibitors may be analyzed by the same method also.


[Acetosulfam, a new sweetener. 1. synthesis and properties (author's transl)]. A survey is given of synthesis, chemical and physical properties, and hydrolytic stability of the new sweetener Acetosulfam (3,4-Dihydro-6-methyl-1,2,3-oxathiazin-4-one-2,2 dioxide potassium salt).


A recording differential respirometer.

A recording differential respirometer. A recording differential respirometer capable of micromeasurement of gaseous changes is described. The rate of volume change under constant pressure is recorded directly. Due to the mechanical nature of the volume measurement, the instrument is drift-free. Factors affecting the sensitivity and correction for deviation due to change in total volumes are discussed.


[Identification of irradiated onions (author's transl)]. A method is described by which irradiated onions are identified by failure to root formation.


[Separation and quantitative "in situ"-determination of organotin compounds on thin layer plates]. Residues of organotin compounds in feed and food are extracted with isopropanol. Clean up by means of a Sephadex LH-20 column and separation of the compounds of Kieselgel-G thin layer plates by 4-methyl-pentanone (2)/pyridine/acetic acid (97.5 + 1.5 +1) is achieved. Triphenyl- and tricyclohexyltin fungicides are quantitatively determined by direct scanning the thin layer plates using a chromatogram spectralphotometer.


[Sample survey of smoking habits in the German, French and Romansch speaking parts of Switzerland in 1975]. In a survey of a representative sample of 900 persons in Switzerland (excluding the Italian speaking parts comprising some 4-5 percent of the population), the smoking habits of the adult population were studied. Smokers were defined as persons smoking at least one cigarette or an equivalent weight of pipe tobacco or cigars per day. 51.8% of men and 29.0% of women over age 15 are smokers. Among male smokers of cigarettes only (42% of all men), over three quarters (77.6%) smoke ten cigarettes or more per day, i.e., a quantity found harmful to health; over one half (55.8%) smoke twenty or more cigarettes per day. Half of all female smokers smoke ten or more cigarettes, more than one in every four female smokers (28.8%) smoke twenty or more cigarettes per day. It is calculated that almost two thirds of all cigarettes sold in Switzerland are smoked by smokers of twenty or more cigarettes per day, and that almost three quarters are smoked by smokers of ten or more cigarettes. Among men, smoking habits are independent of social status, whereas among women, those with higher family incomes show more frequent smoking, but also more widespread cessation of smoking than with lower incomes. Thirty percent of adults having been smokers have given up the habit, so that among men and women above age 15, theree are now some 20% and 14% respectively, of ex-smokers. This corresponds to at least 700,000 former smokers in all of Switzerland. The trend to give up starts already in the group aged 15-24 (over 20% of men and women having ever smoked have given up) and becomes more marked with increasing age. A large part of male and female smokers would like to free themselves of the habit. 30% of male and 34% of female smokers indicate that they had tried seriously to stop smoking during the twelve months preceding the interview. Trying to give up was not significantly associated with intensity of smoking or social status. According to this survey, a majority of the population (57.6%) is in favor of reserving certain parts of restaurants to non-smokers, following the example of non-smokers-compartments in railway trains. In a situation where a non-smoker asks a co-worker in a closed room not to smoke, 78.3% take sides with the non-smoker, either by conceding to him a right to smoke-free air, or by demanding from the smoker to show consideration for the non-smoker. Only 10.9% demand from the non-smoker understanding for the smoker, or concede to the smoker a right to smoke at work. Women show more understanding for cause of the non-smoker than men. This difference is more marked among smokers and former smokers than among non-smokers. Inasmuch as the results of this study are comparable to those of earlier surveys conducted in Switzerland, ther is good agreement. The only exception is a significant increase of the proportion of former smokers in the past years.


SH Reactivity of cigarette smoke and its correlation with carcinogenic effects on hamster lung cultures. After hamster lung cultures were exposed repeatedly to puffs of fresh smoke from 7 types of cigarettes containing variable amounts of particulate and gas vapour phase components, atypical growth and/or malignant cell transformation were observed within a period of 3-6 months. A positive correlation was demonstrable between high SH reactivity and high NO content of the gas vapour phase and malignant transformation. There was no positive correlation for the other analyzed components of the smoke, including tar content.


[The quantitative evaluation of alcohol use in German and Western Switzerland]. Within the scope of a comprehensive study of social mechanisms of the drinking habits, a household survey was conducted among the 15 to 74-year-old population (sample size: 902). Overall per-capita-consumption figures have been, so far, the only available information on drinking in Switzerland. The data collected on various dimensions, i.e. quantity, frequency and variability of alcohol intake show a wide variety of drinking patterns among the 89% of the population using alcohol. Frequency of beer, wine and fermented cider consumption falls mainly into the three categories: daily use, up to twice weekly, rarely (once a month or less). For hard liquor we found: up to twice weekly, rarely. The Swiss have no definite preferences as to wine, beer or other alcoholic beverages. Yet, in the French speaking part wine is used significantly...


[Signs of the zodiac and personality].

[Signs of the zodiac and personality]. 3074 young men resident in the canton of Zurich, representing 50% of the 19 year old male population, form the fully representative sample of our large scale investigation. We investigated whether personality traits measured by means of the differentiated "Freiburger personality inventory" (FPI) could in any way be correlated to the signs of the zodiac under which the young men were born. The statistical analysis did not reveal any correlation between signs of the zodiac and personality. The claim made by astrologers that people can be characterized according to their sign of the zodiac (sagitarius, taurus, cancer, scorpion) must be refuted. Of course the astrologically founded description of human personality does not base itself on the position of the sun only, however the latter does form a very essential part of the astrological evaluation of people. This, at any rate has been shown to be without any scientific basis. The fact that astrological evaluation of human personality is so popular nowadays can be explained by the fact that even modern people are inclined towards magical thinking.


[Air pollution and irritations due to cigarette smoke]. In a nearly airtight climatic chamber of 30 m3 we studied the air pollution due to cigarette smoke as well as resulting irritations and annoyance. When 9 cig/30 m3 have been smoked, acroleine reaches the threshold limit value for industries; when 5 cig/30 m3 have been smoked, the clean air standards for outdoor air are exceeded by acroleine, carbon monoxide, and formaldehyde. The eyes are the most sensitive organ to cigarette smoke, followed by the nose. Annoyance about air quality and the wish to open the door or to leave the room proved to be other susceptible criteria. With 10 cig/30 m3, 9% of the subjects show a "strong" or "very strong" eye irritation, while 78% "wish to leave the room=. The most important of the measured irritants seems to be acroleine.


[Effects of air pollution on health].

[Effects of air pollution on health]. Air pollution is composed of a particulate phase and a gaseous phase. The particulate phase, consisting of dust and aerosols, is the vehicle of toxic pollutants, transporting them into the respiratory tract. The irritants (sulphur dioxide, nitrogen oxides, aldehydes, and hydrocarbons) are the most important pollutants as regards health; the mucous membranes of the eyes and the respiratory tract are mostly affected. Other substances penetrate into the organism where they can develop actions harmful to various organs (carbon monoxide), generate cancer (polyaromatic hydrocarbons) or attack enzymatic systems (lead). Epidemiologic studies have revealed that populations exposed to high degrees of air pollution show increased mortality, which is mainly due to illnesses of the respiratory tract. Atmospheric pollution can also cause sensations of unpleasantness due to irritations of the eyes and the respiratory tract, bad odours, and the impairment of visibility and sunlight.


[Air pollution in an industrial environment and occupational diseases]. Most of the occupational diseases are related to air pollution at the work place. The distribution of gases and vapours and their human absorption are briefly described. The deposition of particles is a function of their physical properties, of the pattern of the respiratory airways and of pulmonary ventilation parameters. Several defence mechanisms also play a role. Illustrative examples are given of occupational diseases caused by solvents, carbon monoxide, metals, dusts (silicosis, asbestosis, pneumoconiosis due to dust of hard metals), allergens and carcinogens. The importance of prevention is emphasized.


[Atmospheric allergens].

[Atmospheric allergens]. Aeromicrobiology techniques allow to determine nature and quantitative distribution of atmospheric particles which are capable of inducing an allergic reaction. Airborne pollens and seasonal mold spores are the main known aeroallergens. Their allergenicity has been clinically and biologically demonstrated and is indeed responsible for pathological manifestations in man especially within the respiratory tract.


[Climate and air pollution].

[Climate and air pollution]. Climate and air pollution are closely related. On the one hand, the climate is more and more influenced, locally as well as globally, by the tremendous concentration of pollutants in our atmosphere. Certain elements of the climate are, on the other hand, directly responsible for the process of dilution and dispersion of pollution emission. Of particular importance is the phenomen of ventilation and inversion. The significance of knowing the regional climatic peculiarities is presented by ways of a smallspace-example of the ventilation existing at the valley of river Aare and of the frequency of inversion existing at the Aare-trench situated north of Berne. Such knowledge should increasingly be used to influence regional planning, to assist in the determination of the position of any important source of pollution and should help to determine the selection of suitable living and recreation areas. Unfavorable meteorological-climatological conditions could aggravate a situation whereby harmless concentrations of pollutants could lead locally to critical proportions. For the better understanding of the meteorological and climatological processes within the lowest 500 m-level of our atmosphere, an increased effort of research should be considered in this connection. Through the use of improved data processing in connection with more closely meshed measuring networks, and of automatic recording facilities, as well as through the increased use of physical models, the problem of immission in our heavily valleyed country could be investigated more thoroughly.


[Epidemiology of chronic bronchitis].

[Epidemiology of chronic bronchitis]. In this short paper, the definition of chronic bronchitis, as it is now widely accepted by epidemiologists, is given and a comparison is made with the disease as usually referred to by general practitioners. Risk factors which are related to the development of the disease are then briefly discussed and the importance of internal parameters is underlined. At last, the methodological difficulties which arise in the assessment of the relationship between air pollution and respiratory symptoms are emphasized.


[Leiomyomas and fusiform neuromas as intramural tumors of the thoracic oesophagus (author's transl)]. On the 2nd Surgical Department of Vienna, only 2.61% of all resected oesophageal tumors are leiomyomas and fusiform neuromas Contrary to the opinion of the most other authors, fusiform neuromas are predominating in our cases. This fact could be explained by the exact histological evaluation which strictly follows the instructions published by Feyrter. The patients are young or middle-aged and suffer from dysphageal and pulmonal troubles. Indication for operation is not only founded on the clinical symptoms, but also on the possibility of a malign character of the tumour. Intramural tumours of the thoracical oesophagus should be ennucleated via a transpleural thoracotomy by preserving the mucoseal tube. Differential diagnosis and clinical experiences are resumed and discussed.


[Method and technique of experimental autotransplantation of a lung and a lung lobe]. The authors have accumulated an experience of 350 canine autotransplantations of a lung and its lobe. The peculiarities of the operative technique are described, and special emphasis is laid on its technical details that largely determine the success of a lung autotransplantation. The described method and technique permit the performance of orthotopic autotransplantation of a whole lung and of its lobe, and of heterotopic autotransplantation of the lower lobe of the right lung into the left pleural cavity in place of a removed lower lobe or whole lung. The first stage of autotransplantation of a lung or its lobe consists in applying an atrio-venous or venous anastomosis and that of the pulmonary artery with continuous U-shaped eversion sutures, with a re-establishment of the circulation, thus reducing the period of lung ischaemia. Upon restoring the blood flow in the lung, a bronchial anastomosis is applied with interrupted or continuous sutures, and the ventilation is restored. The vascular and bronchial anastomoses are applied with synthetic suture material (Orsylon) on atraumatic needles. The extensive experience of the authors in long-term follow-up of the animals after transplantation (up to 5 years) demonstrates that the described technique and method of lung autotransplantation ensures good competence and patency of the vascular and bronchial anastomoses, without any stenoses observed in the late postoperative period. As shown by histological examinations, the inflammatory reaction around the suture material is minimal.


[Valgus deformity of the femoral neck after nailing of infantile femoral shaft fractures (author's transl)]. In 6 patients out of 29 who had suffered fractures of the femoral shaft at childs age and were treated mainly by open nailing, considerable growth disturbances of the major trochanter and valgus deformities of the neck of the femur had been observed in check-ups. The origin and prevention of these complications in nailing and nailremoval are discussed.


[Necrotizing enterocolitis in babies (author's transl)]. Newborns and babies weakened in their resistance will mainly be affected with necrotizing enterocolitis. A conservative therapy is principally applied. It is only by increasing signs of peritonitis or caused by perforation of the intestine that laparotomy is required. A report is presented on 11 babies with surgical therapy and the kind of operative procedure applied. 6 of these babies were cured.


[The reconstruction of inflammatory biliary duct stenoses by using a ring-drainage (author's transl)]. In treating the inflammatory closures and stenoses of the biliary ducts surgically, the bilio-biliary and bilio-digestive anastomoses were splinted by inserting an annular drainage. In this way it was possible to ensure the bileflow into the intestine and to prevent recurrent stenoses. The ring-drainage is suggested to be kept for 2 years at least. In our experience this method has been validated in 13 patients. Therefore it is recommended for use in reconstructive operations with inflammatory obstructions of the biliary tract.


[Treatment of functional sterility using Clostylbegyt]. Report of 39 patients suffering from functional sterility, having been treated with Clostylbegyt. Under analysis were the age of the patients, complications during therapy, time of ovulation and the effect of the drug on several ovarian caused difficulties of conception. Controlling examinations as well as the pregnancies obtained and their progress were discussed.


[Current organizational and clinical aspects of sterility and infertility]. It is reported about an organizational plan for more intensity in the field of medical care and research of sterility and infertility. Diagnosis and therapy of sterility should be carried out within a high specialised centre. General practitioner and gynecologist in general and clinical practice of the territory have to accomplish important problems in prophylaxis and metaphylaxis of sterility and infertility.


[Behavior of heparinocytes and of fibrinolytic degradation products after discontinuation of hormonal contraceptives]. After cessation of hormonal contraception a quick adaptation of the heparinocyte values to the normal menstrual phase course appears, but the values occur at a higher level. Fibrinolytic split products in the blood are really elevated nearly without exception in the first 4 to 6 weeks after ceasing of hormonal contraception. Foremost after the first spontaneous menstrual bleeding they are at a normal level.


[Changes of the endometrium during oral hormonal contraception with ethinyl estradiol sulfonate and norethisterone acetate or d-noregestrel]. 48 fertile women took in three weeks 1 mg ethinylestradiolsulfonate weekly and in the 4th week 10 mg norethisterone acetate, respectively d-norgestrel in different dosages (0,5 mgs, 1,0 mgs, 1,5 mgs or 3,0 mgs). On this 48 women 69 abrasiones were made between the first and 37th treatment cycles in order to estimate the endometrium. Ethinylestradiolsulfonate caused for the most part a proliferation of endometrium, which reached to a glandulare cystic hyperplastic endometrium. We did not observe a reduction of the endometrial respond to this depot-estrogen in dependence on the time of taking. Norethisterone acetate and d-norgestrel effected on a different proliferated endometrium a secretory transfer mation always.


[Specific changes of the uterine cervix due to contraceptives]. A group of 344 cervices, produced by conisation within a period of 5 1/2 years, were examined for specific effects of contraceptives. In half of all women, who used oral contraceptives, specific lesions such as "siebartige polypoide Hyperplasie" (cribriform polypoid hyperplasia) were found. The findings and their etiology and importance are discussed.


[Methods of intrauterine pressure measurements in non-pregnant women]. It is described a method of measurement of intrauterine pressure with perfusion of catheter by nonpregnant women. It is possible to prevent arteficial disturbances on account of obstruction of catheter.


[Vaginal rupture with prolapse of the small intestine]. We report on a case of recidival rupture of an enterocele with vaginal rupture and incarceration of small bowel. This event was probably caused by an extreme insufficiency of the patient's connective tissue. In literature four similar cases have been reported.


[Relations hip between placental weight and age, family characteristics, parity and activity of the mother as well as the weight or maturity and sex of the newborn infant]?1?H. An investigation of the correlation of the placental weights of 500 unselected live-born babies delivered after a gestation period of 33 weeks at the minimum and 42 weeks at the maximum, respectively, with age, family status parity, and mother's occupation, as well as with the weight, maturity, and sex of the neonates yielded the following results: 1. Between primiparae, secundiparae, and multiparae, working and housewife mothers, workers, farmerettes, women doing other jobs, and academically trained women, eutrophic mature and hypertrophic mature neonates, and newly born male and female babies there was observed a roughly similar frequency of the generally accepted "normal weight of placenta" of 400 g to 600 g and no significance of minor differences in frequency, respectively. 2. The high incidence of mothers aged 20 and less in the "normal placental weight group" of 400 g to 600 g compared to 21- to 30-year-old and 31- to 35-year-old mothers was not found to be significant. 3. The high incidence of unmarried mothers in the "normal placental weight group" of 400 g to 600 g compared to married mothers is not significant, the higher incidence of premature labor in unmarried women being due possibly, not to the weight of placenta, but rather primiparity, age under 20, and social class. 4. The higher frequency in the placental weight group up to and including 400 g of married compared to unmarried mothers, primiparae compared to secundiparae, primiparae and secundiparae compared to multiparae, working mothers compared to housewife mothers, and workers and farmerettes compared to both women doing other types of jobs and academically trained women was not found to be significant.


[Low weight and endangering of multiple birth infants]. Multiple pregnancy represents a high risk to the survival of fetuses since insufficient nutrition frequently results in hypotrophic development and low birth weight. The frequency of the occurrence of low birth weight in children from a multiple birth is 10 times higher than in all newborn children and the early noenatal mortality of children froma multiple birth is 8 times higher than that of all newborn infants. The disproportion between the placenta and the fetuses which we usually find in multiple pregnancies may result in the occurrence of cerebral damage. In the period 1965 to 1967 perinatal death associated with cerebral damage by birth injury (recorded on the death certificate) accounted for 5,7% of all children of low birth weight and for 0,2% of children weighing at birth over 2500 g.


[Histological diagnosis in aspiration curettage]. The techniques and diagnostic accuracies for histologic sampling of endometrial tissue after suction curettage performed on 161 patients are discussed. In 90% no tissue was retrieved by sharp curettage after suction curettage. Tissues with higher consistence like polyps were obtained only for 50%. However, it will be expected, that Crumbling tissues of cancer will be obtained.


[Effect of diuresis on the results of quantitative estrogen- and HCG determinations]. Investigations on the influence of the diuresis effect upon the results of quantitative oestrogen and HCG determinations revealed that the oestrogen values increase with the 24-hour amount of urine. Oliguria and polyuria affect oestrogen excretion to a considerable extent; they have to be taken into account in prenatal diagnosis of pregnancy. Comparative HCG checks show that HCG concentration also varies considerable depending on fluid excretion. Diagnostic errors can be diminished or avoided when the quantitative HCG assessment is made on the 24-hour urine and then referred to the whole amount of urine.


[Determination of L-cystine aminopeptidase (serum oxytocinase, EC 3.4.1.2) during normal pregnancy]. It is given a method to the determination of cystine aminopeptidase activity in the serum in pregnancies. A time of few minutes is necessary for one determination. The determination is performed with a spectralphotometer or with the Reaction Rate Analyzer (LKB 8600) in using the chromogen substance 1-cystine-bis p-nitroanilide. This substance is solved in dimethylformamide. The normaly range of the 8th to the 41 th week of pregnancy is determinated in a number of 453. In twins the values were higher. The cystine aminopeptidase is nearly specifically in pregnancies and is produced in the plazenta. It is a statement of cellulary activity in the plazenta.


[Hierdence of X-chromatin post partum].

[Hierdence of X-chromatin post partum]. Determinations of the X-chromatin frequency in buccal smears were performed in 33 pregnant women at the day before delivery and daily for seven days thereafter. In 23 women with a spontaneous delivery there was a statistically significant drop in the X-chromatin frequency after delivery being lowest on the second day. On the fifth day the X-chromatin frequency had reached the predelivery level. In 10 women with operative delivery by cesarean section and hormonal suppression of lactation no such changes in the X-chromatin-frequency have been noted.


[Automatic tocography using the Cardiff infusion system under cardiotocographic control with the fetal monitor BMT 504]. Clinical results of the induction of labour by means of the Cardiff-equipment. The fetal monitor BMT-504 (VEB Kombinat Mebgerätewerk Zwönitz) has been used as cardiotocographic control unit. Labour has been induced with oxytocin (n = 38) or methyloxytocin (n = 30). 50 deliveries, which where induced by means of intravenous oxytocin infusion enables to be comparate the results. Using the automatic infusion the average induction-delivery interval was 4 hours 14 minutes, the average dosage of tocergic drugs was 2 IW oxytocin or 20 mug methyloxytocin. Using oxytocin for labour induction we found an increase in obstetric operative frequency caused by fetal distress. There where an increase in basal tone of uterine activity in this patients. Therefore we recommend methyloxytocin for the labour induction of high risk pregnancies. The safety factors, which are incorporated in the Cardiff-equipment have many advantages in obstetrical routine work, to determine fetal distress at an earlier stage. The results presented show that with this automatic infusion system labour can induced with even greater efficiency and safety. The equipment is very useful in accordance to the continuous increasing number of planned deliveries.


[Screening for diabetes within the scope of prenatal care]. 9482 pregnant women searched for the Department of Prenatale Care of the town Karl-Marx-Stadt between 1968 and 1972. Obesity were found in 6, 2 p.c., glycosuria in 5, 1 p.c., a history of diabetes with glycosuria in 0,5 p.c. and obesity with gylcosuria in 0,5 p.c. The perinatale mortality rate was heightened only in the last group (3,7 p.c.) 51 prediabetic pregnant women were found in these five years by sugar screening. Eight women developed a White class A nad four women a White class B diabetes between 3 and 7 years later.


[Outline for the control of the course of fetal growth]. In a synoptic schema are presented the percentiles curves of the biparietal diameter, the sum of the sagittal and transversal thoracic diameter and the fetal weight (Lubchenco modif.). To attain the percentiles curves of the ultrasonic parameters we applied 5400 mensurations of the biparietal diameter and 1300 mensurations of the thorax. In the diagram are published the percentiles P 10, P 25, P 50, P 75, P 90. It is possible to diagnose a divergence between the cephalic and thoracic growth (dystrophia, hypertrophia) and estimate the gestation weeks.


[Transformation of secretory cylindrial cells into ciliar cells in the epithelium of the human uterine cervix (functional transformation of highly differentiated cells)]. By electron microscopical investigations of the cylindrical epithelium of the human cervix uteri we could show that in ciliar cells a regeneration of ciliars is possible. There is a discussion about the question whether the pinching off of ciliars is the beginning of a transformation process into a secretory cell. The functional change of secretory cells to ciliar cells becomes obvious by the existence of so-called granulo-filamentary bodies in the cytoplasm of ciliar cells. These bodies grow by a granulo-filamentary transformation of secretory granules. As these granulo-filamentary bodies do not take place in the extrusion process but stay in the cytoplasm they may thus be used as an indicator which shows the finished transformation process of a secretory cell into a ciliar cell.


[A Czechoslovak injection-contraceptive agent administered once a month]. During a 20-month period, 26 women aged 38 years on the average (27 to 45 years) received single intramuscular injections of a combination, containing 60 mg of Superlutin caproate plus 10 mg of oestradiol valerate in 1 ml of oily solution, at 4-week intervals as a contraceptive. Altogether 255 cycles were checked. In 6 cycles, minor accessory bleeding occurred, mostly in younger women. No undesired pregnancy took place. Under the name Lutofollin, the injections were prepared at the Research Institute for Pharmacy and Biochemistry in Prague. The preparation is especially suitable for women aged 30 to 45 years, as well as for those intolerant to oral hormonal contraceptives.


[Studies on the increase in the incidence of endometrial and ovarian in cancer in Czechoslovakia during 1960-1973]. During the time period of the last 12 years the incidence of the endometrium carcinoma in the whole CSSR rised to 155,5% in the consideration of the incidence in the years 1961 to 1963. In the same time period the incidence of the ovarial carcinoma has grown up to 117,8% only, what seems to be still in the limits of average incidence shift of all female malignancies in the CSSR (117,1%). The rising incidence of endometrium carcinoma affects primarily the elderly women, but testiefies also that this malignancy is among them today much more frequent. Therefore the rising incidence cannot be explained only as a manifestation of elderly of the female population. In agreement with this reality the endometrium carcinoma is today diagnosed significantly more frequently also among the younger women (at least since 40 years of age). The totals of all endometrium carcinomas rised even more than incidence. The gynaecologists meet today 162% of such malignancies in comparison with the numbers in the years 1961-1963. It means that in the whole CSSR yearly 500 endometrium carcinomas more are diagnosed than before 12 years. The incidence of cervix carcinoma dropped during the same period significantly and the endometrium carcinoma became therefore nearly as frequent as cervical malignancy (1:1,2). Possible reasons of these frequency changes are discussed.