Cartilage space width in slipped capital femoral epiphysis: the relationship to cartilage necrosis. The radiolucent cartilage space of eighty-three patients with unilateral or bilateral slipped capital femoral epiphysis was measured by a standardized technique. In the majority of patients, whether unilateral or bilateral involvement, there was bilateral narrowing of the cartilage space. In the unaffected hip of unilaterally involved patients, there was a progressive narrowing as skeletal maturity was attained. A concomitant anatomical study of cadaver hips, removed at autopsy from adolescent patients, showed a progressive narrowing of the cartilage as the proximal femur matured. Black females showed most narrowing (minimum cartilage space width), had the narrowest final cartilage space widths, and took the longest to attain this final width. While other racial, sexual and therapeutic groups failed to demonstrate statistically significant differences, the general trend was for females, Blacks, and patients treated by osteotomy to have more joint space narrowing. However, rewidening occurred in most of these affected joint spaces, in contrast to the progressive linear decrease observed in unaffected hips and anatomical specimens. On the basis of this study, we feel that cartilage space narrowing may be anticipated in the post-operative period in most patients treated for slipped capital femoral epiphysis. This narrowing appears to improve with time. Narrowing of greater than one-half the original width, in association with pain and limitation of joint function, probably represents "cartilage necrosis," or pathologic joint space narrowing. Unless the narrowing remains less than one-half to two-thirds of the initial cartilage space for more than twenty-four to thirty-six months, probably no specific surgical treatment should be undertaken, other than observation and protected weight bearing during any painful phase. Plotting the roentgenographic cartilage space width during the three month to thirty-six month phase may be useful in monitoring and predicting the outcome.


The "incubation period" of subacute bacterial endocarditis. In an attempt to gain information about the "incubation period" of subacute bacterial endocarditis, the literature was searched for case reports stating a specific interval between an event likely to cause bacteremia and the onset of symptoms. In 76 cases of streptococcal endocarditis for which this information was given, the median "incubation period" was one week. Symptoms began within two weeks in 64 of these cases (84%). Although there may be a bias toward reporting short incubation periods, it is concluded that the incubation period of subacute bacterial endocarditis is often shorter than is generally realized, and that procedures carried out more than two weeks before onset of symptoms are less likely to be causally related. In postcardiotomy cases, where timing of the bacteremia causing endocarditis is less easy to define, 27% of 122 cases of staphylococcal endocarditis developed within two weeks of surgery. This information is relevant to the planning and evaluation of prophylactic chemotherapy against bacterial endocarditis.


Social Darwinism lives! (Should it?).

Social Darwinism lives! (Should it?). Sociobiology has made a resurgence in recent years, but has become enmeshed in political controversy. Indeed, much of the work in sociobiology has been used to justify repressive or racist measures. It is argued that the unfortunate alliance of some sociobiologists and politicians is a poor basis for discrediting the field itself; that a science of sociobiology is possible and, if we seek to know the nature of our social heritage (if any!), needs be vigorously pursued.


The electrically induced thrombosis in the arteria femoralis of pig as a model for in-vivo studies. Arterial thrombosis was experimentally induced in dwarf pigs by use of direct current, via an arterial electrode. The technique used for the experimental induction of thrombosis in pig is compared with that used in the dog. The effect of this experiment, which was performed under constant conditions, on some enzymes and some blood coagulation parameters is discussed.


[Medicinal reduction of mechanical hemolysis]. The mechanical resistance of erythrocytes after gas dispersion (oxygen, resp. mixed oxygen/carbon dioxide) and treatment in the hemoresistometer was studied on human conserved fresh blood under in-vitro conditions. Xylocitin (Lidocain) was tested as to memebrane stabilizing capability. It was found that test doses of about 5 mg and 40 mg per 100 ml of heparinized fresh blood result in an increased resistance of erythrocytes against mechanical trauma.


[Effect of bilateral and unilateral vagal stimulation of gastric acid production in the rat]. In experiments on rats the anterior or/and the posterior gastric vagus nerve were electrically stimulated. The extent and site of acid-producing gastric areas were demonstrated by help of Congo red. Unilateral stimulation resulted in enhanced acid secretion in a smaller area of gastric mucosa. The acid-secreting areas showed no different distribution at stimulation of the anterior or posterior vagus nerve.


[Electrometry of wound healing].

[Electrometry of wound healing]. Methods, advantages, and disadvantages of electrometry on wounds are reported. The author's results were obtained from measurements by help of the DC-Milli-Pico-Meter MV 40 (VEB Präcitronic Dresden) on 20 rats with model wounds during a 22-days period. A relation between average values of wound voltage and time of healing as well as the considerable ranging of the single values could be proved. Because of this ranging the use of the method on patients is questionable. Since the transfer of the results from animal experiments on the human yields problems for several reasons, a clinical checking of the method appears rational.


[Hypothermia and carbon monoxide poisoning]. The lethality of 187 patients with severe carbon monoxide intoxication was investigated in relation to body temperature. 22 per cent of the normothermic, but 36 per cent of hypothermic or hyperthermic patients did not survive the carbon monoxide poisoning. The lethality increases following enhancement of degree and duration of hypothermia. Pretreatment of rats with chlorpromazine producing a decrease of body temperature of 4 degree C induces a small reduction of toxicity after subcutaneous carbon monoxide injection. However, the CO-DL50 decreases from 17 to 11,5 mmol/kg following administration of the same dose of chlorpromazine after carbon monoxide injection. Changes in carboxyhemoglobin levels are consistent with alterations of CO toxicity. On the basis of these results, it appears that it is not advisable to maintain a spontaneous hypothermia during carbon monoxide intoxication.


[The overlooked stone of the biliary tract]. A report is given of current diagnosis and treatment of overlooked stones of the common bile duct, reviewing 81 patients seen in our hospital. Problems arise mainly in icteric and postoperatively critical patients. There is still not enough clinical experience in medical or endoscopic treatment in the disease. Therefore surgical procedures are still the treatment of choice although there is a higher mortality in relaparotomy than in first procedure.


[Iatrogenic injuries of the human bile duct]. The problems of diagnosis and treatment of iatrogenic injuries to the extrahepatic biliary tract are discussed, reviewing 31 own cases. End-to-end anastomoses should only be performed in immediatly detected lesions. In cases of delayed diagnosis only biliodigestive anastomoses, e.g. hepaticojejunostomy, are indicated to avoid stenosis of the anastomosis. Injuries to the biliary tract can be reduced by early diagnosis of bilary diseases and correct intraoperative diagnostic means.


[Chronic pancreatitis--the current state of surgical treatment]. The surgical therapy of chronic pancreatitis has been enriched by the progress of diagnostics in gastroenterology and radiology. This includes as well the definition of indication for surgery as the choice of the most suitable operative procedure. Thus today an individual surgery with regard to the morphological findings is possible by making allowance for the patients personality on the one hand and for the pathologic changes of the gland on the other. Long term follow-up studies of the last years have shown good results after pancreaticojejunostomies and particularly after pancreatic resections. In our twelve years-experience with chronic pancreatitis there is a preference for resection therapy too.


[Malignant obstructive jaundice. Current status of surgical therapy]. 424 patients with malignant jaundice were treated from 1964 to 1976. 152 carcinomas of the extrahepatic biliary tract and 272 carcinomas of the duodenopancreatic region were reported. Initial symptoms of cancer of this region are often vague, so that physicians must employ a high index of suspicion if earlier diagnosis is to be effected. Most of the carcinomas of pancreas and the biliary tract are unresectable because of the early dissemination. The dismal of the malignant tumors of the biliary tract is unchanged during the last 50 years but survival rates are better in carcinoma of the duodeno-pancreatic region.


[Cystadenomas of the common bile duct as the cause of relapsing mechanical jaundice]. Two cases of benign tumors of the extrahepatic biliary ducts with relapsing jaundice are reported. In both cases operation with conservation of natural draining of bile could be performed. Benign tumors of the bile ducts should be taken into consideration, if relapsing jaundice is combined with negative cholangiography or is noticed long time after cholecystecomy of on gallbladder without gallstones. Primary origin of cystadenomas from the extra hepatic biliary ducts is demonstrated.


[Risk of prematurity and reported bleeding in pregnancy (author's transl)]. The analysis of 5.139 cases from the prospective study "Pregnancy and Childdevelopment" (supported by the Deutsche Forschungsgemeinschaft) showns that time and frequency of bleeding in pregnancy influence the risk of premature delivery. Every additional bleeding will increase the risk, especially if bleeding occurs in the second trimester. For example the risk of prematurity exceedes 25%, if bleeding occurs four times or more. After bleeding in early pregnancy the frequency of small for gestational age infants is not increased.


[The effect of Partusisten on the maternal and fetal metabolism, acid-base balance and blood gases intrapartum (author's transl)]. Following i.v. injection of 50 g of Partusisten into the mother there occurs, already within 5 min., a rise in the lactate concentration which reaches its peak after 25--30 min. After 25 min, a similar can be shown in the fetus. The fetal pO2 at this time has risen significantly to 2.1 mmHg, while the pCO2 has fallen by 3 mmHg. The increase in lactate concentration both in mother and fetus alters the acid base balance in both. pH is reduced and base deficit is raised, parallel in mother and fetus. The fetal acidosis is probably due to a lactate infusion from the mother.


[The development of children following intra-uterine transfusions in severe Rh-erythroblastosis (author's transl)]. The development of 18 children who had received 1--3 intra-uterine transfusions (IUT) because of severe Rh-erythroblatosis was followed over the first few years of life and finally checked when they were 2--6 years old. All of them were premature, 2 were born with hydrops, 1 with pre-hydrops. There were many other perinatal riskfactors (asphyxia, trouble with respiration, acidosis, severe anemia, hyperbilirubinemia). Examination (general and neurologic) was supplemented by EEG and psychologic testing )Kramer test, Vineland maturity scale, Denver development scales). No child showed signs of severe cerebral damage. 2 children had unequivocal pathologic signs (slight to medium spastic diplegia or hemipegia with corresponding focal findings in EEG). 3 further children showed minimal cerebral signs without disability. Development of intelligence was notably good throughout. Observations showed abnormal neurologi-signs more often during the first 2 years of life than later. Psychologic examinations, too, showed clear improvement with age. Results are satisfactory and confirm that IUT as a prenatal treatment with very severe Rh-Erythroblastosis is justified.


[The pattern of distribution of free amino acids in human amniotic fluid related to the duration of pregnancy. Part II: Changes in concentration in pathological pregnancy (author's transl)]. 18 free amino acids from 196 specimens of amniotic fluid of pathological pregnancies between the 28th and 41st week of pregnancy were measured by gaschromatography. The concentrations of the amino acids in amniotic fluid in normal and pathological pregnancies were analysed by statistical methods. There were only minor differencies of concentration of free amino acids in the amniotic fluid between normal and pathological pregnancies with the exception of hydroxyproline. This was found in a significantly higher concentration in the amniotic fluid of the pathological group. Supposing that the materno-fetal as well as the feto-maternal amino acid exchange may be reduced by the placenta insufficiency, the significantly higher concentration of hydroxyproline in the amniotic fluid during pathological pregnancies may be caused higher fetal urine excretion of hydroxyproline into the amniotic fluid. The increase of hydroxyproline in the amniotic fluid of pathological pregnancies is probably an early diagnostic parameter of an impaired transplacental exchange -- placenta insufficiency.


[Bilateral intrauterine torsion of the spermatic cord (case report) (author's transl)]. A case of bilateral intrauterine torsion of the spermatic cord is reported. The possibility of an intrauterin origin is given by observations in newborn infants. The head symptoms are scrotal swelling, flush and induration. Already a suspected torsion of the spermatic cord justifies immediate surgery as the germinative and interstitial cells are irreversibly damaged after very short time. The obstetrician is obliged to diagnose these pre- or perinatally originated torsions and to arrange immediate surgery.


Primary lymph node responses to mosquito bites. Post-auricular lymph node responses and changes in fresh weight of thymus and spleen of hamsters and mice at 4 and 8 days after primary exposure of both ears to 20 bites by the mosquito Aedes aegypti were studied quantitatively. In both hosts lymph node changes characteristic of the development of cell-mediated immune responses and those which are believed to lead to antibody production occurred, with the emphasis on the latter phenomena. No reactions of thymus and spleen were observed. The responses recorded are considered to be immunologically specific. In hamsters, but not in mice, the responses related to humoral sensitization coincided in time to a large extent with those of the cell-mediated immune processes. The stronger humoral responses in mice were probably in the first place the result of the relatively higher dosages applied.


[Culex pipiens fatigans: labeling of tissues of normal and infected (Plasmodium cathemerium) females after feeding on tritiated amino acids (author's transl)]. Normal and infected Culex females were fed 11 different amino acids. These substances were labeled with tritium and each was given separately in glucose solution. After the uptake the marker appears first in crop, cardia and midgut. Later on the other tissues get labeled more or less. It seems that the labeling follows a characteristic pattern for each amino acid. Essential amino acids are taken up intensively; for example leucine not only in the midgut epithelium but also in the ovary and the fat body. There is nearly no uptake of the non-essential amino acids alanine, glutamic acid and DOPA by the tissues of both groups of females. These amino acids are only seen in the midgut area and not in the other tissues. In infected mosquitos the uptake of the essential acid, phenylalanine, corresponds only to that of a non-essential amino acid.


[Determination of the factors Gm(1,2,4,5,21) and Inv(1) in human secretions: saliva, sweat, nasal secretion and semen (author's transl)]. If there is enough stain material available Gm and InV factors can be proved to be present in semen. Contamination by nasal or vaginal secretions should be taken into account. Sweat, however, does not interfere with the determination. In saliva, InV but no Gm properties were demonstrable. Stamp glue reacts unspecifically with InV antiserum and could therefore be a source of error. The conclusive value of Gm and InV findings as evidence in court was derived from the phenotype frequencies obtained in blood samples of 400 unrelated persons.


Population genetics of glyoxalase I (E.C.4.4.1.5) in human erythrocytes. 1025 individuals from Southern Germany were examined. The gene frequencies for GLI1 are 0.4235 and for GLI2 0.5765. These frequencies are compared with those of other authors.


[Placenta-imbedded homoeotransplant and the protection of the foetus in the Austrian penal code (author's transl)]. Operations, in which a physician removes vital organs of a foetus in order to sustain other organs of the foetus (e. g. the kidneys) in the uterus for an indefinite period and let them work for the gravida, are in accordance with Austrian law if such surgical interventions are carried out within the first three months of pregnancy with the consent of the expectant mother and after previous consultation with a physician; also, if a termination of pregnancy is justified by one of the indications stipulated in Article 97 Paragraph 1 Item 2 of the Austrian Penal Code.


[Concerning the development of brainstem injuries (author's transl)]. Since the etiology of traumatic brainstem lesions has not been completely clarified we tried to analyse this question from autopsy material with special consideration of the effects of rotational acceleration of the head resulting from an impact force. Seventeen cases without a skull fracture were investigated. We considered the tentorium as a suitable indicator for possible relative movements occuring between cerebral hemispheres and the cerebellum as well as the brainstem since, because of its attachment to the skull, it follows all excursions of the skull directly and simultaneously. The brain, however, due to its inertia, remains stationary in the beginning so that injuries may occur on the structures mentioned. The results of the autopsies confirmed these assumptions, for both uni- and bilateral tears as well as hemorrhages in the tentorium cerebelli were found. Associated were subarchnoid hemorrhages over the upper vermis and thin layered hematomas between the tentorium and the cerebellum. In all cases the brainstems showed both microscopic and macroscopic hemorrhages of the isthmus cerebri and in some cases of the cerebral peduncles and the cerebellar brachia conjunctiva. These hemorrhages are attributed to shearing forces and tension arising from movements between tentorium and the surrounding brain components. The mechanical effects on the brainstem and its surrounding structures at various rotational accelerations of the head (along transversal, vertical and sagital axis) are discussed. The combination of brainstem lesions with injuries of the tentorium suggests that the brainstem injury was a primary result of the impact. Finally the possible significance of rotational acceleration for brainstem injuries caused by whiplash mechanism of the head in connection with improperly used automobile safety belts or inadequate headrests is discussed.


[Forensic applications of human skin spectral remission analysis employing a movable integrated sphere (author's transl)]. Spectral remission analysis has been known for long in the medical sciences [1,2,3] but has gained practical importance only in the last years due to the existence of modern techniques and components [4,5]. In this paper a method is presented which enlarges the range of applications of spectral remission and transmission analysis for wavelengths between 380 and 1100 nm considerably. This is achieved by a novel conception of the measuring instrumentation, the advantages of which are discussed and compared with the conventional technique. In detail these advantages are a) employment of a movable instead of a fixed detector (integrated sphere) b) illumination of standard and probe with radiation from a common source c) considerable increase of sensibility due to the use of selective lock-in amplifiers. As a demonstration of the proposed method results are given for 5 different probes of human skin.


[Sudden unexpected death in rare cervicooccipital dysplasia (author's transl)]. 1. A case of sudden unexpected death due to rare cervicooccipital dysplasia is presented. 2. At postmortem examination of cases of sudden death without a definite cause of death the finding of a deformed base of the skull should suggest removal and mazeration of the upper cervical vertebral column for close scrutiny.


[Combined carbon monoxide/cyanide intoxication due to combustion of plastic material (author's transl)]. A case of combines carbon monoxide and cyanide intoxication due to a fire in a living room is reported.


Bite-marks on battered children.

Bite-marks on battered children. Instances of human bites are generally rare, although it does sometimes occur that people use their teeth as a means of attack of defence. When looking into cases of the ill-treatment of children we often find bite-marks in addition to other signs of abusement. Eleven cases from the Institute of Forensic Medicine at Düsseldorf University are presented out of a total of 48 cases of ill-treatment of children followed by death in which human bite-marks as well as other haematomas on the victims could be proved. In all cases the cause of death was a subdural haematoma. All but three of the offenders were female, and all were young and subject to excess stress so that the act could eventually be regarded as the result of a disintegration of emotional status. The combination of bite-marks with haematomas and other signs of ill-treatment support with sufficient certainty the conclusion that a criminal action of a third person is involved.


[Penicillamine-induced glomerulonephritis]. In 6 of 24 courses of a disease a nephrotic syndrome appeared under the application of penicillamine. An acute renal failure with exitus letalis developed under the penicillamine therapy of a scleroderma. In the treatment of a mercurial poisoning by penicillamine the nephrotic syndrome increased to a proteinuria of 50 g/24 hours which receded after discontinuation of the remedy. In one group of patients with chronic pyelonephritis could be demonstrated that penicillamine in a primarily damaged kidney must not lead to a secondary glomerular lesion. These findings led to the conclusion that in the appearance of a proteinuria under penicillamine a strong observation of the renal function is necessary, if a continution of the therapy is given from vital indication.


[Tubular kidney dysfunction and its etiology in chronic pyelonephritis]. 1. The renal dysfunction in the chronic compensated pyelonephritis means a selective decrease of the maximum osmotic concentration power, the ammonia secretion and the total secretion of hydrogen ions in the glomerular filtration rate, proximal reabsorption of the fluid of the tubule, excretion of osmotically free water and acidity of the urine which can be titrated. 2. The functional distrubances observed in chronic pyelonephritis do not as a whole differ from those disturbances in chronic compensated glomerulonephritis, but in the disease first mentioned there is in every case no decrease of the endogenic creatinine clearance and the maximum water diuresis. 3. The latent chronic pyelonephritis differs from the latent chronic glomerulonephritis by a normal endogenic creatinine clearance and maximum water diuresis and by a decrease of the ammonia and hydrogen ion secretion. These disturbances to a certain extent may be regarded as specific for the chronic pyelonephritis. In comparison with the chronic hypertonic pyelonephritis in the chronic hypertonic pyelonephritis the maximum water diuresis is normal and the titratable acidity is slightly increased. 4. The kind of renal dysfunctions can be of importance for the differential diagnosis between chronic glomerulonephritis and chronic pyelonephritis particularly in the latent forms of the two diseases.


[Diagnostic value of the 131 I-hippuran clearance in chronic pyelonephritis]. The authors report on their 9-year experience concerning the results of the determination of the effective plasma flow by means of the 131J-hippuran clearance in patients with chronic pyelonephritis. On account of the disagreements in literature it was our first task to establish the lower normal limit. Issuing form the parallel investigations with the classical PAH-clearance in 50 patients and in a control group of 71 patients with hearlhy kidneys 487 ml/min were taken into consideration as lower normal limit. The authors examine in 867 patients with chronic pyelonephritis whether it is possible to diagnose relatively early disturbances of the renal function in values of the hippuran clearance lower than 487. It was established that in 28.9% of these patients the ING was normal, in 45% the concentration power maintained and in 70% the rest nitrogen in the serum was not increased. These results allow the recommendation of a broader application of the hippuran clearance in patients with pyelonephritis, since by means of this method relatively earlier restrictions of the renal function can be established than by means of other functional tests (ING and Volhard's test).


[Adenine nucleotide- and 2,3-diphosphoglycerate metabolism in human erythrocytes in chronic kidney insufficiency]. In 38 patients with chronic renal insufficiency of different degree of severity examinations of the stationary concentration of the adenine nucleotides in the erythrocytes were carried out. It was shown that in the red blood cells of uraemics a genuine increase of the concentration of these compounds occurs, in which case the adenosine triphosphate dominates absolutely as well as relatively. In individual cases erytho-cyctic ATP-values of more than 3 micron mol pro ml cells may be achieved. The increase of the ATP-concentration in the red blood cells correlates with the degree of severity of the renal insufficiency and the renal anaemia. The hyperphosphataemia occurring as a rule in renal insuficiency is of causal importance for the increase of ATP. By a consecutive increase of the intracellular phosphate level and by influence on different steps of enzymes (phosphofructokinase, aldolase, glycerin aldehyde phosphate dehydrogenase) and changed regulations it effected an activation of the glycolysis. The increase of the plasma adenine and plasma adenosine concentration plays apparantly an accessory role for the increase of the concentration of the adenine nucleotides existing in the erythrocytes. Together with an increased concentration of 2,3-diphosphogycerate (2,3-DPG) the increase of the ATP-level has an effect on the oxygen transport function function of haemoglobin in the sense of a facilitation of the O2-output. These processes explain the relative adaption of patients with chronic renal insufficiency to renal anaemias of partly high degree.


[Importance of residual diuresis in patients with chronic pyelonephritis under constant dialysis treatment]. In 55% of 100 patients (54 with glomerulonephritis and 46 with pyelonephritis) who had been dialysed in the permanent dialysis treatment for more than one year the tactics of a dialysis per week was estabished at the beginining of the permanent dialysis treatment: in the diuresis of more than 1 litre a day with the residual glomerular filtration about 5 ml/min, in stabilised body-weight, in controllable hypertension and in the compensated clinical picture of renal insufficiency. The residual glomerular filtration can be presumed only in the optimally hydrated patients. The canulation of the subclavian vein has proved significant for the evaluation of optimum hydration.


[Excretion of alanine aminopeptidase in the urine after administration of lysosomotrophic substances in patients with latent or florid pyelonephritis]. It is described a test for the presence of diffuse nephropathies which is based on the fact that after application 20 ml of the renal diatrizoate X-ray contrast medium Visotrast or of 500 ml of a 10% mannitol solution in patients with preexisting renal diseases appear reversible, diagnostically relevant increases of the alanine aminopeptidase excretion with the urine. In persons with healthy kidneys the excretion of enzymes changes insignificantly. The increased excretion of alanine aminopeptidase is also observed in patients with latent pyelonephritis and is traced back to the increased formation of an osmotic nephropathy in patients with preexisting nephropathies.


[Ruptured intracranial aneurysms. Autopsy studies from two pathological institutes (author's transl)]. Among 67,930 autopsies 233 (0.3%) ruptured unoperated intracranial aneurysms were found. 105 aneurysms belonged to the anterior, 89 to the middle, and 29 to the posterior groups. The size, age and sex distribution of the aneurysms as well as the lesions due to their rupture were studied. The following complications were found (table 4): Massive subarachnoid haemorrhages (77%), intracerebral haematomas (61%), massive intraventricular haemorrhages (35%). Intracranial aneurysms were combined with polycystic degeneration of the kidneys in 8 patients. The pathomorphological findings were compared with the clinical diagnoses. The clinical diagnosis of a ruptured intracranial aneurysm was established in 13.9% of the patients only.


[Functioning carcinoma of the exocrinic pancreas. Case report and review of the literature (author's transl)]. The rare case of a 62 years old male with functioning carcinoma of the exocrinic pancreas, liver metastases, and subcutaneous fat necrosis is described. Only 22 relating cases were found in the literature. Referring to published observations the symptomatology of these pancreatic tumours is analysed. The panniculitis which is part of the symptoms corresponds to the Weber-Christian disease or erythema nodosum. It is supposed that lipase-secreting carcinomas of the pancreas occur more frequently than hitherto believed.


[Nevus spilus. A histopathological study (author's transl)]. In the past, the nevus spilus was differently interpreted. Ito and Hamada, however, limited this term to a pigmented macule that had darker speckles within it. This newer definition is a useful one in clinical diagnostics. But histopathologically this lesion seems not to be an entity. A review of the literature and the present study suggest that it is in all probability a café-au-lait-nevus of neurofibromatosis-type. The darker spots are different in their histopathologic structures. They are nevus-cell-nevi, nevoid lentigines, epidermal pigmented macules or localized pigment disturbances with melaninincontinence following inflammatory prozesses.


[Contribution to carcinosarcoma of the uterus (author's transl)]. The histogenesis of carcinosarcomas of the uterus is not clear yet. The different histologic structures of a collisions-tumor which is characterized by a secondary intermingling of sarcomatous and carcinomatous elements are described, and their etiolgy and pathogenesis are discussed.


[Enzyme patterns in connective tissue proliferations (author's transl)]. In a series of benign or semimalignant connective tissue proliferations (4 desmoids, 1 recurrence of a dermatofibrosarcoma protuberans, 4 fibromas, 1 neurofibroma, 3 keloids, 3 Dupuytren's contractures) and a normal fascia for comparison the pattern of 18 enzymes from different metabolic pathways was investigated. It should be clarified whether alterations of the enzyme pattern wouldoccur, asthey are found in malignant tumours. The activity of most of the enzymes investigated increased about twofold in the latter of two extirpations (16 months interval) of a recurring desmoid. In the recurrence of a dermatofibrosarcoma protuberans and in a recurrance of a fibroma a remarkably high activity of glucose-6-phosphate dehydrogenase and pyruvate kinase was found. High activities of these enzymes are known to be characteristic of experimental tumours of animals and human malignant neoplasms. Therefore it is assumed that these differences from the normal patternof enzyme activity are related to recidivity and may be regarded as first signs of a deviation from benignity. Based on these results further studies haveto be done with the aim to find a biochemical tool for, evaluation and prognosis of the course of these diseases.


[Hairy cell leukemia (author's transl)]. 2 cases of hairy cell leukemia are reported. The disease is important for pathologists, because the splenomegaly is the leading clinical sign and often a splenectomy is performed with infomation about the true disease. The morphology of the spleen with infiltration of pulp cords and filling of sinuses by monomorphous blasts, with moderate fibrosis and atrophy of the white pulp is not convincing, because the hairy-like processes of the toumor-cell cytoplasm are not seen by usual histological examination. Hemocytomorphology and -cytochemistry are essential diagnostic procedures.


[Splenectomy findings in Hodgkin's disease (author's transl)]. 32 splenectomy preparations were examinated. Splenic involvement in lymphogranulomatosis was found in 15 cases, mostly of the mixed type of disease. Morphological findings like first-localization of infiltrates, follicle-activation, and mesenchymal reaction are reported in detail. However, the valuation of the findings without knowing the pathogenesis of Hodgkin's disease seems to be to early at the present times.


[Sarcoid-like lesions of the spleen in Hodgkin's disease (author's transl)]. In a systematic study of splenectomy preparations of 32 patients with Hodgkin's disease five cases of sarcoid-like lesions were detected. There was no lymphogranulompatosis of the spleen in two of these five cases. Frequency, localization, and pathogenesis of the sarcoid-like lesions are discussed. No statement is possible concerning the consequences of these granulomas as to clinical prognosis.


[Morphometric investigations on lungs of children in perinatal period (author's transl)]. Morphometric indices were investigated by the method of Dunnill (1974a) on 4 lungs of intranatal stillborns and 4 lungs of preterm liveborns with hyaline membrane disease (HMD). The values of the air-tissue interface ranges for stillborns between 0,16 and 0,37 m2. The values for lungs with HMD lies between 0,09 and 0,17 m2 and therefore distinctly lower. Number of alveoli in the entire lung ranges for stillborns between 8.3 and 13.9 x 10(6). The values for lungs with HMD ranges between 0.6 and 3.9 x 10(6) and therefore distinctly lower, too.


[A case of central core disease. Light microscopic and histochemical studies (author's transl)]. A sporadic case of central core disease in a 5 1/2-year-old girl is reported. Clinically, a retarded motor development existed, furthermore, a muscle weakness and hypotonia of the extremities and trunk, contractures of the hip- and knee-joint,and luxation of both hip-joints. Biopsy specimens are taken from both Mm. gastrocnemii. Muscle fibres show, by morphologic examination, 95 per cent cores, which are characteristic for this myopathy. A further abnormality is seen inthe histochemical preparations for phosphorylase, succinate dehydrogenase, NAD diaphorase tetrazolium reductase, myofibrillar ATPase as well as AS-reaction with and without diastase digestion. With these techniques the muscle fibres show an uniform reaction pattern in which the activities of the oxidative andglycolytic enzymes correspond to the type I fibres of healthy persons. The cores show a lack of a activity of the oxidative and glycolytic enzymes as well as are ATPase- and PAS-negative. By reason of this histochemical behaviour it is suggested that the cores are predominantly unstructured. The cause of this disease might be complex disturbances in the neuro-muscular system manifested in the fetal period.


[A case of central core disease. Electronmicroscopic studies (author's transl)]. A biopsy taken from the right m. gastrocnemius of a sporadic case of central core disease has been investigated by electronmicroscopy. Both longitudinal and cross sections show cores, which are partially in the centre and partially near the sarcolemma of the muscle fibres. These cores are more or less sharply delimited from the intact areas of the muscle fibres. A zone showing a severe destruction of the regularly fibrillar structure is observed in the centre of each core. This destruction zone is surrounded by a transition zone, in which a partial lesion of the fibrillar structure is found whereas the sarcomeric segmentation is preserved. The width of the interfibrillar sarcoplasm is reduced, frequently, however, mitochondria containing cristae of normal structure are observed. The cores are foundlimited by target fibres. Pathogenetically, the damages of z-lines are assumed to be dominant in the formation of the cores.


[Hepatic infestation in mucoviscidosis (author's transl)]. In 25 cases of autoptically proven mucoviscidosis 3 cases were detected with hepatic infestation.  In two cases there was a focal biliary fibrosis (one male baby of 3 months, one female baby of 8 months), the third case was a 7 1/2 years old boy with a multilobulary biliary cirrhosis. The morphologie picture of these lesions is described, and their frequency, etiology and pathogenesis are discussed. Secondary alterations of the liver are for more frequent in this disorder than real liver infestations of mucoviscidosis, possible implications of this fact are shortly mentioned, too.


[Brush-like skull and dystrophy of the brain in consequence of a complex malformation of the heart (author's transl)]. A report it given on a case of transposition of the arterial trunks accompaniedby septal defect, hypoplasia of the pulomonary trunk, and valvular pulmonary stenosisin a 5 1/2 years old male child. Further striking findings consisted in a partial brush-like skull and in a severe dystrophy of the brain.


[Myocardial infarctions without stenosing artery selerosis of thrombosis ofthe coronary arteries (author's transl)]. At autopsies between 1951 and 1969, 246 of 2393 cases with myocardial infarctions and heart muscle scars showed no thrombi and no artery sclerosis to be worth mentioning. The 7 comprehensive morphologically investigated observations of a second case group were discovered in a prospective study from 1970 to 1973. This study included 255 cases with myocardial infarctions or heart muscle scars. Comparatively to the investigations with sclerosis of the coronary arteries, myocardial infarctions without occlusive coronary disease were stated more frequent in woman than in men. Furthermore, more young people were affected from these infarctions. In 3 of 7 cases without sclerosis or thrombosis of the coronary arteries the infarctions were located more frequent subendocardial that in these cases with coronary sclerosis or thrombosis. Respectively to the size the 246 infarctions of the first group, they did not differ from those taken in a respecting group of 2147 cardiac infarctions with stenosing processes of the coronary arteries. Infarctions without sclerosis or thrombosis of the coronary arteries were located more frequently in the ventricular septum and in the wall of the right ventricle. For these infarctions a coincidenceof several, separate not relevant factors in supposed to be the cause. Theinfarctions without stenosing processes of the coronary arteries occupy insome respects an exceptional position, but on principle they do not differ in the morphological findings from the other myocardial infarctions.


[Electron microscopical findings in the sural nerve of twins with metachromatic leukodystrophy. An attempt to classify the findings according to distinctive phases of the disease (author's transl)]. Sural nerve biopsies taken from a pair of twins with metachromatic leukodystrophy were investigated by electron microscopy. The morphological findings showed distinct alterations. In the first twin the particularity was a large number of granules containing sulfatides. In the second twin, however, the main finding was a damage of myelin sheaths evidently caused by an excessive and morphologically as well as chemically defective myelin formation. According to the grading given by Ulrich the first case corresponds to the stadium one, in which a storage of sulfatides dominates, whereas case two showing a severe damage of myelin sheaths is characteristic of the second stadium of metachromatic leukodystrophy.


[The influence of prednisolut on the induction of neurogenic tumours in rats by N-methyl-N-nitrosourea (author's transl)]. Repeated intraperitoneal injections of methylnitrosourea (MNU, 10 mg/kg b. w.) lead to tumours of the nervous system in 32 out of 44 hooded rats (72.7 per cent) and to extraneural growths in 38 animals (86.4 per cent). After combined application of MNU and intramuskular injections of prednisolute (0.56 mg/kg b. w.), in 11 out of 42 rats (26.2 per cent) tumours of the nervous system were found. In this group, there were extraneural tumours in 17 animals (40.5 per cent). The results were compared with findings of other authors obtained after combined application of chemical carcinogens and corticosteroid hormones.


[Malignant tumours of the female sex organs in the autopsy material (author's transl)]. 1209 malignant tumours of the female genital organs were revealed by post-mortem examinations at the Pathological Institute of the Martin-Luther-University, Halle (GDR), in the years 1961 to 1970. They constitute 28.6 per cent of a total of 4232 malignomas including leukemias and other systemic lymphoreticular diseases that were found in females of all age groups during this period. The genital tumours were analysed concerning the localization, age distribution, size, histological classification, invasion of adjacent organs, frequency of metastases, and recurrencies, 729 (= 60.3%) of the tumours originated from the uterus, 399 (= 33.0%) from the ovaries. 95.2 per cent of all tumours were carcinomas and 65.9 per cent developed metastases. The highest frequency of metastases has been found in ovarian tumours (= 89.5%). This was mainly due to the frequency of peritoneal carcinomatosis in patients suffering from these malignomas. It is remarkable that 19.5 per cent of the genital tumours were misdiagnosed by the clinicians.


[Injury of the R. profundus n. ulnaris (author's tranls)]. The loss of function of the R. profundus n. ulnaris results in a severe impairment of the function of the hand. The diagnosis of an isolated injury of this nerve having only motoric fibres is difficult and not always possible. The exact knowledge of the anatomic course should cause every physician taking care of wounds of the hand to think of a possible injury.


[Some remarks on the surgical treatment of osteoarticular tuberculosis (author's transl)]. Due to the improvement of chemotherapy some changes in the last 10 years took place concerning the indications of active surgical interventions. Special aspects of tuberculosis of the spine and joints are emphasized.


[Results and complications of operated femoral fractures (author's transl)]. On the basis of an analysis of results gained from 153 operated femoral fractures the therapeutic possibilities under usual conditions in the majority of surgical departments are demonstrated. For the most part, the intramedullary nailing is made by the open method without drilling, sometimes with circular wiring, rarely urgently but some days later in a planned programme, after preparing the patient in an aseptic but rarely superaseptic theatre. 73.2% of the patients were controlled, 81.4% of them showing very good or good results. Disorders of vascularisation (2.6%), nail dislocations (1.96%), nail bending (3.26%), nail fractures (1.96%) andosteitis (3.26%) were analysed, timely reoperation for avoiding complications is recommended.


[Indication and first results of 110 partial- and total knee joint replacements (author's transl)]. First experiences in allo-arthroplastics of the knee with 82 Guepar- and 28 sledge protheses are reported. The primary indication was painful osteoarthritis. The most important complication was the recurrent dislocation of the patella with following osteoarthritis, secondary vascular and infected tissue lesions.


[Treatment of fractures of paralyzed and partially paralyzed lower extremities (author's transl)]. The negative effects of fractures of paralyzed and partially paralyzed lower extremities are described. A good result to a certain extent restoring the condition from before the accident can only obtained by early osteosynthesis. Only the AO-method and intramedullary nailing should be applied for osteosynthesis.


[Lingering fracture of the femoral neck-a rare overstrain-injury (author's transl)]. The author refers to 2 young patients with spontaneous fractures of the femoral neck. The fatigue fracture of the healthy neck of the femur is extremely rare. The clinical picture and general problems, as well as the diagnostic and therapeutic aspects are discussed.


[Gas and oedema producing infections--today still a challenge (author's transl)]. Clostridial infections, putrid infections with aerobic and anerobic growing germs, air forced into the tissue during the primary trauma and the formation of gas by contact of the wound with aluminium, H2O2 and gasoline may be causes for the formation of gas and oedema in the tissues. Only infections with Clostridia are gas gangrene. We must differentiate the clostridial cellulitis from the clostridial myositis. Bacterioscopy allows a rapid differentiation to be made between putrid and clostridial infection. Beside intensive care and antibiotics, putrid infections demand an early extensive incision, for gas gangrene the radical excision of the damaged tissue is required. The effect of hyperbaric oxygenation is still under discussion. It can never replace surgical treatment.


[Exploratory laparotomy and splenectomy in Hodgkin's disease (author's transl)]. In the diagnosis of Hodgkin's disease the histological investigation of the spleen, liver and abdominal lymph nodes in connection with exploratory laparotomy are necessary for staging and planning the therapy.


[Colon carcinoma - duration of anamnesis and survival time (author's transl)]. In order to prove the hypothesis--short anamnesis; short survival time--the duration of the anamnesis and the period of survival of 230 patients with carcinoma of the colon were statistically mathematically and graphically investigated. No relationship in accordance with a rule was found between the duration of anamnesis and the time of survival. Curative surgery prolonged the period of survival significantly. The duration of the anamnesis depends on fortuitous factors and represents one of the stages of cancer. The delay after the first medical consultation is pointed out. It can be concluded that the resection of cancer in the early stage--early diagnosis--is for the survival decisive. The duration of the anamnesis is more important for the diagnosis than the surgical treatment and the prognosis.


[Gastroenterostomy, indications--complications--reparation (author's transl)]. After presenting the indications of the gastroenterostomy in accordance with current valid pronciples, the early and late postoperative disturbances and their corrections are described. The main immediate complications is the gastric paralysis of the stomach and later the peptic jejunal ulcer. Conservative therapy as well as possible, surgical treatment, especially the degastroenterostomy with and without resection are mentioned.


[Malignant testicular tumours (author's transl)]. By means of the patients, treated from 1964 to 1974, we report on the results of treatment concerning malignant tumours of the testes. An exact histological classification for the selection of the therapy is important. The importance of early diagnosis is stressed. Nowadays retroperitoneal lymphadenectomy is part of the therapy for malignant teratomas of the testes. In bilateral retroperitioneal lymphadenectomy the loss of the potentia generandi is usual.


[Surgical mangement of erectile impotence with special reference to Small-Carrion penil prosthesis (author's transl)]. Due to increasing number of radical surgeries for malignant tumors of the pelvis the incidence of iatrogenically caused erectile impotence rises. Available surgical management comprises implantation of rigid penile prothesis or inflatable device. The authors prefer a rigid implant (Small-Carrion penile prothesis) on account of its simplicity and have been impressed with the results.


[Primary resection in perforated gastric and duodenal ulcers (author's transl)]. From 1951 to 1975 due to perforation of gastric and duodenal ulcers 274 patients have been operated. 179 patients (65,2%) had primary resections of the stomach. The lethality of all patients with perforated gastric and duodenal ulcers was 15%, the lethality rate of primary resections of the perforated stomach amounts to 4,5%.


[Positive barotrauma of the stomach (author's transl)]. A 22-year-old sports diver had dived to a depth of 40 m in a Tyrolian mountain-lake and had to be taken to hospital because of an acute pneumoperitoneum. At the laparotomy a complete rupture of the stomach along the lesser curvature was found and closed operatively. This rupture of the stomach could have been caused only by an extension of the compressed breathing-air swallowed in the depth according to the change of hydrostatic pressure. Experimental examinations revealed that these rupture of the stomach will always be caused within the small curvature by an overpressure ranging between 96 mm and 145 mm Hg or a filling volume of1700 ml to 2200 ml respectively. Moreover,a cardia closing similar to a pressure valve and accompanied by radial ruptures of the mucosa could be observed, within the range of cardia, when the pressure in the stomach had rapidly increased.


[The postvagotomy syndrome (author's transl)]. The postvagotomy syndrome following the operative section of the vagus nerves is characterized by diarrhoea. The incidence of diarrhoea after truneal vagotomy is about 25%, after selective vagotomy 15% and after proximal selective vagotomy only 2%. The possible pathogenetic factors are accelerated passage through the gut, disturbed bile acid metabolism, the bacterical inflammation of the small intestine, and enterohormonal dysregulation. A cholongenetic diarrhoea is probable because after vagotomy the excretion of bile acids is increased and the diarrhoea is interrupted after administring cholestyramin, which absorbs the bile salts in the intestine. In addition the pathogenetic role of an impaired function of the ileocecal valve should be discussed.


[Endometriosis of the small intestine].

[Endometriosis of the small intestine]. The isolated endometriosis is a rare sickness whose existence is little thought of although it shows relative specific symptoms. With the aid of literature -- survey and according to personal experience on two patients suffering from isolated endometriosis of ileumregion, were clinical treatments carried out. Surgical and hormonal treatments as well as combination of both, have special indications for this kind of sickness.


[Modification of the rate of complications in the inflammatory adnexa process and pregnancy interruption]. On account of the case histories of the obstetrics and gynaecological klinic of the States Klinicum Berlin-Buch, the influencing of the complications rate by chronic adnex processes among the pregnant women who came for interruption, was examined. In 1974 and 1975 about 3118 interruptions with vacuum exhaustion and after-curettage, were carried out. During the stationary treatment, there were a total of 195 cases (6,2%) with complications, which later increased by 286 cases (19,1%), within 3 months after the interruption of their pregnancies. The complication's rates post interruption by patients with chronic recidive adnex-process are 27 cases (10,4%) only a little higher than those by the women with clear anamnesis (102 cases=8,2%). Therefore chronic adnex processes do not constitute contraindications for pregnancy interruptions.


[Impulse cytophotometric studies in cytologically suspicious cervical smears]. 187 women with cytologically suspicious cervical smears (Papanicolaou III to V) were investigated by 387 pulse cytophotometric (ICP) measurements. Within the Papanicolaou III group a significantly higher 4c-peak was seen in cases with only one ICP-investigation if we had histologically pathological findings (dysplasia, carcinoma) as contrastes with clinically and cytologically regressive cases. In repeated ICP-investigations we found in group Papanicolaou III (histol.: dysplasia, carcinoma) as well as in group Papanicolaou IV and V a significantly higher mean 4c-height than in only once investigated cases. Within a ICP-series the maximal 4c-height is most representative. The security of diagnosis is raising with repeating ICP-investigations. Here it is a valuable diagnostic aid especially in suspicious cases. All abnormal ICP-findings must be controlled for a long time, even with normal cytological smears. At last, the circumstances causing false negative ICP-results are discussed.


[Vaginal stump recurrence in carcinoma of the corpus uteri]. Among 403 women who had an operation for a cancer of the corpus uteri, and a subsequent radiation (3400 R HD) a total of 10 (2.48%) suffered from a recurrence of the cancer at the vaginal stump. For none of these ten women a 5-year-cure can be reported. To prevent a recurrence of the cancer at the vaginal stump, it is recommended that a vaginal collar should be removed during the operation. Moreover, an increased dose of  irradiation of the small pelvis (6000 R HD), a postoperative vaginal Caesium-137-filling, and a preoperative filling of the uterus with radiation carriers is recommended.


[Perspectives of ultrasonic diagnosis for the localization of intrauterine pessaries. Ultrasonic presentation of various types of IUDs]. The authors report on their experiences with ultrasonic localization of several types of IUDs. The investigations were carried out with the ultrasonic equipment-B-scanning -- Vidoson S 635 (Siemens). The characteristics of the echosonic pictures of 6 IUDs (Szontágh-IUD, Lippes-Loop, Gravigard, Alza-T, Copper-T, Antigon were studied. It could be stated that the IUDs can be well identified by ultrasonics. In cases of IUD in situ and early pregnancy the amnion and the IUD can be exactly localized.


[Evaluation of phagocytosis of Staphylococcus aureus with the aid of lysostaphin (author's transl)]. The Staphylococcus aureus strains HV 1 and K 807 were lyzed by lysostaphin. S. epidermis E 1 and staphylococci extracted with guanidinium chloride were resistant to lysostaphin-induced lysis. In the phagocytosis of S. aureus lysostaphin proved to be most useful for the differentiation between engulfed and extracellular staphylococci, particularly those attached to the surface of the polymorphonuclear granulocytes. It enabled a better recognition of the phagocytized staphylococci and therefore a more precise analysis of the phagocytosis experiments. A further improvement in the evaluation of phagocytosis was possible by the use of radioisotope labelling of staphylococci. This technique in combination with lysostaphin, might be useful for large-scale phagocytosis studies.


[Demonstration and partial purification of staphylokinase (author's transl)]. In these studies the fibrinogen plate medium proved to be not sufficiently specific for the demonstration of staphylokinase (SAK). For this purpose we modified the azocasein-test by the addition of plasminogen. Protease, on the other hand, we measured without plasminogen. This enabled us to differentiate between the 2 enzymes. After precipitation with ZnCl2 from the culture supernatant of Staphylococcus aureus strain, V8, SAK could be prepurified by filtration on ultrogel AcA 44 (tab. 1, fig 1). A more than 100-fold increase in specific SAK-activity (in comparison to that in the culture supernatant) to 34.722 units/mg protein was achieved after 2 X isoelectric focusing between pH 3.5-10.0 and refocusing between pH 5.0-7.0 (fig 2). The partially purified SAK was free of protease, coagulase, beta- and delta-hemolysins. DNase, lipase and phosphatases, but it contained minor amounts of alpha-hemolysin. It revealed only 1 band in the SDS-polyacrylamide-gel-electro-phoresis and 1 precipitin-line in the double immunodiffusion test with an antiserum against the SAK preparation after ultrogelfiltration.


[Studies on the activation of complement by encapsulated and non-encapsulated staphylococci after their extraction with guanidinium chloride (author's transl)]. All demonstrable enzymes and toxins of encapsulated staphylococci (KS) were removed by extraction with guanidinium chloride. The capsules, however, remained apparently intact on the extracted (KS-Gu) staphylococci (fig. 1), as well as clumping factor and protein A. KS and KS-Gu failed to activate complement in the absence of specific antibodies. They showed neither immunadherence (table 1) nor agglutination by an antiserum against C3 (table 2). KS and KS-Gu had no significant chemotactic effects in vitro upon bovine granulocytes (fig. 2).


Xylose lysine deoxycholate agar for the isolation of Salmonella and Shigella from clinical specimens. Xylose lysine deoxycholate (XLD) agar was more efficient for the detection of Shigella sonnei than Salmonella-Shigella (SS) agar and Drigalski agar, XLD was slightly more efficient for the detection of Salmonellae by direct plating than SS agar. Xylose lysine deoxycholate agar is proposed as the second selective plating medium for Shigellae isolation. It is also a useful second selecting plating medium for the isolation of Salmonellae serotypes, which form non-characteristic colonies on Bismuth-Sulfite agar. Efficiency comparisons between 4 direct plating media and one enrichment medium were made during the period of 3 years by analysing 21793 fresh clinical stool specimens. In that time 1394 Salmonella and 519 Shigella strains were isolated.


Behaviour of Salmonellae non-pathogenic for mice. I. Neutralization of their toxicities by induced antiprotein antibodies. Groups of mice hyperimmunized with proteins from Salmonella strains which are not pathogens for mice (S. typhi o901, S. typhi Ty2, S. blockley, S. newport) resisted inoculation with concentrations of homologous and related heterologous liver bacteria, which killed all the controls in 20-48 hrs. The toxicity of the Salmonella tested was about 100-1000 times lower than that of the pathogenic S. typhimurium and concentrations of 10(8) or 10(9) bacteria (according to the strains used) were necessary to kill all the controls. In contrast to the period of incubation (2-12 days) required for S. typhimurium to kill all the controls and eventually some of the immunized mice, too, the killing with the human pathogenic Salmonella took place within 20-48 hrs. The toxicity of the big concentrations of bacteria needed to kill the controls was apparently neutralized by the antiprotein antibodies induced in the immunized mice. In no group of mice resisting inoculations with 1 x 10(8) or 1 x 10(9) of the homologous or heterologous tested Salmonellae protection could be obtained against infection with 1LD100 (1 x 10(6) of S. typhimurium. These results underline the specificity of host-parasite relations in infection and minimize the role attributed to the cellular mechanism, which is insufficient for protection against an infection if the pathogen tested is not specific for the host in experiment. In contrast to events in mice protected against the infection with S. typhimurium, and its related "in vivo", S. paratyphi B and S. paratyphi C, the antibodies initially present in the sera of the mice immunized with proteins from the human pathogens were no longer found 25 days after the infections. Reinfections of some of the groups of the surviving mice did not result in protections.


Recent experiences with the Salmonella-O-1-phage in routine diagnostic work. Sensitivity to the O-1-phage was tested on 5287 Salmonella strains isolated in the course of routine diagnostic work over the period 1971-1973. 3380 (99,2%) strains of the B group, 676 (97,8%) of the C group, 840 (98,8%) of the D group, and 195 (83,0%) of the E group strains were sensitive to the O-1-phage. 92 of the 5 287 strains belonged to other O-groups in the Kauffmann-White scheme; 91,3% of these were phage-positive. 5274 of the strains belonged to subgenus I and only 100 of them were not sensitive to the O-1-phage. A total of 13 strains belonged to subgenera II, III, and IV. The O-1-phage was considered to be suitable for the identification of Salmonella bacteria. It should, however, be observed that monophasic strains belonging to subgenus III and strains belonging to subgenus IV are usually not sensitive to the O-1-phage. Of the total number of strains, 98,0% were sensitive to the O-1-phage.


[The development of antibiotics resistance among Salmonella bacteria of animal origin in the Federal Republic of Germany and Berlin (West). 5th communication: 1974 Annual report (author's transl)]. 2713 salmonella strains having been isolated by veterinary laboratories in the Federal Republic of Germany including West Berlin in 1974 were tested for resistance to tetracyclines, ampicillin, chloramphenicol, kanamycin, gentamycin, furazolidone, nitrofurazone, and trimethoprim. 21.7% of the strains tested were resistant to one or several of the antibacterially effective substances examined. The proportion of the resistant strains amounted to 52% for S. typhimurium and 4.7% for S. typhimurium var. copenhagen, 16.8% for S. enteritidis, and 22.1% for S. panama, 85.1% of all resistant strains belonged to these types. Out of 589 resistant strains found, resistance determinants were present in 93.7% to tetracyclines, 34.6% to ampicillin, 32.4% to chloramphenicol, 25.3% to kanamycin, 3.4% to furazolidone, and 0.5% to nitrofurazone. 1 strain of S. typhimurium var. copenhagen had a transmissible determinant of resistance to trimethoprim. No strain was resistant to gentamycin. 93.4% of the strains transmitted resistance determinants to E. coli K-12. A transmission of resisance to furazolidone and nitrofurazone could not be demonstrated. The serotypes were exhibiting clear-cut differences in their resistances patterns.


[The development of antibiotics resistance among Salmonella bacteria of animal origin in the Federal Republic of Germany and Berlin (West). 6th communication: 1975 Annual report (author's transl)]. 2563 salmonella strains having been isolated by veterinary laboratories in the Federal Republic of Germany including West Berlin in 1975 were tested for resistance to tetracyclines, ampicillin, chloramphenicol, kanamycin, gentamycin, furazolidone, nitrofurazone, and trimethoprim. 11.4% of the strains tested were resistant to one or several of the above mentioned substances. The proportion of the resistant strains amounted to 36.0% for S. typhimurium, and 4.3% for S. typhimurium var. copenhagen, as well as 70% for S. dublin. 79.4% of all resistant strains belonged to these types. For S. panama, the proportion of resistant strains decreased to 6.7%. Out of 291 resistant strains found, resistance determinants were present in 89.0% to tetracyclines, 47.0% to chloramphenicol, 28.5% to ampicillin, 24.1% to kanamycin, and 4.1% to furazolidone. Resistance determinants to gentamycin, nitro-furazone, and trimethoprim did not occur, 81.1% of the strains transmitted resistance determinants to E. coli K-12. A transmission of resistance to furazolidone could not be demonstrated. The different serotypes exhibited clear-cut differences in their resistance patterns.


[Influence of latent vitamin A deficiency of the mouse on the production of humoral antibodies against sheep erythrocytes and on the resistance against infection with Listeria monocytogenes (author's transl)]. Mice fed with a vitamin A free diet for several months did not develop signs of vitamin A deficiency. However, chemical analysis revealed a reduced content of vitamin A in the liver of such mice. The ability of these animals were latent vitamin A deficiency to produce antibodies against parenterally applicated sheep erythrocytes was not hampered. Similar numbers of antibody producing cells could be detected in the spleen of these mice compared with control animals. Resistance against intravenous infection with L. monocytogenes of these mice with latent vitamin A deficiency was not altered. The numbers of viable germs recovered from spleen and liver 2 days after infection were similar in both vitamin A deprived and normal mice.


Factor analysis of Basovizza serogroup of "Leptospira biflexa". Factor analysis is performed on serotypes of Basovizza serogroup of "Leptospira biflexa". The results show the arrangement of main factors typical for the members of this serogroup as well as the antigens common with serotypes of the heterologous serogroup. The existence of a main haptene-like factor is also hypothesized.


[Characterization of Acholeplasma Strains by Horizontal Polyacrylamide Flat Gel Electrophoresis (author's transl)]. Proteins extracted with phenol-acetic acid-water (2:1:0.5, w/v/v) from Acholeplasma laidlawii (PG 8), A. granularum (BTS-39), A. oculi (19L), A. modicum (PG 49), A. axanthum (S743) and the Acholeplasma strains C1 and C112 (which were isolated from aborted horse foetuses) were compared by electrophoresis in horizontal acidic polyacylamide flat gel using the electrophoresis equipment LKB Multiphor 2117. In this system the gels are not prepared in the electrophoresis chamber but between glas plates. For electrophoresis they are applied onto a special cooling plate. This makes it possible to produce a number of identical gels (from the same gel mixture and polymerized under the same conditions) what can be important for comparing investigations. The gels can be stored for more than 4 weeks in the refrigerator at +4 degrees C. Marked differences were observed between the electrophoretic patterns of each of the established species and the horse strains C1 and C112. The results are in agreement with those obtained in serological investigations in which the strains C1 and C112 were different from the established Acholeplasma species.


[The Influence of the Permeability of the Cell Membrane on TMPD Oxydase Activity (author's transl)]. 26 bacterial strains representing a variety of both Gram-negative and Gram-postive groups were investigated for their N,N,N',N'-Tetramethyl-1, 4-phenylendiamin (TMPD) oxidase activities and cytochrome contents. The oxidase activites of colonies were examined by dropping the reagent on agar surface colonies. Intact and sonicated cells were tested by recording the oxidation of the TMPD reagent at 546 nm after addition to the cell suspensions. Cytochromes were determined by recording the difference spectra (KBH4-reduced minus H2O2-oxidized) between 400nm and 630 nm. After sonication of intact cells of the "oxidase negative" Enterobacteriaceae except the Proteus strains, the Flavobacterium strains, Streptococcus faecalis, Xanthomonas phaseoli, and the Acinetobacter strains investigated oxidase activities were observed and the oxidase activities of the "oxidase positive" Bacillus and Micrococcus strains and Haemophilus influenzae were increases. These observations show that negative oxidase reactions exhibited by bacterial colonies may not only be due to the lack of the oxidizing enzyme system itself but also to impermeability of the cell membrane for the TMPD reagent. The TMPD oxidase activity could not be correlated to the cytochrome contents of the cells.


[Susceptibility to Thiamphenicol and Chloramphenicol of Anaerobic Bacteria (author's transl)]. The in vitro susceptibility to thiamphenicol and chloramphenicol of 272 anaerobes, most of which were recent clinical isolated, was determined by broth dilution tests, With chloramphenicol, 133 anaerobic gram-negative non-sporing rods (48 Bacteroides fragilis, 13 B. thetaiotaomicron, 14 B. oralis, 16 Sphaerophorus varius etc.) had MIC values of 0.03 through 16 microng/ml. Very similar results (MIC, 0.06-16 microng/ml) were obtained with thiamphenicol. In concentrations of 4 microng/ml or less chloramphenicol inhibited 90.2% and thiamphenicol 78.95% of the strains. Strains with only moderate sensitivity to both antibiotics (MIC, 8 or 16 microng/ml) belonged to B. fragilis or other Bacteroides species. Members of the Fusobacterium and Sphaerophorus group were susceptible to less than or equal to 2 microng chloramphenicol/ml and less than or equal to 4 microng thiamphenicol/ml respectively. With both antibiotics, 102 strains of gram-positive non-sporing anaerobes (P. acnes, Peptostreptococcus spp., Peptococcus spp.) were susceptible to less than or equal to 8 microng/ml. Of 37 Clostridium isolates, 35 (belonging to C. perfringens, C. septicum, C. cadaveris etc.) were inhibited by concentrations of 8 microng/ml or less of chloramphenicol and thiamphenicol. Only one strain each of C. perfringens and Clostridium sp. had an MIC of 16 microng thiamphenicol/ml. Accordingly, resistance to thiamphenicol or chloramphenicol was not observed. A standardized monodisk agardiffusion test was performed on 40 Bacteroidaceae, 18 Peptococcaceae and 20 C, (P.) acnes strains. Only a poor correlation was observed between MIC and zone size for thiamphenicol and chloramphenicol. Therefore, inhibition zone diameter measurement cannot be regarded as a reliable method to detect chloramphenicol or thiamphenicol resistance in anaerobes. Thiamphenicol, which is virtually as active against anaerobes as chloramphenicol but lacks serious toxicity, may well play an important role in the therapy of various anaerobic infections.


Thymidine Content in Commercially Prepared Media. The thymidine content of a number of media now available commercially was determined, using Lactobacillus arabinosus ATCC 8014. The thymidine concentration in most liquid media was so high (greater than 0.01 microng/ml) that, without further treatment, these media could not be used for the testing of sulphonamides, trimethoprim or combinations thereof, more especially if bactericidal action was being investigated. Low and tolerable thymidine amounts were found in some agar media. Considerable variation was observed in the thymidine concentration in the same media produced by different manufacturers, as e.g; in Mueller Hinton Agar, as well as in different batches of one medium from the same manufacturer.


Ocular cryptococcosis - experimental and clinical observations. During the previous studies, we could demonstrate that there are strains of Cryptococcus neoformans which after intraperitoneal inoculation, are capble of surviving only in the brain of mice without causing any apparent clinical symptom; only in about 4% of the animals the fatal involvement of the CNS occurred. The present investigations suggest that the selective involvement of eye, i.e., formation of intraocular cryptococcoma, with subsequent blindness is also possible under similar experimental conditions. It was observed that a short-lived uremia caused by intramuscular injection of 0.2 ml glycerine could enhance the rate of the selective involvement of the CNS including the eye. The uremia was controlled by the auxanographic method using STAIB's technique of serum-residual-nitrogen-auxanogram and employing the strain used for infecting the mice. These animal experiments are discussed in connection with a clinical case of intra-ocular cryptococcosis in which the only known basic disease was uremia of unknown orgin. The spontaneously healing cryptococcosis detected in this case after the treatment of uremia, has been discussed. Cases of ocular cryptococcosis described in the world literature have been also briefly discussed inconnection with our results. These microbiological observations will be supplemented by the histopathological findings to be published separately.


Kinetics of antibody mediated suppression of humoral immune response to Toxoplasma gondii at a cellular level. The effect of passively transferred Toxoplasma gondii antiserum was examined at a cellular level by rosette forming cell response in NMRI mouse spleen. The initial number of responding rosette forming cells was decreased in antibody treated animals; However, their rate of proliferation in comparison to untreated group was not significantly affected. Almost similar response could be obtained by injecting low 5 x 10(4) Toxoplasma dose alone or a combination of passive antibody and higher antigen dose of 1 x 10(6) parasites.


UDPglucuronic acid pyrophosphatase assay with the aid of alkaline phosphatase. A simple and sensitive method has been described for the determination of UDPglucuronic acid pyrophosphatase activity. Pyrophosphatase-free alkaline phosphatase preparation is added to the reaction mixture in order to hydrolyze the phosphate esters (UMP and alpha-D-glucuronic acid 1-phosphate) produced by pyrophosphatase. The inorganic phosphate liberated is measured by a modification of Fiske and SubbaRow's method. The phosphatase coupled method is time saving, easy to perform and accurate. It can also be used for pyrophosphatase assays with other nucleotide substrates like UDPglucose, UDP-N-acetylglucosamine, NAD+, NADH, NADP+ and NADPH.


[Lumbar sympathectomy for occlusion of thesuperficial femoral artery (author's transl)]. Lumbar sympathectomy is a good procedure for occlusion of the superficial femoral artery provided collateral circulation be stimulated by walking, and of course provided this circulation be intact. This requires an aortography which is necessary to arrive at a good prognosis. Lumbar sympathectomy without a previous aortogram is meaningless: it would lead to the ignorance of short stenoses of the internal iliac or deep femoral arteries and misinterpretation of the efficiency of lumbar sympathectomy.


[Present place of lumbar sympathectomy in arteritis of the lower limbs (author's transl)]. A study of 75 lumbar sympathectomy helped the authors in specifying the indications of this operation for arteritis of the lower limbs. Lumbar sympathectomy is based on precise anatomical facts : para-vertebral sympathetic chain is usual but a collateral chain must be searched if the latter appears too thin. Lumbar sympathectomy can be performed alone or in association with reconstructive procedures. It is used alone in old people for its antalgic and moderately functional effect in accordance with their level of activity. Also it is used alone in cases of gangrene localized or pending or in the absence of a runoff vasculature. It is associated to repair if one wants to improve an incompetent peripheral perfusion. The authors record 79% of favourable results of which 52% were maintained when lumbar sympathectomy was used alone. In patients where direct vascular surgery is added, favorable results account for 82% of which 78% long lasting.


Indications and results of lumbar sympathectomy. According to our experience the lumbar sympathectomy is not indicated for the treatment in clinical stage II. The best results for lumbar sympathectomy are to be expected in clinical stage III. We consider the protective sympathectomy combined with reconstructive arterial surgery indicate only in individual cases.


[The role of lumbar sympathectomy. Review of the cases performed between 1950 and 1955 (author's transl)]. This reviews 839 isolated lumbar sympathectomy performed between 1950 and 1975. The patients are stratified by decades and grouped in 3 periods : 1950 to 1959, 1960 to 1969 and 1970 to 1975. In the first period most patients were between 50 and 59 years old; in the last period most were between 60 and 69 years old. At this time direct vascular reconstruction had become more frequent. The approach described by Pearls was used exclusively in the last period. Isolated lumbar sympathectomy yields a symptomatic improvement. Best results are obtined in peripheral and isolated lesions.


[Influence of lumbar sympathectomy on the proportion of amputation (author's transl)]. One hundred and eighty-three lower limbs with arterial occlusion and stade II chronic ischemia were followed for 5 years. Two groups, comparable as to age, sex number and location of lesions were formed by prospective randomization. Ninety limbs were treated by lumbar sympathectomy and 93 were not operated. After 5 years there is no difference between the 2 groups as to mortality, cardiovascular morbidity, claudication or minor or major amputations.


The lumbar sympathetic. Anatomy and surgical implications. The ganglionated lumbar sympathetic chains lie on the lateral aspects of the bodies of the lumbar vertebrae and not more laterally as in the thorax where the chain lies in relation to the heads and necks of the ribs. Lumbar ganglia vary in number. They are best numbered according to the spinal nerve to which the particular ganglion sends its postganglionic fibers, but, at operation, the surgeon is unable to obtain this kind of information. It is customary to mark the extent of resection by the application of a dura clip to the proximal and distal ends of the trunk. Roentgenographic visualization later can approximate the level of resection in relation to the vertebrae. Anomalies can lead to unsuccessful denervation of the lower extremities. These include extraganglionic connecting sympathetic nerve trunks, intermediate ganglia, and cross-over fibers connecting the right and left lumbar sympathetic trunks usually at the level of the fourth and fifth lumbar segments, but anatomically sometimes as high as the third and second. Specific complications of lumbar sympathectomy include failure of adequate denervation, brief paralytic ileus, hyperidrosis in parts of the body which remain normally innervated, sexual dysfunction, and post-sympathectomy neuralgia.


[Electron microscopic studies of lumbar sympathetic chains resected for arteritis of the lower limbs (author's transl)]. Eighteen lumbar sympathetic chains resected for lower limb arteritis are examined on electron microscopy. A comparative study of the nature of lesions is done for diabetics and non-diabetics. Development of vascular lesions, clearly accelerated in the diabetic does not coincide with neurological lesions. These are much more frequent in diabetics, which explains the increased failure rate of lumbar sympathectomy in this disease as the result of lumbar sympathectomy depends on the state of nervous tissue. Examination of the state of nervous tissue. Examination of this tissue could therefore help establish a surgical prognosis.


[Experimental study of the sensitivity to catecholamines after lumbar sympathectomy (author's transl)]. To determine sensitivity to catecholamines after lumbar sympathectomy the authors first tested it in dogs : there was an increase in reactions to catecholamine beyond doubt after bilateral lumbar sympathectomy. In patients with arteritis they recorded, on a segment of the lower limb, a rheographic tracing with simultaneous modifications of the arterial blood pressure and electrocardiogram. These were studied after injection of adrenalin or noradrenalin in a dose of 5 to 7.5 mug (physiologic or stress level). Each of these tests were performed before and after lumbar sympathectomy.


[Isotopic criteria for the assessment of the effects of lumbar sympathectomy (author's transl)]. The authors present a work intended to assess the effects of lumbar sympathectomy using radioactive microspheres. These contain 99mTe and are injected into the femoral artery. The distribution of radioactivity is then measured at the lower limb with a gamma camera linked to a computer. Seventeen patients were tested before and after lumbar sympathectomy. It appears from this short series that lumbar sympathectomy causes a redistribution of the radioactive material directed towards the extremities, mainly the feet.


[Evaluation of the results of lumbar sympathectomy with functional vascular tests. Statistical study (author's transl)]. A series of 100 unselected patients operated on for lumbar sympathectomy were studied by digit plethysmography, thest of hyperemia, rheography, measurement of segmental pressure and dynamic tests, treadmill and Strandness test. Statistical analysis of data showed that isolated lesions of atheroma yield the best result. Increase in walking perimeter and in blood flow (rheographic quotient) were the only parameters showing statistical change. Forecasting of the effect of lumbar sympathectomy by the hyperemia test of Hillestad was confirmed. Other forms of disease : diffuse lesions, lesions of arteries in the legs or due to diabetes were followed by very numerous failures. Lumbar sympathectomy is justified as an isolate procedure for femoral lesions, and associated to reconstructive aorto-iliac surgery whenever the distal runoff consists only of a deep femoral artery.


[Forecasting of the effects of lumbar sympathectomy by the radiothermometry with pentothal (author's transl)]. This test has been previously described and is used routinely by the authors since 1960. The method is based on the alternate arterial blood distribution between skin and muscle of a limb, depending on modifications in the vasomotor tone. Skin temperature, arteriography and progression speed of the contrast medium are measured simultaneously. The test shows the morphology of the arterial lesion. It measures vasomotor reserve by these parameters, especially the skin temperature, before and after administration of pentothal. Results are rated as good, average and poor. The authors have compared this test, performed before surgery, to the results of lumbar sympathectomy and found an excellent correlation. Late result of lumbar sympathectomy can thus be foreseen by means of this test provided no new organic lesion interferes with the hemodynamics of the limb.


[Interest of the local regional anesthesia in lumbar sympathectomy (author's transl)]. Authors report 163 cases of lumbar sympathectomy they did under local anesthesia from 1968 to 1975. All were older--and poor risk patients. Approach was always lumbar with resection of distal part of the 12th rib. If good care is taken to do anesthesia infiltration of the five lower intercostal nerves and of the 1st and 2nd posterior lumbar nerves, anesthesia is quite good, and surgery easy and painless. The main advantages are:--easy excision of the first lumbar sympathetic node through this lumbar approach;--low lethality as far as authors consider almost no contra-indications;--very fast recovery of bowel movements;--immediate oral feeding which is important for diabetic patients;--no tracheal, bronchial or lung postoperative infestation or trouble. Patients have never had any trouble (convulsions) from lignocaine since gardenal is given in pre-anesthesia.


Our experience in lumbar ganglionectomy. A critical comparison of the 1950-1965 and the 1966-1975 time spans. The authors compare the figures for a sequence of lumbar ganglionectomy operations in 2 different time spans. They point to a reduction in lumbar ganglionectomy indications as related to the spreading of arterial reconstructive surgery. The follow-up review of the results has shown that th percent worsening rate in the second time span should be ascribed to a change in the kind of cases rather than to a modification in the nature of indications. The authors conclude by describing the role of lumbar ganglionectomy as fundamental in dysfunctional, inflammatory and peripheral degenerative forms, and supporting in reconstructive surgery operations on mixed atherosclerotic forms.


Synthesis rates of fibrinogen and albumin in patients with rheumatoid arthritis. In four patients with rheumatoid arthritis synthesis rates of fibrinogen and albumin were studied with and 14C carbonate method described by Mc Farlane and Reeve. One of the patients was studied twice with and without steroid treatment. The following results were obtained: 1. There was no correlation between plasma fibrinogen levels and fibrinogen synthesis rates. Contrary to the results from turnover studies of labelled fibrinogen reported in the literature normal fibrinogen synthesis rates were found in the presence of elevated plasma fibrinogen levels in three of the five studies performed, corresponding to low fractional synthesis rates. Two patients showed elevated fibrinogen synthesis rates. In these patients the fractional synthesis rate was also well above normal. 2. Albumin synthesis rates were elvated in one patients treated with steroids and in one patient with very active arthritis. In the rest of the studies albumin synthesis was low. There was no correlation with fibrinogen synthesis rates.


Bile salts secretion in cirrhosis.

Bile salts secretion in cirrhosis. The bile salts secretion was studied in ten normal subjects and sixteen patients with alcoholic cirrhosis, in a basal period and during 60 minutes after Secretin injection. Total bile salts were measured by a modification of the enzymatic method of Iwata and Yamasaki and the individual bile salts were separated by silica gel thin-layer chromatography. During the 60 minutes after Secretin the mean concentration was 2.88 +/- 2.58 muM/ml in normals and 1.96 +/- 1.25 muM/ml in cirrhotics. The difference is not significant. During the first 20 minutes however the concentration was higher than 3 muM/ml in 8 out of 10 normals and lower than 2 muM/ml in 10 out 16 cirrhotics. The ratios of tri-to dihydroxy bile salts was similar in both groups. The ratios between bile salts conjugated with glycine and with taurine was higher in normals, and the ratio between free to conjugated bile salts was higher in cirrhotics. The lower concentration of total bile salts immediatly after Secretin, the higher proportion of taurin conjugates and of free bile salts could be important factors in the difficulties of fact digestion and absorption frequently found in patients with alcoholic cirrhosis.


The incidence of gallstones in Greece; an autopsy study. In the fifty-year period, from 1925 to 1974,  6596 autopsies were performed at three departments of Pathology in Athens. The incidence of gallstones was 5.97% in the total material. The incidence in females was 8.86% and in males 4.52%, with a ratio 2:1. An increase of the incidence has been noticed since 1925. Under the presented data Greece could be included among the countries with an intermediate frequency of gallstones, but with a tendency to follow the Western countries pattern. The significance of the Greek standard of living and the dietary surveys on the gallstone formation, are briefly discussed.


False-positive liver scan caused by anomalous quadrate lobe and right portal branch. A case of early cirrhosis exhibiting a discrete scan defect along the inferomedial margin of the liver near the hilum is described. Peritoneoscopy and percutaneous transhepatic portography disclosed that the quadrate lobe had a tongue like protrusion increasing activity below the hilum on the scan and a dilated right portal branch which divided near the superior mesenteric vein entered the liver at the porta hepatis.


Familial aggregation of peptic ulcers and ischaemic heart disease. Common etiologic factors? A family with an unexpected aggregation of both ischaemic heart disease and peptic ulcers is presented. Possible mechanisms behind an association between the two diseases are discussed. It is suggested that, depending on the genetic susceptibility, similar environmental stimuli like preexisting "stress" could induce either ischaemic heart disease or peptic ulcer.


Diagnostic value of endoscopic retrograde cholangio-pancreatography in biliodigestive anastomoses. Endoscopic retrograde cholangio-pancreatography performed in patients with bilodigestive anastomosis may furnish not only reliable radiograms revealing abnormal morphology of the two duct system but allows also endoscopic investigation of the stoma, which is often of equal diagnostic value in such patients. The size of the anastomosis is of crucial importance in such complications as cholangitis and secondary bile stone formation. In a significant portion of patients with biliodigestive anastomoses, i.e. in 75% of the present patient material, a morphologic abnormality could be demonstrated offering in many if not most cases the possibility of a surgical correction and eventual cure of the symptoms.


The lysosomal hydrolases in acute experimental pancreatitis in dogs treated with glucagon. In dogs with acute experimental pancreatitis (AEP) induced according to Elliotts method the total, free and latent activity of lysosomal hydrolases (acid phosphatase, beta-glucuronidase and cathepsins) in whole homogenates and some subfractions of pancreas were studied. The animals were divided into three groups of 6 dogs each: I. control healthy dogs. II. AEP-treated with glucagon (0.33 mg of glucagon in drop infusion 3 times every six hours). III. AEP without any drug treatment. In dogs treated with glucagon the significant decrease of relative free activity of all tested hydrolases (66-80%) in comparison with the group without any treatment (III/80-90%) was found. Moreover significant decrease of total catheptic activity (about 1/3) in the former group was demonstrated. Incubation of lysosomal enriched fraction taken from group II/in medium buffered to pH 5.0 caused decreasing release of catheptic activity (60% of total) in comparison with the group III (75%). The histochemical reaction for acid phosphatase according to Gomoris method in pancreatic acinar cells of dogs treated with glucagon was less intensive than reaction in untreated animals. These results indicate on the less impairment of pancreatic lysosomes in AEP treated with glucagon in comparison with that in untreated animals.


Effect of lysine-acetylsalicylate on serum gastrin levels. The effect on serum gastrin levels of lysin-acetylsalicylate (LAS), water soluble derivative of acetylsalicylic acid, was investigated in mice. Intragastrically administered LAS did not at all alter serum gastrin values while--when given via the intravenous route--LAS not earlier than at the very high dose of 450 mug/g caused a short-lived significant increase in serum gastrin. These results are in keeping with the view that salicylates do not owe their potential ulcerogenic properties to stimulation the gastrin-gastric secrection mechanism.


The effect of vagotomy on hepatic regeneration in rats. Liver regeneration was studied in rats that had undergone a bilateral cervical vagotomy. DNA synthesis, measured as the incorporation of 3H-thymidine into DNA, AT 24 hr after partial hepatectomy was significantly reduced in vagotomized rats. Ornithine decarboxylase (ODC) activity was significantly less at 4 hr after partial hepatectomy in vagotomized rats but was equal to controls at 8 and 24 hr. This data suggest that the liver parenchyma receives vagal innervation and that this innervation may play a role in the control of liver regeneration.


The cardiovascular effects of neuroleptanaesthesia. Oxygen uptake, cardiac output, stroke volume and arterial and central blood pressures were measured before and after induction of neuroleptanaesthesia in 27 subjects. Nine were elderly patients operated on for obliterative arteriosclerotic disease, and the other 18--nine elderly and nine younger patients--underwent operation for varicose veins. Cardiac output, stroke volume and systolic arterial blood pressure decreased significantly with a corresponding decrease in oxygen uptake. The changes were most pronounced in the patients with arteriosclerotic disease. The arterio-venous oxygen difference was unchanged in the arteriosclerotics and decreased in the other two groups. The central pressures remained unchanged in all groups. It is concluded that the cardiovascular changes induced by neuroleptanaesthesia are due to a decrease in oxygen uptake and not to myocardial depression.


Bupivacaine (Marcaine): an evaluation of its tissue and systemic toxicity in humans. In countries other than the U.S.A., dosages of bupivacaine have been limited to 100 mg without epinephrine and 150 mg with epinephrine. A review of 7,688 regional block procedures employing bupivacaine in concentrations of 0.25, 0.5, and 0.75%, and in dosages as high as 600 mg, indicated that such stringent restrictions: (1) are unwarranted, (2) make comparisons with other local anesthetic agents difficult, and (3) are in need of revision.


[Lysosomes of blast cells in various cytochemical types of acute leukemia]. In 25 cases cytochemical types of acute leukemia were determined using the classification of Loeffler. Three cytochemical methods used were: p.a.S.-glycogen content, pox-peroxidase activity, and esterase activity determinatione. At the same time selective identification of lysosomes in perypheral blood blast cells was done using vital euchrisine staining and fluorescence microscopy. A correlation was observed between the cytochemical types of acute leukaemia and the lysosomal pattern. The fluorescence method of the identification of lysosomes is suggested for diagnosis of acute leukaemia.


Hypoxia-induced vasoconstriction in isolated perfused lungs exposed to injectable or inhalation anesthetics. Investigations during the last two decades have revealed a tendency to inpaired pulmonary gas exchange in patients during general anesthesia. In the awake state, arterial hypoxemia is counteracted by a mechanism which tends to normalize the ventilation/perfusion ratio of the lungs by way of a hypoxia-induced vasoconstriction in poorly ventilated areas. This results in a redistribution of perfusion to more adequately ventilated lung regions. Recent observations suggest, however, that this beneficial mechanism is blunted by some commonly used inhalation anesthetics. In the present study the effect of inhalation anesthetics and injectable anesthetics on the vasoconstrictor response to acute alveolar hypoxia have been compared in isolated blood-perfused rat lungs. The experiments showed that the response was unaffected by N2O and injectable anesthetics, while a reversible, dose-dependent damping effect was demonstrated for the volatile inhalation anesthetics, ether, halothane and methoxyflurance. The effect could be demonstrated at blood concentrations comparable to those used in clinical anesthesia, and it was not due to a general paralysis of the vascular smooth muscle. The findings might, at least in part, explain the occurrence of arterial hypoxemia during general inhalation anesthesia.


Blood flow in the rabbit tracheal mucosa under normal conditions and under the influence of tracheal intubation. Isotope labelled microspheres were used to study the capillary blood perfusion of the rabbit tracheal mucosa. Under resting conditions the perfusion was about 0.3 ml/min - g (i.e. about 60% of the relative cerebral blood flow). Irritation of the tracheal mucosa by an endotracheal tube caused a steep rise in blood flow, tenfold or more. This was probably due to relaxation of the arterioles caused by a release of histamine-like substances. When an endotracheal tube is equipped with a small cuff (small resting diameter, low residual volume), the part of the mucosa in contact with the cuff, i.e. the mucosa covering the surface and edges of the cartilages, will be ischaemic at a cuff to tracheal wall pressure (C-T pressure) of greater than 30 millimeters of mercury. This abrupt ischaemia threshold contributes to the risk of deep mucosal damage with subsequent tracheal scarring, possibly proceeding to stenosis. Our present studies indicate that the ideal large cuff, with properties resembling those of an air cushion, will allow the major part of the arterial pressure to be propagated as far down as the capillaries. Under these conditions the cuff would permit some of the capillary blood perfusion of the tracheal mucosa covering the cartilages also at C-T pressures exceeding 30 mmHg. Although this investigation supports the concept that the ideal thin-walled large cuff interferes much less with the mucosal blood perfusion than the small cuff, we recommend that the cuff pressure be monitored and kept below 20 mmHg.


[Number and localization of Peyer's patches in the small intestine of the rabbit (Oryctolagus cuniculus)]. In the rabbit intestine Peyer's patches can easily be distinguished. They are found in the jejunum and ileum, but not in the duodenum. The highest number observed is seven. In most animals the first, i.e. proximally situated patch has a rather well-defined place in the beginning of the jejunum; similarly, the last, i.e. distally situated one mostly has its place in the end of the ileum. The demarcation of the three classical sections of the small intestine is discussed from a comparative viewpoint with special criticism as to what is called ileum in man.


Relationship between facial protrusion and tooth length in four strains of rats. Total tooth length was measured in the first lower molar of two short-faced strains of rats (Sprague-Dawley and Buffalo) and two long-faced strains (BN and GRL). Tooth length was significantly longer in the long-faced than in the short-faced strains. The same correlation had previously been found in dogs, baboons and human populations, as well as in rats in which facial shortening was obtained experimentally by septum removal. The data suggest that the same mechanism is responsible for this relationship in all groups.


[Angioarchitecture of the medulla oblongata in the guinea pig]. The angioarchitectonic regions in the medulla oblongata and the midbrain of 14 grown-up guinea pigs are discribed. According to direction and number of the supplying arteries, three sections are distinguished. The medial part is supplied worst. It contains the medial row of the nuclei of the cranial nerves. The more lateral parts have always double or treble supplies. They are distinguished by a high capillary density. Those parts are associated with the medullar nuclei of the cranial nerves.