[Therapeutic tactics in treatment of patients with cranio-cerebral injury and alcoholic intoxication]. Case-histories of 1077 victims of cerebro-cranial injuries, 38 per cent of whom were admitted in the state of alcoholic ebriation, were analyzed. Alcoholic ebriation was found to materially change the clinical picture of the cerebro-cranial trauma, simulating, sometimes, a picture of a traumatic brain lesion. Curative measures aimed at the treatment of the traumatic lesion of the brain were applied in a complex set, depending upon the nature and the severity of the cerebro-cranial injury, the phase (stage) and degree of alcoholic ebriation.


[Significance of morphological changes in the middle meningeal arteries in the development of epidural hematomas after mild cerebro-cranial injury]. Among 58 patients with epidural hematomas in 8 cases they developed following a light cerebro-cranial injury with no fractured cranial bones. In 26 patients who died of diverse causes a histological examination of median meningeal arteries disclosed the presence of focal elastofibrosis, atrophy of the central layer, deposition of lime, cleavage of the elastic membrane, atherosclerosis, thrombogenesis, acute inflammatory process, formation of non-traumatic sacular and arterio-venous aneurysm. These alterations, especially the sacular and arterio-venous aneurysms, may be causative of blood effusion into the epidural space and lead to the development of hematomas following a slight injury of the head.


[Experience with 60 frontal myelotomies in treatment of spastic manifestations in patients with injuries of the spine and spinal cord]. A 10-year experience gained in the surgical treatment of spastic manifestations in patients with the injured vetebral column and spinal cord is summarized. In 57 cases a total of 60 modified Bischof's operations were performed. A clinical classification has been worked out, at the basis of which there are the intensity and frequency of synergies. Spasticity disappeared in 54 of the patients operated upon. The elimination of the synergy, hypertonicity, mono- and pplysynaptic reflexes created favourable conditions for a subsequent rehabilitative therapy, which included walking and self-service training. Myelotomy proved quite effective irrespective of the time lapsed from the moment of injury.


[System of programmed control of an in- and outflow device for long-term irrigation of the bladder]. A unique apparatus for programmed monitoring of Monro's system in patients with affections and lesions of the spinal cord is described. The apparatus assembly includes a 2-mode time relay, retention device, electric magnet with a core and two half-rings. The compactness and ruggedness of the unit enables its use under any conditions. The reliability of its construction has stood the test of its long-term continuous operation. Thanks to the presence of the program time relay the cyclic recurrence of the urinary bladder lavage is strictly adhered to.


[Study of muscular evoked potentials by the built-up current in diagnosis of nerve injuries]. In 129 patients the diagnosis was defined over periods from 1 month to 2 years following the damage of the nerves with the help of myopotentials evoked through stimulation of the nerves with batches (charges) of a built-up current of varying frequency lasting for 1 second. With the lability of the neuro-muscular system falling from 35 down to 10 pulses/sec, a reduced amplitude of periliminal peak potentials, post-tetanic after-potentials and in the absence of pessimal inhibition of up to 1000 pulses/sec the operative treatment is, as a rule, not indicated. Late after injury and with a low amplitude of evoked myopotentials, falling down to 5--26 mug, an amplitude transformation from 2 up to 10 pulses/sec, the absence of periliminal rising peak potentials and post-tetanic after-potentials (spikes) surgery is commonly indicated. The operative intervention is also indicated in the absence of all types of the evoked myopotentials when this is combined with other factors.


[Possibilities of measurement of impedance by the use of long-range intracerebral electrodes]. An investigation of constituents in the complex (overall) resistance of deep-lying brain structures of patients with hyperkinesis treated by employing implanted electrodes helped disclose some specific features common to the impedance of conduction pathways, ventricles and some basal ganglia. The actual value of the impedance depends upon the technical peculiarities of the method. The latter does not permit it to identify the position of the electrodes amidsts various cellular structures, but is of a definite value in defining more accurately the localization of electrodes and in identifying them.


[Architectonics of the branch-forming veins passing through the emissaries of the cranial vault]. The structure of the veins forming the frontal, occiputal, mastoidal and sinciputal veins--emissaries was studied on 48 human cadavers by using various methods of silver-staining and a delicate anatomic sectioning and examination of the impregnated material with a binocular magnifying glass. The architectonics of these veins showed the drainage of the venous blood from the soft tissues of the cranial vault and its periosteum to proceed predominantly under normal condtions into the sinuses of the dura mater.


[Problems of treatment of contusions and dislocations of the brain]. The clinical course and prognosis in the event of a severe cerebrocrainial trauma depend, above all, on the extent of the contusion and smashing of the brain sustained. The pathogenetic factor of prime importance determining the severity of the contusion is the development of the local and general cerebral edema. Rapidly accuring edema and turgescence of the brain, rising intracranial pressure lead to the dislocation of the brain attended by a clinical picture of a grave secondary lesion of the brain stem. To eliminate or prevent the emergence of the dislocation syndrome an operative removal of the primary contusion focus and concussory treatment of the brain in combination with the pathogenetic conservative therapy, aimed at preventing further progressive edema of the brain, are indicated in some of such patients.


[Characteristics of a stable long-term cell line obtained from a dedifferentiated human astrocytoma]. There has been obtained and is being maintained in vitro for over 12 years a stable cellular line DAPT, derived from a dedifferentiated human astrocytoma. In monolayer cultures the cells have passed 270 times. During 22 month (63 passages) the cells had a fibroblast-like shape, their growth having thereafter assumed an epithelioid character. On being impregnated with chlorous gold after Ramon-and-Kachal the cellular cytoplasma is stained purple-violet. In the periods of the fibroblast-like and epithelioid growth the time of the population doubling was 145 and 74 hours, respectively. The mitotic index amounted to 18%. When investigated during the 3d (106th passage) and 11th (250th passage) years of its cultivation the population consisted largely of cells containing 60-65 chromosomes. The carotype of the DAPT cells retained the main traits common to the structure of the human caryotype. After 7-9 months of cultivation (16-25th passages) the DAPT cells demonstrated the presence therein of an active glutamineketoacidic aminotransferase. Further on the activity of the enzyme declined. Factors influencing the changeability of the stable cellular DAPT line are discussed.


[Angiography in cancer metastasis to the brain]. Cranio- and angiographic examinations of 89 patients with nodular metastases of cancer into the brain, observed at the N.N. Burdenko Institute of Neurosurgery over a period of 1959 through 1973, are analyzed. Consideration was also given to the duration of anamnesis, to the presence of congestive manifestations on the eye fundus and to their intensity. Main angiographic signs characteristic of carcinomas metastases into the brain, viz. the nature of the cerebral vessels displacement, the structure of the tumours vasculature, the sources of the tumours blood supply and the routes of the blood drainage from metastases, etc. are presented. Major differential-diagnostic distinctions among metastatic cancers, gliomas and meningiomas are listed. An analysis of angiograms with due consideration of anamnestic data and clinical symptoms enables it to establish in most case a differential diagnosis as against primary brain tumours.


[Acid phosphatase activity in cultures of glial tumors]. With 18 glial brain tumours serving as a base material the activity of acid phosphatase was studied dynamically in the course of cultivation. The enzyme is demonstrable both in differentiated and actively proliferating cells, as well as in those showing signs of dystrophy. The enzyme was found to display chiefly a moderate activity in monomorphic tumour cells, its content being higher in atypical neoplastic cells. A significantly rising activity of the acid phosphatase was discovered in cells presenting dystrophic and necrobiotic alterations.


[The clinical picture and course of acoustic neurinoma in advanced age]. Specificity marking the evolution and clinical picture of acoustic neurinoma in persons of advanced age is described. A great interest of the cases under study consists in that quite often the clinical picture and the course of the disease in this age category are atypical, this being due to the age of the patients and intercurrent, most often vascular diseases of the brain.


[The structure of the arteries of the base of the brain in saccular aneurysms]. In 100 autopsy observations with saccular aneurysms of diverse localization the structure of arteries at the base of the brain was studied. In 26 per cent of the cases this structure was of the normal or "classic" type. In some instances there could be detected deviations from the "classic" type, with a tendency in certain localization of the aneurysm towards hypoplasia of the proximal length of the anterior cerebral artery. Frequently encountered divergences from the "classic" type of the structure come as a result of a delayed development of the vessels at the base of the brain during early stages of ontogenesis.


[Topographo-anatomic interrelationships between the branches of the lumbar arteries and the spinal ganglia, nerves and roots]. By using a complex of investigation methods variants of branchingout of the spinal cord and spinal ganglia blood supply sources and their anatomo-topographic interrelations were discerned in 140 preparations of lumbar spinal ganglia obtained from human cadavers of both sexes and different age. With the help of anastomoses these sources form a specific arterial circle around the ganglion. The radicular arteries are noted to be non-equivalent. The annular architectonics of the blood vessels is considered as a morphological manifestation of a functionally reliable blood supply to the border area between the central and peripheral divisions of the nervous system.


[Prolonged catheterization of the superficial temporal artery for repeated angiography]. A method of a long-term retrograde catheterization of the superficial temporal artery for performance of a repeated angiographic investigation following operations for saccular aneurysms of the cerebral vessels is described. The proposed procedure was successfully empolyed in 7 patients without any complications.


[Vertebrogenic lumbosacral radiculitis unrelated to disk herniation]. A classification of changes in the inferior lumbar portion of the spine that cause radicular pain and symptoms not amenable to concervative therapy is given. In most cases the said changes can be educed through a clinico-roentgenological investigation. Anatomical data bear proof to the presence of structural variants in which, in case of an intercurrent osteochondrosis without hernia of the disc, the compression of the root becomes quite probable. The classification lists changes that should be looked for when no hernia of the disc could be detected and lays emphasis on the multiplicity of causes accounting for the emergence of vertebrogenic radiculitis.


[Hydrolytic splitting of vitamin A esters in the blood]. The retinol and retinylpalmitate content along with the retinylacetate and retinylpalmitate-hydrolase in the blood of the portal vein and in the peripheral blood from the superficial vein of the hind limb of dogs was determined in chronic experiments before and 1, 2, 3 and 4 hours after administration of the vitamin A preparations into the small intestine fistula. The introduction of an oily retinylacetate solution into the fistula was attended both by an increase of the retinylpalmitate content in the blood plasma and the appearance therein of the retinyl-palmitat-hydrolase activity. Introduction of an aquous-colloidal solution of retinyl-palmitate caused a rise in the latter's content in the blood but was not accompanied by the appearance of the retinyl-palmitate-hydrolase activity. In the blood taken on an empty stomach no capacity for retinyl-palmitate hydrolysis was in evidence. It is presumed that the emergence of the retinyl-palmitate activity in the blood following introduction of precisely the oily retinylacetate solution is due to an intensified supply of the pancreatic enzymes into the blood in response to the fat load. The retinylacetate-hydrolase activity was continually present in the blood and did not vary in its intensity in the dynamics of absorption.


[A method of venous occlusion plethysmography for quantitative study of peripheral hemodynamics in cranio-cerebral trauma]. A method of quantitative investigation of the peripheral blood flow (in ml/100 cm3/min) involving the use of venous occlusion plethysmography is described. Mathematical procedures applied in processing the arterial in flow curves are adduced. Conditions attending an investigation of the blood flow in the forearm vessels are depicted. The expediency of a bilateral examination of the peripheral circulation and vascular resistance in a cerebro-cranial injury is shown, there being, as a rule, a considerable asymmetry between the sides.


[Influence of vitamin A on the sialoglycoproteids and the electrophoretic motility of erythrocytes]. Tests conducted on albino rats with experimental avitaminosis and hypervitaminosis A provide evidence that vitamin A has an influence on sialoglycoproteids and on the electrophoretic motility of erythrocytes. In the states under study there is observed an appreciable fall in the hemoglobin and sialic acids content in the erythrocytes, the electrophoretic motility of the latter being on the decrease. These data support the opinion according to which optimal amounts of vitamin A are needed for a normal functioning of the red blood cells.


[Influence of qualitatively different diets on the reproductive capacity and function of the adrenal cortex in rats with experimental toxic hepatitis]. The effect of a diet rich in protein and the group B vitamins on the function of the ovaries and adrenal cortex, as well as on the reproductive capacity of animals with experimental affection of the liver produced by administration of carbon tetrachloride was studied on 115 mongrel albino female-rats. A high-standard semisynthetic diet devised at the Institute of nutrition of the AMS of the USSR and three isocaloric experimental diets calorifically enriched by 20, 50 and 100 per cent and containing a double amount of the group B vitamins were used in tests. The protein and vitamins enrichment of the diet, although failing to normalize the estrual cycle, neveretheless contributed to a significant reduction of the embryos' death in pregnant animals, the restoration of the reproductive capacity of the rats being directly proportional to the degree of the protein enrichment of the diet. The use of experimental diets helped normalize the adrenal cortex function in pregnant rats with toxic hepatitis, this manifesting itself in the falling amount of corticosterone in the blood serum outflowing from the suprarenals down to the control level.


[Diets for students of professional-technical secondary schools situated in zones of endemic goiter]. Menu, formulation of meals, chemical composition and calorific value embracing 10 different dietary patterns for students of vocational technical schools disposed within an area of endemic goitre are cited. In compiling the rations account has been taken of the age-specific features of the students, the physiological standard rates now in force, a collection of meals formulations and the funds allocated for alimentation in the said schools. The proposed rations may be of prophylactic importance in the foci of endemic goitre and should help strengthen the health of the students.


Detection of antibody to hepatitis Bs-antigen in patients with acute and chronic hepatitis as measured by a modified procedure of the radioimmunoassay Ausria I 125. A simple modification of the radioimmunoassay Ausria I 125 was employed for detecting anti-HBs using the inhibition of a constant amount of HBs Ag. Anti-HBs was demonstrated in up to 82% of follow-up patients recovering from viral hepatitis B and in 79% of hemophilia patients. The antibody was found in 3.4% of healthy blood donors and in 10% of family contacts of patients with acute HBs Ag-positive viral hepatitis. The frequency of anti-HBs in 44 patients with HBs Ag-negative chronic aggressive hepatitis or cryptogenic liver cirrhosis (23%) did not differ significantly as compared with the occurrence of anti-HBs in 58 patients with chronic rheumatoid arthritis (16%). These findings give further support to the suggestion that the hepatitis B virus does not contribute to the aetiology of HBs Ag-negative chronic active hepatitis.


Transfer factor preparations: some physico-chemical and biological properties. Some biological and physico-chemical properties were tested in 50 lots of transfer factor (TF). Each lot contained the extracts of a pool of 20 buffy coats, each originating from a 400 ml blood donation of a healthy individual. The optical densities at 260 and 280 nm were within a narrow range in all TF lots. The ratio 260/280 was 2.56-3.02. One unit TF (defined as the extract of two buffy coats (corresponding to 1-2 X 10(9) leucocytes) contained 36.58 +/- 3.77 mg of peptides as measured by the Lowry method and 123.6 +/- 4.5 mg ribose as estimated by the orcinol method. Cytotoxicity of TF lots was tested by measurement of chromium release of PHA-stimulated lymphocytes. Cytotoxicity was above 10% in 20 of 27 TF lots tested, most of which were produced by an Amicon ultrafiltration cell. Pyrogenicity was present in 8 of 42 TF lots produced by Amicon filters, but only in 1 of 8 lots produced by Sartorius filters. Sephadex G-10 chromatograms of TF gave characteristic patterns yielding 8 peaks. Sephadex G-25 chromatograms reproducibly showed 5 peaks. The distribution of osmotic activity, peptides and ribose in respect of the chromatographic fractions is given.


Experiments on the preparation of blood components with the IBM 2991 blood cell processor. Experiments were carried out with the IBM 2991 Blood Cell Processor in order to study the sedimentation behaviour of blood cells from human ACD blood during centrifugation. Based on this behaviour procedures were developed for plasmapheresis and leucapheresis using the Blood Cell Processor. Accumulation of platelets was observed to occur at the plasma-cell interface during centrifugation at 1,000 g; this led to the development of a one-step method for the preparation of platelet concentrates.


[Analysis by means of pancreatozymin of the degree of parallelism of secretion of pancreatic enzymes in healthy persons and patients with chronic pancreatitis]. In 14 normal individuals and in 28 patients with chronic recurrent pancreatitis the total secretion of amylase, lipase and trypsin, as well as the proportions of these enzymes in 20 minute portions of the duodenal contents under basal conditions and after an intravenous injection of 1.5 Un/kg of the "Boots" pancreozymin were studied. A definite disproportion in the stimulated secretion of pancreatic enzymes with a higher amylase/lipase ratio and a lower lipase/trypsin ratio was found to occur as a physiological phenomenon, the degree of this disproportionality, however, being substantially greater in patients with chronic pancreatitis than in healthy persons. An inference is drawn that, along with an investigation into the overall amount of enzymes secreted secondary to pancreozymin stimulation, of importance is not so much the very fact of divulging the non-proportionality of the stimulated pancreatic enzymes secretion, but rather the analysis of the nature and the degree of this disproportionality. This is essential, in particular, when estimating the effect of various nutritional patterns on the external secretion of the pancreas.


[Study of the sarcoplasmic and myofibrillary proteins of sublimation dried meat by the method of high-volt electrophoresis in starch gel]. Data obtained from a study of the effect produced by freezing at -196, -30 and -18 degrees and subsequent sublimation drying for 420, 240 and 210 minutes respectively on the sarcoplasmic and myofibrillary proteins of meat are reported. The condition of the proteinic system in the muscle tissue was judged from dissolubility of proteinic substances (by employing methods allowing complete extraction of sarcoplasmic and myofibrillary proteins to be realized) and from electrophoretic mobility in a starch gel. Freezing and sublimation drying were found to result in reduced extractability of both the sarcoplasmic and myofibrillary proteins. The dissolubility of the sarcoplasmic proteins was then 1.7-2,0 times as low as that of the myofibrillary ones. Experiments have demonstrated a definite divergence between the data on the extractability of the proteins and the capacity of the muscle tissue to retain the muscle juice. A close positive correlation between the organoleptic valuation of the desiccated muscle tissue and the content of native myofibrillary proteins, determined through high-voltage electrophoresis in a starch  gel, has been established.


Phosphoglucomutase 3: formal and population genetics and observations on abnormal phenotypes. 514 healthy blood donors and 47 families with 122 offspring were studied for phosphoglucomutase 3 (PGM3) from leukocytes. There was a good agreement of allelic frequencies obtained compared to those reported previously in Caucasians. In addition, three individuals with abnormal phenotypes were observed: one was a patient with Hodgkin's disease, the other two were apparently healthy blood donors. In two cases, family members could be studied; none carried the abnormal type of the father. The possible background of these observations with respect to the attachment of the PGM3 locus to the immunogenetic linkage group--the major histocompatibility complex--on chromosome No. 6 in man is discussed.


A simple method for the prediction of ABO incompatibility using Sephadex A-50. Prediction of ABO incompatibility. A rapid and simple method of demonstrating the presence of high titre IgG anti-A or anti-B (anti A/B) is described. The method requires the separation of IgG anti-A/B from IgM anti-A/B using DEAE Sephadex A-50 by a simple spin technique, and the subsequent titration of the IgG fraction to detect the presence of high titre IgG anti-A/B. Since high titre IgG anti-A/B is usually associated with ABO incompatibility the test is a useful guide to the prediction of ABO incompatibility in routine antenatal samples.


Separation of ABH, I, Ss antigenic activity from the MN-active sialoglycoprotein of the human erythrocyte membrane. The erythrocyte sialoglycoprotein was purified from cells with complementary ABO(H), MN and Ss phenotypes. Serological examination of the sialoglycoprotein preparations demonstrated that this molecule does not carry the ABO(H), I or Ss antigens. The results also suggest that Ss activity may be associated with a minor erythorcyte glycoprotein. The characteristics of the ABO(H) and I antigens are consistent with earlier suggestions that these antigens are carried on complex glycolipids.


[Influence of methandrostenolone on some aspects of protein metabolism in rats in the context of various protein rations]. Wistar male-rats receiving by mouth dianobol for 10 days and 9 months and fed on rations with different proportions of protein were investigated. Dianobol is shown to produce under definite conditions changes in the intensity of the protein synthesis in the muscle tissue and liver of the test animals and also to raise the activity of tryptophan-peroxidase and of alanine-amintransferase, the protein level in the ration being here of substantial importance. With its long-term administration to rats dianobol displays an androgenic effect on the gonads and the supernumerally genitals without exercising any stimulating action on the weight gain.


A case of Ax phenotype transmitted by an A2B parent. The authors report a family in which the father is Ax, the mother B, the paternal grandmother Ax; 3 children out of 6 are A2B and the other three Ax. One of A2B children is married to an O subject, and she had a son of phenotype Ax. It was observed that Ax gene in position trans of a B gene behaves phenotypically as an A2.


[Chromatographic method of determination of the toxicity of grain affected by Fusarium sporotrichiella]. The chromatographic method for determining the toxicity of the cereal crop grain affected by micromycates F. sporotrichiella is proposed. The method is based on the separation of the lipids extracted from the grain under examination in a thin layer of the silica gel and detection on the chromatogram of two toxic fractions with Rf-0.06 and 1.22 fluorecent in the UV-light by emitting greyish-green and emerald-green coloured light. The chromatographic method is more sensitive, visually obvious and quicker by comparison with the biological ones.


The ultrasonic evaluation of nonfunctioning thyroid nodules. Thyroid echography was carried out on 100 patients with thyroid abnormalities to evaluate the diagnostic accuracy of ultrasound in differentiating simple thyroid cysts from solid thyroid nodules. In all 46 proven cases, the ultrasonic diagnosis of the solid or cystic nature of thyroid nodules was correct.A proposed diagnostic workup of a hypofunctioning (cold) thyroid nodule is suggested with primary needle aspiration and cytologic examination of the cyst fluid being recommended if the nodule is shown to be entirely cystic by ultrasound.


Diffusing capacity, specific diffusing capacity and interpretation of diffusion defects. Six pathophysiologic mechanisms of a reduced single breath CO diffusing capacity are discussed and the usefulness of relating carbon monoxide (CO) uptake to the functioning alveolar volume (DL/VA, specific diffusing capacity) is illustrated for several pulmonary diseases. In patients with emphysema and pulmonary emboli (pulmonary vascular occlusive disease), reduced CO uptake is associated with significantly reduced DL/VA and is compatible with reduction of pulmonary capillary bed. In patients with pulmonary alveolar proteinosis, improvement in CO uptake and DL/VA follows lung lavage and suggests that lung units partially filled with proteinaceous material are responsible for hypoxemia, reduced CO uptake and reduced DL/VA. In most cases of radiation fibrosis, sarcoidosis and miscellaneous interstitial fibrosis, reduced CO uptake is associated with a normal DL/VA and suggests that loss of alveolar units, both capillaries and alveoli, has occurred. New regression equations for DL and DL/VA are established for children and adults. DL/VA is linearly related to height and independent of age and sex, while different predictive equations must be used for DL for the 5 through 17 and 18 through 76 age groups. The new regression equations for DL show better correlation in adults we studied over 50 years of age than previous regression equations which use a constant reduction of 2 to 3 ml CO per minute per mm of mercury for each 10 years of adult aging.


Advances in the clinical care of burned patients. Very few areas of medical science have experienced more rapid development of new and beneficial treatment approaches during the past two decades than the disciplines required for total care of patients with major thermal injury. The introduction of a multidisciplinary scientific approach to the diagnosis and treatment of very complex postburn complications has been primarily responsible for the major advances in clinical care. This report highlights those areas of advancement which have been most significant in upgrading current inpatient therapy.


Candide becomes a doctor.

Candide becomes a doctor. It has been shown that things cannot be otherwise; since everything was created for a purpose, this purpose must inevitably be the best possible. Observe that noses were made to wear spectacles and so we have spectacles. Legs were obviously intended to wear breeches and so we have breeches. Stones were made to be cut and to be made into mansions. That is why His Lordship has such a very fine mansion. The greatest baron in the province should be the best housed. Pigs were made to be eaten, so we eat pork all the year round. Therefore, people who told us merely that everything was well ordained were talking nonsense. They should have said, "Everything is ordained for the best."(1)


Ruptured abdominal aortic aneurysms. Surgical treatment. The records of 62 consecutive patients with ruptured abdominal aortic aneurysms were analyzed to determine what factors contribute to lower mortality. Survival was directly related to the immediate preoperative hemodynamic status of the patients. In 18 cases in which operation was carried out with patients stable, 83 percent of the patients survived. Even if shock was present by the time of operation (37 cases), a 68 percent survival rate was achieved. Cardiac arrest occurred before obtaining aortic control in seven patients and one survived. Survival rates were increased if certain preoperative, operative and postoperative guidelines were followed. Since the combined operative mortality and late graft failure rate in 125 elective aneurysmectomies done during the same decade was under 5 percent, all abdominal aortic aneurysms with few exceptions should be surgically treated before rupture occurs.


Infectious urethritis in men and women. Diagnosis and treatment. Acute and recurrent infectious urethritis in men and women is commonly seen by physicians. Since specific therapy varies widely with the type of urethritis present, the proper diagnosis must be clearly established if curative drug therapy is to be selected. It is valuable, therefore, to review the diagnosis and therapy of the various forms of infectious urethritis that are recognized today in both men and women.


Multiple endocrine adenomatosis type II (Sipple's syndrome) in twins. Medullary carcinoma of the thyroid, pheochromocytoma and multiple mucosal neuromas (MEA-II), a familial disorder of neuroectodermal tissue, is believed to be inherited in an autosomal dominant pattern. The occurrence of this syndrome in twins has not previously been reported. We have documented the presence of MEA-II in a pair of twins. The high incidence of bilaterality of pheochromocytoma is emphasized, as well as the usefulness of preoperative catecholamine fractionation, and vena cava catheterization sampling.


Lipid components of the hydrocarbon assimilating yeast Candida lipolytica (strain 10). The utilization of n-hexadecane by Candida lipolytica (stain 10) was studied with respect to the lipid content, phospholipid and fatty acid profiles resulting at various growth times. Thin layer chromatography of the lipid extracts showed quantitative changes in the different lipid classes. The phospholipid fraction obtained at each growth time was separated into 8 classes: lysophosphatidylcholine, sphingomyelin, phosphatidylcholine, phosphatidylethanolamine, glycophospholipid, phosphatidylglycerol, cardiolopin, and phosphatidic acid. Differences in the percentage fatty acid composition of the lipid extracts were observed at various stages of growth. The cellular fatty acids included palmitic, palmitoleic (35-52%), stearic, oleic, linoleic (26-39%), and pentadecanoic (2-12%) as major components. This indicates that fatty acid(s) of the same length as that of the substrate was the most abundant component, thus showing intact incorporation mechaism. Fatty acids having longer chain lengths were also formed in substantial amounts indicating C2 addition and beta-oxidation of the fatty acids formed in the yeast.


[Physiology and biochemistry of streptomycetes. III. Incorporation of D-glucose-u-14C in paramomycin as indicator of antibiotic biosynthesis by Streptomyces albus var. metamycinus nov. var]. Paromomycin was isolated from culture filtrates of Streptomyces albus var. metamycinus nov. var. after feeding the growing cultures with D-glucose-u-14C. From the different incorporation rates conclusions concerning different features of the paromomycin biosynthesis (utilization of the carbon source, proportional and disproportional changes of the rates of synthesis) could be drawn. Uptake and metabolism of glucose are discussed.


[Influence of an acute hypercalcemia on the gastric secretion in duodenal ulcer, peptic ulcer of the jejunum and Zollinger-Ellison syndrome]. In 36 patients with ulcer without Zollinger-Ellison-syndrome (25 patients with recurrent duodenal ulcer, 11 with an ulcus pepticum jejuni after B II-resection of the stomach) and 2 patients suffering from ulcus pepticum jejuni with an ascertained gastrinoma the secretion of acid was compared after stimulation of pentagstrin (6 mug/kg) and calcium (4 mg Ca++/kg/h). The secretion of hydrochloric acid was statistically significantly stimulated in all patients suffering from ulcer by the hypercalcaemia (increase of the serum calcium concentration from 5.0 +/- 0.3 mval/1 to 6.2 +/- 0.8 mval/1). But in patients suffering from ulcer with gastrinoma the stimulatory effect was larger than in such patients without autonomous source of gastrin: the calcium-stimulated secretion of hydrochloric acid was on the average in cases of duodenal ulcer 40% (2 to 68%), in the ulcera peptica jejuni 47% (17 to 75%), in the 4 comparative examinations of the two patients with Zollinger-Ellison-syndrome, however, always more than 100% (106 to 177%) of the pentagastrin-stimulated peak secretion. The comparative test of the pentagastrin and calcium-stimulated secretion of hydrochloric acid could be a help for the proof of autonomous places of the formation of gastrin.


[Pancreas-secretion test in pregnancy].

[Pancreas-secretion test in pregnancy]. In 3 groups of young women - non-pregnant, early pregnant and highly pregnant - the function of the excretory pancreas was examined with the help of the analysis of the duodenal juice after specific stimulation of the pancreas the evocation test. In these cases the secretion of the pancreases was significantly limited during pregnancy; during early pregnancy the findings were clearer than in the late pregnancy. In the first trimester of pregnancy the values of blood amylasis were low, around the date of birth they were normal with inclination to increased values.


[Patholgenesis of anemias in chronic liver diseases]. In a complex examination of clinically healthy persons, with postprandial glucosuria or affected with a hereditary diabetes mellitus differences were found in the dynamics of the insulin secretion in oral and venous glucose tolerance dependent on the character of the glucose tolerance. With the deterioration of the latter the insulinaemia increase and prolongs in oral tolerance, in venous tolerance, however, it will be lower and lower. The through analysis of the results refers to the pathogenetic role of the peripheral resistance to the insulin as well as the disturbed secretory function of the islet apparatus. The established connections allow of the derivation of pathogenetically proved criteria for the differentiation of normal, subnormal and pathologic glucose tolerance. The confronting of the insulinaemia with the adiposity of the persons examined detects the fundamental difference between persons with normal and disturbed carbohydrate tolerance. The increase of weight contributes to the manifestation of the genetic defect. From the prophylactic point of view apart from the significance of the adequate dietetic regimen the attention is also drawn to the effect of biguanides.


[Hospitalized hypertensiol patients with gastrointestinal disease]. A careful codification according to the rules of electronic data processing of all data given and especially of the admission number on the signature margin of th medical record gives the possiblity of a rapid return of information for the practice and of a scientific evalustion. 404 patients with hypertension (400-404) of the distric Rostock who were treated in the clinic simultaneously suffered from gastrointestinal diseases (531-536, 570-577). For a more specialized analysis of the clinical data from case histories the four largest institutions of the district were chosen. From this results a relation number of 100 patients with these diagnostic combinations. 73% of these patients were of female sex. The higher blood pressure values at the beginning of the treatment we find in hypertensive patients with simultaneous disease of the gallbladder, in which cases these patients to 44% also showed an overweight. In 74% of the patients there occurred a systolic decrease of blood pressure, in 66% a diastolic one. More frequently than on the average the decrease of the blood pressure appeared in patients with liver and gall-bladder diseases.


[Urinary alanine aminopeptidase and lysozyme excretion in patients with diabetes]. The excretion of alanine aminopeptidase in the urine is changed by several factors influencing the tubuli. The diabetics increasedly excrete alanine aminopeptidase in the urine, apparantly as an expression of an increased cell moulting of the tubuli. Whether the increased alanine aminopeptidase activity of the urine may indicate a diabetic nephropathy, is to be clarified only by means of bioptic investigations of the kidneys. Streptomycin can also like a nephrostasis as a sequel of a decompensated cor pulmonale increase the activity of alanine aminopeptidase of the urine.


[Importance of adipose tissue hypertrophy for the pathogenesis of maturity-onset diabetes]. In 56 maturity-onset-diabetics and 20 test persons with pathologic glucose tolerance were established significantly larger volumes of adipocytes than in 142 test persons with normal glucose tolerance and normal serum triglycerides. The differences could only be proved taking into consideration the influence of the index of ideal weight and the difference of sex. The pathogenetic importance of the excessive hypertrophy of adipose tissue is discussed on the basis of the increased turnover rate of free fatty acids.


[Effect of weight reduction on carbohydrate and fatty-acid metabolism in obese, maturity-onset diabetic patients]. In 35 adipose maturity-onset-diabetics (27 women, 8 men, average age 48 years) we examined the influence of a 4--5-week slimming cure on the carbohydrate and fat metabolism. A significant decrease showed the index of ideal weight, volume of adipozytes, fasting free fatty acids concentration, triglyceride content of the liver as well as systolic blood pressure. The decrease of the triglycerides, of cholesterol and of the uric acid level in the serum could not be ascertained statistically. The reduction of weight did not cause an essential change of the basal and stimulated insulin concentrations, whereas the glucose tolerance clearly improved. After an observation period of 36.5 months behaviour of weight and form of therapy are analysed.


[Hyperlipoproteinemia -- cause or sequelae of maturity-onset diabetes]. With the help of data from literature and own long-term observations the importance of the hyperlipoproteinaemias (HLP type IIb-V) as precursors of the maturity-onset-diabetes is discussed. The assumption of transitions of the hyperlipoproteinaemias with insignificant disturbances of the carbohydrate tolerance and hyperinsulinism into a condition with manifest diabetes mellitus and relative lack of insulin appears justified. Differential diagnostics (e.g. by determination of the insulin response after glucose tolerance) and adequate differential therapy of the symptom complex belonging to the metabolic syndrome are demanded.


[Studies on the influence of body weight and form of therapy on the development of fatty liver in maturity-onset diabetes]. On the basis of our findings can be established that the frequent appearance of a fatty degeneration of the liver in diabetes mellitus is the resultant of a multifactorial disturbance, in which case above all the type of diabetes, the relative weight, disturbances of lipidmetabolism and the form of therapy are decisive for the size of the adipose degeneration.


[Liver diseases in diabetes mellitus].

[Liver diseases in diabetes mellitus]. In a number of 3,554 clinically manifest diabetics who were admitted for the treatment of metabolism or other diseases from 1967 to 1974 12.1 per cent of hepatopathies were found. In men the incidence was 15.2 per cent, in women 10.7 per cent. Among these the fatty degeneration of the liver (28.8 per cent) and the cirrhosis (17.4 per cent) were most frequent. Referred to the entirety the result was an incidence of cirrhosis of 2.1 per cent. The confirmation of the diagnosis is performed by biopsy and endoscopy in 92 per cent. In 60 per cent of the examined persons the diagnosis was unknown before admission. There was no correlation to the duration of the diabetes. In the number of patients there appeared above all persons older than 50 to 60 years. The following concomitant diseases occurred: hypertension (33 per cent), coronary diseases (32 per cent), pyelonephritis (17 per cent) and adiposity (13 per cent).


[Studies on the relationship between diabetes mellitus and necrobiosis lipoidica]. From 1970 to 1974 in the dermatological clinic of Leipig University in 17 women and 3 men a necrobiosis lipoidica was established. Of these patients hitherto 12 female patients with histologally ascertained diagnosis underwent a clinico-angiological follow-up examination. Apart from this metabolic disturbances were thought for. In two thirds a disturbance of the carbohypdrate metabolism, in three fourths a disturbance of the lipometabolism was found; hyperlipoproteidaemia and diabetic change of the metabolism were simultaneously present in 7 out of 12 female patients. Uric acid level of the serum and rheumatic serology were, however, rarely pathological. A disturbance of the arterial blood supply of the legs could be ascertained in three fourths of the women who underwent a control examination. In these cases 15 to 19 extremities affected with necrobiosis had a disturbance of the blood supply. The microangiopathy histologically provable in foci of necrobiosis was to be seen only in one long-term diabetic also on the eye-ground. One third of the female patients suffered from hypertension. In all cases disturbances of the carbohydrate metabolism or of the lipometabolism and/or of the local blood supply could be proved. On the basis of these findings adequate examinations are recommendable in patients with necrobiosis lipoidical with regard to therapeutic consequences.


[Mechanism of the effect of electrostimulation during the interruption of tachycardial arrhythmias]. With the help of three individual electrocariograpic observations which were collected at the end of tachycardiac disturbances of rhythm by electrostimulation, the author enters the mechanism of action of this form of the cardiac electrotherapy. From this its indication and the most rational practical approach are derived.


[Pictures of the fascicular block inacute myocardial infarct with special reference to left anterior hemiblock and the bifascicular block of the anterior type]. In the etiology of uni, bi- and trifascicular block pictures the acute myocardial infarction plays an important role. From the topographic relations of the supply of coronary vessels to the coduction system certain correlations between localisation of infarction and kind of blocking are to be explained. The electrocardiographic changes of the individual block pictures are explained. 765 (581 males, 184 females) patients with acute myocardial infarction were examined concerning frequency and prognosis of the left anterior hemiblock and the bifascular block of anterior type (left anterior hemiblock, right bundle branch block). A left anterior hemiblock could be proved in 90 cases (11.8%), a bifascicular block of anterior type in 38 cases (5%). With 30% the lethality of the first group was not essentially above the lethality of patients with infarction without block pictures (29.6%). In patients with bifascicular block of anterior type it was significantly incrased with 68.4%. The two block forms were nearly exclusively found in the anterior wall infarction and its combination with a posterior wall infarction, respectively. 11 patients, out of whom 9 died, showed a transition of the bifascicular block into a trifascicular one. In 6 cases a left anterior hemiblock had preceded. The results concerning frequency and prognosis much correspond with the reports of other authors. In the bifascicular block, apart from the danger of a sudden asystolia, also the most cases larger size of the extension of the infarction with the adequately higher risk of a muscular insuficiency might be responsible for the bad prognosis. The therapeutic possibilities and necessities deriving from this are explained.


[Electrogastrographic studies in patients with gastric and duodenal ulcer]. The establishment of the motor activity of the gastrointestinal tract is difficult to be performed. The method of electrogastroenterography gives an evidence through an indirect registration of the summation vectors of the action potential. In patients with ventricular ulcer a statistically certain retardation of the changes of the potential/min. in comparison to a control group is to be proved. In patients with duodenal ulcer in the same way a trend is to be observed. It is especially referred to the importance of these examination methods in the sense of examinations of the course of the disease.


Diagnosis and therapy of primary hyperaldosteronism in general practice. Taking into consideration an own observation of Conn's syndrome the diagnostics and therapy of the primary hyperaldosteronism is described. The recognition of Conn's syndrome is important for that account as it coincides with an operatively curable hypertension. Therefore, a diagnostic step programme is proposed. Thus, the first tentative diagnosis shall be made already by a general practitioner. Other specialised and highly specialised investigations have the task to ascertain the diagnosis and to find the right way in therapy.


[Aseptic bone infarcts in occupational divers]. A report is given on dispensary investigations of professional divers. In 32 of a control group consisting of altogether 41 scaphander divers radiologically were found changes in the sense of aseptic bone necroses. 18 of the examined persons showed polyostotic affection and 14 had a monostotic localisation of the foci. Divers with no extensive findings could further work in their profession with a limitation of depth up to 13 depth of water. On the other hand examined persons with severe changes had temporarily to leave their profession. Relevant problems of the clinical symptomatology and the radiological differential diagnostics of aseptic bone necroses are discussed.


[Developmental trends in exogenous intoxications]. In this paper are described the change of the toxic remedies and the decrease of the lethality from 10.6% to 0.6% in 2,515 in-patients with exogenic intoxications treated in the clinic for internal medicine of Rostock University from 1946 to 1973. The establishment of the first detoxication central in the GDR is announced.


[Chronic liver diseases with negative laboratory findings]. Chronic liver diseases may be overlooked, when regular laboratory-chemical findings are overvalued. This is important especially for those which coincide with a particupation of the bile ducts. Even in insignificant clinical references laparoscopy and biopsy under direct vision are necessary. The blind biopsy of the liver is not always sufficient as it does not regularly deliver characteristic tissue.


[Diabetes mellitus and its vascular manifestations]. In 1,796 diabetics who died from 1957-1971 the average age of life, the causes of death and the average age in the individual stages of arteriosclerosis of the aorta, the coronary and cerebral vessels were followed up. This was compared with the same number of non-diabetics of the same age. It was shown that in the individual stage of arteriosclerosis there is no essential difference between diabetics and non-diabetics, however, not in the frequency of the individual stages of arteriosclerosis. The arteriosclerosis of III. degree is essentially more frequent in diabetics than in non-diabetics. The greatest difference is present in coronary sclerosis in men as well as in women. The more frequent appearance of the myocardial infaraction in diabetics in comparison to non-diabetics, the survival time, the effect of therapy as well as the disturbed glucose tolerance in myocardial infarction are discussed.


[Relationship between disorders of the purine and carbohydrate metabolism]. Disturbances of the carbohydrate metabolism more frequently appear in patients suffering from gout. On the other hand, in contrast to older data, in diabetics disturbances of the purin metabolism are also frequently found. Under the momentaneous enviromental factors and forming of life genetic prediapositions may lead to the manifestations of the two metabolic disturbances.


[Hyperlipoproteinemias in diabetes mellitus]. Among 200 diabetics 63 patients (31.5%) with primary and 44 patients (22%) with secondary hyperlipoproteinaemias were found. The secondary hyperlipoproteinaemias belonged to the types IV and V, the primary hyperkipoproteinaemias to the types IIa, IIb, IV and V. In primary hypercholesterolaemias (IIa, IIb) the retinopathia diabetica by far more frequently occurs than in primary hypertriglyceridaemias.


[Studies of nephropathies in 168 diabetic patients with over 20-year onset of the disease]. Within a clinical epidemiological investigation 168 diabetics were examined multidisciplinarily who survived the beginning of their disease by at least 20 years. The qualitative proof of protein in the urine was regarded as criterion for the presence of a diabetic nephropathy. 29% of the long-term diabetics showed a proteinuria. In a control group of probands with healthy metabolism, however, only 2.5% proteinurias were found. Statistically ascertained correlations were the results in cases of proteinuria and retinopathy (microangio-pathy). Particularly close were the relations of proteinuria to arteriolosclerosis (macroangiopathy). There were no relations between the proof of a proteinuria and the quality of the control of the carbohydrate metabolism which was pursued during decades.


[Kidney biopsy in the differential diagnostic clarification of renal diseases in diabetic patients]. The diagnosis of arteriosclerosis is simple. The chronic pyelonephritis, however, is in most cases not clearly to be diagnosed, but only with a certain probability. To the glomerulosclerosis is applied that conspicuous findings allow of a doubtless diagnosis. But not in the least seldom there exist certain difficulties, above all in the initial stage and in the clear limitation to glomerulonephritis. In the majority of these cases the modern morphologic investigation methods lead to a clarification, but also the exact anamnestic and clinical data may be very useful for a probability diagnosis.


[Objective grading of stenosing coronary artery processes through the quantification of pathological-anatomical data their relations 1. Basic methodical concept and 1st results]. Proceeding from an estimation of the hitherto known models of the judgement of the coronary arteriosclerosis and the achieved degree of quantificability methodic principles are developed to quantify the influence of pathologo-anatomical parameters on the myocardial infarction with the help of mathematical methods using electronic data processing. With the help of the comparison of evaluation schemata according to Herzog/Schoenmackers and Romaniuk/Schroder on the basis of 174 hearts coronarographed post mortem a possibility is demostrated to estimate objectively the efficiency of evaluation schemata. The improvement of the evaluation after inclusion of the absolute mass of the heart is demonstrated. Herzog/Schoenmackers's valuation after the mathematical judgement of the probationers examined results in a wrong coordination of altogether 15 per cent, Romaniuk/Schroder's valuatiom results in 12.6 per cent. After the inclusion of the abolute mass of the heart into this valuation a decrease of the malcoordination to 10.3 per cent was achieved.


[Lymphocyte transformation test  in the diagnosis of chronic pancreatitides]. For the immunological diagnostics of the chronic pancreatitis preliminary results on the proof of specifically sensibilized lymphocytes are demonstrated by means of a lymphocyte transformation test. The in-vitro-stimulation is successful in such a case, when no in-vivo-stimulation preceded, i.e. beyond an acute attack.


[Complications after antirabies treatment using the Hempt-vaccine]. A report is given on experiences with complications after antirabic treatment with hempt-vaccine gathered during 15 years (1960 to 1974). Among 4,315 inoculated persons local reactions appeared in 1.9%, a phenol shock in 0.11%, general reactions in 0.21% and neurological complications in 0.069%. In casuistic form is reported on postvaccinal neuritis, dorsolumbal myelitis and meningoencephalitis.


[Frequent errors in ECG registration].

[Frequent errors in ECG registration]. The correct ECG-registration is the basic prerequisite for a certain ECG-diagnostics. If certain mistakes in registration are not taken into consideration diagnostic errors attended with grave consequences are possible. The disturbances most frequently observed in practice (disturbances on the patient's part, errors in working, technical disturbances) are described and explained.


[Thoracic gunshot-injury with penetration of the pericardium in a 15-year-old student]. On account of the exceptionality is reported on a 15-year-old adolescent who suffered a gunshot into the thorax by a device which was built by himself. More than 12 hours after the accident for the first time a physician was consulted. Then the patient was transported to Leipzig for operation. The missile had penetrated the anterior wall of the pericardium, had passed through the cleft between exterior layer of the myocardium and the pericardium and lodged at the trangression into the adjacent lung. The postoperative course was without complications. The patient could be dismissed without any complaints.


[Eye changes in diabetes mellitus].

[Eye changes in diabetes mellitus]. In ophthalmological examinations on 820 diabetics in 32% a diabetic retinopathy I or II was found. The frequency of retinopathy correlates with the duration of diabetes. A glaucoma (4.8%) or an increased intra-ocular pressure, respectively, was statistically significantly more frequent in diabetics than in the total population. Among 714 patients with glaucoma about 17% of diabetics were found. Compared with the morbidity of diabetes of adequate age groups of the total population this is statistically significant. The intraocular pressure of patients with glaucoma and diabetes is therapeutically worse to be influenced than in patients with glaucoma without diabetes. They need a particularly attentive control and therapy. By means of electon-microscope examinations as a possible cause for the association of glaucoma and diabetes mellitus similar changes in the iridocorneal angle could be found in the two diseases.


[Secretion of insulin and disorders in fatty acid metabolism in diabetic patients with coronary heart diseases]. The behaviour of the blood glucose, the insulin secretion, the free fatty acids, of glycerol and of the triglycerides after glucose tolerance test was examined in 66 patients with condition after myocardial infarction. 16 of the 34 patients loaded with an oral glucose tolerance test and 25 of the 31 patients loaded with an intravenous glucose infusion test showed disturbances of the glucose tolerance. The insulin secretion was significantly different neither in normal nor disturbed or lying in the borderline region glucose tolerance. With increasing glycerol values a significant deterioration of the glucose tolerance developed. The triglyceride values in the plasma increased with increasing insulin secretion. The results seem to be important with regard to the pathogenetic relations between the carbohydrate and fat metabolism and might be fo importance also for a differentiated therapy.


[Electrocardiographic findings in a selection-free number of cases of long-term diabetic patients]. When the conventional ECG after resting was used for establishing frequency and degree of severity of the ischaemic heart disease the stronger cardiac endangering of the longterm diabetic could be ascertained only from residues of an infarction (pathologic Q- and QS-types). With regard to all electrocardiographic criteria of the ischaemic heart disease according to the WHO-definition concerning the coronary risk a dependence on age, over-weight and increase of blood pressure was found without essential differences between the two groups. According to data in literature ischaemic reactions in diabetics are significantly more frequently to be expected only by inclusion of the electrocardiogram after work. Among the group of diabetics the frequency of the ischaemic heart disease increased with the duration of the disease. In contrast to retinopathy there was no dependence on the quality of the metabolic condition.


[Significance of the PV 1 index in the ECG of diabetes mellitus and in the early forms of chronic ischemic heart disease]. In 152 patients with diabetes mellitus, chronic ischaemic heart diseases and hypertension the so-called ptf-product resulting from the height of the amplitude of P and its time of spreading) measured in the lead V1 (PV1-index), was determined and compared with the values of 93 persons with healthy heart. Patients of the groups of diseases mentioned showed significantly higher pathological values than persons with healthy heart (limiting value -0.02 mms). A comparison between patients with chromic ischaemic heart disease at the age of 36-55 years and a group of diabetics of the same age without the clinical signs of an ischaemic heart disease resulted in no statistically ascertained differences. But compared with a group of persons with healthy heart of the same age the groups clearly differed: 63.9% of pathological values in the total group of disease compared with 18.5% of pathological values in persons with healthy heart. In 137 patients with latent diabetes (protodiabetes) in 54.7% also pathological ptf-values were found. It is possible that the determination of the ptf-product is able to ascertain already early forms of a chronic ischaemic heart disease still before its clinical manifestation. The large number of pathological values in patients with protodiabetes could be a first reference to early beginning disturbances of the left-sided atrial activity in the sense of a microangiopathy.


[Earning- and working disability in long-term diabetic patients]. On the basis of the experiences of the Berlin Central Institution for Diabetes and Metabolic Diseases is reported on the capacity to earn their living and the fitness for work of diabetics, especially of 268 long-term diabetics at the age in which they can earn their living and at the retirement age. 31% of these patients belonged to the group of pensioners, 19% of them are still working. 69% of the long-term diabetics are at working age, of them 24% are already pensioners due to diabetes and 4% due to other diseases. Among the complications of diabetes leading to pensioning are frequently mentioned retinopathy, nephropathy in the wider sense, macroangiopathy and neuropathy, rarely, however, instable metabolism. The peculiarities are discussed. In answering the difficult question of the estimation of the incapacity to earn one's living in diabetics in every case the diabetologist should be consulted.


[Is there a variation of death causes in diabetic patients]. On the basis of the post-mortem records of the Institute of Pathology of the University and District Hospital Rostock taking into consideration the clinical records the cause of 355 diabetics who died in the Rostock clinics from 1956 to 1972 were established and analysed. The results were compared with similar examinations of previous years, in which cases among others we established an increase of the mortality of diabetes and an increase of pyogenic infections and sclerosing vascular diseases as causes of death in diabetics. Special attention is paid to the factors of risk for the development of complications dangerous to life in diabetics and it is referred to the prophylactic and therapeutic consequences, respectively, resulting from this.


[Diagnosis and therapy of arteriovenous lung fistulas]. On the basis of 6 own cases, 5 of which were observed during one year, the clinical picture, the diagnostics and the therapy of the arteriovenous pulmonary fistula are described. Of decisive diagnostic importance is the angiography of the pulmonary artery which should always be used for the clarification of unclear pulmonary foci as well as clinically unclear cyanosis. For the removal of this shunt connection in the lesser circulatory system therapeutically only the operation comes into question. On account of the threatening complications and the inclination to the dilation of the fistula with growing age it is indicated also in cases with only slight haemodynamic effect. Dependent on the anatomical position of the fistula the ligature of the afferent artery is recommended.


[Clinical-pharmacological studies on the effect of mephentermin and methamphetamine on the hemodynamics of the lung circulation]. In haemodynamic investigations of altogether 40 male probands with normal and restricted functional capacity of the lungs the result of an intravenous injection of mephentermine (30 mg) or methamphetamine (15 mg) was a transient increase of the mean pressure in the pulmonary artery and of the resistance of the pulmonary vessels. Temporarily parallel the arterial mean pressure and the resistance of the vessels in the greater circulatory system in most cases increased by about the same, in healthy persons after application of methamphetamine by a smaller relative amount. In the dosage used the vasoconstrictive effect of methamphetamine was altogether only somewhat more expressed. At the time of the maximum increase of the mean pressure of the pulmonary artery in healthy persons methamphetamine had a negative chronotropic and inotropic effect. It is referred to practical therapeutic consequences.


[Holiday effect in myocardial infarct].

[Holiday effect in myocardial infarct]. Aimed measures of the organisation of the combat against infarction demand also the observation of temporary frequencies. On the basis of the evaluation of certificates of death of the month December of the years 1969 to 1973 of the GDR with differentiation according to so-called prehospital dead (persons who died at home and on the way to the hospital) and patients who died in the hospital with high significance an unwarrantedly high prehospital mortality during the period from Christmas to the end of the year (25th to 31st December) was established compared with the preceding week (18th to 24th December). Since in contrast to this the hospital cases and the cases "on the way" do not show any significant differences main tasks for the beginning of improvements concerning health policy may be deduced, all the more since the so-called holiday effect, expressed by a high home/clinic-relation of patients who died of myocardial infarction, could be restricted to 6 counties of the GDR on account of the analysis of further localities. From the results the tendency of a retrogression of the holiday effect is to be read off in the course of years. In the discussion an explantation of this peculiarity is attempted, and practicable conclusions for the removal and thus for the improvement the infarct situation are formulated.


[The significance of the angina pectoris syndrome in a multidisciplinary emergency unit]. A report is given on the incidence-rate of the angina-pectoris-syndrome in the reception ward of a multidisciplinary intensive care unit. In the course of 6 years a total of 83,048 patients was examined. 36,076 of them were patients with internal diseases, 28 per cent having cardio-circulatory disturbances. In only 25 per cent of the cases being admitted with the tentative diagnosis of myocardial infarction this could be confirmed. Complaints of arthrogenous or vertebrogenous character or hypertonic crises as causative factors for cardialgias must especially be taken into consideration differential-diagnostically.


[Infestation with intestinal helminths in the inhabitants of the city of Dresden]. It is reported on the data of helminthological investigations performed on 1323 Dresden inhabitants at the age of 14 to 70 years. Furthermore the notifications of the affections with tapeworm which had come into the district hygiene inspection of Dresden were evaluated. An affection with Ascaris lumbricoides of 1.2%, with Trichuris trichiura of 1.6%, with Enterobius vermicularis of 14.5% and with Taeniarhynchus saginatus of about 1% were proved. In the case of Enterobius vermicularis the for the most part affected age groups were the 14- to 20-year-old test persons and concerning Taeniarhynchus saginatus the 21- to 70-year-old test persons. Accumulations of the extensity of the affection with helminths bound to a species of hosts were not detected. Concerning the taeniarhynchosis since 1966 a permanent increase of the extensity of affection is to be registered. The duty of notification concerning taeniarhynchosis is often neglected. Only about 1/6 of the affection with tapeworm is notified in the district hygiene inspection.


[Enzymes in urine following administration of hypertonic solutions]. 3 patients with chronic nephropathies were given 20 ml of a diatrizoate-X-ray contrast medium, 500 ml of a 10% mannitol solution and 500 ml of a 10% dextran solution intravenously, and the behaviour of the excretion of protein, alanine aminopeptidase, beta-glucuronidase, aryl sulphatase A and lysozyme with the urine was tested. After application of these substances a transient increase of the excretion of alanine aminopeptidase, aryl sulphatase A and protein takes place. Conspicuous is the temporary decrease of the beta-glucuronidase activity in the urine after application of these hypertonic solutions. As a common cause of these changes alterations of the tubular cell in the sense of an osmotic nephropathy are to be assumed.


[Aminopeptidases in the serum following myocardial infarct]. In 19 patients wiht myocardial infarction during 7 weeks after the onset of the infarction the serum activities of the leucine aminopeptidase (LAP) and of the alanine aminopeptidase (AAP) were determined. Here an increase of the LAP-values with a maximum in the 1st week was found. Apparantly a hypoxic lesion of the hepatocytes is to be regarded as cause for this. In patients with shock symptomatology as well as with heart decompensation the AAP-activities were on the average higher than in the cases with myocardial infarction without these alterations during the whole period of observation. In all myocardial infarctions the AAP-zymograms showed an additional anodic AAP-fraction as it was observed in previous investigations in cholestasis.


[Hypogonadism in male patients with chronic liver disease]. On the basis of own investigations of the testosteron metabolism in hepatopathy must be assumed that the hypogonadism appearing in liver diseases is to be regarded as peripheral form, i.e. it is not centrally evoked by gonadotropin insufficiency. An own pathogenetic concept is discussed.


[Studies on the cancer-diagnostic evidence of erythrocyte changes during the course of neoplasm treatment]. In the present communication is reported on the results of further observations of the course of the index of the change of erythrocytes of 12 patients in connection with four clinical findings and parameters. The data got in these cases continue the previously presented reports on the results. In 9 out of 12 cases there is a correspondence with the indices of the change of erythrocytes and the clinical data belonging to this; in the remaining three cases the indices of the change of erythrocytes cause to presume a continuation of the malignant processes, though the other findings do not indicate this at present.


[Vasculitis nodularis with participation of inner organs]. The vasculitis nodularis belongs to the group of the allergic-hyperergic vascular diseases of the skin, which above all the small veins are affected at. The participation of internal organs is unusual. It is reported on a 31-year-old Syrian patient in whom a participation of the liver in form of a granulomatous hepatitis and of the kidneys appeared. A hypertension might be attributed to the participation of the kidneys. The incorporation of a thrombosis of the central vein of the right eye in this disease is probable. The main symptoms of the disease were nodes of the size of a bean occurring in batches, lying subcutaneously, and were paraclinical signs for inflammation. The permanently increased absorption-antistreptolysin titre spoke for an allergic-hyperergic vascular process induced by streptococci.


[Biological basis of behavior regulation]. A changing of the information is taken as basis for the behaviour of the organism. While the metabolism produces a connective relation with the environment, the changing of the information delivers an informational relation. The two processes are essential constituents of the organism as an open system for the maintenance and the increase of the negentropy. The informational connection with the environment is primarily non-communicative (the recipient performs the verification of the meaning of the signs with meaning). On the basis of the changing of information three environments may be differed: (1) the own environment (telereceptoric informations on the own body), (2) the informational environment and (3) the communicative environment (common alphabet). The most important determinants of the behavior which connect the organism with its informational environment are pretensions to space, time, metabolism and changing of form. In the communicative environment there may be pretensions to territory, sex, care and social ones. In organism the behaviour is above all determined by vigilance, emotion, motivation, memory (storage), selector (and receptor) as well as operator (and effector). The comparative behavioural sciences allow certain universal evidence on the basis of such parameters. Here also constituents of the human behaviour can be seized.


[The clinical significance of controlled artificial respiration in patients with acute myocardial infarct]. It is reported on the results of the treatment with artificial ventilation in 20 patients with complicated myocardial infarction. As indicating sign a decreased arterial PO2 (lower than 70 Torr at an respiration of 50% O2 in the respiration air) was considered. Further references to clinical indications were depression of the breathing centre, severe pulmonary oedema, shock and life-threatening therapy-resistent disturbances of the rhythm. The long-term successes of the treatment with controlled respiration showed a clear dependence on the severity of the cardiac lesion and the general condition of the patient. In 10 cases only a transient improvement could be achieved. Three patients survived.


[The relationship between the surface of the peripheral volume pulse and the segmental blood flow]. It is reported on 65 patients, out of whom in 48 cases angiographically proved vascular obstructions in the pelvic and femoral regions were present. The comparison of the plethysmographic area calculated and the values of the blood supply established in the same segment of extremities resulted in a good correlation. The area of the peripheral volume pulse gives references to the compensation degree of a vascular obstruction. Slighter sclerotic vascular changes already cause a significant decrease of the area of the volume pulse, so that this method of evaluation seems to be suitable for the early recognition of the arteriosclerosis in the area of extremities.


[Differential diagnosis of essential adiposity and Cushings syndrome]. On account of the increasing number of patients with essential obesity the delimitation of the Cushing-syndrome is of actual importance. Two observations of hypercortisolism in hyperplasia of the adrenal glands are reported on and the differential-diagnostically important parameters are demonstrated. According to our opinion anamnesis and clinical findings give the possibility of making a diagnosis already on a large scale. Analyses of the hormones and special X-ray examinations only serve for the preoperative ascertainment and localisation of the endocrine defective function. With the help of literary data causes and possibilities of treatment of Cushing's syndrome are entered.


[Kyrle's disease (hyperketarosis follicularis et parafollicularis): local and systemic therapy with vitamin A acid (retinoic acid)]. The cause of Kyrle's disease (hyperkeratosis follicularis et parafollicularis) is unknown. The prognosis is very poor indeed; there is no specific treatment. The normal ranges of serum retinol and carotene were investigated in 10 healthy females. In a female patient suffering from Kyrle's disease, the serum level of retinol was found in the lower part of the normal range. Striking improvement has been noted when the patient was treated systemically with vitamin A acid (retinoic acid) which was associated with elevation of serum levels of retinol and carotene. When this form of therapy was withdrawn, recurrence of the skin lesions was observed and the serum levels of retinol and carotene declined to a level similar to that before the treatment. The administration of vitamin A acid was resumed, and with rising levels of retinol and carotene the skin condition again improved. Several possibilities regarding the treatment of Kyrle's disease as well as the mode of action of vitamin A acid are discussed.


[Studies on the skin surface dosage of dermatopharmaceutical preparations]. In human volunteers presenting with normal skin an investigation has been carried out to determine the specific skin surface dose, the actual application volume, and the theoretical surface film thickness resulting from thin and thick layer inunction of 4 common corticosteroid topicals. The findings obtained indicate that the skin surface dose provides the most suitable criterion for the terrain saturation behaviour exhibited by different formulation types of semi-solid topical preparations (inunguenda). Various aspects of the surface dosage concept are discussed with regard to the active agents and forms of application of external skin remedies. Predicative clinical determinations of the skin surface doses of topicals relating to special therapeutic and assessment procedures are believed to be a valuable complement to experimental (predictive) determinations of this parameter; some problems involved are pointed out by reference to a clinical trial example. Data on the application dosage of topicals--either by skin surface dose or by volume or layer thickness quantification--have been extracted from the dermatological literature and are reviewed with the aim of furnishing a basis for comparative estimation of our experimental results.


Effect of bilirubin on stored red blood cells. Bilirubin may cause haemolysis of red cells, especially in the presence of light. The possible dependence of this effect on the metabolic state of the cells has been investigated. For this purpose erythrocytes were stored up to five days to deplete the concentration of ATP. Every day a constant amount of bilirubin was added to the cells. On third day of storage bilirubin induced haemolysis, which was aggravated rapidly during further storage. Bilirubin-induced haemolysis could be reduced after increasing the ATP levels by incubation of the red cells with inosine.


On the fluorimetric determination of oestriol in pregnancy urines after thin layer chromatography. An improved method is described for the determination of oestriol concentrations in urines of pregnant women. Oestriol is detected as a derivate of 1-dimethylaminonaphtalene-5-sulphonylchloride (DANSYLchloride). The method has the following characteristics: 1. The recovery of oestriol-16-glucuronide is 94%. 2. For the interpretation of the results obtained with this method mean values and 95% probability bounds of urinary oestriol excretion for each week of the last three months of pregnancy are given. (e.g. 49--125 mumol/24 h at 32 weeks of gestation, 108--238 mumol/24 h at 40 weeks). 3. The coefficient of variation of the method is 4% (from day to day). 4. The lowest detectable concentration is 3 mumol/l. 5. Influence of glucose can be eliminated. 6. Other urinary compounds have no influence on the determination.


A systematic investigation on the Hemalog. The Hemalog system is an automated hematological instrument. From one sample this instrument determines the value for platelets (PBC), white blood cells (WBC), red blood cells (RBC), hemoglobin (Hb) and the hematocrit simultaneously. Moreover the system calculates the derived values: the mean cell volume (MCV), mean cell hemoglobin (MCH) and the mean cell hemoglobin concentration (MCHC). The values were investigated for cross sample contamination, coincidence, reproducibility, and compared with other methods. From this comparative study we can conclude that the Hemalog is a suitable and reliable instrument for hematological determination.


Quality control in hematology by means of values from patients. The results of the analyses which were obtained with the Hemalog for the determination of platelets, white blood cells, red blood cells, hemoglobin and hematocrit were statistically analysed for the quality control of the determinations. Now that the testing method has been applied for 6 months, it appears from the results that it is extremely suitable for the determination of hemoglobin, red blood cells and the hematocrit and, to a lesser extent, for white blood cells and platelets.


[The influence of feeding on clinical-chemical parameters in the serum of rats (author's transl)]. In the serum of 40 male and 40 female rats  the following parameters were determined: Sodium, potassium, creatinine, chloride, calcium, inorganic phosphorus, glucose, urea, protein, cholesterol, bilirubin, lipids, alanine amino-transferase, alkaline phosphatase and leucine arylamidase. The analyses were carried out in the same rats both after continuous feeding, and after a 24-hour fasting periods spaced at intervals of 3- to 4-weeks. The concentration of glucose and the activities of alanine aminotransferase and alkaline phosphatase were higher after feeding than after fasting, and in most cases these differences were statistically significant. The concentration of lipids tended towards increased values. The other parameters examined were slightly or not influenced by the time of the foregoing feeding.


[Micro method for the selective assay of unesterified long chain fatty acids in serum (author's transl)]. A microanalytical method is reported for the selective and direct determination of low concentrations of unesterified fatty acids in serum. A new procedure is used to form derivatives of the fatty acids with alkyl iodide, which are separated over a solid phase of K2CO3. The assay was developed for the qualitative and quantitative determination of unesterified fatty acids mobilized from fat tissue in defined metabolic states.


[Quantitative determination of enteral calcium resorption with enriched stable 46Ca (author's transl)]. The application of a Ca-resportion test without the use of radioisotopes, which can therefore be used for babies, children and pregnant women, was investigated on 14 adult patients. In place of a radioisotope, an enriched form of the stable isotope 46Ca was administered orally, and the proportion of the applied dose of 46Ca appearing in the serum and urine was measured. 46Ca was measured by neutron activation over 47Sc. The clinical picture showed a close correlation with the determined resorption capacities. On the basis of the results, patients were classified into three groups: those with normal, increased, and decreased Ca-resorption.


[The effect of light on the cholesterol determination]. The colour reaction between cholesterol, acetic acid, sulphuric acid and ferric chloride is influenced by light. According to the intensity and length of exposure, a reduction in extinction is proportional to the cholesterol content.


[Combined cleaning and cold sterilization procedure for cleaning rooms in virological establishments]. It is reported of a new technique for the cleansing and cold sterilization of glass-ware which is particularly suited for virological laboratories and other laboratories working at cell and tissue cultures. The combined use of an alkaline cleansing agent and sterilization with Wofasteril, a peracetic acid preparation, permits to accelerate considerably the return of culture flasks for re-use.


[Report on the experience in intracellular microelectrode studies of the external eye muscles with the stereotactic surgical device SESH-2]. The Soviet SESH-2 stereotactic surgical device for micro-electrode examinations offers technical advantages in the derivation of the intracellular muscle fibre membrane potential after resting and of the intracellular potential of the peripheric ocular muscles after irritation as well as in the study of the central irritation of the nuclei of the ocular muscles. The coupling of two hydraulic micromanipulators permits to perform in vivo various investigations of the ocular muscles by means of micro-electrodes. The numerous possibilities of variation and assembly according to the modular principle allows also simultaneous studies on ocular muscle mechanics.


[A new automated method for the complement fixation reaction]. The authors describe an automatic method for the complement fixation reaction. Antigen, complement, and barbitolum-buffer are dropped automatically. The fixation reaction is performed in a refugotor, in Kolmer's method. An autoanalyzer (flow-stream principle) is used for the lysis reaction. The advantages of this method are discussed.


[A method for the fragmentation of bull spermatozoa and the isolation of median piece-tail fragments]. A method is proposed for ultrasonic fragmentation of spermatozoa of Bos taurus followed by the isolation of a middle piece-tail-fraction.


[The sterilization of serum and trypsin for cell cultivation with betapropiolactone]. The authors describe a method for the cold sterilization of serum and trypsin with beta-propiolactone which is intended for use in cell cultivation. It is an effectual preventative against contamination by viruses and mycoplasms via the serum and trypsin used.


[A rinsing attachment for the apparatus for automated analysis]. The authors describe a rinsing attachment for the flow-through type auto-analyzer of the VEB MLW Prüfgerätewerk Medingen. This attachment reduces the material and time required for clinicochemical and other techniques.


[A measuring probe for glucose. 2. International state; further measurements, studies and experiences with the glucose probe]. Subsequent to the first paper and complementary to it, the present one gives a survey of the international state of work at a glucose probe (and an artificial pancreas) as well as additional methodical advice. It then discuss the glucose probe and its measuring properties including the possibility of kinetic measurement. It also deals with other probe systems, the use of carrier-fixed enzymes and the problem of miniaturization. The paper concludes with an economic consideration and an evaluation of the results of obtained.


Cytochemical differentiation of red and white fibers in the respiratory muscles of a fresh-water mud-eel, Macrognathus aculeatum (Bloch). 1. Functional morphology including the origin, insertion, innervation and action of the respiratory muscles in relation to buccal pressure and opercular suction pumps in a fresh-water mud-eel, Macrognathus aculeatum have been studied. 2. Cytochemical studies were made on the SDH activity of Adductor maxillaris, Adductor mandibularis, Protractor hyoideus, Dilator-operculi, Levator operculi, Adductor operculi, Inferior and Superior Hyohyoideus and the adductor muscles of gill filaments. The intensity of reaction reveals the composite nature of the respiratory muscles. Adductor mandibularis is made up entirely of white muscle fibers whereas others are composed of red as well as white muscle fibers. The Adductor maxillaris consists of superficial white muscle fibers whereas the interior is dominated by red muscle fibers. 3. The muscles innervated by the branches of VIIth facialis is dominated by red fibers whereas those innervated by the Vth trigeminal are dominated by white muscle fibers. 4. The adductor muscle units of the gills are made up entirely of red muscle fibers. This suggests the continued role of adductor muscle during the ventilation of gill lamellae.


Polyploidy in the human myometrium.

Polyploidy in the human myometrium. In an investigation to determine whether the enlargement of cells and nuclei in the myometrium of the human uterus during pregnancy is related to the development of polyploidy or not, the following facts were established, mainly on the basis of cytophotometric analysis of nuclei isolated with a newly developed mechanical technique from a series of uteri in different states with regard to the reproductive process (juvenile, nulligravida, gravida, sectio parva, sectio caesarea). 1. Polyploid nuclei arise only during pregnancy. They can still be found for many years after the puerperium; their occurrence, however, remains a discrete phenomenon. 2. During pregnancy, a swelling of virtually all diploid nuclei is observed, which is present  as early as 16 weeks after conception, but a significant increase of the nuclear projection area is found only in the Caesarean section group. This swelling, which (might occur under hormonal influence is possibly of a functional nature and is separate from the development of polyploidy as such. 3. By means of the tracing of double sex chromatin bodies in the nuclei, the occurrence of tetraploid nuclei in the myometrium could be demonstrated both in nuclear suspensions and in sections of intact uterine wall.


[Cytoarchitecture of the formatio reticularis of the brain stem of the dolphin]. In the present study some qualitative and quantitative features of the reticular formation of the medulla oblongata, pons and midbrain have been elucidated by cytoarchitectonic methods in the dolphin (Tursiops truncatus). The studies have demonstrated that similar to land mammalia, the dolphin has a reticular formation made up of spatially open cell groups lying in the deepest parts of the brain stem. Cytoarchitectonically the component parts of the reticular formation show a number of peculiarities enabling us to distinguish separate nuclei. In the dolphin peculiar architectonics have been observed in the nucleus gigantocellularis medullae oblongatae, nucleus papillioformis or the nucleus reticularis tegmenti Bechterewi and the nucleus centralis superior medialis seu ventralis. Fairly poor in cells are the nucleus centralis caudalis pontis and the nucleus  centralis oralis pontis. We failed to single out as autonomous nuclei cell groups corresponding to  the nucleus funiculi lateralis and the nucleus paratrochlearis of the land mammalia. The size and density of cells in nuclei have a number of peculiarities. The analysis of the ratios of the brainstem volume to that of reticular structures has shown them to be the smallest in the dolphin as compared with land mammals. The smaller share held by the brain-stem reticular formation and its cytoarchitectonic features can be associated with the functional properties resulting from the greater specialization of some of brain-stem systems (e.g. auditory, vestibular, extrapyramidal etc.) in the dolphin in comparison with land mammals.


[The application of special photographic technics in electron microscopy]. The paper reports about the application of special photographical technics in the electron microscopy. Using this methods the information contents of electromicrogramms are better to be utilized than with conventional photographical technics. Holocopy (Holokopie) allows to copy negatives of a high degree of density whereas the developing detail filter technics (Entwicklungs-detailverfahren, EDFV) as a photochemical mask method equalizes the plain contrast and improves the detail contrast and the sharpness of outlines.


Postischaemic circulation disturbances.

Postischaemic circulation disturbances. Restoration of blood supply after ischaemic conditions in extremities and testes is inhibited by reversible intravasal aggregation of erythrocytes. This process is promoted by the increased permeability of the capillaries associated with the formation of oedema and the entailing increase of the haematocrit. For overcoming the stasis the increased structural viscosity caused by the aggregation of erythrocytes requires an increase in pressure as a starter effect which is not achieved by the flow pressure at once everywhere. Intravenously administered particles of Indian ink mark the formation and dissolution of aggregates. Even areas with originally normal blood supply may be obstructed by the later formation of aggregates. Thrombi on the walls of arterial and venous vessels and other lesions of the intima do not sufficiently explain the disturbance of perfusion. Oedema and extravasating leucocytes are found in the microcirculation. The parenchyma to be supplied shows formation of necrosis.


[Stratification in the central nervous system]. Stratigenesis in the optic tectum of developing chick embryos was investigated between the 4th and the 11th day of incubation. Stratification is achieved by successive emigration of cell contigents from the proliferative layer. In the opinion of the authors the main factor which determines this very regular cell migration would be a gradient of oxygen and of metabolites. The gradient has to appear in the wall of tectum due to its typical vascular network. Experiences with induced hypoxia or with selective damage of the proliferative layer strengthen the hypotesis of an oxygen gradient playing the role of a generally active epigenetic factor in the stratigenesis of the central nervous system.


[Ball cells and the structure of the epidermis of anuran larvae. I. Ascaphus truei Stejneger]. 1. A special cell numerously occuring in the epidermis of the anuran larva of Ascaphus truei which must be called ball cell because of its usual shape, more thoroughly has been investigated by microscope. Especially plain preparations besides cross sections stained in customary way, respectively worked up histochemically with regard to orientation, were used for that. 2. The ball cell-the very characteristical epidermal attribute of Ascaphus larva-is an exocrine element with apparently far extending continuous merocrine secretion. The product contains mucous substances partly being of acid kind. The activity in any case is extending to metamorphosis. 3. Altogether the cells are forming a simple endoepidermal plain gland with differently displayed parts: strong condensation of the elements, for instance, in a circumoral zone, scanty distribution in the whole middle back over all.


Ultrastructural studies on Diphyllobothrium ditremum and D. dendriticum (Cestoda, Pseudophyllidea), with emphasis on the scolex tegument and the tegument in the area around the genital atrium. The scolices of D. ditremum and D. dendriticum are similar in regard to general morphology and ultrastructure of the tegument. At the scolex apex and along the upper bothrial edges sensory endings are numerous. The inner bothrium surface of D. ditremum appears to be plain or smooth, the distal cytoplasm is only about 0.6 mum thick and covered with long and slender microtriches. When D. ditremum is attached to the host gut an adhesive layer of secreted substance exists between the inner bothrium surface and the host intestinal villi. In D. dendriticum, however, no secreted layer exists between the inner bothrium surface and the host intestinal villi and the inner bothrium surface of this species appears to be lobed or lappet formed. The lobes are protrusions of the distal cytoplasm and are covered with long and slender microtriches. Large conglomerations of secretion globules appearing to be enclosed by a double membrane, are observed in the scolices of D. dendriticum and D. ditremum, although more frequent in the latter. Differences existing between the distal cytoplasm of the scolex and the gravid proglottid are described. The papillae around the genital atrium in mature and gravid segments were studied. Each papilla appears as a thickening of the distal cytoplasm, which in this region is 10-12 mum thick, when studied with transmission electron microscope. From the area between the papillae sensory endings appearing in sections to be either single, double or triple are described.


Aerobic glucose metabolism in the digestive gland of Littorina saxatilis rudis (Maton) and in the daughter sporocysts of Microphallus similis (Jäg.). Experiments, some in vitro and some in vivo, with glucose-U-14C, acetate-U-14C, succinate-1,4-14C, pyruvate-U-14C and citrate-1,5-14C indicate that the digestive gland of Littorina saxatilis rudis and the daughter sporocysts of Microphallus similis aerobically catabolise glucose via an EMP pathway, a TCA cycle, phosphoenolpyruvate carboxylation and malate decarboxylation. The host and parasite have similar transamination and synthetic reactions and alanine as a major carbohydrate excretory product. Oxidative metabolism appears to be less efficient in the parasite than in the host.


Morphology and behaviour of sex chromosomes during meiosis in Ascaris suum. The morphology and behaviour of sex chromosomes was studied in A. suum during meiosis. It was found that the five sex chromosomes have their proper characteristic. The largest is submetacentric, of 2 microns mean length. The second largest is acrocentric, mean length of 1.4 mu. The third largest is metacentric, 1.2 mu mean length. The fourth and the fifth are metacentric, of mean length of 1 mu. In primary and secondary spermatocyte cells the sex chromosomes are close to each other, most often in the peripheral part of the cell. During anaphase I the pentad sex chromosomes lie freely between the two sister cells. It is assumed that in anaphase II the five sex chromosomes divide equally and are regularly distributed in the daughter cells. It was found that the chromosomes set of female Ascaris in metaphase I contains 24 bivalent chromosomes n = 24 and of male Ascaris 19 bivalents and 5 univalents. It is assumed that the univalent chromosomes, found in spermatocyte cells, determine sex.


An ideal catheter: the simple curve.

An ideal catheter: the simple curve. A complex variety of catheter shapes has developed in the short period since Seldinger first introduced percutaneous angiography. The author has discovered in the course of several thousand selective arteriograms that only only one cartheter is needed: the original simple curve.


Emergency selective aortography for acute lesions of the thoracic aorta. Emergency selective aortography is necessary for the definitive diagnosis of acute lesions of the thoracic aorta and defines their therapeutic possibilities. Cineradiography is very helpful and is complementary fo the roentgenograms. In this paper the study of dissecting aneurysms, tears of the aortic wall, ruptured aortic aneurysms and traumatic aortic lacerations is described. A new anatomic classification of dissecting aneurysms combined with that of De Bakey et al. is presented.


Spontaneous rupture of an iliac vein.

Spontaneous rupture of an iliac vein. A 67 year old female was seen as an emergency some three days following a minor fall with spontaneous rupture of the left iliac vein. Emergency surgery consisted of repair of the venous rent, compartmentation of the vena cava, thrombectomy, and subsequently anticoagulation. Etiology of the rupture was considered to be the thrombosis in the proximal portion of the iliac vein which created a high venous pressure behind the thrombus.


The influence of selected cytostatics on human trophoblast in vitro. The effect of cytostatics (Methotrexate, Oncovin and Dactinomycin) on early human trophoblast in vitro was studied by the tissue (organ) culture technique according to Trowell and by brief incubation with thymidine 3H. The cytostatics were tested by the method of Tanneberger in clinical and tenfold higher doses. The criteria for cytostatic efficacy were based an activity of DNA, histologic and histochemical changes, and secretion of hormonal chorionic gonadotropin. In vitro cultures of trophoblast were found to be a good model for evaluation of cytostatics, and the tested chemotherapeutics were effective chemotherapeutically. Upon addition to in vitro cultures they changed the structure and function of trophoblastic cells, resulting in depression of DNA resynthesis, histologic changes, changes in enzyme activities assessed histochemically, and impaired HCG secretion. The most pronounced effects were obtained with Dactinomycin or with a combination of Dactinomycin and methotrexate. Methotrexate alone had the weakest effect on DNA resynthesis and structure of the trophoblastic cells. The effect achieved with methotrexate after 120 hours was equal to the effect of Dactinomycin after 48 hours. Comparison of the histologic and hormonal results with DNA activity showed concordance between the intensity of morphologic and hormonal changes and impairment of nucleic acid functions.